Thanks for your interest! No, my book is on the management of side effects while the website covers all of psychopharmacology (including side effects). Also, the website is being continually updated. If you are not sure, may I request you to take a look at what your colleagues have said about our service? https://simpleandpractical.com/reviews.
Hi Dr. Kumar. Our stance is that we provide information and education for mental health clinicians. If our Members use some of that as part of patient education, that is fine, but the Member is the one who is responsible for the patient care and for making sure the information is appropriate for that particular patient.
I have a patient who is stabilized on lithium but is experiencing a tremor. Level – 0.8. Do you have any suggestions on treating? She is 45 year old. Dosage 450 mg po qhs [at bedtime] and 300 mg po qam [in the morning].
On any page on the website, if you go to the Menu, then Side Effects, then Tremors, you can see the articles we have about tremors. They cover how to evaluate and treat lithium-induced benign tremors if needed.
Hello. I just wanted to reach out as I am getting ready to start an Inpatient position and was looking for a resource. I went on Amazon but there are many choices and I was unsure which to choose. I was hoping you had a suggestion. I am nervous as this is my first inpatient position at a very stressful time. Any suggestion would be appreciated. Thanks, Carrie
Hi. The latest email regarding stimulants and antipsychotics is so interesting and helpful. I have a patient with ADHD and bipolar disorder. She does not take her stimulant daily and was being prescribed aripiprazole for symptoms of depression. She reports only using the stimulant when she needs to focus on bills or other tasks. She reported extrapyramidal symptoms involving mouth movement and attributed this to her aripiprazole and stopped that medication abruptly ( she reported this to me). She is now off of her aripiprazole and we are monitoring her for extrapyramidal symptoms but your email makes so much sense in this regard. Thank you so much.
Just a comment on the article on gabapentin—it also helps with neuropathic pain. So, the VA has issued a warning about the potential for gabapentin and pregabalin to lead to fatalities from respiratory depression when combined with other CNS depressants, and is starting to consider these agents as controlled drugs. I’m an addiction psychiatrist and I use it for alcohol use disorder, sleep, and a number of conditions characterized by anxiety, such as PTSD. I use it for patients on buprenorphine. I’ve found it useful in helping veterans with mild TBI who have anger and mood reactivity problems. And it’s helped pain patients with addiction problems by managing pain to where they can reduce the dose or get off of opioids and focus on regaining a normal life. So, I’m at a loss about what to do now that gabapentin and pregabalin are starting to be treated as “controlled substances”. This is a problem for mental health and primary care at the VA and I’m sure elsewhere. So, how do we approach use of gabapentin or pregabalin for patient benefit and monitor it’s safety? Any ideas? Thank you.
I AM LOOKING FOR THE LIST I HAVE SEEN IDENTIFYING SLEEP MEDICATIONS THAT SHOULD BE AVOIDED IN PATIENTS IN THE GERIATRIC AGE GROUP AND WHICH ARE BETTER TOLERATED
Just a positive comment about the article on the use of cyproheptadine: it is extremely clear,well written and very helpful. Thank you, very much. The details in that posting increase the likelihood that i will be prescribing it, since anorgasmia and erectile dysfunctions are such common side effects of serotonergic medications. Thank you.
Arthur N Papas, MD
California has adopted a new law as of January 1st of this year requiring “prescribers” to provide a naloxone prescription– and to educate caregivers on its use–for all patients on concomitant opioids and benzos. I DO NOT prescribe opioids but I do prescribe benzos to some patients on opiods and would like to comply with this law when I am not sure that the opioid prescriber knows the patient is on benzos too (and therefore may not have provided this prescription.) Do you have any training or reference materials for this?
Thank you!
please .. what is the most common psychiatric disorder in children, can you arrange the most common disrders in children from the most common to the less common..thank you
Hi Dr. Othman. The name of this website is Simple and Practical Mental Health because, unlike many other sources of information, we focus ONLY on teaching what is of practical use in diagnosing and treating our patients. The question of arranging disorders in children from the most common to the less common does not seem to be of any practical use to justify spending time on it.
I read in the Pearls about Suboxone that you need to be careful starting someone if they have been abstinent even for a couple of weeks because their tolerance can be reduced. Since you can’t wait for them to go into withdrawl to induce them, what is the best and safest way for determining the correct dose?
I’m interested in a subscription but have too many so I’d rather buy the latest book. Does the book have everything the website has?
Thanks for your interest! No, my book is on the management of side effects while the website covers all of psychopharmacology (including side effects). Also, the website is being continually updated. If you are not sure, may I request you to take a look at what your colleagues have said about our service? https://simpleandpractical.com/reviews.
Are we able to use any medical content for practice website for patient education?
Hi Dr. Kumar. Our stance is that we provide information and education for mental health clinicians. If our Members use some of that as part of patient education, that is fine, but the Member is the one who is responsible for the patient care and for making sure the information is appropriate for that particular patient.
I have a patient who is stabilized on lithium but is experiencing a tremor. Level – 0.8. Do you have any suggestions on treating? She is 45 year old. Dosage 450 mg po qhs [at bedtime] and 300 mg po qam [in the morning].
On any page on the website, if you go to the Menu, then Side Effects, then Tremors, you can see the articles we have about tremors. They cover how to evaluate and treat lithium-induced benign tremors if needed.
