abilify to counteract prolactin increase with risperdal
Do you guys do this often? Ive done this in the past a while ago, and have used abilify in conjunction with clozapine. Risperdal has been amazing for one of my bipolar patients (shes completely stable on it now) but shes having persistent increased prolactin and galactorrhea. Was considering adding 5mg abilify to try and offset prolactin increase but may have her see endo too. (Source: Student Doctor Network)
Source: Student Doctor Network - February 7, 2024 Category: Universities & Medical Training Authors: annoyedpsychiatrist Tags: Psychiatry Source Type: forums
Bipolar II in Residency
Has anyone had bipolar II in residency? What specialties would be most conducive to getting regular sleep as a resident? (Source: Student Doctor Network)
Source: Student Doctor Network - February 3, 2024 Category: Universities & Medical Training Authors: EllenHartman Tags: General Residency Issues Source Type: forums
Lower Credit Load, 4 Withdrawals, & 4.5 Years
Hi, I'm a senior and my credit load looks like this with a 3.88 GPA:
Freshman
Fall 16
Spring 16
Sophomore
Fall 19
Spring 10
Summer 12
Junior
Fall 17
Spring 15 with 4 Ws leaving 6 credits
Summer 6 credits
Senior
Fall 12
Spring 12
Super Senior Fall 12
I haven't taken the MCAT yet, since I had to take Physics II. My withdrawals were from a bipolar diagnosis. My 10 credit semester was from major depression which I recovered from, and my 12 credit semesters are because I had to take...
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Source: Student Doctor Network - February 1, 2024 Category: Universities & Medical Training Authors: EllenHartman Tags: What Are My Chances? WAMC Medical Source Type: forums
Bipolar I and med school
I was recently diagnosed with bipolar I disorder in June 2022. I was pre-med in undergrad (BA Biochemistry) and have a pre-med postbacc under my belt (MS in Biomedical Science). I am not the typical pre-med; non-traditional student 31 YO. I check ALL of the boxes except MCAT (two <50% attempts). Got the grades, research, volunteering, patient care experience, everything. Didn't do a typical postabacc either, it was at an academic med center/med school and we took the MS 1 curriculum for our...
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Source: Student Doctor Network - January 5, 2024 Category: Universities & Medical Training Authors: Package Guy Tags: Psychiatry Source Type: forums
Risperdal withdrawal
I have a client with bipolar 1 disorder who has taken 6mg of risperdal daily for years. The medication has worked well for her but led to an 80 pound weight gain. The client has been working with weight management and taking Wegovy for 5 months with no weight loss at all. She quit her risperdal cold Turkey more than a week ago. Today, I noticed irritability and restlessness. The client has started having sleep difficulties. I reflected my observations today and expressed concerns for her...
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Source: Student Doctor Network - December 16, 2023 Category: Universities & Medical Training Authors: psychma Tags: Psychiatry Source Type: forums
Psychotic patients who are victims of catfishing scams
I’m taking care of a patient who is manic but also seems to be a victim of a catfishing scam, where she believes that she is going to be marrying Johnny Depp, and has been hacked and has been homeless for many years in financial stress. This patient has suffered enormous loss, and her psychotic level of denial is a defense to addess this. I’m curious more generally though, as apparently and unfortunately, this seems to be a very common scam among many vulnerable individuals.
Delusions are...
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Source: Student Doctor Network - October 3, 2023 Category: Universities & Medical Training Authors: Lexanoob Tags: Psychiatry Source Type: forums
It's not GAD
Seems like every patient I see has generalized anxiety disorder listed in their chart.
Maybe 1/10 or less actually has it. If you actually bother to draw the meaningful distinctions within everything described as "anxiety", turns out most of these people have one or more of PTSD, OCD, social anxiety disorder, Mdd w/anxious distress, bipolar disorder, hell even legit adhd, sometimes acute appropriate situational anxiety (ie...while waiting for a biopsy result...) literally anything else but...
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Source: Student Doctor Network - September 25, 2023 Category: Universities & Medical Training Authors: Celexa Tags: Psychiatry Source Type: forums
Managing a difficult psych attending
I’ve gotten helpful responses before, so I thought I’d try again.
Client is mid-fourties’ and female. She was diagnosed 15 years ago by her psychiatrist as having bipolar 1, ocd, and ptsd. This client has taken medication for bipolar for 15 years with significant weight gain and sexual side effects as well as hair loss. Client was recently discharged for depression with suicidal ideation and intent after staying a week on the inpatient unit. This is when I began seeing her.
