Psychiatry

Have you modified prescribing practices in light of the UK safety update noting the risk of neurodevelopmental disorders in children whose fathers too...

3 Answers available

How do you approach treatment-resistant depression and anxiety related to menopause refractory to SSRI/SNRIs and hormone replacement therapy?

1 Answer available

How will the removal of the clozapine REMS requirement change your clinical practice?

1 Answer available

How do you monitor patients who are symptomatically well-managed on clozapine with supratherapeutic drug levels?

1 Answer available

How do you cross-taper when switching from an SSRI to an SNRI?

2 Answers available

Would you use bupropion for mood disorder or substance use in an adult patient with previous childhood seizures that resolved?

1 Answer available

How do you approach diagnosing ADHD in patients with significant trauma histories?

1 Answer available

How do you manage lamotrigine or lithium induced acne?

2 Answers available

What is your approach to GLP-1 agonists as a psychiatrist in patients who are overweight or have eating-related disorders?

Do you consider this medication for "food noise" associated with BED/bulimia?

1 Answer available

How do you approach deprescribing psychiatric medications in elderly patients with polypharmacy concerns?

1 Answer available

How do you counsel/approach antidepressant use in patients planning to utilize or self-administer psychedelics for chronic PTSD or depression?

With patients increasingly accessing psychedelics through online forums or home-grown sources for chronic PTSD and depression, how should psychiatrist...

1 Answer available

Would you consider over-the-counter dextromethorphan (low dose, slow titration) as augmentation in MDD?

Considering a growing interest in the use of dextromethorphan for depression (Majeed et al., PMID 33682569).

2 Answers available

Do you modify dosing or use of bupropion to mitigate seizure risk in patients without eating disorder who are restricting calories to lose weight?

Do you worry about additional increased risk of seizure for patients using medications to assist in weight loss such as GLP-1 agonists?

1 Answer available

Do you screen for MTHFR polymorphisms in your patients with treatment-resistant depression?

1 Answer available

How do you approach antidepressant choices for patients with generalized anxiety disorder when the patient reports excessive sedation on low doses of SSRIs?

4 Answers available

How do you treat decreased libido from SSRIs?

Any alternatives to drug holiday, bupropion, sildenafil, and yohimbine?

12 Answers available

How do you transition patients between different long-acting injectable antipsychotics?

3 Answers available

Is there a benefit to augmenting treatment for schizophrenia by adding aripiprazole (a partial D2 agonist) to a full D2 antagonist such as haloperidol?

1 Answer available

How do you approach a treatment relationship with a patient who is non-adherent to recommendations and also is not interested in transfer to another practitioner?

10 Answers available

What strategies have you found most effective for supporting weight loss in patients with bipolar disorder while minimizing the risk of mood destabilization?

5 Answers available

When do you use seizure prophylaxis in patients on clozapine?

7 Answers available

What are your perspectives on using GLP-1 agonists as a primary or adjunctive treatment in psychiatric care?

1 Answer available

Do you believe that buspirone is ineffective in patients who are previously treated with benzodiazepines?

8 Answers available

What is your preferred first-line agent to treat anxiety in patients with Parkinson's disease?

3 Answers available

How do you approach pharmacologic management of OCD in patients with comorbid bipolar disorder, particularly when considering SSRIs or clomipramine?

1 Answer available

What do you do when a patient experiences multiple rounds of antidepressant-related tachyphylaxis?

4 Answers available

What pharmacologic treatments have you found helpful in treating comorbid schizophrenia and OCD?

1 Answer available

How do you navigate C-2 refills in patients who are stable in their treatment and do not otherwise need to be clinically seen monthly?

Would you consider charging a small fee for managing C-2 prescriptions between appointments instead of requiring the patient to come monthly?

4 Answers available

Given some of the theoretical relationship between glutamate and OCD, do you ever consider the use of NMDA (or AMPA) antagonists for the treatment of refractory OCD?

2 Answers available

When do you decide to use liothyronine (T3) for augmentation in treatment for treatment-resistant depression and how do you implement it?

1 Answer available

How do you manage obsessive-compulsive disorder refractory to high-dose SSRI and cognitive behavioral therapy?

