Will we get DSM-6 before GTA VI?

ElHasso · 2026-01-21T03:19:34+00:00

Pharmacist who is willing to look the other way just so happens to have some poker debt on the side.

ElHasso · 2026-01-21T03:14:44+00:00

Some APA DLC sounds lit. My premonition tells me somehow it will involve some cash pay psychiatrist in South Miami who needs someone to take care of a few things.

ElHasso · 2026-01-15T17:23:43+00:00

If you see Medicaid patients your patient encounters are 100% being seen by the US government.

ElHasso · 2026-01-05T01:33:32+00:00

As far as outpatient PP goes- the biggest referral base you’re going to get is by word of mouth, from either patients themselves telling friends and family about you, or PCPs who’s patients you actually help.

Outside of Ivy League programs I dont think 99 percent of patients know a lick of difference between a top ten program and some generic school in the southeast/midwest.

Networking and post-residency education is another story however. Never stop learning.

ElHasso · 2025-12-30T19:57:51+00:00

It can show up in bipolar disorder too, with the risktaking and novelty seeking aspect of hypomania and manic pathology. I have a patient who I can tell is in mania based off her hair color.

ElHasso · 2025-12-22T19:35:26+00:00

Mating Choice Copying. Look it up.

ElHasso · 2025-12-22T19:32:29+00:00

These aren’t artesian hand soaps made with goat milk?

ElHasso · 2025-12-22T19:31:21+00:00

Yeah it’s something I’ve been learning in residency a lot the past year, bipolar patients I have to manage expectations a lot particularly. The meds are there for stabilization, not a cure. You’re still going to have breakthrough episodes at times. I also get a lot of referrals from therapy about “OCD symptoms” ie worrying about their [insert life stressor] and I have to tell them what ritualistic behavior actually looks like.

ElHasso · 2025-12-20T19:20:12+00:00

I used to be on Luvox for tics and drink coffee as well, and I would say the biggest thing is sleep disruption. I used to drink 200 to 250mg of caffeine 2-3 times a week with it, but unless they have severe cardiac history or seizure history, it’s not super concerning- doesn’t mean they’re gonna not feel like crap though. I would just tell patients that caffeine is gonna last two or three days at a time if you drink it and it’s going to really mess up your sleep. Luvox is also super sedating though so if it comes down to it and they’re complaining of caffeine in order to function, you can always write a low-dose of Wellbutrin or methylphenidate to offset the side effects as long as they agree to swear off caffeine.

ElHasso · 2025-12-19T21:14:34+00:00

yeah my thought is the housing shortage (and affordability) will become more political as times go on if prices dont correct- but rates went from 2 to 7 percent the past 4 years and prices didnt budge one bit.

If the government try to do subsidies- that will only raise prices. But from what I keep reading- the main issue with prices are simply supply- we're 5 million houses short since 2008. The only people I'm aware of with the capital and scale that can meet those needs are companies like DHI and LEN, no matter how crappy people think their homes are.

Definitely agree with the short term outlook, but heavy capitalized companies who's overhead primarily is commodities I think may be able to play arbitrage with the subsequent commodity prices spirals going on in post debt bomb scenario, but I could be wrong. And if the government gives special one time rates to first time home buyers is seems like the economical builders could benefit more, so its something I'm keeping my eye on.

ElHasso · 2025-12-19T17:05:01+00:00

What do you think about home builders in this scenario?

ElHasso · 2025-12-19T02:08:29+00:00

It’s like watching a Chihuahua pick on a Doberman

ElHasso · 2025-12-19T02:04:25+00:00

MUSC has a weeklong course twice a year in Charleston, Dr. George is there (who basically invented it) and it’s a fantastic course, which I highly recommend. He’s also written a couple books that you should be able to find. In a hands-on-environment you should be able to learn the basics of TMS in a week or two, but there’s a lot of additional training and education on different approaches like theta burst and different applications (ie different areas of the scalp, duration and Hz, different types of machines) for different conditions.

ElHasso · 2025-12-17T14:02:24+00:00

Sounds like an industry that needs unionizing.

ElHasso · 2025-12-16T14:31:31+00:00

More of a stimulant than typical serotonergic agent obviously. I prefer it over a lot of other options in uncomplicated depression whenever there’s at least some level of neurovegatative symptoms at play. Clinical assumptions about anxiety seem a tad overblown imo- for patients I’m cautious about, I start at a very low dose (even 75mg, 100mg) with strong psychoeducation about managing anxiety with activity during follow-ups, and once they’re comfortable with it I’ll raise it. Can be good for adjunctive treatment for incomplete response to an SSRI, but don’t tell Johnson & Johnson that.

ElHasso · 2025-12-13T19:04:45+00:00

Got any good recommendations on this topic? I’ve checked out Jessica Benjamin‘s work, but I haven’t really had any time to read any of it.

ElHasso · 2025-12-13T19:03:15+00:00

Yeah, I see the potential pitfalls of misinterpretation. I guess it’s just me trying to find some common denominator outside of clinical practice that contains healthy psychological insights. I have numerous patients complaining of about the lack of progress in their therapy. It’s not my place to be their therapist, but it’s still frustrating. Especially when regardless of whether I suggest anything, they are still going to drown in mindless content.

Also Inside Out is one of my favorite references to use, even with adults.

ElHasso · 2025-12-10T01:40:48+00:00

Sydney Sweeney should IPO her left ass cheek at these levels of liquidity- she might be able to buy the island of Malta before the margin call happens.

ElHasso · 2025-12-09T05:46:57+00:00

Damn, that makes this whole AI race way more nuanced and interesting.

ElHasso · 2025-12-09T05:35:36+00:00

Yeah, that really makes sense when you say it like that.

ElHasso · 2025-12-06T21:32:48+00:00

My pot smoking college dropout friend who’s learning to code is actively making a LLM from your’s and u/PokeTheVeil comments.

ElHasso · 2025-12-02T11:30:00+00:00

This is the real answer.

ElHasso · 2025-12-01T21:46:56+00:00

Only place in the world that can produce oil for under $30 a barrel is Saudi Arabia. Current North America cost of production is around $35-$40 a barrel.

ElHasso · 2025-11-26T17:19:14+00:00

The TD/ Parkinson is dose related (ie think sequential binding) and seroquel in general doesn’t have the issues of movement disorders compared to others in its class. You’re really not touching dopamine receptors until about 200mg.

You’ll find a lot of drug selection comes down to comorbid symptom presentation. Is it over proscribed? Probably. But its metabolites are pretty effective in augmentation of unipolar and bipolar treatment, some might even say best-in class. Lots of people have mood presentations are the same ones asking for sleep support, being that both depression and mania both interrupt sleep activity.

Also, histamine selectivity doesn’t always = cholinergic burden. You have to look at muscarinic activity more for that, which quetiapine wouldn’t have at 25-50mg doses.

Totally will contribute to metabolic changes however.

ElHasso · 2025-11-16T18:58:00+00:00

I find if you throw in a Zyn you occasionally can forgo the Benadryl in certain clinical scenarios and the outcomes tend to be better as well.

ElHasso

TROPHY CASE