At the client’s...
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Source: Student Doctor Network - September 14, 2023 Category: Universities & Medical Training Authors: psychma Tags: Psychiatry Source Type: forums
Cluster B:histrionic traits
I have a relatively new client of 3 months that I inherited from a retiring psychologist. No personality pathology, PTSD, OCD, and bipolar 1 disorder. Client has had middle insomnia since November 2022 and is often sleeping 2-4 hours a night. She once fell asleep during our session. This client also stopped her risperdal cold Turkey due to excessive weight gain. She has had a sleep study, seen a sleep psychologist and has tried every sleep medication. She is now on Belsomra and her sleep is...
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Source: Student Doctor Network - August 7, 2023 Category: Universities & Medical Training Authors: psychma Tags: Psychiatry Source Type: forums
Bipolar Disorder, diagnosis and treatment in children
(Source: BMJ Comments)
Source: BMJ Comments - July 18, 2023 Category: General Medicine Source Type: forums
Pre-round separately or as a group?
Hey there,
I am wondering if the residents should pre-round separately or as a group with medical students for inpatient pts (psychosis, bipolar, SI). Some of the medical students prefer independence and appear to get annoyed if you round together. However, some pts seem preoccupied about discharge and i would hate for the pts to get aggressive because we bother them with the same questions (Source: Student Doctor Network)
Source: Student Doctor Network - July 16, 2023 Category: Universities & Medical Training Authors: hopefulscribe2 Tags: Psychiatry Source Type: forums
BPD Question
How do you reconcile an attachment to mood disorder diagnoses in borderlines whose actual consolidating diagnosis is that of borderline PD? What strategies do you incorporate to manage these patients? I find it to be a nightmare in the outpatient setting when inheriting such patients.
I have many colleagues who offer an alleged unspecified mood disorder or bipolar spectrum illness diagnosis to borderlines. Sometimes they want it on paper to substantiate use of atypicals (liability)...or...
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Source: Student Doctor Network - July 8, 2023 Category: Universities & Medical Training Authors: clement Tags: Psychiatry Source Type: forums
Lithium+Valproate combination in bipolar disorder
I've seen a lot of psychiatrists in my neck of the woods prescribe lithium AND valproic acid to bipolar patients - usually in lower doses (i.e 600-900mg Lithium and 1g Depakote for a 160 pound male patient), which doesn't make a lot of sense to me - I'd rather just prescribe one in a higher dose and follow it up with serum concentration tests.
Having said that, are there situations where it is recommended to associate Lithium and Valproic Acid, instead of focusing on third of fourth line...
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Source: Student Doctor Network - July 2, 2023 Category: Universities & Medical Training Authors: FrancisTheCatatonic Tags: Psychiatry Source Type: forums
Medication high scores
Let's have some fun. What are the highest prescribed doses of medication you've ever seen, both indicated and not indicated? Let's keep to outpatient and also things you know a pharmacy actually filled. I've had catatonic and manic inpatients on elephant doses of benzos but that's different.
Here are some of mine:
Risperidone 8mg bid. An antipsychotic was indicated, but... Not that much.
Adderall IR 30mg qid. Suspect pt was diverting, shocked someone was filling it.
Xanax 2mg qid. Pt...
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Source: Student Doctor Network - June 28, 2023 Category: Universities & Medical Training Authors: Celexa Tags: Psychiatry Source Type: forums
Low GPA high MCAT (3.45/521) which schools should I apply to? Good EC ’s. ORM. In Alaska
Hello everyone!
I have no idea the tier or number of schools I should be applying to.
3.45/521 (130/131/130/130)
High Upwards trend, 2.0 first 2 sems, mom was having bipolar manic episodes during that time which is talked about in my PS. 3.7+ for last 4 years. No gap years.
Clinical
100 hrs ER Scribe
1500 hrs Scribe/MA neurology 1yr
4000 hrs MA Pediatrics 2yr
- very pt centered position, no phones calls or insurance BS. I work closely with providers and pts so I think my writing will...
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Source: Student Doctor Network - June 28, 2023 Category: Universities & Medical Training Authors: Alaska Dude Tags: What Are My Chances? WAMC Medical Source Type: forums
