Treatment resistant psychosis
Wanting some additional thoughts/critique of my thought process.
Male 40s schizoaffective, bipolar type
Got dc from long term psych admission (about 9 months) on total 300 Clozaril, Depakote with level low 50s, Lithium barely therapeutic. Briefly out at ALF then admitted for threats driven by continued psychosis. Clozaril slowly ticked up current admission few steps and the level is like 460 ng/ml now. Depakote increased x 2 with previous increase barely moving the needle to upper 50s...
Treatment resistant psychosis (Source: Student Doctor Network)
Source: Student Doctor Network - December 20, 2019 Category: Universities & Medical Training Authors: xavier2000 Tags: Psychiatry Source Type: forums
Interesting popular press article on remitted/misdiagnosed (?) bipolar disorder
I Built My Identity Around Being Bipolar. Then My Doctor Said I’m Not Bipolar
What happens when what’s wrong with you isn’t what’s wrong with you?
www.phillymag.com
Thoughts? (Source: Student Doctor Network)
Source: Student Doctor Network - November 11, 2019 Category: Universities & Medical Training Authors: futureapppsy2 Tags: Psychiatry Source Type: forums
Medicare keeps denying labs
Hi,
I have been taking medicare patients for a while.
lately after a local community center went bankrupt, i decided to take a few patients.
One current issue I keep having is that medicare keeps denying coverage for labs like cbc, chem panel, lipids, hemoglobin A1c.
The labs (quest/labcorp) don't know what it is either other than we have the wrong codes.
I am using the standard codes for bipolar/schizophrenia. F31.x, F20.x etc.
Anyone else having this issues/have experience with this? (Source: Student Doctor Network)
Source: Student Doctor Network - September 21, 2019 Category: Universities & Medical Training Authors: Indodo Tags: Psychiatry 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
Autism and gender dysphoria
I recently tested a teenage girl who has accumulated the following diagnoses in 5+ years: ADHD, ASD, OCD, Bipolar, MDD, GAD, and Gender Dysphoria. Has anyone ever worked with a someone with ASPERGERS (I know it isn't technically a diagnosis anymore but I feel it better captures her presentation) and Gender Dysphoria? I am certain she is on the spectrum, but I can't really discern if she thinks she is meant to be a boy because she feels different than everyone else, or if it's true gender...
Autism and gender dysphoria (Source: Student Doctor Network)
Source: Student Doctor Network - May 3, 2019 Category: Universities & Medical Training Authors: LadyHalcyon Tags: Psychology [Psy.D. / Ph.D.] Source Type: forums
Would you ever consider prescribing statins?
I spend half my week in a community clinic working with a lot of folks with schizophrenia or bipolar 1 so have fair number on SGAs either PO or LAI.
I’m constantly getting lipid panels back that are off the chain, refer to primary care and seems less than 20% of patients ever actually go. Currently I would never consider prescribing statins because I’m not up on guidelines, but has gotten me starting to wonder. I can check any labs I want and presumably it’s not rocket science to follow...
Would you ever consider prescribing statins? (Source: Student Doctor Network)
Source: Student Doctor Network - April 25, 2019 Category: Universities & Medical Training Authors: Armadillos Tags: Psychiatry Source Type: forums
Re: Assessment and management of bipolar disorder: summary of updated NICE guidance
(Source: BMJ Comments)
Source: BMJ Comments - April 18, 2019 Category: General Medicine Source Type: forums
Treatment of bipolar disorder and Six Sigma*
(Source: BMJ Comments)
Source: BMJ Comments - March 7, 2019 Category: General Medicine Source Type: forums
Studying Medicine with Bipolar Disoredr
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Studying Medicine with Bipolar Disoredr
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Source: The Student Room - January 8, 2019 Category: Universities & Medical Training Authors: ecolier Tags: Medicine Source Type: forums
μΥ StorΥ
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Hi everyone! I’m 23 year...
Source: The Student Room - December 2, 2018 Category: Universities & Medical Training Authors: dopAntagonist Tags: Medicine Source Type: forums
Clinical pet peeves?
What are your clinical pet peeves?
My top ones:
-People being diagnosed with both MDD and bipolar disorder, without noting that bipolar also explains the MDEs.
-Autism (ASD) diagnoses being given on parent report and/or brief, informal observation alone.
-PTSD diagnoses with no index traumatic event noted. (Source: Student Doctor Network)
Source: Student Doctor Network - May 3, 2018 Category: Universities & Medical Training Authors: futureapppsy2 Source Type: forums
bipolar...
Curious to know what other people's experiences/thoughts are. That is, with people who insist on the bipolar diagnosis and go out pursuing mood stabilizers and antipsychotics. I've had a recent case who I was not convinced was bipolar but pt has undergone various mood stabilizers and antipsychotics from another provider. No surprise, still depressed, feeling sedated and totally flat after thousands of dollars spent on outpatient visits (not with me) and medication that wasn't a fit to begin...
bipolar... (Source: Student Doctor Network)
Source: Student Doctor Network - April 22, 2018 Category: Universities & Medical Training Authors: randomdoc1 Source Type: forums
Random Psychiatry venting
My patient's GF: (at appt with pt) "Doctor, I too have bipolar disorder. My psychiatrist has me on Zoloft and Klonopin".
Me: "Oh, anything else?
Her: "Nope, those two meds are what works for my bipolar disorder."
Me: "Uh....alrighty then, I will leave that to your psychiatrist". (Source: Student Doctor Network)
Source: Student Doctor Network - April 10, 2018 Category: Universities & Medical Training Authors: Messerschmitts Source Type: forums
Messed up half of undergrad, fixable?
I've been pre med since the second semester of my freshman year in undergrad, now on my 4th year. Everything was going pretty well until my mental illness (bipolar II + severe depression) destroyed my life. My grades slipped and I've had to drop classes for the past year and a half. Most of my drops are classified as non academic due to illness but a couple aren't because I didn't turn the paperwork for them in quickly enough. This semester was my worst one yet and I ended up having to drop...
Messed up half of undergrad, fixable? (Source: Student Doctor Network)
Source: Student Doctor Network - April 10, 2018 Category: Universities & Medical Training Authors: LioraStar Source Type: forums
Need education on Personality Testing
Can anyone who is knowledgeable in psychological testing like MMPI, ect. tell me what the utility of it is in diagnosing bipolar disorder or a thought disorder. I work with a therapist who frequently tells me that that so and so patient has a thought disorder or bipolar disorder based on their testing. These assessments often seem way off to me based on my experience with the patient. She's always really concerned about these results despite my feeling that they're not clinically meaningful. (Source: Student Doctor Network)
Source: Student Doctor Network - March 17, 2018 Category: Universities & Medical Training Authors: resident1985 Source Type: forums
