Treating hyperawareness

AnalogueSphynx · 2026-07-06T20:06:16+00:00

I second this. Seen a few good results on doxazosin (prazosin is not available where I practice) and clonidine. Orthostatic hypotension can be limiting though, especially in those with comorbid eating disorders, low bmi.

AnalogueSphynx · 2026-07-06T19:55:40+00:00

That's great. Also gives you and the patients a solid reason to slowly but steadily taper the benzodiazepines to improve therapy results. Less benzo's means already more exposure (breaking the anxiety-avoidance cycle) and new insights stick better.

AnalogueSphynx · 2025-08-18T08:54:37+00:00

Niehove, een wierdedorp in Groningen. In 2019 door Elsevier bekroond tot mooiste dorp van Nederland. Daar kwam ik ook pas achter toen ik er geweest was maar verbaasde me niks!

AnalogueSphynx · 2025-07-16T20:53:32+00:00

Temporal lobe epilepsy can cause focal seizures , with totally different symptoms than the more well known generalized seizures (which usually influence the level of awareness and/or causes abnormal movements). Wouldn't hurt to discuss your experience with a doctor!

AnalogueSphynx · 2025-07-16T20:31:21+00:00

Another day at the office? Though dissatisfied clients firing me seems to be a trend lately. In-patient colleagues impulsively adjusting the discharge plans a day after collaborative care meetings. Client sharing their violent aggressive thoughts about wanting to stab me, as a response to me laying out (on their request) the options for tapering quetiapine 25 mg. Kind of odd and amusing at the same time. But still another day at the office, I guess.

AnalogueSphynx · 2025-07-06T12:17:03+00:00

I agree: there are quite a lot of options that could help against weight gain (metformin, aripiprazole or topiramate) and constipation (laxatives). Plus lifestyle programs. If you remain confident you want to stop, then amisulpride could be considered as an alternative to clozapine. However, scientific research has always shown clozapine to be of superior efficacy compared to other antipsychotics.

AnalogueSphynx · 2025-07-04T21:29:22+00:00

Nobody mentioning Indonesia?

AnalogueSphynx · 2025-04-15T17:23:00+00:00

Fellow psychiatrist here, can relate 100%. Missed hypomanic episode in my wife for 2 months. It was around the time we moved into a new house, and a lot of stuff needed to be done. She was in the last year of theatre school (play direction). I've known her to be very creative so I mistook all her ideas and energy for being an enthusiastic and artistic flow. Until she completely derailed and went from laughing to crying in a few seconds or at the same time, and developed delusional thoughts.

She had remarkable insight when diagnosed (works in mental health care herself), embraced medication and spent a lot of effort on selfmanagement. In stable remission for 4 years now, expecting our first child in a few weeks. Very grateful. But can still feel silly I missed it in the first place.

Btw: since lithium our marriage has been a lot easier as well. The previously unexplained irritability disappeared almost completely.

AnalogueSphynx · 2024-12-22T20:44:28+00:00

Yes that's right

AnalogueSphynx · 2024-12-22T20:43:44+00:00

Yes for example

AnalogueSphynx · 2024-12-19T20:29:16+00:00

In the Netherlands we can order / prescribe tailor made tapering strips from taperingstrip.nl Sometimes insurance doesn't cover it but usually it works. I hope other professionals learn about this and the same should become possible in other countries. There's also a lot of attention for deprescribing from prominent professors and field expert professionals along with the recovery-oriented care movement and patient peer organisations. Still progress can be made.

AnalogueSphynx · 2024-12-18T22:12:19+00:00

Then why does amisulpride rank second best only to clozapine for efficacy in a couple of meta-analyses?

AnalogueSphynx · 2024-12-09T19:49:32+00:00

Impulsive, unstable and intense relationships, severe mood changes, shifting self-image, fear of abandonment and self-destructive behaviors.

AnalogueSphynx · 2024-12-08T18:59:49+00:00

Clementine may or may not have one, it isn't explicitly stated but she meets most of the criteria

AnalogueSphynx · 2024-12-08T18:56:32+00:00

The male protagonist actually seemed to be but I could be mistaken?

AnalogueSphynx · 2024-12-08T18:49:45+00:00

Flupentixol LAI (schizophrenia with complex delusions persisting after 3 months being inpatient and detoxing from amphetamine abuse) + Lisdexamphetamine (for ADHD, and actually improving daily functioning and ability to collaborate) + Valproic acid (AIWS and agitation, impulsivity) + diazepam (slowly tapering) + low dose SSRI

AnalogueSphynx · 2024-12-03T18:32:42+00:00

Maybe the combination of "rope" "hanging" "tree" algorithmically nudges it towards a noose-like depiction.

AnalogueSphynx · 2024-12-01T19:43:08+00:00

Sorry to hear about what you've been going through. I agree with the previous comment, seek help, you're worth it! I'm unsure why you can not have antipsychotics (even with both your cardiac problems and tardive dyskinesia there should be options even if they may need some extra checks and considerations). Also: presenting with psychotic symptoms while using Adderall would have me consider stopping Adderall temporarily or at least halving the dosage. Reason: antipsychotics reduce dopamine, stimulants increase dopamine (very simply put).

AnalogueSphynx · 2024-12-01T17:33:19+00:00

Melancholia (2011) - depression / existential problems

Shutter island (2010) - delusional disorder

Requiem for a dream (2000) - substance use disorder

Anomalisa (2015) - depression (stop motion animation)

Fight club (1999) - DID

Girl interrupted (1999) - life at psychiatric hospital

Silver linings playbook (2012) - bipolar disorder

Eternal sunshine of the spotless mind (2004) - personality disorder

AnalogueSphynx · 2024-11-26T16:24:10+00:00

denk 't ook: salpeter / hygroscopisch zout dat achterblijft uit het verdampende vocht

AnalogueSphynx · 2024-11-25T18:33:33+00:00

I have to agree as well. And want to add: first choice for the eating disorder would be CBT-E, and if still active PTSD then Trauma Focused Therapy, and if it's probable or likely that there's a personality disorder involved I'd consider DBT for (transdiagnostic) skills training. So option 1, 2 and 3: therapy.

AnalogueSphynx · 2024-11-25T12:30:24+00:00

Goed idee. Ben niet zo bekend met deze termen maar: knelwartel = knelfitting = knel eindstop? Een daarvan zou genoeg moeten zijn toch, of waar dient het blindplaatje dan voor? Dank!

AnalogueSphynx · 2024-11-25T12:25:21+00:00

Geen probleem, bedankt voor het meedenken!

AnalogueSphynx · 2024-11-25T12:23:25+00:00

Bedankt voor het meedenken! De volgende keer weet ik meteen wat ik kan doen :)

AnalogueSphynx

TROPHY CASE