In December 2014, the patient went to our hospital clinic, complaining poor quality of sleep at night, with only two hours of sleep per night. After intermittent administration of the two drugs for six months, the patients still suffered poor sleep quality and quitted the medicine due to large side effect. In 2012, she went to the doctor at Ningxia mentalĪnd was prescribed mirtazapine, clonazepam.
#REFRACTORY INSOMNIA MEANING SKIN#
Due to the frequent intimidation of her ex-husband, patient claimed that she can only sleep about two hours per night, had fear at night and depressed, accompanied by recurrent skin diseases: seborrheic dermatitis and eczema. The patient had a long-term administration of diazepam which was not effective for these symptoms. At daytime, she felt irritated, depressed and headache which seriously affected her performance in the daily work. She normally slept for 3 - 4 hours at night, sometimes sleeplessness overnight. Patient claimed her poor sleep appeared in 2008, presented as difficulty in falling asleep, shortened sleep time and light sleep, due to tensive relationship between patient and her husband.
We here report this case.Ĭhief Complaint: “More than eight years of poor sleep, worsen in recent three months”Ĭase history: a 42-year-old female patient came to see doctor at the outpatient department in our hospital in December 2014. Recently, a long-term insomnia patient was admitted in our hospital and treated with MECT, which showed good response. However, MECT on long-term refractory insomnia has not been reported. Recently, it has been reported that MECT has a certain effect in the treatment of severe paradoxical insomnia. Because of its curative effect and relative safety, MECT is widely used in clinical treatments such as schizophrenia (presence of delusions, hallucinations, mania and stupor) and severe depression especially in patients with suicidal tendencies. The MECT has been clinically proven to be a relatively safe physical therapy in psychiatric treatments with fewer complications. MECT is a technically improved electric shock treatment, which is done under general anesthesia and muscle completely relaxed, while monitoring multiple body function parameters including blood pressure, Electroencephalography (EEG), pulse oxygen saturation and respiration. īeyond drug treatment, clinicians started to explore other effective therapeutic way including physical stimulation, for example, the modified electroconvulsive therapy (MECT).
Melatonin, a physiological hormone involved in sleep timing, is currently used exogenously in the treatment of primary and secondary sleep disorders. Newly developed compounds such as GABA receptor subtype-selective compounds (S)-3-(aminomethyl)-5- methylhexanoic acid (Pregabalin) may overcome the side effects and the risk of drug dependence of classical benzodiazepine. The traditional treatment of insomnia includes the use of benzodiazepines and non-benzodiazepine hypnotics. The resistant or refractory insomnia can be defined if insomnia treatment with three different treatment options is unsuccessful.
#REFRACTORY INSOMNIA MEANING MANUAL#
Based on the Diagnostic and Statistical Manual of Mental Disorders, 4 th Edition, Text revision (DSM-IV-TR), the diagnosis of insomnia is defined by a duration of at least 1 month and by symptoms that do not occur exclusively during the course of another sleep disorder, mental disorder, or medical disorder or result from use of substances or medications.
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