Confused about Lithium vs Depakote in Bipolar
My understanding is that both medications work better in acute mania than bipolar depression. However CANMAT seems to indicate good efficacy of both in bipolar depression. Though I've heard that VPA is better for mixed episodes. All things being equal how do you weigh starting Li vs VPA in a patient with no contraindications for either. Do you choose one over another based on presenting symptoms? (Source: Student Doctor Network)
Source: Student Doctor Network - April 22, 2022 Category: Universities & Medical Training Authors: yanks26dmb Tags: Psychiatry Source Type: forums
Career Change - questions about finishing old prereqs, old LORs and more.
Hi everyone,
I'm looking to go back and finish up my premed courses: I have a degree from 2018 in Mathematics from a Pac-12 with some non-published research (Wet Bench Genetics work, presentations on a Mathematical Model of Cancer that I improved on as well as Algebra), some solids ECs with low-end hours Volunteering, worked in an ER for ~8 months. Tons of leadership (especially now). Nothing beyond a lower GPA that causes pause for my application.
I was diagnosed with bipolar the last...
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Source: Student Doctor Network - March 29, 2022 Category: Universities & Medical Training Authors: FatJoshPeck Tags: Nontraditional Students Source Type: forums
dexmedetomidine (POPrecedex) for agitation, and maybe delirium, and maybe dementia with behavioral disturbance?
https://www.empr.com/home/news/drugs-in-the-pipeline/dexmedetgomidine-bxcl50-schizophrenia-bipolar-disorder/
What do you think of these studies using the intensivist's best friend, aka Precedex, in PO form for agitation in Schizophrenia and Bipolar disorder? I'd wonder if this would have applications in hyperactive delirium and/or dementia with behavioral disturbance. Brand name POPrecedex is my suggestion. (Source: Student Doctor Network)
Source: Student Doctor Network - March 6, 2022 Category: Universities & Medical Training Authors: nexus73 Tags: Psychiatry Source Type: forums
Does this kind of job exist?
Does this job exist
-working mostly with patients who have schizophrenia, schizoaffective, bipolar 1, and/or OCD. May sound selfish/awful, but these are disorders I'm interested in and everything else I find exhausting
-working with patients in a secure living environment
- seeing about 5-10 patients per day and working about 3 days per week
Money not very important, I would work for as little as 90,000$ per year. I don't care much about money.
I feel so burned out in residency. I'm tired...
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Source: Student Doctor Network - February 5, 2022 Category: Universities & Medical Training Authors: Desired Member Tags: Psychiatry Source Type: forums
Persistent tachycardia in potential first-break psychosis
Hi all,
I have this patient on our unit who is in their early 20s. She presents as having severe borderline personality disorder but has a strong family history of bipolar disorder I as well. She was medication naive at presentation save for venlafaxine. The only odd thing about her is that she has persistent tachycardia into the 120s and has since her arrival. She's not dehydrated. She has negative ANA and CRP. Do you think there could be something organic underlying her mix of BPD +/-...
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Source: Student Doctor Network - January 16, 2022 Category: Universities & Medical Training Authors: Psychferlyfe3000 Tags: Psychiatry Source Type: forums
How would you help this type of patient?
I have a patient who is in his early 60s who has chronic severe PTSD and I think likely either borderline traits or borderline personality disorder. This patient doesn't have any suicidal ideation. No mania or psychosis. No depressive episode. The patient refuses to take medication for PTSD, and mistakenly says another physician has told him SSRIs will harm his heart and wont' accept education to the contrary. He won't even listen to that same physician. He will only take clonazepam 1mg PO...
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Source: Student Doctor Network - December 8, 2021 Category: Universities & Medical Training Authors: wolfvgang22 Tags: Psychiatry Source Type: forums
risk of mania or hedonic dysregulation syndrom with ER or IR pramipexole
hello
does anyone have a paper or experience with trying out the 2 version of prami and seeing an increase of mania (broadly defined) or hedonic dysregulation syndrom with either IR or ER pramipexole?
i would wager the ER release is less prone to such effets but i've got nothing to base this on
thanks (Source: Student Doctor Network)
Source: Student Doctor Network - October 24, 2021 Category: Universities & Medical Training Authors: Sikrouf Tags: Psychiatry Source Type: forums
Mania without sleep disturbance
So this is one I've asked around about and have meant to post here for a while. The specific question is:
"Can a person have a full-blown manic episode and not experience any sleep disturbance?"
