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تعال اشرحلك الفرق بين Sympathetic و Parasympathetic بشكل مبسط و سريع: القصة باختصار: الجهاز العصبي هو المدير اللي يقسم الموظفين في جسمك إلى قسمين: - CNS (المخ والحبل الشوكي): هذا زي الرئيس العام اللي ياخذ كل القرارات الكبرى. - PNS (الجهاز العصبي المحيطي): اللي يقسم موظفيه إلى…
What would the STAR*D #depression trial look like if done today? A STAR*D for adolescents is underway. The med algorithm is here: ncbi.nlm.nih.gov/pmc/articles/P… Starts w/ fluoxetine (which has best evidence in youth) or CBT. Then augment with aripiprazole, olanzapine, or lithium.
100% of experts recommend #lithium for older patients with #bipolar disorder, recurrent/treatment-resistant #depression, and #suicide prevention in survey: ncbi.nlm.nih.gov/pmc/articles/P… Aim for levels 0.6-0.8 age <65; 0.4-0.7 age 65-79; 0.4-0.6 age >80. See full recs on p109.
Simple Structure with Complex Effects on the Brain
Here are some scenarios where using more than one med is supported by evidence. What would you add? From a recent talk by our gero-psych editor, Dr. Collier at Mass Psychiatric Society #psychiatry #depression #bipolar #schizophrenia
Increased Intracranial pressure treatment
Essential tremor as a prodromal feature of Parkinson's disease #ET #tremor #prodromal #PD #Parkinson @PRDAssociation @ELSNeurology Log in: prd-journal.com/article/S1353-…
Carbamazepine (CBZ) is underutilized, not because of tolerability but drug interactions. Our 2022 book Prescribing Psychotropics gives numeric adjustments for CBZ & other psych interactions: amzn.to/4009FduTIP Asenapine=2nd gen antipsychotic least likely to interact w/CBZ
Solriamfetol (Sunosi) is a new dopamine-norepinephrine reuptake inhibitor that - like modafinil - is approved for narcolepsy. And, like modafinil, it improved #ADHD (small, industry sponsored RCT of 60 adults; large effect, tolerable, schedule-IV control) pubmed.ncbi.nlm.nih.gov/37819836
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