Running head: A Puerto Rican Woman with Comorbid Addiction 3
Mrs. Maria Perez is a 53-year-old Puerto Rican female who presents to the office today
due
... [Show More] to gambling and an alcohol use disorder. She began using alcohol in her teens after her
father’s death and has been involved with Alcoholics Anonymous on and off since that time. As
an adult, she has begun gambling as well and has taken 50,000 dollars from her retirement
account to cover her debts without her husband’s knowledge. Although she describes her mood
as sad, she does not have symptoms of major depression or other psychiatric disorders.
Decision One
The three medications to choose from are Naltrexone IM, Antabuse PO, or Campral PO.
Naltrexone is IM and has the easiest dosing regimen. Campral will also assist with
compulsive behavior or cravings but has a more complex dosage, requiring the patient to take
medications three times a day. Even if the patient is very desperate to take the medication as
prescribed and overcome some of the problems from her addictions, it is a difficult regimen. I
find it difficult to take medication twice a day, three times a day is almost impossible, especially
on days that I work. I am leaning toward the IM Naltrexone. I need to make sure it is the most
effective of the three so that I can give my patient the best information available upon which to
base a decision. She may have a problem with needles, as I do. She may do very well with a
TID was scheduled out of a desire to avoid injection. Antabuse will cause adverse reactions to the
intake of alcohol creating an aversion rather than inhibiting the impulse to drink.
Pathological gambling (PG) is a relatively common and often disabling psychiatric
condition characterized by intrusive urges to engage in harmful gambling behavior. Although
common and financially devastating to individuals and families, there currently exist no formally
approved pharmacotherapeutic interventions for this disorder[Gra14]. [Show Less]