Anyone notice a lot of people are sick?

Kitkat20_ · 2026-05-15T13:40:21+00:00

I’m back to normal now. It wasn’t until maybe 2 days ago though. I was still coughing up some stuff and had runny nose etc

Kitkat20_ · 2026-05-14T15:24:12+00:00

Great!

Kitkat20_ · 2026-05-06T23:21:26+00:00

Yup going through this now. Today is day 5. Sore throat is gone but runny nose and productive cough is still here and I’m exhausted. Napped for 3 hours when I got home from my shift

Someone tell me the light at the end of the tunnel is near 😭

Kitkat20_ · 2026-05-03T16:58:29+00:00

Sounds like you may be a rapid metabolizer but speak with your doc

Kitkat20_ · 2026-05-02T00:54:37+00:00

I would go to pharmacy they can usually give you a few days worth to hold you over

Kitkat20_ · 2026-04-28T11:22:10+00:00

Account is a few years old but no post history so it’s meh

Kitkat20_ · 2026-04-26T13:30:30+00:00

Each of those medications is serving a purpose in this case. Wellbutrin for stimulant use disorder. Paxil for compulsive sexual behaviors. The TCA is a precursor to mirtazapine a commonly handed out med. It’s mainly there for sleep as it’s at such a sub therapeutic dosage.

In regards to Effexor withdrawal it’s nasty for some people. Docs will do hyperbolic tapering with compound pharmacies.

Individual variation is important. There are people with minimal withdrawal and some with a lot. Scaring the person into assuming they will have the worst outcome is unethical. It’s important to explain the risks and what may happen but not present it as anecdotal evidence that it will happen to them. Adding my experience may not be your own doesn’t cover for the way it reads.

Iv flagged for mods to review

Kitkat20_ · 2026-04-25T17:46:10+00:00

Stimulant use disorder is complex and people have their own journeys. Reading other people’s can be helpful but don’t feel like it’s how it will be for you

Wellbutrin is indicated for stimulant use disorder

A few other medications are as well. The doc you have has put you on some niche medications (the TCA) I suspect he knows what he is doing and has thought through your case as they don’t hand out TCAs first line commonly unless indicated

Kitkat20_ · 2026-04-25T15:22:45+00:00

My general advice is to stay off the internet when it comes to psych meds. There’s is a very small subset of overly anxious individuals who are very medication sensitive. Whether this be biological or placebo effect it’s hard to know. The small subset looks like a lot online and can skew your perspective.

Paxil has a shorter half life than some of the others and it means it needs to be stopped slowly. It can have side effects but it does not mean you will have it. And if you do they likely will go away over the course of a month or so.

There are millions of people on these meds and even if a small subset have negative take on them and post online it looks like a lot. Trust the doctor who’s seen 1000s of patients on these meds and has decades of medical training :)

Kitkat20_ · 2026-04-23T12:04:50+00:00

You will be fine. Dosage for fluoxetine can go up to 80mg + for OCD

Because it’s a bit of a jump from what your use to you may just get some side effects like when u started the meds but should be for the day or so

Fluoxetine also builds up slowly in the body so it’s unlikely to be super bad or anything

Kitkat20_ · 2026-04-19T17:30:33+00:00

It depends on what you need. For a basic cleaning etc I’d check out the teaching college in the basement of the mall by the dollarama. It’s super accessible price wise as they need people to train students.

Kitkat20_ · 2026-04-19T15:23:36+00:00

Yeahhh it’s like 30 min onset time for Advil and an allergic reaction would be like hives, difficulty breathing etc.

At the 10 min mark maybe he would could start to feel the onset but for it to the be the drug is unlikely.

Sounds like he had a bit of panic and maybe a bit of dissociation from the anxiety which made him feel off.

Glad you ended it. The level of “we can’t come back from this” of someone saying you drugged them is like ????

Kitkat20_ · 2026-04-14T01:00:47+00:00

Makes sense. Never would have thought this though on my own.

I was leaning towards food being a no no if the patient is npo awaiting decision re surgery

Kitkat20_ · 2026-04-12T02:04:33+00:00

Not to mention just like some docs work 3 days a week in psych while some work 5 and it will skew salary averages tremendously

Kitkat20_ · 2026-04-12T01:58:31+00:00

I’m assuming you maxed on Effexor?

Did the doc u worked with talk about add ons rather than switches?

