Citation

Petrous J, Furmaga K. BMJ Case Rep. 2017; 2017: e222037.

Affiliation

Psychiatry, Pine Rest Christian Mental Health Services, Grand Rapids, Michigan, USA.

Copyright

(Copyright © 2017, BMJ Publishing Group)

DOI

10.1136/bcr-2017-222037

PMID

29066641

Abstract

A 59-year-old woman on daily peritoneal dialysis for end-stage renal failure received care at an outpatient psychiatric clinic for her diagnoses that include major depressive disorder, generalised anxiety disorder and insomnia disorder. Although there was partial improvement in the patient's mood and anxiety symptoms with antidepressant treatment, insomnia remained a persistent complaint despite adequate trials of different sleep medications. The novel hypnotic, suvorexant (Belsomra, Merck & Co.) was then initiated at the recommended bedtime dose of 10 mg and was followed by a 15 mg dose the following night. Within an hour after taking her second suvorexant dose, the severity of patient's depression symptoms worsened and was accompanied by new onset of suicidal thoughts.

© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Language: en

Keywords

depressive disorder; psychiatry (drugs and medicines); sleep disorders; suicide (psychiatry); unwanted effects / adverse reactions