2 Answers available

How do you approach treatment-refractory schizophrenia which has not responded to multiple antipsychotic trials including clozapine?

11 Answers available

How do you approach patient requests for medical time away from work or other accommodations (such as disability paperwork) when the patients have mild-moderate symptoms being managed in the outpatient setting?

How do you evaluate for time off? Return to work? How do you deal with time off requests in the presence of non-adherence to treatment recommendations...

2 Answers available

How do you differentiate postpartum psychosis from postpartum obsessive compulsive disorder?

2 Answers available

When do you consider lamotrigine in bipolar depression?

6 Answers available

How do you approach anxiety management for patients who have been on long-term (years or more) daily benzodiazepines?

How do you approach this in patients who are approaching or are over 65 given the contraindications of benzodiazepine use in geriatric populations? Wh...

7 Answers available

How do you approach the use of SSRIs to treat bipolar depression?

How do you balance the benefits of treating depression versus the risk of transition to mania? Do you consider stopping the medication as soon as the ...

10 Answers available

Do you routinely prescribe an anticholinergic agent for EPS prophylaxis when starting or continuing antipsychotics or do you prefer to use it only as needed (prn) if/when symptoms develop?

5 Answers available

Do you avoid triptans in patients on SSRI's due to the potential risk of serotonin syndrome?

7 Answers available

How do you counsel patients regarding using stimulants for attention-deficit/hyperactivity disorder during pregnancy?

1 Answer available

How do you handle elevated blood calcium levels from lithium?

1 Answer available

What considerations do you take in starting stimulant medications for the management of adult ADHD?

Do you defer or avoid use in patients with untreated simple hypertension or other cardiac history?

4 Answers available

What medications do you find helpful to reduce drooling associated with antipsychotics?

4 Answers available

Would you be comfortable using isotretinoin in a female teenage patient who has a history of depression that is now stable but with a prior suicide attempt two years ago?

7 Answers available

What is your approach for managing persistent psychotic symptoms of a hallucinogen-induced persisting psychotic disorder?

For example, related to psilocybin or synthetic THC?

2 Answers available

How do you assess and adjust treatment in patients who develops hypothyroidism after being on lithium for several years?

1 Answer available

When do you attribute tremors to lamotrigine?

1 Answer available

How do you differentiate between hyperactive delirium and excited catatonia?

1 Answer available

Do you observe worsening irritability, mood symptoms, or increased rates of suicidal ideation in patients with Bipolar Disorder who are using hormone birth control (hormone releasing IUD included)?

How do you address exacerbation of mood symptoms in patients who want to continue hormone birth control?

2 Answers available

Are the laws regarding prescribing C-2 medications different for mail order pharmacies?

How is it that I'm able to prescribe medications to patients (in my state) via legitimate mail order pharmacies that are located in a different state?...

2 Answers available

What is the best approach to treatment for cenestopathies (sensation of electric current in patient's brain) accompanied by anxiety and inability to sleep?

4 Answers available

How do you treat patients with comorbid Bipolar Disorder and ADHD?

When using a stimulant, how aggressive are you with an anti-manic mood stabilizer?

4 Answers available

When do you use SNRIs or norepinephrine reuptake inhibitors (e.g., atomoxetine) for the treatment of ADHD?

5 Answers available

What parameters do you follow to avoid rebound effects when using clonidine only for nightly or daily as-needed indications?

1 Answer available

What do you use for treatment-refractory anxiety where trials of antidepressants have not worked either from ability to tolerate or inadequate effect?

1 Answer available

What medications best treat Intermittent Explosive Disorder?

What medications bests treat Intermittent Explosive Disorder?

9 Answers available

How reliable do you find it to make the diagnosis of bipolar disorder based on a patient report of prior symptoms or questionnaire and not the actual observation of hypo/mania on the exam?

What are some ways to predict patient report alone may lead to a "false positive" bipolar disorder diagnosis and other psychiatric syndromes are prese...

2 Answers available

When do you consider using multiple antipsychotic medications for chronic management of psychosis?

Does your approach change when using a long-acting injection antipsychotic with oral antipsychotic medication?