Hello. I just wanted to reach out as I am getting ready to start an Inpatient position and was looking for a resource. I went on Amazon but there are many choices and I was unsure which to choose. I was hoping you had a suggestion. I am nervous as this is my first inpatient position at a very stressful time. Any suggestion would be appreciated. Thanks, Carrie
Hi Carrie. Please see the following page for our recommendations: https://simpleandpractical.com/best-books-inpatient-psychiatry/
Best wishes for your work on the inpatient unit.
Raj
Hi. The latest email regarding stimulants and antipsychotics is so interesting and helpful. I have a patient with ADHD and bipolar disorder. She does not take her stimulant daily and was being prescribed aripiprazole for symptoms of depression. She reports only using the stimulant when she needs to focus on bills or other tasks. She reported extrapyramidal symptoms involving mouth movement and attributed this to her aripiprazole and stopped that medication abruptly ( she reported this to me). She is now off of her aripiprazole and we are monitoring her for extrapyramidal symptoms but your email makes so much sense in this regard. Thank you so much.
Just a comment on the article on gabapentin—it also helps with neuropathic pain. So, the VA has issued a warning about the potential for gabapentin and pregabalin to lead to fatalities from respiratory depression when combined with other CNS depressants, and is starting to consider these agents as controlled drugs. I’m an addiction psychiatrist and I use it for alcohol use disorder, sleep, and a number of conditions characterized by anxiety, such as PTSD. I use it for patients on buprenorphine. I’ve found it useful in helping veterans with mild TBI who have anger and mood reactivity problems. And it’s helped pain patients with addiction problems by managing pain to where they can reduce the dose or get off of opioids and focus on regaining a normal life. So, I’m at a loss about what to do now that gabapentin and pregabalin are starting to be treated as “controlled substances”. This is a problem for mental health and primary care at the VA and I’m sure elsewhere. So, how do we approach use of gabapentin or pregabalin for patient benefit and monitor it’s safety? Any ideas? Thank you.
I AM LOOKING FOR THE LIST I HAVE SEEN IDENTIFYING SLEEP MEDICATIONS THAT SHOULD BE AVOIDED IN PATIENTS IN THE GERIATRIC AGE GROUP AND WHICH ARE BETTER TOLERATED
Beer’s criteria is available as a link on the Duke website.
Has there been a topic on patients receiving prednisone and coordination of care vis a vis psychiatric conditions?
Just a positive comment about the article on the use of cyproheptadine: it is extremely clear,well written and very helpful. Thank you, very much. The details in that posting increase the likelihood that i will be prescribing it, since anorgasmia and erectile dysfunctions are such common side effects of serotonergic medications. Thank you.
Arthur N Papas, MD
Thanks, Dr. Papas, for your kind words! If you do use it, I would appreciate it if you could share with your experience. — Raj
California has adopted a new law as of January 1st of this year requiring “prescribers” to provide a naloxone prescription– and to educate caregivers on its use–for all patients on concomitant opioids and benzos. I DO NOT prescribe opioids but I do prescribe benzos to some patients on opiods and would like to comply with this law when I am not sure that the opioid prescriber knows the patient is on benzos too (and therefore may not have provided this prescription.) Do you have any training or reference materials for this?
Thank you!
please .. what is the most common psychiatric disorder in children, can you arrange the most common disrders in children from the most common to the less common..thank you
Hi Dr. Othman. The name of this website is Simple and Practical Mental Health because, unlike many other sources of information, we focus ONLY on teaching what is of practical use in diagnosing and treating our patients. The question of arranging disorders in children from the most common to the less common does not seem to be of any practical use to justify spending time on it.
Dr. Othman, your question made me curious if my reflex response was correct, and yes, anxiety, as well as depression are two of the three most common psychiatric disorders in children. ADHD is diagnosed in greater numbers, but it is important to consider that childhood anxiety of any sort as well as childhood depression can look like ADHD, though are often not evaluated for in the 3-10 year old set.
Untreated childhood anxiety and depression are two modifiable risk factors for the development of eating disorders.
Do treat childhood anxiety and mood disorders.
Do learn about proven eating disorder prevention tools! (like The Body Project: —
https://www.nationaleatingdisorders.org/get-involved/the-body-project)
https://www.nationaleatingdisorders.org/learn/general-information/prevention)
https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
https://www.cdc.gov/childrensmentalhealth/data.html
Thanks, Dr. O’Neil!
Can you comment on Steven Johnson Syndrome and the increased risk with history of herpes or viral infections?
Thanks. Your question has now been answered at these two links:
https://simpleandpractical.com/non-drug-causes-stevens-johnson-syndrome-sjs-toxic-epidermal-necrolysis-ten/
https://simpleandpractical.com/stevens-johnson-syndrome-sjs-toxic-epidermal-necrolysis-ten-past-infections/
I read in the Pearls about Suboxone that you need to be careful starting someone if they have been abstinent even for a couple of weeks because their tolerance can be reduced. Since you can’t wait for them to go into withdrawl to induce them, what is the best and safest way for determining the correct dose?
I see rapid cycling diagnoses so often because someone has mood swings per se. Can you comment about that in your emails?
What advise you have for tx of depressed patients with elevated intra-ocular pressure ?