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Emily Deans MD

@evolutionarypsy

12 Jun

@ChrisPalmerMD

Now I’m watching @ChrisPalmerMD who is making the case that metabolic disorder is an underlying cause of mental illness (I’m already a member of the choir here, obvs)

Some papers: pubmed.ncbi.nlm.nih.gov/30254236/

People with diabetes are 2x more likely to have clinical depression and depression also worsens the outcomes of diabetes. Similar numbers and bidirectional relationship for cardiovascular disease (even after controlling for other modifiable risk factors like smoking)

Read 20 tweets

Emily Deans MD

@evolutionarypsy

12 Jun

Nice review on neurocircuitry of OCD: Neuroscientifically Informed Formulation and Treatment Planning for Patients With Obsessive-Compulsive Disorder: A Review - PubMed pubmed.ncbi.nlm.nih.gov/30140845/

Some people with disabling OCD that doesn’t respond to other treatments will get surgery, like a cingulotomy or gamma knife capsulotomy, but since 2018 deep TMS targeting the anterior cingulate/ dorsal-medial prefrontal cortex had been FDA approved for OCD.

Severe non-responsive OCD is pretty much the only thing in psychiatry surgery is used for anymore.

Read 7 tweets

Emily Deans MD

@evolutionarypsy

11 Jun

👇🏻👀 capecod.com/cape-wide-news…

https://twitter.com/susanzalkind/status/1403382738506424320

We have a play by play

https://twitter.com/susanzalkind/status/1403382738506424320

https://twitter.com/meagankolkmann/status/1403419383012249606

https://twitter.com/meagankolkmann/status/1403419383012249606

Read 4 tweets

Emily Deans MD

@evolutionarypsy

11 Jun

Dr. Winkelman says a CPAP is like an arranged marriage. At first you are wondering who you are in bed with, but sometimes you end up falling in love.

Winkelman doesn’t think much of the purported differences between benzos and zolpidem/zaleplon. I miss grumpy expert psychiatrists who tell it like it is.

The orexin antagonists (suvorexant, lemborexant) work equal to zolpidem, very few side effects, scheduled but no evidence of abuse, good luck getting insurance to pay for them lol

Read 10 tweets

Emily Deans MD

@evolutionarypsy

11 Jun

Yesterday Dr. Ongur was pretty down on genetic testing used in psych/psychopharmacology. He focuses on bipolar and schizophrenia and I don’t see much use for testing in those patients. Dr. Seiner who works with refractory depression is more mixed…

…it sometimes gives you ideas and things to think about, and current research involves a *lot* of genetic testing, and patients really like it, but not ready for prime time. Dr. Ongur was also under the impression it costs $3000 but for most patients it’s $350 or less or covered

I’ve found it helpful in my practice for treatment refractory depressed (with some overlap with OCD) patients, but not as any kind of Rosetta Stone, just gives you some direction to add to the history and physical and can also affirm pt’s prior experiences with meds

Read 10 tweets

Emily Deans MD

@evolutionarypsy

10 Jun

Question from Mom

I should clarify that my mom doesn’t think vaccines make you magnetic. She doesn’t understand why people could possibly think that.

I explained a little bit why people think things like this and she replied: “what is wrong with people?”

Read 4 tweets

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