2 Answers available

How do you approach a patient who exhibits classic bipolar symptomatology (including cycling sleep changes, behavioral changes, and mood changes) but has never responded to any form of adequate trials of mood stabilizer treatment?

When would you consider symptoms to be potentially of other etiology? Would you ever consider a conversion or functional diagnosis?

1 Answer available

How do you manage emotional blunting due to SSRIs/SNRIs?

7 Answers available

How do you counsel patients with bipolar disorder who want to breastfeed?

3 Answers available

What medications are safe to use to treat major depression and/or anxiety in a patient with closed-angle glaucoma?

In light of research that suggests SSRIs increase the risk of closed-angle glaucoma, Chen et al., PMID 28257449.

1 Answer available

Are there any potentially successful pharmacologic interventions (instead of CBT or behavioral interventions alone) for Schizoid personality disorder?

4 Answers available

What or where is the best reference guide for managing patients with bipolar disorder who are on meds and want to become pregnant?

Can you include both patient directed and clinician directed resources?

1 Answer available

Do you warn patients about suicidal ideation when starting anti-seizure medications?

1 Answer available

What antidepressants are recommended for management of depression or anxiety in patients with spinal cord injuries?

Do you avoid certain antidepressants related to the risks on suppressing respiratory-drive which is potentially concerning in patients with high cord ...

1 Answer available

How do you treat a patient with shared delusional disorder aka folie à deux?

1 Answer available

How do you titrate lithium for patients with bipolar affective disorder during pregnancy and immediately after delivery in the context of fluid shifts and changing levels?

2 Answers available

What is the best way to manage low systolic blood pressures on clozapine when the patient has failed multiple other antipsychotic trials?

1 Answer available

How do you counsel patients when they ask whether the SSRI or SNRI antidepressant you have recommended will result in weight gain?

Have you found significant differences among SSRIs and SNRIs (e.g., paroxetine vs fluoxetine vs sertraline vs escitalopram vs duloxetine)? What data d...

3 Answers available

What is the best treatment option for a patient with bipolar disorder, who stopped her medication at the start of pregnancy and is now at the end of 2nd trimester?

4 Answers available

How do you treat postpartum obsessive-compulsive disorder?

1 Answer available

When and how do you taper antipsychotics after a resolved episode of bipolar mania with psychotic features?

3 Answers available

How do you approach tapering electroconvulsive therapy after an acute treatment course leading to successful resolution of symptoms for treatment-resistant depression?

1 Answer available

How do you approach neuromodulation in postpartum depression?

How have you accessed neurosteroids (allopregnanolone) for patients?

1 Answer available

Is there evidence to suggest there is a withdrawal syndrome from muscle relaxants such as tizanidine?

I have observed a trend where patients who are being tapered off of long-term benzodiazepine (especially in the geriatric population) prescriptions ar...

1 Answer available

What varying approaches do you take in suicide risk assessments?

Do you use different approaches in different settings (i.e., the ED vs. outpatient clinic)? Do you use different approaches for chronic vs acute suici...

3 Answers available

How do you approach managing perioperative anxiety in Mohs patients?

1 Answer available

Would you avoid the use of keppra in patients with TBI due to concerns for worsening agitation?

2 Answers available

How do you approach treating patients with delusions of parasitosis who can not tolerate an antipsychotic?

1 Answer available

How do you evaluate patients with suspected pseudo-dementia?

1 Answer available

How do you approach the management of patients on lamotrigine who develop a minor rash?

Should one restart lamotrigine or look for an alternative? If no other alternative available, is slow titration vs regular titration preferred?

4 Answers available

What is your approach to using apremilast for psoriatic arthritis in patients with history of depression?

1 Answer available

How do you approach NSAID use in patients on SSRIs?

Do you avoid due to the increased risk of GI adverse events?

1 Answer available

Do you taper memantine after completion of 24 weeks of therapy?

There does not appear to be any guidance from the most recent published protocols on this topic. For individuals with dementia, recommendations call f...

3 Answers available

What is the best way to manage severe claustrophobia and anxiety for Thermoplastic masks?

4 Answers available