I realize that technically this is possible per DSM criteria, but I've only ever seen it in the case below and have never been able to find anything in the literature about true bipolar manic episodes where sleep was preserved. I've gotten slightly mixed answers from attendings, but have had a few...
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Source: Student Doctor Network - September 17, 2021 Category: Universities & Medical Training Authors: Stagg737 Tags: Psychiatry Source Type: forums
Delirium or Primary psych issue
Elderly patient with hx of schizoaffective disorder and chronic kidney disease initially admitted to psych with mania/psychosis (including profound confusion and disorientation), but transferred to medicine when acute on chronic renal failure and elevated calcium was discovered. Attending psychiatrist suspects delirium.
Medical service treats medical problems over the course of 1 week, but mania/psychosis/confusion persist. Brain imaging and extensive lab workup unremarkable for ongoing...
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Source: Student Doctor Network - July 20, 2021 Category: Universities & Medical Training Authors: nexus73 Tags: Psychiatry Source Type: forums
Medical/Mental Health LOA & Step 1 - Need Advice
Hey guys, I'm an M2 and need some advice regarding taking a medical LOA for mental health reasons and taking Step 1.
For some background info: I was diagnosed with Bipolar II disorder in undergrad, started treatment at the time, and have been relatively stable on the same medication for it for ~9 years now (I'm a non-trad student). I definitely still experience depressive and hypomanic episodes, but since I've been on-treatment the symptoms are relatively "minor"/muted-- I can definitely...
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Source: Student Doctor Network - April 25, 2021 Category: Universities & Medical Training Authors: NeedAdvice123 Tags: Medical Students - MD Source Type: forums
Mental health issues and licensing
I am an AMG. After medical school graduation, I was hospitalized several times for bipolar psychosis before receiving the correct diagnosis and treatment, which ended up costing me my residency (after my program found out I was admitted to a psych unit they insisted I see an outside psychiatrist who confirmed the initial diagnosis; because of this the program did not renew my contract). I did not complete intern year.
Fortunately I am now in full remission. After consultation with an...
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Source: Student Doctor Network - April 3, 2021 Category: Universities & Medical Training Authors: MD5348904 Tags: General Residency Issues Source Type: forums
Si rfa
Would a venom style needle affect the strip lesioning bipolar technique? (Source: Student Doctor Network)
Source: Student Doctor Network - January 9, 2021 Category: Universities & Medical Training Authors: paindoctor2014 Tags: Pain Medicine Source Type: forums
On leave of absence, not sure if I should go to fourth year?
Seeking opinions, please be civil.
I became ill with a schizoaffective disorder bipolar type right before I was scheduled to begin the fourth year of med school. I was studying master's of public health following the first psychotic break that happened the year before. Right now I am on a leave of absence, and given my condition I'm pretty sure I'm not going to residency (can't handle the stress).
Does it make sense then for me to go to M4 just to get the fancy M.D. after my name? I...
On leave of absence, not sure if I should go to fourth year? (Source: Student Doctor Network)
Source: Student Doctor Network - November 15, 2020 Category: Universities & Medical Training Authors: kakashi1992 Tags: Medical Students - MD Source Type: forums
RFA questions
I had a couple of questions pop up and wanted your opinions.
1. Patients with implants such as pacemaker/defibrillator, what kind of precautions do you take when performing RFA in this population? Do you put a magnet over the implanted device, perform bipolar RFA, or do you just avoid RFA in this case altogether?
2. Cervical RFAs - are any of you using the coolief needles to do this with the 2mm active tip? (Source: Student Doctor Network)
Source: Student Doctor Network - October 14, 2020 Category: Universities & Medical Training Authors: GottaHaveIt Tags: Pain Medicine Source Type: forums
Engineering Graduate School to Medicine
Hi everyone. I am a graduate student at UCLA pursuing a M.S. in bioengineering. My interests have changed recently and I am now looking to go to medical school to eventually become a psychiatrist. This decision was sparked in Jan 2020 when I found my mom and brother were using addictive, illegal drugs again. This is nothing new, drug and alcohol addiction have occurred throughout my family since I can remember. Bipolar disorder, obsessive compulsive disorder, attention deficit disorder, and...
Engineering Graduate School to Medicine (Source: Student Doctor Network)
Source: Student Doctor Network - August 25, 2020 Category: Universities & Medical Training Authors: healthEngineer Tags: Nontraditional Students Source Type: forums
