Beers Criteria

[iconic]

Ketamine has been used for a long time in psych in IV form and approved as nasal spray not too long ago. I’ve also seen practices that offer it as troches. I’ve never really seen it work except for chronic suicidality and they have to keep getting maintaince treatments. Def no social stigma with marijuana in my patient population.. if anything hard to convince them that maybe it’s making their mood/sleep/psychosis worse

[Reality Check 2]

EMDR, It works. Ketamine is up and coming. Not sure on the whole magnet thing.

My grieving patients have devolved into panic and severe anxiety - can't sleep, can't think, can't function. Especially if the death was traumatic, unexpected or witnessed. Or absent - COVID in the ICU. 

0.5 of Ativan or Xanax - 10 pills - maybe they take 2-3 - the viewing, the burial or cremation. It works.

Keeps them from crawling the walls and spiraling down the toilet of despair, sleeplessness, etc. No numbness, just keeping the spiral from swirling out of control.

That's my take, anyway.

 

[iconic]

1 minute ago, Reality Check 2 said:

EMDR, It works. Ketamine is up and coming. Not sure on the whole magnet thing.

My grieving patients have devolved into panic and severe anxiety - can't sleep, can't think, can't function. Especially if the death was traumatic, unexpected or witnessed. Or absent - COVID in the ICU. 

0.5 of Ativan or Xanax - 10 pills - maybe they take 2-3 - the viewing, the burial or cremation. It works.

Keeps them from crawling the walls and spiraling down the toilet of despair, sleeplessness, etc. No numbness, just keeping the spiral from swirling out of control.

That's my take, anyway.

 

Well if they develop a panic disorder or MDD that’s a different story. EMDR is what everyone has heard about for PTSD, but there is other therapies for trauma. 

[LT_Oneal_PAC]

4 hours ago, EMEDPA said:

I have a friend who is a psych MD who told me if he had major depression he would elect for ECT over meds.

I’ve never seen the long term effects of it like your friend has, but man I didn’t care for the immediate effects. I’ve been in about 30 or so during anesthesia times. They always woke up looking like I shot their dog in front of them, begging me to help them, not knowing where they were, who they are. Maybe it’s worth that, but whoa boy did I have some emotions seeing people like that over and over again.

[iconic]

Fun fact: ECT was born out of the idea that patients could not have both schizophrenia and epilepsy. Of course, it is not an effective treatment for schizophrenia and there is no relationship between the two. It can also cause some permanent memory loss. Wouldn't be my first choice treatment for depression, although it can be done first-line for psychotic depression.