- Joined
- Jun 7, 2013
- Messages
- 123
- Reaction score
- 54
#1: I get a guy released from prison a few months back. Comes to me on Clozaril and Lithium. Either Clozaril is an absolute miracle for him.....or I'm really looking at an Antisocial guy (w/Conduct history), borderline intellectual functioning........who got thrown on Clozaril for being...Antisocial lol. His 3 admission write ups are weak - having worked with these attendings - vague "psychotic" symptoms noted on the H&P, followed by progress notes talking of no evidence of psychosis. Pt denies any history of psychosis, organized, not responding, no overt (and denies several) delusions, etc. On top of it - horrible patient to be placed on these meds in the correctional setting - intermittently compliant, at best, changing some things up, slowly, too
#2: Get a lady labeled as "Schizoaffective;" one admission,5 years ago, for 3 days. Diagnosed as Psychosis NOS, discharged on Effexor only. Her psychotic symptoms were "putting clothes in an oven" for one day, and knowing what she was doing was not correct. Somewhere along the way....Schizoaffective gets tossed on, as does Perphenazine. Borderline Traits (check - abandonment fears, acts out subsequently, her "lethality" history includes telling a nurse inpatient she was "hearing command AH" and placed on 1:1 for a couple of hours; She grabbed a knife once, and REALLY wanted to do it, but didn't. She hears "the voice of God"....like "Mrs. X - you should go to Church"
This is just 2 I've seen recently this month. This is really just me venting, I guess
And wow, Cluster B's are soooo much easier to deal with when not devaluing the hell out of me. It's the one of the few things that gets under my skin. Basic human courtesy people. Side note - any good tips on dealing/managing it?
#2: Get a lady labeled as "Schizoaffective;" one admission,5 years ago, for 3 days. Diagnosed as Psychosis NOS, discharged on Effexor only. Her psychotic symptoms were "putting clothes in an oven" for one day, and knowing what she was doing was not correct. Somewhere along the way....Schizoaffective gets tossed on, as does Perphenazine. Borderline Traits (check - abandonment fears, acts out subsequently, her "lethality" history includes telling a nurse inpatient she was "hearing command AH" and placed on 1:1 for a couple of hours; She grabbed a knife once, and REALLY wanted to do it, but didn't. She hears "the voice of God"....like "Mrs. X - you should go to Church"
This is just 2 I've seen recently this month. This is really just me venting, I guess
And wow, Cluster B's are soooo much easier to deal with when not devaluing the hell out of me. It's the one of the few things that gets under my skin. Basic human courtesy people. Side note - any good tips on dealing/managing it?
