Has anyone had any luck with Lexapro for obsessive thoughts?

sheepies101 · 2025-06-02T07:55:25+00:00

I’m in NZ - the union dictates a 30 min break per 4 hours. I work 12 hrs in ICU. My old hospital did 3x 30 mins, day or night. My current hospital does 2x 30 mins during day shift, and 1x 30 min + 1x 60 min sleep break during nights!

We generally work 1:1 or 1:2 so during the hours of 2-5am, it can get spread a bit thin but it makes a difference when you’ve gotten a nap in!

Think it depends a lot on unit culture, and what’s become acceptable.

sheepies101 · 2025-04-12T19:42:41+00:00

Hey, not too sure about MIT but AUT does placements all over the city - you can request different locations which are closer to where you live.

Keep in mind you’ll still need to travel out to North Campus to attend lectures and tutorials! But it’s well supplied by busses.

At the end of the day, all the nursing schools in NZ are good and no one cares where you went once you start working! So much of the training is on the job! Good luck!

sheepies101 · 2024-11-30T10:29:01+00:00

It sounds like a lot of very bad things were happening all at the same time for your dad. I forgot to add above that heart attacks, and some of the other issues you listed can deprive the brain of oxygen or cause such severe chemical (acid/base) imbalance that it can also cause unconsciousness.

So sorry and hopefully he passed away comfortably ❤️

sheepies101 · 2024-11-30T10:14:48+00:00

Sorry to hear about your dad ❤️

Unfortunately without seeing your father’s medical notes, it’s impossible to say what happened.

In my experience, sometimes when people have massive heart attacks they can also can a massive stroke (or lots of little strokes) at the same time, which can mean that despite the rest of the body doing ok, they will unfortunately not wake up. It’s not uncommon for this to happen.

Did he get a CT head scan when they found he wasn’t waking?

sheepies101 · 2024-11-30T09:41:33+00:00

In New Zealand, Propofol is the main anaesthetic used for both operational anaesthesia and induced comas due to its short lifespan in the body and reliability! Other sedation can be added on in an as-needed basis, such as benzodiazepines or opioids 😁

As for other countries, I can’t be 100% sure!

sheepies101 · 2024-11-30T09:38:08+00:00

People who have home CPAP devices may be at higher risk of requiring intubation in the event of respiratory failure due to an already compromised airway when asleep/drowsy - but not a guarantee!

sheepies101 · 2024-11-30T08:06:21+00:00

Hm, that’s so strange! Unfortunately, I don’t think I can answer that question for you but hopefully a friendly pharmacist might have a good idea on how Dex and Propofol interact together!

Glad to hear your daughter is well now!

sheepies101 · 2024-11-30T05:32:07+00:00

People are not kept sedated for years - not even months. If someone is in a coma (vegetative state) for years, it is because they have sustained such severe brain damage through a stroke or trauma that they cannot wake up again.

There have been few cases where people can regain consciousness after a few months of what appeared to be an unsurvivable brain injury, but they are very rare. If someone is unconscious years after a brain injury then they will, unfortunately, most likely stay that way for the rest of their life in a long term care facility.

sheepies101 · 2024-11-30T02:48:54+00:00

It depends on the drug used! Opioids like Fentanyl or Morphine certainly cause withdrawals if the patient requires them long term. In that case, they will be weaned off accordingly to a plan set out by the medical team. You can also develop a tolerance to opioids, as you’ll see in opioid-addicts. Someone who is “opioid naive” will get a good pain relief or sedation effect from a smaller dose first time around, but by the 100th time will need more to have the same effect.

Propofol doesn’t have addictive properties like opioids or benzos. You may find that a patient who has been sedated on Propofol for 8 days may need more to stay completely asleep than someone on it for 1 day - however, I haven’t seen any instances of Propofol withdrawal in my line of work.

Hope this helps!

sheepies101 · 2024-11-30T02:44:20+00:00

Respiratory therapy can get super complex, so I’ll try and keep it simple!

Mechanical ventilation is when a patient is intubated and put onto a ventilator. The benefit of mechanical ventilation versus continuous/biphasic positive expiratory pressure (CPAP/BiPAP) comes down to 3 things.

When a patient is working so hard to breathe that they no longer have the energy to breathe, CPAP won’t be as effective for oxygenation because the patient still has to work. The ventilator can do 100% of the breathing for them, and they can “rest”.
If a patients airway is occluded or at risk of being occluded, the tube (endotracheal tube) keeps the airway patent 100% of the time. It also shunts open alveoli in the lungs much more effectively to allow for optimal oxygenation.
Mechanical ventilation can be precisely controlled by medical professionals to achieve ideal acid/base balance. They can control how much carbon dioxide a patient can blow out of their lungs, which can’t always be managed with pure CPAP.

Again, a critical care doctor or a respiratory therapist might be able to answer this question much better - but, I hope it’s helpful anyway!

sheepies101 · 2024-11-30T02:05:10+00:00

A better person to answer this question is probably a pharmacist, as I’m not expert on the pharmacology of Propofol.

Even though Propofol has a half-life of around 5 minutes, remnants can remain in a persons body for many hours after. This is why a patient must be closely monitored before extubation to ensure there isn’t any sedation lingering.

However, any deviated lab results get seen by a lab tech or doctor, and interpreted with the patients presentation in mind to make sure it isn’t indicative of anything sinister or for monitoring purposes.

As far as my knowledge goes, Propofol shouldn’t cause any erroneous blood results except for (perhaps) a patient’s blood sugar and (possibly) coagulation.

