Ketamine clinics shutting down
I for one am relieved. It had gotten ridiculous.
Large network of clinics offering ketamine for depression shuts down
One of the largest operators of ketamine clinics in the country abruptly closed its facilities this week, leaving patients in the dark and out of treatment for depression and other chronic conditions.
www.statnews.com (Source: Student Doctor Network)
Source: Student Doctor Network - March 26, 2023 Category: Universities & Medical Training Authors: randomdoc1 Tags: Psychiatry Source Type: forums
methylphenidates/stimulants in geriatric depression, as an adjunct medication
Any general thoughts on this? I treat a large pool of geri patients, id say >50% are geri or close to it. A lot of men tend to not do so well with age, become severely depressed, lay in bed all day and have zero motivation. Had one guy in his late 60s who had been on adderall 40 xr BID (no misuse on his part, just an idiot prescriber) and he did not do well when he went off. Eventually we decided on a low dose of vyvanse and hes the best hes ever been. Im noticing males tend to do worse...
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Source: Student Doctor Network - March 24, 2023 Category: Universities & Medical Training Authors: annoyedpsychiatrist Tags: Psychiatry Source Type: forums
Versed and fentanyl for sedation
What are y'all's thoughts on the common practice and combination of versed and fentanyl for procedural sedation and Mac? This practice is incredibly pervasive in anesthesia. In my reading and understanding it seems like versed alone would be the much better agent as combining the two makes a patient much more prone to respiratory depression per benzodiazepine warnings. Yet we routinely give both. Is there any utility to fentanyl for minimal stimulation procedures aka less painful? I'm a...
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Source: Student Doctor Network - March 23, 2023 Category: Universities & Medical Training Authors: medicine2wallstreet Tags: Anesthesiology Source Type: forums
Discussion - "The Last of Us" Finale Ethical Question - SPOILERS
Obviously, this thread will be full of spoilers, so be warned.
Here's the ethical dillema and some ideas to consider. Short recap for anyone who is not ever going to watch the show or play the game.
Joel is a survivor of a massive fungal pandemic that has killed off most of humanity. His only daughter was killed at the beginning of the pandemic, which led him to attempt suicide, from which he recovered. He has survived through a variety of means, including by murdering other...
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Source: Student Doctor Network - March 15, 2023 Category: Universities & Medical Training Authors: WildWing Tags: Casper/Situational Judgement Tests Source Type: forums
Saffron
What do you think about its role in treatment of depression and anxiety? There are quite a few studies suggesting positive effects, and interestingly also studies suggesting benefits for erectile dysfunction and overeating, which are two main side effects of SSRIs. Seems very interesting as a possibility for treatment of lower level depression and anxiety. Thoughts? (Source: Student Doctor Network)
Source: Student Doctor Network - March 11, 2023 Category: Universities & Medical Training Authors: luckybuck Tags: Psychiatry Source Type: forums
Meeting with Dean for unprofessionalism concerns
Hello, I am an M2 student in an MD school. I had a really tough year. Something traumatic happened a couple of months ago, and various personal issues put a strain on my mental health. I always had some baseline depression but it got worse than ever and as a result, I have been slipping in school performance. I had missed the deadline for three assignments without being able to email my instructors ahead of time. Per our school policy, this files under "unprofessionalism" and would get the...
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Source: Student Doctor Network - March 10, 2023 Category: Universities & Medical Training Authors: Protolytic Tags: Medical Students (MD) Source Type: forums
ChatGPT did a better job than most residents
Ok so I didn't think this would go the way it did but the system did ****ing amazing. Better than many residents I would argue. My prompts in bold:
How would you treat depression in an unmotivated young person who spends most of the day isolating and has intense difficulty in interpersonal functioning?
Depression can be a challenging condition to manage, especially in young people who are experiencing difficulty with motivation and interpersonal functioning. It's important to note...
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Source: Student Doctor Network - February 25, 2023 Category: Universities & Medical Training Authors: SmallBird Tags: Psychiatry Source Type: forums
Psychiatry as a Specialty Choice
When I was growing up, I had always thought I'd want to be a psychiatrist. I then experienced significant emotional and, at times, physical abuse at the hands of a family member, and that family member ultimately committed suicide. This whole situation is incredibly complex and not really something that I should get into here. In any case, this led me to believe that I should not go into psychiatry for multiple reasons. The first is that I was worried the emotional baggage that I received...
