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I have a patient that is on lamotrigine (Lamictal) 150 mg twice daily. She is reporting episodes of memory loss. In Epocrates it does list amnesia as a side effect but I have never encountered this before. What is your experience with this?
Sara Lewis, APRN
Dr. Mago: MORE PLEASE about medications and TMS! I need to learn that whole literature quickly. Thank you, sir.
Susan O’Connor MD
Nashville, TN
What are the adverse effects of long term stimulant use ?
What is best approach for individual whose dx include Oppositional Defiant Disorder, Schizophrenia, skin picking and Seizure disorder who refuses to take medications. Receives Naltrexone, DepoProvera,Gabatril, risperdal consta,Cogentin, Luvox and Ativan crisis meds( pacing and wears same clothing color repeatedly, complaints of skin crawling sensations) How should the medication refusal be approached? Any suggestions?
p.s. If there was a different place to post , I did not find it
Hello Dr. Mago. Thank you for your invaluable website and daily emails.
Do you find stimulant levels clinically useful? Can they help determine the need for a higher daily dose of stimulants?
If so, are there any guidelines to follow when ordering these levels? Is there a specific time related to ingestion of the medication that is best to check the level, and is this affected by the type of stimulant formulation?
I am a newer prescriber and rarely prescribe benzodiazepines. I work with several psychiatrists that have 30 and 40 years of experience. They are amazing physicians and prescribe benzodiazepines frequently. It has been said that “the pendulum has swung” from over use of benzodiazepines to under use of benzodiazepines. I would be interested to know what the current research shows regarding the risks and benefits of benzodiazepines, reducing benzodiazepine prescribing, and especially patient outcomes.
I agree with your colleagues that the pendulum has swung too far in the other direction (against even the appropriate use of benzodiazepines). Many, many leading psychopharmacology experts have expressed this concern as well. For their viewpoints on this, please see https://simpleandpractical.com/controversy-benzodiazepines-overuse-underuse. More to follow on specific myths and valid concerns about benzodiazepines.
What is the difference between rapid cycling in bipolar disorder versus cyclothymia?
i think there is a discrepancy between the theoretical and the clinical significance of serotonin syndrome. augmentation of SSRIs with buspirone is a common stratergy, ( was part of the STAR-D trial). i wouldnt let that theoretical risk deter the augmentation unless there’s a h/o sensitivity.
Recently I watched the 3 part series on OCD with the discussion of high dosages for SSRI’s used in treatment of OCD. Duloxetine was not mentioned. How high may it be dosed for OCD treatment?
Question:
I have a patient who I prescribed clonidine for a porn addiction (I have used in the past with good results). His girlfriend who is a nurse said not to take it b/c it could lower his resistance if exposed to the coronaivrus.
Please comment.
Does adding buspirone to an SSRI significantly increase the risk for serotonin syndrome?
Does it?? I thought it didn’t.. no idea how I assumed that. Great question.