I love genuine questions and people putting in the effort to love and understand each other better. If you come at me just wanting to argue I’m going to troll you back. FAFO.

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Joined 1 year ago
Cake day: June 12th, 2023
  • Apytele@sh.itjust.workstoMicroblog Memes@lemmy.world•*straw slurp sound*English
    23·
    21 hours ago

    When I was in middle school and first learned about gay men I thought one penis would have to open up somehow to accept the other penis as what I now know would be called sounding. Also knowing what I know now that would be pretty extreme even for sounding but I was a preteen fundie and had gotten all my sex ed from an anatomy and physiology book in the family library with 0 direction from any adult so in the absence of any better ideas that seemed like the most likely way that would work out. Anyway this is a great example of why puritans wind up so kinky; you have no idea what normal sex looks like so you just have to imagine it and sometimes the imagination comes up with some really weird shit and before you know it you’re having preteen wet dreams about stuff the human body doesn’t even do.

  • Apytele@sh.itjust.workstoTechnology@lemmy.world•*Permanently Deleted*English
    1·
    21 days ago

    I’m surprised that particular aspect of the side effect profile comes into play with acute usage.

    Well obvs. It’s basically,“idk which receptor is making them _____ (punch people, refuse to eat or drink, or whatever other immediate harm to themselves / others), but we need it to stop 3 days ago and can figure out the details or a potential cross-taper to something better later.”

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

    Color me fascinated, lol. My guesses are personal experience / reading up on your own treatment or that of a loved one, tangential relation to the field such as clinical research, or just plain personal fascination. Given you linked to a drug that appears to be in trials my first guess is actually the second one. Hadn’t heard of it, and I’m hopeful, but after seeing abilify get approved for acute agitation I’m… skeptical.

    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.

    Yeah a lot of people don’t realize the damage is additive, both people w/ these disorders and unrelated laypeople who think “talented artist stops taking their meds and continues to be talented but starts creating art with weirder subject matter as their brain boils” is a cool story.

    I’m mostly replying to add though that risperdal also has the distinction of being avaliable as a long-acting injectable, and if you’re trialing oral meds before committing to an LAI, your options are somewhat narrowed. Zyprexa does have an LAI available, but I’ve actually never seen it used and while I can’t tell you why for certain, I do have a guess.

    If you have a patient sick enough that you’re considering an LAI, you don’t want to take benzos off the table for an entire month, especially if it turns out to be inadequate after discharge and they wind up in an ED agitated and unable to report their own med hx and get B52ed and stop breathing. I’ve had a pharmacist tell me considering that interaction is going out of style but a history of that kind of adverse event is difficult for a med to shake. Accutane still has suicidal ideation in adolescents listed as a side effect but I have a strong suspicion that it’s less causation and more correlation with the impact of pizza face on the self and social esteem of a teenager.

  • Apytele@sh.itjust.workstoTechnology@lemmy.world•*Permanently Deleted*English
    4·
    21 days ago

    Dude sometimes we still give thorazine. And tbh ime the 3rd gens don’t do shit for my typical patient. For context also though, I’m essentially providing ICU level care, so when you say the word “symptom control” it’s often referring to like, fists.

    We had a Lady maxxed on Haldol BID one time and she managed to cheek for a week and eventually she just hauled off and rapid fire punched a nurse in the head three times. She legit thought a man was entering through her window every night on a beam of light to forcibly impregnate her and deliver the baby. She kept demanding to see the 50 babies she had up on L&D from the past few months. I’ve actually seen quite a few pregnancy delusions and they’re almost always completely wild psychosis. Another was such an angry manic but high insight enough that when she couldn’t take it anymore she would just come scream at me for the thorazine.

    I’m unsure if you don’t work inpatient psychiatry or you just work somewhere significantly classier than I do. I do work in an inner city area that’s flush with people stuck in a cycle of drugs / homelessness so I’m also not going to tell you that any of this is the best solution, just that it’s the only one avaliable to any of us right now due to shitty government policies.