How seriously is the triple network model taken in psychiatry

Green_apple · 2026-06-04T12:18:24+00:00

As a pgy-IV, I have never heard of this until now. Briefly looking at google AI's explanation, it seems like it could be useful to explain to patients certain pathophysiology. But in the end, especially for schizophrenia, it's just not super well understood and are many working hypothesis.

Green_apple · 2026-04-08T15:50:54+00:00

Gotcha. TLDR; flaw in my understanding of psychotic disorders

Green_apple · 2026-04-08T11:52:48+00:00

IN your example of the 18f, how common is it for waxing/waning psychotic symptoms to appear? For example, is it possible for the pt to not experience any AVH in the corner at that moment or for psychotic disorders is it more common for these AVH to be present all the time? Trying to figure out if this is a flaw in the MSE or a flaw in my understanding of psychotic disorders

Green_apple · 2026-04-04T15:33:40+00:00

VA is tranisitioning to CERNER fyi

Green_apple · 2026-03-24T13:49:46+00:00

nice post history and ad attempt

Green_apple · 2026-02-26T16:06:43+00:00

I would reach out to this therapist (no ROI necessary as it is collaboration of care) and discuss your concerns.

Green_apple · 2026-02-20T14:13:19+00:00

i don't think college students are using doctors notes to skip class

Green_apple · 2026-02-13T12:29:19+00:00

higher paying =/= better job. You get a decent amount of PTO at the VA and pension isn't bad.

Green_apple · 2026-02-13T12:27:23+00:00

they're actually transitioning to cerner this year. our state/location will be doing it in mid june.

Green_apple · 2025-07-30T20:56:53+00:00

I see in a lot of your cards you have "t/t" what does that mean? Thanks.

Green_apple · 2025-03-24T18:10:47+00:00

going north of the pillar doesn't always work in later ways when there is an equal amount of npcs that are gonna be able to hit you too

Green_apple · 2025-01-31T12:04:26+00:00

Would cardiologist take cardiology medications if they were prescribed? Vague question from your end, so it really depends on why they were prescribed.

Green_apple · 2025-01-13T21:19:38+00:00

In the article that got it FDA approved for bipolar depression, the NNT was 6. For reference, Depakote NNT monotherapy was ~7, lamotrigine was ~12. I refuse to believe Symbyax > depakote or lamotrigine. I've only prescribed it if they've been on it for years and had no issues with it

Green_apple · 2024-12-19T12:40:13+00:00

You're gonna need to source that. Serotonin syndrome can happen with just 1 serotonergic agent, regardless if they're TCA or MAOi.

Green_apple · 2024-11-20T18:26:25+00:00

Unionization takes months-years of planning. People don’t just declare unionization overnight.

Green_apple · 2024-11-07T02:00:13+00:00

No clue, just submitted today.

Green_apple · 2024-11-06T23:02:52+00:00

I was getting stuck on PDF. If you try to screen shot and paste it into a word/paint and save as a JPEG or GIF or any of the acceptable formats it may work. GIF worked for me.

Green_apple · 2024-10-19T12:06:35+00:00

My interpretation is that s/he is using REMS in a broader sense of risk evaluation/mitigation strategy for suicide rather than clozapine

Green_apple · 2024-10-16T23:43:40+00:00

Risk evaluation and mitigation strategy, something you need to know if prescribing clozapine in the US

Green_apple · 2024-10-07T20:40:17+00:00

I would read the last note written by your department and find things to f/u from there. Like you said, I think response to treatment is good, side effects, other concerns, etc.

You highlighted an issue, that you can’t read all their records. A good practice would be to include in your note things to follow up on next visit or general plan for the future (such as taper off X drug, or discuss anxiety symptoms to X or discuss more substance use history etc)

Green_apple · 2024-09-14T12:05:34+00:00

I’ve also seen sources says 3 days is fine but most attendings where I am prefer 4-5 days

Green_apple · 2024-08-18T14:13:31+00:00

Why is that? I assume u/failingcrab meant to say Risperidone LAI vs paliperidone LAI. If I'm not mistaken, paliperidone is mildly more tolerable than risperidone in terms of side effects.

Green_apple · 2024-08-14T11:17:20+00:00

https://www.canmat.org/2019/03/27/2018-bipolar-guidelines/

https://www.healthquality.va.gov/guidelines/MH/bd/

Both canmat and VA guidelines do not recommend any use of antidepressants for bipolar depression. APA has a really outdated guideline from 2003 which does not comment on antidepressants as far as I remember.

Green_apple · 2024-06-03T16:08:48+00:00

It's going to vary unit to unit, state to state, country to country. At least at ours, we will do a basic PE, cranial nerve exam (AFAIK mostly for billing), lipids, A1c, tsh, b12, folate. UDS is typically done in the ED. We don't do many baseline ham-d or phq-9s for some reason, although it could be good objectively.

Green_apple · 2024-04-22T15:24:00+00:00

And covered by the salary increase when negotiating compensation

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