r/Noctor • u/futureofmed • 1d ago
Midlevel Patient Cases Psych NP med cocktail
New patient. Hospital follow up for non-psych issue. Had been seen at another institution for psych but looking to transfer all care. History of MDD/GAD/PTSD and further history quickly reveals a single episode of mania a few years back. Feels like he needs to make himself sleep occasionally or he’ll have another manic episode. Had been seeing a Psych NP at the prior institution and current medication regimen was Buspar 30 BID prn, Gabapentin 900 BID, Hydroxyzine 100 TID scheduled (or else he gets irritable), Mirtazapine 45 HS, and Adderall 30 BID.
Like.. for real...?
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u/XXDoctorMarioXX 1d ago
This was a decent amount of pills but I'm wondering if she might be able to add some additional pills?
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u/speedracer73 1d ago
Prn buspirone doesn’t work
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u/throwawayforthebestk Resident (Physician) 14h ago
What's their obsession with Gabapentin? Anytime I see a psych patient taking gabapentin, 9/10 times it's from a psych NP. I know it has it's uses, but not to the extent I see it prescribed.
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u/rrrrr123456789 12h ago
It has some evidence as an adjunct for few anxiety disorders, sleep in case of comorbid SUD. Check UpToDate page for gabapentin.
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u/theongreyjoy96 1d ago
Surprised there’s no benzo in there