Weird case. Treatment Resistant Depression but after a snake bite
Got a patient that was already seen by a great clinician and she couldn't get this patient better. Was tried on all the conventional meds. A few SSRIs, SNRIs, Lamotrigine, Lithium, atypical antipsychotics (and yes the better ones for depression such as Aripiprazole, Cariprazine) , Bupropion, augmentation agents such as Buspirone, Auvelity, Esketamine, TMS (not ECT...yet).
After several meetings she finally said something that hit me like a ton of bricks. She told me she never had mental...
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Source: Student Doctor Network - October 11, 2023 Category: Universities & Medical Training Authors: whopper Tags: Psychiatry Source Type: forums
Buspirone - a glorified placebo?
So, I know this question has come up many times before, but I was actually courious to know other psychiatrists opinion on augmentation for GAD after SSRIs/CBT.
Sometimes, my patients still get residual symtomps that affect their quality of life, like insomnia or irritability even with behavioral interventions like sleep hygiene, and even after CBT and max-dose SSRIs. In these cases, if the patient had a good response to the SSRI for their anxiety, I'm always inclined to augment with a...
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Source: Student Doctor Network - July 14, 2023 Category: Universities & Medical Training Authors: thelastpsych Tags: Psychiatry Source Type: forums
Benzo vs other options for anxiety
Question for the psychiatrists here from a pain physician.
All the national guidelines I’ve read about anxiety management, state that virtually no one should be prescribed chronic daily benzodiazepines for anxiety, (particularly short acting agents such as Xanax), and definitely not tid or qid dosing. Some papers do mention a small supply for rescue benzo doses to be used 3-5 times a month max.
Everything else should be used instead of benzos, so psychotherapy, multiple SSRI, buspirone...
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Source: Student Doctor Network - April 17, 2022 Category: Universities & Medical Training Authors: bedrock Tags: Psychiatry Source Type: forums
Uncharted Territory: The treatment-resistant depressed patient who is chronically suicidal
Case example: Patient is severely depressed as measured by a depression scale, but is able to stay independent. All SSRIs, SNRIs, Wellbutrin, Mirtazapine, Parnate, and 3 TCAs have also been tried at therapeutic dosages for over 1 month each. Also combinations have been tried, as well as augmentation medications (Buspirone, low dosage antipsychotic, low dosage antipsychotics indicated for depression, Lamotrigine), TMS, Esketamine, and still the patient is still depressed with no significant...
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Source: Student Doctor Network - November 20, 2020 Category: Universities & Medical Training Authors: whopper Tags: Psychiatry Source Type: forums
Buspirone - is it better than valium? Anxiety is killing me need something to
Forum: Health
Posted By: Ciel.
Post Time: 01-09-2016 at 18:45 (Source: The Student Room)
Source: The Student Room - September 1, 2016 Category: Universities & Medical Training Source Type: forums