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Source: Student Doctor Network - February 25, 2023 Category: Universities & Medical Training Authors: HarmlessGhost Tags: Psychiatry Source Type: forums
Outpatient Ketamine infusion requirement
What specific emergency equipment is required for outpatient ketamine infusion? Airway, crash cart, defib (is a standard AED ok?), lock box for meds, personnel credentials?
What doses are people here given for depression, PTSD, OCD, CRPS, fibro etc? (Source: Student Doctor Network)
Source: Student Doctor Network - February 14, 2023 Category: Universities & Medical Training Authors: gaschicago Tags: Pain Medicine Source Type: forums
Vitamin D linked to fewer suicides.
Vitamin D Supplementation Linked to Fewer Suicide Attempts
A large retrospective study of US veterans finds those receiving vitamin D2 or D3 had fewer suicide attempts or episodes of intentional self-harm than matched peers who didn't take the vitamin.
www.medscape.com (Source: Student Doctor Network)
Source: Student Doctor Network - February 5, 2023 Category: Universities & Medical Training Authors: whopper Tags: Psychiatry Source Type: forums
Neuropsychologists
What's the recognized neuropsychology board/agency to go to, to look up the people who have done an actual fellowship and picked up the certification?
My new location I'm in is surrounded with every psychologist, without neuropsych fellowship training, doing testing and training random people to be their psychometrists.
Gotta love seeing reports on a patient who is floridly depressed, with anxiety, and untreated OSA; getting a report that just says ADD 'in my professional opinion' and no...
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Source: Student Doctor Network - January 30, 2023 Category: Universities & Medical Training Authors: Sushirolls Tags: Psychiatry Source Type: forums
Lamictal augmentation for unipolar depression
Covering for an NP today and her overall diagnoses and management is driving me f*cking insane, doing things like diagnosing BPD as bipolar, and starting Lamictal for irritability.
Have seen multiple patients of hers with MDD only today, resulting in her starting low dose Prozac, Seroquel 25 mg QHS for sleep, and Lamictal AT THE SAME TIME.
Here are 4 patients of hers I saw today, all MDD:
Patient 1: Trintellex 10 mg once daily, Ritalin 30 mg once daily, Lamictal 150 mg
Patient 2: Prozac 10...
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Source: Student Doctor Network - January 27, 2023 Category: Universities & Medical Training Authors: yoloswagpoop42069 Tags: Psychiatry Source Type: forums
When do you start SSRIs?
I know it’s a weird question, but let me explain. I trained in a dynamically oriented programme and I remain dynamically inclined. I feel like I conceptualise depression differently from most colleagues. But out of training now, the pressures and demands of daily practice are different. I see low mood and anxiety every day, but rarely what I would conceptualise as “pathological”.
Generally the evidence shows that for mild or moderate depression, lifestyle change and various forms of...
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Source: Student Doctor Network - January 26, 2023 Category: Universities & Medical Training Authors: vanfanal Tags: Psychiatry Source Type: forums
Opening for Child Fellowship in my same city - Conflicted
Hey everyone,
I'm a PGY3 and there is an opening for a child psych spot at a local university, and I am conflicted. I do enjoy my child outpatient days, particularly teenagers struggling with trauma, eating disorders, depression and anxiety; but I also find it exhausting. And I am not a big fan of autism. I also find parents exhausting, and that every patient visit takes forever due to overbearing parents. I haven't had any inpatient child experience either.
I guess the pros are that it...
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Source: Student Doctor Network - January 15, 2023 Category: Universities & Medical Training Authors: HinduHammer Tags: Psychiatry Source Type: forums
Negligence accusation story.
Inspired by a recent ED forum post, I thought I would share my experience of negligence accusation. It never progressed to a lawsuit thankfully but took a lot of time and emotional toll. This occurred shortly after I finished residency.
Working inpatient psych, our team was consulted to see a woman in her early 50s who appeared frankly psychotic/manic. History from her husband notable for depression, and unclear history of possible hypomanic episodes on a few occasions over their 30-year...
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Source: Student Doctor Network - January 8, 2023 Category: Universities & Medical Training Authors: nexus73 Tags: Psychiatry Source Type: forums
