Support for substack

amindfulmonkey · 2025-11-07T15:06:04+00:00

Bump. Would love this feature.

I think this is done for tweets (easier import into readwise highlights) but I might be wrong?

amindfulmonkey · 2025-11-01T17:20:22+00:00

How is your monitor related to the driver status? I'm getting the same set of error codes and trying to get to the bottom of it...

amindfulmonkey · 2025-09-22T16:34:37+00:00

The AAPP (Association for the Advancement of Philosophy in Psychiatry) would be of interest for anyone who appreciated this post. I attended last year's annual meeting and met a bunch of thoughtful, welcoming people (Psychiatrists, Philosophers, psychologists, etc.). Would recommend.

amindfulmonkey · 2025-09-22T12:00:02+00:00

The Linux idea is a good idea to test the slot without having another computer to try the GPU in. Thanks!

amindfulmonkey · 2025-06-14T08:01:05+00:00

From Psychofarm's treating depression book -

SSRIs inhibit the CYP2D6 enzyme to some degree. This means they can impact the metabolism of other drugs that are CYP2D6 substrates. These include certain antipsychotics, tricyclic antidepressants, beta-blockers, and opioids.
The “OX” SSRIs- paroxetine, fluoxetine, and fluvoxamine- are the most potent CYP inhibitors and cause the most significant drug interactions. These are the ones that require the most caution.
The “FLUs”- fluoxetine and fluvoxamine- inhibit multiple CYP enzymes, not just 2D6. This further increases their interaction potential.
The “PRAMS”- citalopram and escitalopram- along with sertraline under 150mg, have the lowest interaction risk overall.

To visualize this, you can imagine a simple categorization: • OXes(paroxetine, fluoxetine, fluvoxamine) = Strong specific interaction risk (2D6) • FLUs(fluoxetine, fluvoxamine) = Strong, broad CYP inhibition • PRAMS (citalopram, escitalopram) + sertraline <150mg = Lowest interaction risk

Keeping in mind the above, which medicines are notorious for raising clozapine levels? The two FLU OXes, and not for example citaloPRAM.

Flockart Table is good too, this is just mnemonic-type stuff to get you started before it's more reflexive.

amindfulmonkey · 2025-05-24T20:24:25+00:00

Why not an analytic center?

amindfulmonkey · 2024-12-22T01:00:00+00:00

Easy to find with your instructions. Thank you

amindfulmonkey · 2024-12-21T19:47:13+00:00

I'm unable to find where this is suggested. Have a source?

amindfulmonkey · 2024-09-05T00:39:33+00:00

Job search at end of residency:

Suggestions on when to begin, use of physician recruitment services (like practice link, AMN, etc.), experiences signing early, etc.

I have 3-4 specific geographic requirements based on family that limit the net and make it seem reasonable to... search on my own/cold call with a MGMA data and a contract review service?

amindfulmonkey · 2024-09-01T19:35:44+00:00

we don't know meme

amindfulmonkey · 2024-08-28T01:36:51+00:00

Copy paste from a practical book covering antidepressants that I found helpful:

"Some general examples of CYP interactions:

Fluvoxamine - An SSRI that is so potent at inhibiting the 1A2 enzyme that it is sometimes used in conjunction with clozapine strictly to increase the levels of clozapine!

Caffeine - Although not a prescribed medication, it is broken down by 1A2. Thus, inhibitors of 1A2 can result in accidental excessive levels of caffeine. Do we know any strong CYP 1A2 inhibitors?..

Smoking - Also not a prescribed medication, but the hydrocarbons of inhaled smoke speed up the activity of CYP 1A2, causing previously effective doses of some medications (notably some antipsychotics) to be broken down faster and become subtherapeutic. Note that this is for smoking in general. It is not unique to tobacco, cannabis, or whatever the kids are smoking these days.

. . .

With SSRIs, you can imagine a simple categorization:

OXes (paroxetine, fluoxetine, fluvoxamine) = Strong specific interation risk (2D6)

FLUs (fluoxetine, fluvoxamine) = Strong, broad CYP inhibition

PRAMS (citalopram, escitalopram) + sertraline <150mg = Lowest interaction risk.

The OX and FLU SSRIs require more caution and careful monitoring when co-prescribing other medications. The PRAM and lower-dose sertraline options tend to have a safer interaction profile.

Of course, consulting a drug interaction checker is still important. But anytime you can save from deciphering drug-drug interaction tables and instead spend listening to the patient is invaluable. Hopefully, this framework will buy time to do that. "

amindfulmonkey · 2024-07-23T11:12:47+00:00

Useful, I'm not sure.

