Clozapine causes fewer extrapyramidal symptoms, but other toxicities limit use
Newer 💊 such as olanzapine, quetiapine, risperidone, & many later drugs retain potential to cause serious neurological, metabolic, other problems #MedEd
5/ Avoid serious harms when #prescribing dopamine antagonists:
⚠️Prescribe only when essential
↘️Use lowest effective dose
⏳Cautious time-limited prescribing for ppl w/ psychotic disorders & for some LTC residents after non-drug options exhausted
1⃣ A drug is prescribed 💊
2⃣ #AdverseEvent occurs but is misinterpreted as a new medical condition ⚠️
3⃣Another drug is prescribed for the drug-induced adverse event 💊💊
✅Fewer than 2% of urine cultures meaningfully impact choice of treatment or need for follow-up
✅Most guidelines recommend against culture for
symptomatic uncomplicated #UTIs
2/6 Consistent evidence that minority of pts get clinically meaningful pain relief from any dose of:
✅#Cyclobenzaprine (at best 1/4)
✅#Duloxetine (at best 1/6)
✅#Gabapentin / #Pregabalin (at best 1/6)
A 2021 Canadian systematic review found NNT (numbers needed to treat) of 6-7 for "clinically meaningful benefit" (defined as ≥30% reduction in pain or pain & function)