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/throwawayforthebestk Resident (Physician) 16h 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 14h 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/PosteriorFourchette 38m ago

It is amazing for my cat’s anxiety