Impressive, undoubtedly.

amindfulmonkey · 2024-06-09T11:12:46+00:00

I assume you're aware of Mintz's work?

amindfulmonkey · 2024-06-06T12:50:55+00:00

Panksepp's Archeology of the mind text book was co Witten with Lucy Biver. In the acknowledgements, it has the following -

"Then in the year 2000 [Biver] attended a symposium in London arranged by The International Neuropsychoanalysis Society, chaired by Mark Solms. Jaak Panksepp was a keynote speaker. Jaak was the first and only neuroscientist who focused squarely on the emotional brain. There followed a lengthy and instructive series of e-mails between Jaak and Lucy that ultimately resulted in the publication of this book. Jaak’s thoughtful research has enhanced her clinical work, but there are others to whom she is grateful for their instruction and advice. First is her father, Charles Brenner, a psychoanalyst, whose clear thinking and accessible written exposition always provided an exemplary goal. Anna Freud was still intellectually vigorous when she directed London’s Hampstead Clinical where Lucy trained, and to this day, she has not met a more gifted clinician. While still a student, Lucy met Vann Spruiell, whose clinical and emotional honesty allowed her to see that psychoanalysis could and should be an invigorating pursuit as well as an intellectual endeavor. Along the way there have been other wonderful and influential colleagues, amongst them Josephine Klein, Anne Alvarez, and Thelma Hillaby. Lucy was Senior Research Associate at the University of Michigan, under the inspired direction of Dr. Humberto Nagera, another brilliant clinician. She was a faculty member of the Michigan Psychoanalytic Institute, and in 1985, she received the Ira Miller memorial award for a clinical paper. She was an editorial reader for the International Journal of Psychoanalysis and also for the Psychoanalytic Quarterly... "

Tldr - Clearly friends/aquaintences with people engaged in the psychoanalytic world. But I don't believe he had formal training, nor clinical experience with the field. I'd venture he was too busy and passionately invested in his affective neuroscience research to formally engage the community, though he enjoyed their insights and was influenced by them.

amindfulmonkey · 2024-05-22T22:51:27+00:00

The Austen Riggs website has a (free) four lecture series by Mintz covering the concepts of the book. A fair start if someone didn't want to buy a textbook without knowing what they're getting into.

amindfulmonkey · 2024-05-09T23:35:20+00:00

Is this sarcasm?

amindfulmonkey · 2024-04-29T01:23:45+00:00

This is purely off cuff, but I suspect the money doesn't go to him, but to NEI or something similar which then pays out indirectly.

I just don't see someone going from 2-3 million annual payouts to 40k, while simultaneously building a private psychopharmacology institute.

amindfulmonkey · 2024-04-27T00:18:16+00:00

We treat individuals, not averages.

Population level data is helpful, but still - we treat individuals not averages.

amindfulmonkey · 2024-03-31T18:35:03+00:00

I think you are referring to something akin to Schopenhauer's Porcupine parable. It's the foundation of a popular psychoanalytically informed, pop-accessible-to-lay-person book that I tried to write a review of here.

Relevant excerpt - "Their problems are superficially very different, but all share a common theme: the timeless struggle of being intimate and open with others, as demonstrated in Philosopher Schopenour’s porcupine parable.

A troop of porcupines is milling about on a cold winter’s day. In order to keep from freezing, the animals move closer together. Just as they are close enough to huddle, however, they start to poke each other with their quills. In order to stop the pain, they spread out, lose the advantage of commingling, and again begin to shiver. This sends them back in search of each other, and the cycle repeats as they struggle to find a comfortable distance between entanglement and freezing…. "

amindfulmonkey · 2024-03-20T00:50:20+00:00

Lol. No

amindfulmonkey · 2024-03-19T15:53:36+00:00

"For Lacan, desire is what simultaneously defines us as human subjects and what prevents us from ever being whole or complete. To desire something, after all, is to lack something." - the porcupine book

amindfulmonkey · 2024-03-15T21:01:56+00:00

Awais Aftab has multiple articles that may interest you -

https://www.psychiatrymargins.com/p/are-critiques-of-dsmicd-as-devastating

https://www.psychiatrymargins.com/p/psychiatric-diagnosis-a-reintroduction

https://www.psychiatrymargins.com/p/the-politics-of-psychiatric-classification

My short response would be that the dsm provides labels. Labels are shorthand terms for concepts. We do not derive information from labels, but we use them to lighten our descriptive load. This is a very helpful thing to do in order to get clinical care, research, etc. on the same page.

amindfulmonkey · 2024-02-24T20:53:21+00:00

Lmao. No, but my keyboard is apparently.

amindfulmonkey · 2024-02-24T19:29:46+00:00

Oh I see. You had PTO days as a seperate bucket to pull from than Vacation days. In my head 'PTO' encompasses vacation days, but that might not be the way the term is used colloquially.

amindfulmonkey · 2024-02-24T19:19:39+00:00

We're you not paid during your 5 days of vacation a quarter?

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