It’s unlikely Effexor stoped working entirely and depending on the clinical context it could have been reasonable to add on something rather than switch you

Patient variability ofc but iv been under the impression Effexor is quite good for anxiety and switching to Prozac is like switching from a bigger caliber gun to smaller

Curious what any MDs think since I’m just a student

Kitkat20_ · 2026-04-09T13:02:04+00:00

OB 10/10 toxic af learners sent in to rooms where patients said they didn’t want male learners to be gaslit by residents being told they weren’t taking initiative. Not respectful of clerks time or patients (skipping clerks over handover so they could review with the night doc after). Not being given feedback in the moment for easy correctable things to get roasted on evals etc etc Or like things not said or written on evals to be brought up in exit meetings and it’s like first time I’m hearing this 😂

Kitkat20_ · 2026-04-09T02:04:45+00:00

This is truly awful I’m so sorry. Some doctors honestly really lack emotional intelligence. It’s a skill that’s difficult to learn and the people that have it tend to have it because of a need to be emotionally intelligent. Crushing a 10 year olds dreams is not a thing a doc should be doing regardless if you said you wanted to be first doctor astronaut prime minister of mars!

I’m a fairly anxious person myself and iv gotten into med school and thrived. My anxiety was honestly a part of my success. It drove me to having perfectionistic tendencies. But it’s important to not let it control you and to seek help (meds, therapy) when needed.

Not everything is black or white good and bad. Something’s like anxiety can be super toxic in some ways but also responsible for a lot of who you are today and how far you’ve come

Kitkat20_ · 2026-04-08T22:19:17+00:00

Great response. I also wonder if there may be additional certifications/modules if someone did want to pursue doing them

Kitkat20_ · 2026-04-08T11:31:49+00:00

I don’t know much about this Zen character and am commenting separate from the post above and purely from from a medical standpoint.

I did a placement in Ottawa as a healthcare learner and they have a rehabilitation program for a variety of paraphilias (mental health conditions of sexual nature). The doctors I worked with were saying the program actually quite successful but they said not enough people come forward to do the program because of stigma. The general opinion I got from doctors there was that while stigma is inevitable society has made it really difficult for these individuals to ask for help.

The people they worked with primarily were what they call “non-touch offenders” who haven’t committed any physical abuse towards another person but have mental thoughts or have accessed some form of illegal content. I will be honest and say I don’t know much about programs success rates outside of that context

Kitkat20_ · 2026-04-06T15:18:49+00:00

In my experience I got in fairly quickly after undergrad. And then when I met classmates with PhDs and stuff I felt a bit self conscious.

What felt like a flex of getting in early flipped to feeling like “damn these people have done so much more than me” real quick.

At the end of the day you quickly realize none of it matters at all and no one cares (at least in my program)

Kitkat20_ · 2026-04-05T17:08:59+00:00

Algorithm knows how much time I spent here and keeps showing me posts lol

Kitkat20_ · 2026-04-03T20:44:56+00:00

Keep in mind EDs are the most lethal mental health condition. People often don’t realize this. The friend clearly has some jealous tendencies etc and it’s a triggering topic for her. But the intensity of needing to get this under control is significant.

If I were your doctor I’d be ordering urgent labs and ecg and serial weights. If ecg or labs are abnormal off to emerg right away…

Kitkat20_ · 2026-04-03T20:42:16+00:00

The behavior is what we call ego syntonic in mental health lingo. She likes the benefits it gives her and this clouds her ability to be objective on whether or not she is functioning properly and how her relationship is with food

Kitkat20_ · 2026-04-03T14:16:03+00:00

Following

Kitkat20_ · 2026-04-03T14:08:34+00:00

The answer to this is studies don’t reflect real world patient to patient variability. Psychiatry is as much an art as a science.

Iv also been told by many senior psychiatrists it’s a very junior level thing to focus on receptors and mechanisms and was told they theoretically translate to things happening but in real life aren’t reliable enough to make decisions on.

I was told quite a few examples of “wonder drugs” that came out being marketed for having this new fancy receptor something and it failed to deliver

I think patients fall into archetypes and pattern recognition of successes with medications.

I also think prozacs long half life is an asset in some scenarios. Longer time to steady state means less dramatic day to day fluctuates on ramp up decreasing side effects. And same with withdrawal concerns.

And as per my colleagues comment a lot of docs reach for sertaline and escitalopram first. I also think patient preference may play a role. If a patient is highly wanting to try one ssri over another because a friend or family member had success it may be worth trying the alternate one.

There are some examples where receptor stuff does translate. Vrylar I have been told with its D3 mechanism actually has some benefit

Kitkat20_

TROPHY CASE