[No. 12] Inquiry Problem <Psychosomatic Medicine: Depression Edition>

Question 12

Psychosomatic Medicine, 32-year-old female, height 150 cm, weight 55 kg

History of Present Illness
Hospitalized for depression. Medication adjustment. The following drugs were prescribed for nocturnal delirium. The patient had a day-night reversal lifestyle.

Prescription
Rp1. Risperidone 1 mg tablet, 1 tablet, for agitation
Rp2. Belsomra 20 mg tablet, 1 tablet, at bedtime
Rp3. Rozerem (ramelteon) 8 mg tablet, 1 tablet, for insomnia

Now, what would you do for an inquiry regarding this?

A hint: consider whether this usage is appropriate based on the drug's mechanism of action.

Prescription
Rp1. Risperidone 1 mg tablet, 1 tablet, for agitation
Rp2. Belsomra (suvorexant) 20 mg tablet, 1 tablet, at bedtime
Rp3. Rozerem (ramelteon) 8 mg tablet, 1 tablet, for insomnia

This is the point for today. Ramelteon is a drug that improves insomnia caused by day-night reversal. It is a drug that requires several days of continuous use to show effects. Therefore, no effect can be expected if it is taken irregularly, such as only when insomnia occurs. So, if you are going to use it, it should be taken at bedtime, just like Belsomra.
Some doctors occasionally use it with the idea of a placebo, but personally, I don't think that's good.
By the way, there is no problem with using Belsomra and Rozerem together as sleeping pills.

See you next time! Please be sure to watch tomorrow as well.
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