Apytele

Also that lack of polish reads as sketchy to a lot of people with only basic tech literacy. I've had trouble getting other Healthcare workers to join and they always look at me sideways when they first glance at the layout. I actually agree that making something slicker looking the default would pull more normies without having to sacrifice a customizable interface for the people with enough know-how that they're probably already modding it anyway. A big part of reddit for me was commiserating about my Healthcare job and while some of us are tech literate a lot just... aren't.

Mine are mostly for being a trans person the wrong way. People do nooot like my brand / combo of gender apathy but also having been surgically confirmed with some androgynizing removals. I get called transphobic a LOT just by saying I don't personally get dysphoria related to pronouns. I understand that others do. I understand that for many the whole passing one way or the other thing is a matter of safety. But I'm good being called whatever personally idc. Straight to jail. I've learned to just stay away from trans communities they're pretty much all just assholes.

"They have taken you from the Imperial City's prison, first by carriage and now by boat, to the east, to Morrowind. Fear not, for I am watchful. You, have been chosen."

I do actually like this version better ty! I'm unsure that the order is the same as I'm used to.

I'm surprised that particular aspect of the side effect profile comes into play with acute usage.

Well obvs. It's basically,"idk which receptor is making them _____ (punch people, refuse to eat or drink, or whatever other immediate harm to themselves / others), but we need it to stop 3 days ago and can figure out the details or a potential cross-taper to something better later."

Ah, yes, this happens a lot. No, I don't work in the medical field at all. I just know things, for reasons.

Color me fascinated, lol. My guesses are personal experience / reading up on your own treatment or that of a loved one, tangential relation to the field such as clinical research, or just plain personal fascination. Given you linked to a drug that appears to be in trials my first guess is actually the second one. Hadn't heard of it, and I'm hopeful, but after seeing abilify get approved for acute agitation I'm... skeptical.

i.e. the psychosis has done so much cumulative damage at this point that you need to fall back to the typicals. That explains why the third-gens are useless.

Yeah a lot of people don't realize the damage is additive, both people w/ these disorders and unrelated laypeople who think "talented artist stops taking their meds and continues to be talented but starts creating art with weirder subject matter as their brain boils" is a cool story.

I'm mostly replying to add though that risperdal also has the distinction of being avaliable as a long-acting injectable, and if you're trialing oral meds before committing to an LAI, your options are somewhat narrowed. Zyprexa does have an LAI available, but I've actually never seen it used and while I can't tell you why for certain, I do have a guess.

If you have a patient sick enough that you're considering an LAI, you don't want to take benzos off the table for an entire month, especially if it turns out to be inadequate after discharge and they wind up in an ED agitated and unable to report their own med hx and get B52ed and stop breathing. I've had a pharmacist tell me considering that interaction is going out of style but a history of that kind of adverse event is difficult for a med to shake. Accutane still has suicidal ideation in adolescents listed as a side effect but I have a strong suspicion that it's less causation and more correlation with the impact of pizza face on the self and social esteem of a teenager.

Dude sometimes we still give thorazine. And tbh ime the 3rd gens don't do shit for my typical patient. For context also though, I'm essentially providing ICU level care, so when you say the word "symptom control" it's often referring to like, fists.

We had a Lady maxxed on Haldol BID one time and she managed to cheek for a week and eventually she just hauled off and rapid fire punched a nurse in the head three times. She legit thought a man was entering through her window every night on a beam of light to forcibly impregnate her and deliver the baby. She kept demanding to see the 50 babies she had up on L&D from the past few months. I've actually seen quite a few pregnancy delusions and they're almost always completely wild psychosis. Another was such an angry manic but high insight enough that when she couldn't take it anymore she would just come scream at me for the thorazine.

I'm unsure if you don't work inpatient psychiatry or you just work somewhere significantly classier than I do. I do work in an inner city area that's flush with people stuck in a cycle of drugs / homelessness so I'm also not going to tell you that any of this is the best solution, just that it's the only one avaliable to any of us right now due to shitty government policies.

To the extent that men can lactate! It's one of the possible side effects of risperdal, which I have to be aware of because I give it fairly regularly. It's all the same structures it's just a matter of the hormone signals they're getting.

an oldie but goodie

And she is mighty.

You know this is the recommended stance when deescalating violent psych patient because it keeps your hands visible (as in, not hiding something) and in front of your body / face in case they start swinging. I've never really felt comfortable doing it though and this kind of explains a possible reason why. I actually had a guy the other night who asked why everyone else was scared of him and I didn't seem to be. There were probably a couple other reasons though (I've dealt with waaay wilder men, and also he mostly struck me as young, dumb, and loud, and dumb in the young sense not in the cognitively not there sense). But as far as this pose idk it just always seemed really patronizing to me. I usually stand more like One of these where at least one hand is on the neck or side of the head. Usually with my hands overlapping but my fingers not intertwined so they're easy to separate and throw up in front of my face but not overtly defensive.

Honestly my biggest issue is getting randomly banned from trans spaces for expressing my own lived experience with surgery and how I view my own body and gender. They're so "inclusive" that they start excluding people that don't use their very specific language or share their beliefs exactly. They keep kicking people out then wondering where all the people went!

I actually love this comment and this style of humor and wanted you to know that I'm absolutely chuffed.