Treating Social Anxiety/GAD
Student here with a couple questions.
1) When treating Social Anxiety/GAD what do you take into consideration when prescribing medications? (This is after trying CBT)
From what I read online first line of treatment is always an SSRI, Remeron, TCA's etc. All of which are usually for depression, OCD, and other issues that seem to be a little more severe IMO. They all can have bad side effects and in the case of Mirtazapine needs a higher dose because too low of a dose causes extreme...
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Source: Student Doctor Network - April 21, 2022 Category: Universities & Medical Training Authors: maverick323 Tags: Psychiatry Source Type: forums
Anorgasmia Treatments?
Looking for some input from the hive mind here.
33yo with schizophrenia. Had him on inpt for about 4 months before he was finally stabilised on Abilify Maintena 400mg and olanzapine 10mg. But he’s had Anorgasmia since being on the meds. Not sure which one did it as he came to me on both. No erectile difficulties, he just can’t finish. I tried bupropion and mirtazapine, no effect. Right now I’ve left him on trazodone 50mg qhs and amantadine 100mg BID (amantadine to counteract D2 blockade...
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Source: Student Doctor Network - April 11, 2022 Category: Universities & Medical Training Authors: vanfanal Tags: Psychiatry Source Type: forums
Depressed elderly w/ poor appetite and sleep, but obese - mirtazapine when?
As stated
Patient and family are concerned with sleep and poor appetite but patient is technically either obese or overweight ... what would be your go to?
edit: here, let me make the question more clear
In a patient who is objectively overweight but who has clear concerns for decreased appetite and food intake, what's your approach in regards to the appetite? (Source: Student Doctor Network)
Source: Student Doctor Network - March 24, 2022 Category: Universities & Medical Training Authors: caxoo Tags: Psychiatry Source Type: forums
Antidepressants in patient with arrhythmias
I haven't found much data to suggest which medications might have the best safety profile, with the exception of recommendations to avoid TCAs and possibly celexa. I also see mirtazapine is associated with potential for slight increase in qtc, but nothing concrete in terms of guidelines. How would you handle a patient with history of arrhythmia on rate control? (Source: Student Doctor Network)
Source: Student Doctor Network - December 23, 2020 Category: Universities & Medical Training Authors: Psychresy 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
Re: Mirtazapine added to SSRIs or SNRIs for treatment resistant depression in primary care: phase III randomised placebo controlled trial (MIR)
(Source: BMJ Comments)
Source: BMJ Comments - February 3, 2019 Category: General Medicine Source Type: forums
Mirtazapine added to SSRIs or SNRIs for resistant depression: EBM and the Declaration of Helsinki.
(Source: BMJ Comments)
Source: BMJ Comments - December 6, 2018 Category: General Medicine Source Type: forums
Re: Mirtazapine added to SSRIs or SNRIs for treatment resistant depression in primary care: phase III randomised placebo controlled trial (MIR)
(Source: BMJ Comments)
Source: BMJ Comments - December 4, 2018 Category: General Medicine Source Type: forums
sexual dysfunction
How do you guys typically handle the common complaint of sexual dysfunction with antidepressants? I just wanted to see what other ideas are out there. I know antidepressants less prone to causing this are mirtazapine and bupropion. I've heard of adding bupropion to the regimen and cyproheptadine. I've also heard of just adding some prn Viagra for the men who specifically complain of erectile dysfunction. Any other thoughts? Also, how would you guys typically rank how notorious certain...
sexual dysfunction (Source: Student Doctor Network)
Source: Student Doctor Network - November 9, 2016 Category: Universities & Medical Training Authors: randomdoc1 Source Type: forums
