Old People With Unipolar Depression on Seroquel 800mg
I inherited a dump of a case in the outpatient setting. 74 yo on Seroquel 800 (14 years), Trazodone 200, Prazosin 1mg AM, 2mg HS, Ativan 0.5 bid prn. Has an obviously high tolerance to the sedating effects of her regimen. Unipolar depression per the last treating psychiatrist of years, oh and a and a touch of ptsd. How slowly would you shave off Seroquel? It’s 90% being used as a sleep aid only.
Formerly w/ an iatrogenic sedative hypnotic use d/o in full remission until it was decided...
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Source: Student Doctor Network - July 20, 2023 Category: Universities & Medical Training Authors: clement Tags: Psychiatry Source Type: forums
Benzodiazepine Question
Working on a grand rounds regarding benzodiazepines and wanted to touch on the addictive potential (amongst other things, obviously), but I'm having trouble finding good articles describing how common benzo abuse actually is. For example, lots of my outpatient colleagues LOVE to brag about how they never prescribe benzos. This got me thinking, have we ever had a study to back this up? If I were to prescribe 1000 different people a 30-day supply of Ativan for GAD, how many of them are going...
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Source: Student Doctor Network - October 25, 2022 Category: Universities & Medical Training Authors: psych_0 Tags: Psychiatry Source Type: forums
Med malpractice reviewer: fall after Ativan and Tramadol prescriptions
Fall After Ativan and Tramadol Prescriptions
Fascinating read (Source: Student Doctor Network)
Source: Student Doctor Network - April 15, 2022 Category: Universities & Medical Training Authors: Agast Tags: Pain Medicine Source Type: forums
Homeless psych dispo -WWYD?
Had a case recently with a homeless guy coming to the ED after being release from jail the same day asking for help because of a panic attack. He definitely was cogent and coherent enough that I didn’t think he was exhibiting any emergent toxidrome or withdrawal.
So I give him a rx for a couple Xanax because he supposedly lost his after his car was stolen while he was in jail. I give him some lorazepam in the ED. I offer to have him stay overnight in the lobby for the social worker to see...
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Source: Student Doctor Network - January 23, 2021 Category: Universities & Medical Training Authors: pandahunter Tags: Emergency Medicine Source Type: forums
Psych 5150 Question
Can someone on a 5150 refuse a medical workup? I had one last night who was a real a-hole. Came in on a 5150. First he was mute for several hours then after ativan 1mg IM he was yelling and screaming saying he wants a second opinion, wanted a lawyer, all this crap. Refused to give blood and urine for medical clearance.
I think they can...if they can make informed medical decisions then I think they can. But I don't know...and if they refuse to be cooperative then we can't medically...
Psych 5150 Question (Source: Student Doctor Network)
Source: Student Doctor Network - June 30, 2019 Category: Universities & Medical Training Authors: thegenius Tags: Emergency Medicine Source Type: forums
CAP job offer
What are your thoughts on this CAP job offer?
outpatient community mental health center in rural Indiana
CAP only
Will be the only child psychiatrist with 2NP
1 hr initial eval, 20-30 min f/u
1:4 call covering 20 bed inpt unit
Compensation:
-$275k annual salary
-Potential productivity bonus in addition to base after 3 years; $63 for each WRVU each year in excess of 3750 WRVU’s
-$100k signing bonus forgiven over 5 ys or $60k for 3 ys.
-$1k/month education stipend
-$15k relocation
-$5k cme...
CAP job offer (Source: Student Doctor Network)
Source: Student Doctor Network - April 7, 2019 Category: Universities & Medical Training Authors: Haldol Lorazepam Tags: Psychiatry Source Type: forums
Benzo withdrawal induced mania
Anyone here ever treat this & find anything out of the ordinary?
I was transferred to a new unit-got a lady who was getting PRNs round the clock which included Ativan 2mg QID-PRN. As many of us know Haldol, Cogentin Ativan are given as a cocktail. Well this lady got the cocktail round the clock for weeks. She eventually became ativan dependent. Reason why I know is becuase I stopped her Ativan when I came to the new unit, trying to avoid iatrogenic ativan dependence, and the next day...
Benzo withdrawal induced mania (Source: Student Doctor Network)
Source: Student Doctor Network - November 5, 2017 Category: Universities & Medical Training Authors: whopper Source Type: forums
Agitation in children-what's your preferred IM?
Affective or psychotic agitation in younger children 3-16 y/o, what's your go to IM? 5/2/2 [haldol/Ativan/benadryl]? Thorazine? zyprexa? ativan? (Source: Student Doctor Network)
Source: Student Doctor Network - October 6, 2017 Category: Universities & Medical Training Authors: Madden007 Source Type: forums
Child fellowship UW, seattle vs WU, St louis
I'm confused, which one of the above is regarded better for CAP fellowship? Also, location wise? Which city has a better life style? TIA (Source: Student Doctor Network)
Source: Student Doctor Network - June 7, 2017 Category: Universities & Medical Training Authors: Haldol Lorazepam Source Type: forums
Best CAP fellowship programs
With more than 100 programs for the child& adolescent fellowship, what would be the top/best ones in terms of training quality, depth of faculty expertise etc? I'm planning to apply to only 10 max. TIA (Source: Student Doctor Network)
Source: Student Doctor Network - June 2, 2017 Category: Universities & Medical Training Authors: Haldol Lorazepam Source Type: forums
max dose for ativan
had an incident today where this patient in ER jumping and going crazy so doctor decided to give ativan 4mg iv push x4 times
I was kind of scared that patient might undergo respiratory depression but nurse was screaming to verify
hope pt is okay (Source: Student Doctor Network)
Source: Student Doctor Network - March 25, 2017 Category: Universities & Medical Training Authors: skarndghks2017 Source Type: forums
Ativan for catatonia
What is the maximum daily dose of ativan you have used for treatment of catatonia? I currently have an inpatient responding to 4 mg QID, with catatonia 2/2 depressive illness. He persists with residual catatonic symptoms, word finding difficulties, latent responses, at times appearing to get locked up in his thoughts when asked a questions. Not sedated at all from this dose. (Source: Student Doctor Network)
Source: Student Doctor Network - December 9, 2016 Category: Universities & Medical Training Authors: nexus73 Source Type: forums
Expertise requested - proper description of Akathesia
... UWorld is so annoying for Psychiatry...
Can anyone offer a guideline for what a professional description for Akathesia should be?
Should a board review exam describe Akathesia as:
1.) "agitated"
2.) escaping a ward at a hospital
3.) walking around all day outside
4.) "aggressive" if asked to remain inside ?
Furthermore.. even if it was some kind of akathesia.. would YOU decrease the risperodone and prescribe lorazepam ? This is news to me that Akathesia would...
Expertise requested - proper description of Akathesia (Source: Student Doctor Network)
Source: Student Doctor Network - November 11, 2016 Category: Universities & Medical Training Authors: omn Source Type: forums
Psych Pharmacy text books/resources
I am starting a new job in a psych hospital and was wondering if there are any books /sources that you recommend on psych drugs?
for example, there was an order for Ativan IM for a pt who was on Zyprexa IM...
I just dont want to miss any of those tricky situations...
Ive worked in retain fro few years and did not have to deal with psych pharmacy in that aspect.
Especially pediatric psych
Any good books/sources for psych pharmacists? (Source: Student Doctor Network)
Source: Student Doctor Network - September 15, 2016 Category: Universities & Medical Training Authors: Lisochka Source Type: forums