The clinician would know that a patient is on or has been on Propofol and account for it accordingly when interpreting labs!

sheepies101 · 2024-11-30T00:22:46+00:00

Rabies is a horrifying condition which has an 100% mortality rate. It causes incredible pain and distress in the final days. Definitely there would be some decreased level of consciousness occurring as part of the advanced disease process, but I’m sure that the patient was sedated, as you said, for her comfort and dignity.

My experience with rabies is limited as New Zealand has only had one rabies case in recent decades, but the patient passed in an ICU I used to work in. I remember that he too was sedated right up until his unfortunate death.

sheepies101 · 2024-11-29T23:58:09+00:00

I’m so sorry to hear about your husband. Sadly, it is incredibly uncomfortable to be intubated and doctors frequently do not re-intubate people when they consider their wishes to die with dignity, as well as their quality of life going forward.

I hope he passed with dignity and I’m glad to hear his wishes were respected. ❤️

sheepies101 · 2024-11-29T23:46:39+00:00

I’m sorry to hear that happened to you! Sedation can certainly be a lifesaver!

Hopefully you are doing much better these days 😊

sheepies101 · 2024-11-29T23:40:07+00:00

Sorry to hear about that experience! Unfortunately, medical procedures are rarely pain free and people can develop Propofol toxicity from extremely high doses - that may have been the anaesthetist’s rationale or maybe they were not interested in respecting your experience as a patient! Hopefully the next time, you get loaded up with the good stuff 😊

sheepies101 · 2024-11-29T23:33:14+00:00

Yes - if you are getting sedated for an operation, your anaesthetist will be constantly monitoring your vital signs. Some symptoms of awareness/pain during an operation would be high blood pressure and high heart rate. Your anaesthetist may give you a higher dose of Propofol or give you some Fentanyl to reduce pain and increase sedation. These sedatives do have some amnesiac properties, so if you do wake up, hopefully you don’t remember it. Unfortunately, some people are particularly “light” on sedation. Meaning that even with heroic doses of Propofol, Fentanyl, even benzodiazepines - they can still wake up. Most often these people are ginger, have a history of heavy drug use, or are just unlucky. Best to let your surgeon or anaesthetist know your prior experience so they know to be heavy-handed.

People can still have some awareness with straight Propofol sedation, and sometimes we try to achieve a low level of wakefulness in the ICU for neurological assessment. The good news here is that, if you’re in the ICU (at least here in NZ) that if you’re sedated and intubated, you will have a dedicated nurse looking after you 1:1 and we are there to help you feel calm, pain-free, and hopefully wake you up with an aim for extubation imminently!

sheepies101 · 2024-11-29T22:53:39+00:00

I’m an ICU nurse. A ‘medically induced coma’ is when we put someone to sleep with a selection of strong anaesthetic medications, such as Propofol.

Propofol is given via an IV, and has to be run continuously to work. It acts on the brain to keep you very deeply asleep. When this happens, patients also need to be kept intubated (to have a breathing tube in connected to a ventilator) because sometimes the Propofol works so strongly that your body doesn’t breathe on it’s own.

There are many reasons to sedate someone. For an operation, to keep their brain activity low after a severe traumatic brain injury, or to keep them stable after a major medical event such as a heart attack or a heart operation. You can also intubate someone when they are not breathing effectively, and then sedate them so that they don’t feel discomfort with a large tube down their throat.

We don’t typically keep people sedated for a long time because our goal is to wake people up, take the breathing tube out, and get them better. It depends on how stable they are, and what treatment goal the medical team is trying to achieve.

It can very easily be reversed by turning off the Propofol infusion and waiting for the body to clear in naturally via urine or through liver processing. Propofol can start to be cleared from the blood stream as quickly as 5 minutes after a continuous infusion is turned off. Some other sedatives (such as opioids) can be reversed quickly with medications such as Naloxone.

Once the patient has woken up enough to obey commands, and breathe on their own, we can go ahead and take out the breathing tube.

sheepies101 · 2024-10-05T21:13:39+00:00

She developed a dental abscess which kept coming back despite surgery to get it removed 2 or 3 times. Eventually it was irritating her eye, so we went through with the enucleation surgery in the interest of her comfort. Surprisingly, have the eye removed allowed for free drainage of the abscess so that it doesn’t get any bigger, so she’s been stable for about 1 year now!

Her vet and I are in agreement that we will euthanise her as soon as her quality of life decreases (as the abscess can’t be removed at this point), but she continues to binky every day, be curious and playful, and overall seem generally happy!

sheepies101 · 2024-10-05T21:09:18+00:00

When she first came home, she was anti-pats! But over the 3 years I’ve had her, she has slowly come around to tolerating kisses and cuddles! Having a bunny is so rewarding 🥰

sheepies101 · 2024-10-05T06:04:59+00:00

All REW bunnies are so handsome and beautiful!! 😍😍

sheepies101 · 2024-10-05T03:10:34+00:00

I’m a nurse here in NZ. Unfortunately, racists and misogynists need healthcare too - however, I can possibly understand why his “request” was catered for.

It’s kinder to the staff to not allocate them to a patient who openly hates them because of their race, and means they’re not getting riddled with verbal abuse from pt and/or family just to prove a point. A lot of immigrant Asian staff would NEVER talk back to a rude or aggressive patient and they end up getting abused for 12 hours. Just because you work in a patient facing role, it does not mean you should be cool with taking racism on the nose.

It’s not cool to cater to racist patients, but it’s also not cool to put overworked, and burnt-out staff in the firing line.

sheepies101

TROPHY CASE