General Internal Medicine&nbsp;&nbsp;&nbsp;

How do you counsel patients on the risks vs benefits of naltrexone for alcohol use disorder with persistently elevated liver enzymes?

Is there an absolute cutoff for AST/ALT that you use where the risks outweigh the potential harm reduction benefits of using the medication? &nbs...

What therapeutic approaches have you found effective for athletes with anorexia nervosa whose eating disorder symptoms are intertwined with sport-driven weight pressures?

How do you balance the risks and benefits of stimulant treatment in patients with poorly controlled hypertension?

How do you weigh cardiovascular risks against the potential functional and emotional consequences of undertreated ADHD? What blood pressure thresholds...

How do stroke-risk considerations affect your use of atypical antipsychotics for patients with dementia?

Related Q&A on antipsychotics in Alzheimer's.In light of the publication from Choma et al., PMID 41063545.

What pharmacologic and non-pharmacologic strategies have you found helpful in managing brain fog following COVID-19 infection?

What do you recommend as a first-line antidepressant in patients with major depressive disorder and migraines?

How do you approach titration or transitioning to Cobenfy in patients currently on an antipsychotic?

Are there any special concerns for antipsychotics with a higher anticholinergic burden?

What medications are preferred and contraindicated for insomnia in patients with a recent stroke or traumatic brain injury?

How do you approach managing intolerable vivid dreams as a side effect of SSRIs?

When would you consider prescribing a wakefulness promoting agent for excessive daytime sleepiness from insufficient sleep?

I.e. no sleep disorder diagnosis, unsuccessful behavioral interventions for improved sleep

How do you counsel patients who are interested in using kratom for chronic pain management?

Do you have any concerns about administering a Vivitrol injection when a patient has severe coagulopathy and/or thrombocytopenia related to cirrhosis?

What is your medication of choice when considering outpatient alcohol withdrawal management (diazepam vs chlordiazepoxide vs lorazepam)?

For your recommended medication, are you doing a scheduled set dose, or is it primarily symptom-driven?

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...

How do you determine when ongoing outpatient treatment is no longer beneficial, and it may be appropriate to transition a patient to another provider?

How do you counsel patients on the risks and benefits of antidepressant use during pregnancy?

How do you approach shared decision-making when patients express hesitancy about medication exposure in utero? What is your approach when a patient is...

3 Answers available

When do you consider using disulfiram in patients with alcohol use disorder?

In what patient populations would you consider using disulfiram (Antabuse) instead of, or in addition to, acamprosate or naltrexone? In your experienc...

6 Answers available

How do you counsel patients with depression about the role exercise may play in alleviating depressive symptoms?

How do you educate patients about the role exercise may play in depression treatment? What type, frequency, and intensity of exercise do you recommend...

Is there a role for functional medicine approaches in psychiatric treatment?

How do you critically assess the evidence base for functional medicine approaches? How do you respond when patients specifically request functional me...

What are your preferred non-benzodiazepine therapies for the hyperactive/agitated phase of methamphetamine withdrawal, both in the hospital and in the office?

Assume QTc is not prolonged, electrolytes are reasonably normal, and the patient is not already on heavy psychotropic polypharmacy.

Do you consider using buspirone for the management of anxiety in older patients?

When do you use seizure prophylaxis in patients on clozapine?

7 Answers available

What approaches have you found most helpful for concurrent severe major depressive disorder and alcohol use disorder?

6 Answers available

How do you approach weaning patients off of buprenorphine?

8 Answers available

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

What types of cardiac conduction abnormalities would lead you to avoid using tricyclic antidepressants?

8 Answers available

When do you consider attributing isolated psychosis to an acute ischemic stroke?

3 Answers available

Is there a role for use of GLP-1/GIP receptor agonists in the management of substance use disorders, whether or not they meet other inclusion criteria for their use?

Do you prescribe linezolid to patients who are concomitantly on an SSRI?

8 Answers available

How do you approach patients who identify so strongly with being sick or with a particular diagnostic label that it makes up a significant portion of their identity?

How do you differentiate demoralization from depression during cancer treatment?

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

How do you differentiate between hyperactive delirium and excited catatonia?

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 ...

How do you manage tacrolimus-related psychosis?

When do you consider the use of clonidine in gabaergic withdrawal and how do you approach the risk of masking the autonomic signs of withdrawal when it is used?

Would you consider the risk of masking autonomic signs of alcohol withdrawal with clonidine different from beta-blockers?

How do you approach managing perioperative anxiety in Mohs patients?

How do you manage stroke-related abulia?

Do you avoid SSRIs in patients with a history of RCVS?

What work-up do you recommend in patients with early-onset dementia?

Which genetic/other testing should be considered in an early-onset dementia work-up?

How do you evaluate patients with suspected pseudo-dementia?

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?

How do you approach the workup and management of patients with suspected functional neurologic disorders?

What testing do you typically proceed with?