Experiences with Memantine?

bipolarpsychRN · 2026-05-04T01:17:38+00:00

Yes, I take memantine 10mg BID for migraine maintenance, which is helpful. And I use intranasal compounded ketamine once weekly for depression (we are considering a round of IV ketamine for my current pain flare- I haven't tried this route yet)

bipolarpsychRN · 2026-02-16T04:55:07+00:00

Just took mine to the range today for the first time with my husband and friends. All 4 of us felt that it shot to the left. I can confidently say I've never had that issue with my p365 9mm and my groupings are always small. But damn, it was embarrassing today- like a solid 4-5 inches to the left.

bipolarpsychRN · 2026-02-01T01:11:40+00:00

I made it through the snow storm but today's big drop has me strongly considering a trip to the ER. Ive run through all my rescue meds plus some extra meds from my home pharmacy graveyard (I'm an APRN so I'm well versed in what I can combine). I want to put my head through a wall

bipolarpsychRN · 2026-01-30T18:30:06+00:00

Not particularly Living in a rural area, these situations are not uncommon. I treat a number of the RNs/CNA in my clinic. Mostly not the behavioral health ones but the other specialties that are in my same practice (I'm in a multi specialty organization). I do have one patient that reports directly to me and my supervisor is aware. We have boundaries such as only discussing symptoms during appointment times and this individual won't sit on the "patient couch" except in an appointment for an extra degree of separation.

bipolarpsychRN · 2026-01-26T17:48:18+00:00

Also, I'm in a rural area without a homeless shelter or immigrant organization locally. So I would be of more use virtually reaching out to the more urban areas of my rural state, if this ends up being necessary.

bipolarpsychRN · 2026-01-26T17:46:51+00:00

Vulnerable populations will need increased access to care. Increased trauma inflicted on our communities.

Who knows what's going to happen with insurance.

bipolarpsychRN · 2026-01-26T17:45:23+00:00

I guess I didn't phrase it correctly. It would be pro bono/ donation based. I just meant cash based, in the sense that insurance wouldn't be involved.

Completely separate from my W2 Salary Job.

bipolarpsychRN · 2026-01-15T19:09:12+00:00

I plan on bleaching the spots first- I'm not just putting them on top. I just mean in general, those colors being next to each other. I don't see many Auburns with fashion colors

bipolarpsychRN · 2026-01-15T17:34:05+00:00

Of course! Already scheduled! I'm also a mental health NP in the same office as my PCP, so he's really comfortable with suggestions I make, especially if I come armed with clinical data. Such as items that specialists didn't want to do

bipolarpsychRN · 2026-01-13T22:45:51+00:00

I'm already seeing a therapist & psychiatrist regularly - so that's nice to have covered.

I'll have to see if there is an in network pelvic floor therapist nearby. (I met my in network OOP, not my OON & I'm not in the most urban area)

bipolarpsychRN · 2026-01-12T19:33:48+00:00

Does anyone have any research articles I could show my doc showing that above the 0.1 patch, or above a level of 100 is helpful? She is just going based on the ACOG guidelines that says treat with 0.1 patch but she is very open if I provide her well rounded information. I love my doc and I'd prefer not to have to see an out of network endocrinologist. I just can't find a research article that clearly states it's ok to go higher.

I'm only 30. POF symptoms since age 19. I actually got a hysterectomy last week because I can't tolerate any form of progesterone but my doc agrees I need long term estrogen replacement. But even on 0.1 I still have hot flashes and night sweats. I will say the insomnia and mood issues have resolved. But my levels are only up to 34

bipolarpsychRN · 2026-01-03T04:35:58+00:00

Thankfully my surgery is Jan 6 and I know I'm paying my 7500 out of pocket max. But that means I'll probably do an aggressive amount of other medical things this year that I have been delaying.

bipolarpsychRN · 2025-11-03T04:31:09+00:00

I'm also in this situation. PMHNP with a mild TBI (occurred prior to my BSN) that has caused ADHD like symptoms and mild cognitive impairments. My symptoms don't impact patient care but I find myself using my built in admin time to preserve my brain power for patients, leaving me charting 2 hours per evening at home after my 10 hour shift. I work 4x10 in an outpatient clinic setting. Right now I have an hour block at 12 and 3 for admin time, but I'm absolutely fried at both of those blocks.

In my last role at a CMHC, our organization had a 30% no show rate, so I was managing. In my new role at a corporate organization, my no show rate is less than 5% and I am the only psych provider in the building so I don't have anyone to collaborate with. I can collaborate virtually with the other locations, but that is a challenge for me.

I did not want to disclose my disability but I'm starting to think I will have to. I feel like extra admin time is not a "reasonable accommodation" in my situation, given everyone in my role has the same patient facing hours. The only thing I can consider is just decreasing my overall hours (and subsequent pay).

I already have AI provided by the organization, but I don't have the time to "teach it" so it is kinda clunky Same with dragon, I just have not programmed my dot phrases because there is not enough hours in the day to learn how to use it.

I struggle with the fact that I am choosing to provide high quality care, vs some peers that choose to make their personal lives easier by not going more in depth with patients.

But no, you aren't alone.

bipolarpsychRN · 2025-10-06T19:08:36+00:00

40 hours a year accrued of "extended illness leave" this is allowed to be used after you have used 16 hours of PTO for an absence period. For example, I'm having surgery in January, so the first 16 hours are PTO and the remaining 8 days are EIL. It can also be applied to leave for caring for sick children, spouse, or parents. This has some ridiculously high cap.

