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i would like to know what is the rationale behind prescribing methylphenidate as well as TID prn benzodiazepine in a patient aged more than 60 yrs?
Start a therapeutic benzo taper, and offer to go really slow, and they may just discover they need a smarter doctor.its frustrating when one inherits such cases in clinic.
Either the mice are real because he is too twacked out to keep his house clean or he should lay off the meth pipe for awhile. You could always do what I have seen some providers do: diagnose it as schizoaffective and add in quetiapine. I have heard on the street that it really helps take the edge off the harsh comedown from methamphetamine and if you can fight off the sleep then the high is pretty decent, too.Just saw a patient on consult ritalin , diazepam, oxycodone and tramadol , who is using double the diazepam and taking one extra ritalin along with marijuana with dysphoria, restlessness who is seeing mice infestation in the house.
i would like to know what is the rationale behind prescribing methylphenidate as well as TID prn benzodiazepine in a patient aged more than 60 yrs?
Its the dice rolling prescribing algortihm based on the Dungeons and Dragons 20 sided die..
Roll to determine # of starting meds.
1-7= 1 med
8-13= 2 meds
14-17=3 meds
18-19=4 meds
and...
Critical Hit: 5 meds!
1-Prozac
2-Citalopram
3-Lexapro
4-Sertraline
5-Paxil
6-Lithium
7-Depakote
8-Carbamazepine
9-Trileptal
10-Lamictal
11-Risperdal
12-Zyprea
13-Geodon
14-Abilify
15-Methylphenidate
16-Concerta
17-Vyvanse
18-Valium
19-Ativan
and...
Critical Hit 20-Clozapine.
Simply see a patient, play video games while your computer screen's back is to the patient and roll a 20 sided die to determine the medication.
And I'll bet you this dice rolling method would probably end up with better results than some psychiatrists.
And what about diagnosis?
No need for dice there.
EVERYONE HAS BIPOLAR DISORDER. EVERYONE. If the patient disagrees with you...simply tell them that if you have ups and downs they have it.
If you're feeling like an artist, throw something that depends on your fancy on the moment. Schizophrenia, depression, panic disorder, etc.
Simply tailor the dx to fit the med.
For those new here that don't know me, yes I'm joking but I swear the above will get better results than some doctors I've seen.
Its the dice rolling prescribing algortihm based on the Dungeons and Dragons 20 sided die..
Roll to determine # of starting meds.
1-7= 1 med
8-13= 2 meds
14-17=3 meds
18-19=4 meds
and...
Critical Hit: 5 meds!
1-Prozac
2-Citalopram
3-Lexapro
4-Sertraline
5-Paxil
6-Lithium
7-Depakote
8-Carbamazepine
9-Trileptal
10-Lamictal
11-Risperdal
12-Zyprea
13-Geodon
14-Abilify
15-Methylphenidate
16-Concerta
17-Vyvanse
18-Valium
19-Ativan
and...
Critical Hit 20-Clozapine.
Simply see a patient, play video games while your computer screen's back is to the patient and roll a 20 sided die to determine the medication.
And I'll bet you this dice rolling method would probably end up with better results than some psychiatrists.
And what about diagnosis?
No need for dice there.
EVERYONE HAS BIPOLAR DISORDER. EVERYONE. If the patient disagrees with you...simply tell them that if you have ups and downs they have it.
If you're feeling like an artist, throw something that depends on your fancy on the moment. Schizophrenia, depression, panic disorder, etc.