• JWBananas
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    15 hours ago

    ICU level care

    Acute care, understood.

    referring to like, fists.

    i.e. “I need Olanzapine [broad receptor affinity, highly anti-cholinergic, well-tolerated], but, like, faster.” I’m surprised that particular aspect of the side effect profile comes into play with acute usage.

    I’m unsure if you don’t work inpatient psychiatry or you just work somewhere significantly classier than I do.

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

    I do work in an inner city area that’s flush with people stuck in a cycle of drugs / homelessness

    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.

    On a different note, have you heard about Cobenfy yet?

    https://www.npr.org/sections/shots-health-news/2024/09/27/g-s1-25089/karxt-cobenfy-schizophrenia-psychosis-fda

    It obviously isn’t suited to the needs of your practice. But I’m really glad we’re making progress on alternative treatment approaches, especially novel ones like anti-muscarinics.

    Hopefully the new glutamatergics can reach your setting soon.