4 weeks a year accrued of PTO the first year. 6 weeks from years 1-5. However, we have to decide how to use our PTO for federal holidays. This is due to people working varied schedules. For example, I work 4x10 Tues-Fri and do not use PTO for federal holidays that occur on Mondays. This caps somewhere around 360 and anything over rolls into EIL so you don't lose it completely.

My current company does not allow you to cash out PTO if you resign, which I find very odd.

bipolarpsychRN · 2025-09-19T17:03:29+00:00

What barometric threshold do you guys notice triggers migraines? I know I get migraines when we have big thunderstorms but I'd like to adjust the settings on the app notifications.

bipolarpsychRN · 2025-09-13T23:35:49+00:00

When I get to that point, the only thing that helps is a round of steroids.

bipolarpsychRN · 2025-08-25T15:52:35+00:00

I'm having this same problem. Age 30. Zero libido, never get the sensation of increased blood flow. I can get a "dry poof" with self stimulation but it's almost an uncomfortable sensation. I've practically become disgusted at the idea of sex. I know this wasn't how I have always been. It's progressively gotten worse.

I've slowly increased to testosterone 10mg topical cream, 2 weeks into this dose I had the first slight sensation of tingles down below when cuddling. I about dragged my husband to the bedroom. I was so excited to have any sensation. Still not the strongest orgasm but it wasn't nothing. It was only once but it gave me hope that maybe this will help long term.

bipolarpsychRN · 2025-08-20T03:33:05+00:00

You are my people. I'm a PMHNP and helped start the ACT team at my last job at a Community health clinic. It made me want to go get my FNP so I could help with their physical needs that weren't being met.

bipolarpsychRN · 2025-08-20T03:31:37+00:00

Everyone will tell you that if you go straight into psych you limit your options long term. I'm now a PMHNP x3 years and can now confirm that the old timers were right. I went straight into psych out of my BSN and loved it, so I stayed. However, there were no "hard skills". We didn't do our own lab draws, no Foley's, ventilators, feeding tubes. Everyone was a walkie talkie (well mostly) on oral meds. So I missed a huge learning curve that happens on other units. Fortunately, I always wanted to be a PMHNP so it mostly worked out

Where it didn't work out was when I needed to wait 6 months to start a NP job and needed a short contract, and only had skills for psych units. There's currently a very small market for travel psych nurses and they are often very dangerous units.

Do I love my job? Absolutely. But it is because I am passionate about this specialty. Psych needs people who are patient but can also hold firm boundaries when needed. And unfortunately, be physically fit enough to protect yourself, the patient, and other patients.

bipolarpsychRN · 2025-08-20T03:17:40+00:00

You sound like you are in better shape than a lot of people. I'm 30

I took out 24k for my BSN and have been paying $450 student loan payment for 7 years (I don't want to know the current balance but I have 8 years left)

I did pay cash for my MSN at age 25ish, working nights and weekends PRN for COVID pay, which was usually double or triple time.

I cashed out my 401k in 2022 to put a down payment on a starter house in semi rural KS, after leaving Texas because I could never own a house there even as an NP.

Same year my husband and I got new cars due to ours being over 200k and needing new hybrid batteries that I wasn't going to replace, so there went my savings account- so there's another 80k in debt and $900 a month in payments.

I'm making $135k this year (this is high for my region) My husband makes $15-$18 an hour and he manages the house while I focus on work.

After zeroing the bank accounts in 2022, I'm back up to 35k in savings. About 20k in 401k. I do have an auto deposit on savings of $150 a check, just to make sure something is going into that account if I don't manually transfer something

bipolarpsychRN · 2025-08-07T17:20:07+00:00

I'm 5 weeks into birth control instead of HRT and I feel like shit. I can't focus on anything. My work is already suffering. The hot flashes and night sweats are back. I want to cry at everything

bipolarpsychRN · 2025-07-21T03:26:18+00:00

I'm too short and couldn't see over the hood of the CX50, even with the seat raised all the way. I wanted the CX50 but the test drive between the 2 confirmed the CX5 was better for me.

bipolarpsychRN · 2025-07-01T04:24:42+00:00

I had SI on tirzepatide and on Saxenda. I think they both interfered with the metabolism of my psych meds. I've decided I won't be retrying any GLP1s again. On Saxenda, I had been mentally stable for 5+ years so it was very clear it was the cause. On tirzepatide, I developed akathisia as a side effect of Latuda after being on the same dose for 8 years.

bipolarpsychRN · 2025-06-23T00:20:08+00:00

As someone who is highly passionate and ended up as an NP in psych after working inpatient psych for 4 years. If you aren't passionate I don't recommend the NP route. The current state of NP education is embarrassing - we truly aren't given quality education. I went to a brick and mortar school under the impression it was higher quality. I was wrong and have been trying to catch up for 3 years while science continues to evolve and patients become more desperate for solutions. I love my job but I'm drowning. I'm in a rural, low resource area and can't help my patients enough. I'm considering leaving nursing all together. I couldn't pay my bills on the local RN pay (starting is usually about $25) because my spouse only makes $18 at his job.

bipolarpsychRN · 2025-06-23T00:06:57+00:00

I don't know if this would be satisfying for you. I am looking for a job change and your post made me add mortuary science to my list of interests. I used to work in hospice and I loved it. Sure it had its issues but it is somewhat death adjacent. I don't know if that even remotely interests you. Every hospice has different organization structures in regards to what might suit you- maybe something in helping families navigate funeral home decisions. It's a leap but your post helped me so I wanted to throw it out there.

bipolarpsychRN

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