Insomnia meds
PGY-1 (Europe) having difficulties with patients with insomnia in the depression ward.
Currently I try with my patients the following order.
1) Sleep Hygiene
2) Baldrian and natural remedies
3) Zopiclon 3,75-7,5mg (only a few weeks)
4) Quetiapin (25mg)
4) Here is where I find it hard. Usually would go with Pipamperon 40mg.
I've seen colleagues go with Agomelatin, Mirtazapin, Amitriptyline, Imipramine. Yesterday I had a Patient requesting Trazodon, because she had it prescribed in the...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - February 1, 2022 Category: Universities & Medical Training Authors: Tangerine123 Tags: Psychiatry Source Type: forums
I'm sad
I just needed to vent. Sorry in advance. Looking for sympathy.
Admitted 40s M with schizoaffective do. His med list from the midlevel provider outpatient: Trinza, Seroquel, Abilify, Rexulti - all at healthy Christian doses. If that was not enough, also takes Adderall, Elavil, and a squirt of Requip. I thought he was pulling my leg when he reported that. Sure enough med rec came back spot on. to his report. I feel sorry that he is going to have a few days of not knowing if he is...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - October 20, 2021 Category: Universities & Medical Training Authors: xavier2000 Tags: Psychiatry Source Type: forums
What do you guys prefer for neuropathic pharm treatment?
I'm a Psych resident, hoping to go into pain.
Anyways, our program, if we have a patient with depression and neuropathic pain, we seem to always jump straight for Cymbalta.
Was interested what the literature/your anecdotal data suggests for neuropathic pain? Effexor? Elavil? Neurontin?
Is Cymbalta the best? (Source: Student Doctor Network)
Source: Student Doctor Network - August 21, 2020 Category: Universities & Medical Training Authors: Blitz2006 Tags: Pain Medicine Source Type: forums
Lamictal dosing for bipolar disorder
I was reviewing some information about a new patient I will be seeing in a couple of weeks, and was surprised to see that the patient reports taking 500 mg of Lamictal for bipolar disorder. Other current medications include Abilify 15 mg, Elavil 25 mg, Celexa 40 mg, and Adderall 10 mg.
I have several patients on Lamictal, and usually stop around 100-200 mg. I have taken it up to 250 mg on occasion, but I don't think I've ever prescribed higher than that and certainly not 500 mg. I...
Lamictal dosing for bipolar disorder (Source: Student Doctor Network)
Source: Student Doctor Network - July 17, 2019 Category: Universities & Medical Training Authors: SpongeBob DoctorPants Tags: Psychiatry Source Type: forums
Duplicate Therapy- SSRI+SSRI/SSRI+SNRI
How often do you encounter this combination working in retail and how do you resolve it? I have seen numerous patients that have prescriptions for escitalopram 10 mg + escitalopram 20 mg from the same prescriber, in addition to something like venlafaxine/duloxetine or fluoxetine and/or amitriptyline from another.
To make it worse, most of these all are usually a (re)fill 05 and only have DUR comments that only contain 'dose ok' or 'patient on both' without providing any more information. (Source: Student Doctor Network)
Source: Student Doctor Network - September 19, 2017 Category: Universities & Medical Training Authors: josh6718 Source Type: forums
PHN refractory to conventional treatment
I saw a new patient in the office yesterday. 70 y/0 M with 1.5 years of severe pain secondary to a shingles outbreak in the left T5/T6 dermatomes. It doesn't appear that he received timely antiviral therapy at the time of outbreak and now he is suffering for it. He even asked to take off his shirt during the middle of the consultation secondary to pain. Prior to seeing me he has tried Hydrocodone, Gabapentin, Lyrica, Amitriptyline, Lidocaine ointment / patches, Calamine lotion and...
PHN refractory to conventional treatment (Source: Student Doctor Network)
Source: Student Doctor Network - March 30, 2017 Category: Universities & Medical Training Authors: EruditeDoc Source Type: forums
Let me just show you this....
This is not made up. This is a real medication regimen of patient I have been referred. Comments?
Buproprion XL 300 mg in am
buspar 15 mg twice daily
zoloft 200 mg daily
remeron 30 mg nightly
geodon 20 mg twice daily
Adderall XR 30 mg in am
Adderall 10 mg at noon
Lamictal 200mg- 2.5 tabs daily
minipress 10 mg nightly
elavil 100 mg nightly
restoril 15 mg nightly
imitrex 50 mg as needed (Source: Student Doctor Network)
Source: Student Doctor Network - July 19, 2016 Category: Universities & Medical Training Authors: erg923 Source Type: forums
