Neuroscience Educational Institute

[Merrit]

Does anyone know about this online educational insititute? Their membership costs about $200. There are some educational resources on their website, such as Master Psychopharmacology Program. Dr. Stahl is the host of the program. Do you think it is worth doing it to improve the basic psychiatric knowledge and practice quality?

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[nitemagi]

NEI is Stahl's company. Our residency gets the Masters program for free, which is nice. If I had to pay I might do it after residency to keep up on things, but it's a lot of time to go through it.

 

[Merrit]

Hi Nitemagi,

Does it help with Board certification? I have to pass some other similar psychiatric exams next year, but I dont know whether his program helps. What do you think?

 

[nitemagi]

Hi Nitemagi,

Does it help with Board certification? I have to pass some other similar psychiatric exams next year, but I dont know whether his program helps. What do you think?

I would definitively say no. Though I haven't even finished the course, to be honest (it's meant to be done over a course of months). It's geared for higher order understanding of psychopharm, basically the advanced aspects of meds 2 steps past the FDA indications (1 step might be that quetiapine's active metabolite is a Norepi Reup inhib). It's past what the boards tests, from my understanding.

 

[Merrit]

Thank you for your opinion.

Do you know any good question banks or study materials available for passing part 1 psych board exam?

 

[billypilgrim37]

(1 step might be that quetiapine's active metabolite is a Norepi Reup inhib)

Not to derail the thread, but I've read that AZ basically had to propose that mechanism in order to get Seroquel XR approved for a depression adjunct (they have to at least propose a viable), but that the actual binding coefficients and concentration of the NERI component are so small that it wouldn't really make any sense whatsoever to say this was "why" Seroquel XR had "antidepressant" action. I'm always torn between Stahl being brilliant and Stahl cashing checks from the drug companies, as both things seem to be frequently important to everything he does.

 

[nitemagi]

Not to derail the thread, but I've read that AZ basically had to propose that mechanism in order to get Seroquel XR approved for a depression adjunct (they have to at least propose a viable), but that the actual binding coefficients and concentration of the NERI component are so small that it wouldn't really make any sense whatsoever to say this was "why" Seroquel XR had "antidepressant" action. I'm always torn between Stahl being brilliant and Stahl cashing checks from the drug companies, as both things seem to be frequently important to everything he does.

I agree. You can't ignore the potential bias.

Doing a quick search came up with this:
http://thelastpsychiatrist.com/2010/02/how_seroquel_xr_works_part_1.html
which touches on the Ki of norquetiapine for the NE reuptake receptor.

Interestingly when I search on my favorite database of receptor affinity (which includes data on every chemical ever studied)
http://pdsp.med.unc.edu/pdsp.php
I find nothing on norquetiapine aka DesAlkyl-quetiapine.

I don't like the XR anyway.

 

[nitemagi]

Thank you for your opinion.

Do you know any good question banks or study materials available for passing part 1 psych board exam?

I hear old PRITE's are mixed, and the focus book is good. Haven't heard any reviews on courses though I get mailings on at least a weekly basis.

 

[Merrit]

Many physicians use 25 mg Seroquel XR as sleeping pill, 150 mg or 300 mg as an adjuctive agent for depression, and higher doses for psychosis. How it works does not really matter as long as it works. I found it's pain in the ass when Seroquel XR is no longer Medicaid preferred drug. I had to switch Medicaid patients from XR to plain generic. Some of my patients do not respond to generic for some reason. Isn't it strange?

On NSI website, it says, their master psychopharmacology program helps with passing board exam. But I am wondering it is really practice oriented or mainly basic science oriented?

Thank you.

 

[Merrit]

The old PRITE's cost $150 each. It is very expensive. I thought there were free downloads somewhere. But I couldn't find them via google.

 

[billypilgrim37]

Many physicians use 25 mg Seroquel XR as sleeping pill, 150 mg or 300 mg as an adjuctive agent for depression, and higher doses for psychosis. How it works does not really matter as long as it works.

It "works" by knocking patient's out. Almost any sedating agent is going to improve a HAM-D or a BDI or whatever scale you're using. Many other sedating agents aren't going to give you metabolic syndrome or cost 300-700/month (there is no generic Seroquel--only Seroquel that pads AZ stock and gets the cute drug rep to wink more often).

Seroquel is a perfectly good drug for a lot of patients. Seroquel XR is a good drug for a tiny subset of those patients. As an antidepressant adjunct, it should be pretty low on the list given the many downsides of its use.

 

[Merrit]

I always think all antidepressants work by sedating pts out more or less. some may knock them out at high doses.

Effexor (venlafaxine), prozac are the ones can have some activating feature.

The only FDA approved adjuctve antidepressants are abilify and seroquel. abilify can be activiting in some pts, seroquel almost always sedating.

The sleeping pills: trazodone, benerdryl, vistarial, are all sedating. low dose seroquel thus is reasonable candidate for insomnia. lunesta probably the only one that will cause drosiness next morning.

Anyway, where can i find cheap Focus Psychiatry Review, Beat the Boards, Kauffman's notes? and other good question bank and review DVD or books?

 

[billypilgrim37]

The only FDA approved adjuctve antidepressants are abilify and seroquel.

So this thread can return, and since the exact same discussion is happening on a different thread, I'll just point you over to whopper's response, with which I agree.

 

[whopper]

How it works does not really matter as long as it works.

I wouldn't say that.

As writen above, Seroquel can cause metabolic problems, in large part due to it's antihistamine mechanism.

Also it requires labwork if you care to follow ADA and APA guidelines.

There are several generics that do just as well that are cheaper, do not cause weight gain, and do not require labwork.

The best intervention for poor sleep is sleep hygiene. Meds of course are sometimes needed, but there are better meds than others.

 

[Merrit]

I have seen trazodone, remeron, hydroxyzine, even benerdryl etc (including many antidipressants) also cause significant wt gain. Therefore, we really need to check CMP w/ LFTs, lipid profile, TSH, even CBC at least every 6 months.

My question is what is the newest version for Fucus Psychiatry? 2007? because I plan to buy from Amazon soon. Your help is highly appreciated.

 

[michaelrack]

The best intervention for poor sleep is sleep hygiene.

The best intervention is addressing the underlying etiologies and contributing factors of the sleep problem. Usually addressing sleep hygiene is a component of this