General Psychiatry&nbsp;&nbsp;&nbsp;

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

11 Answers available

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

What is your approach in counseling a patient with delusions of parasitosis?

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

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

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.

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

What are the most effective strategies for managing weight gain associated with antipsychotic medications?

9 Answers 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).

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

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?

When do you use seizure prophylaxis in patients on clozapine?

6 Answers available

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

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

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...

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

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

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

6 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?

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?...

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?

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?

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

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...

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

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?

How do you treat postpartum obsessive-compulsive disorder?

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?

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

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

When do you consider lamotrigine in bipolar depression?

6 Answers available

How do you approach neuromodulation in postpartum depression?

How have you accessed neurosteroids (allopregnanolone) for patients?

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?

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

7 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...

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?

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...

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 differentiate postpartum psychosis from postpartum obsessive compulsive disorder?

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

How do you approach managing perioperative anxiety in Mohs patients?

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

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

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?

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

How do you approach NSAID use in patients on SSRIs?

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

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...

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