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Doug Berger Tokyo

Japan Psychiatrist

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BLOG:  Douglas-Berger-Psychiatrist-Tokyo.com

INFORMATIONAL PAGE:  Douglas-Berger-Psychiatrist-Tokyo-Info.com

REVIEWS WEBSITE:  Douglas-Berger-Psychiatrist-Tokyo-Reviews.com

MAIN WEBSITE: DouglasBergerPsychiatristTokyo.com

Drugs need time to work, too many persons aren't patient enough to wait and give up. Sometimes persons will even run into getting treatments that are un- or poorly proven, leading to a disaster. Proper degree of patience is the answer!

Many psychiatric patients are on a cycle of taking and stopping their meds, why? They don't want to accept being sick so they try to stop, the med is still in them they feel better so they conclude they are better...until they crash, and repeat the cycle.

Tolerance to a drug? Yes common, especially in the CNS where nerves need to adapt to changing environments and protect the brain quickly. This makes CNS drugs loose effects. The remedy is pulse dosing, rotations, and adaptive changes.

The usual suspects: "missed doses", "not needed doses", "non-compliant with dosing". They all lead to recurrent symptoms that then seem to be on a merry-go-round.

What is CNS medication "hesitancy"? "It will change my personality", "it's addictive", "It's only for crazy people", etc. While many of these persons drink, smoke, do some drugs, etc., the "brain drug" fear is a tough nut to crack.

Can you give elderly medications? Often yes, but be careful of the dose and monitor closely. Many doctors will just avoid it for "responsibility" reasons not clinical reasons.

Can we use pk and pd in the office with patients? Yes, sometimes, but in psychiatry, at the end of the day it's the subjective way the patient responds that drives dosing and/or drug-type regimen.

Risks of drugs during pregnancy? Look at the stages: fertility effects, malformations, newborn toxicity & withdrawal, lactation. There is no way to study these well & Drs not easily willing to take risk & say ok to take them. Us: https://t.co/VOm63Hc41r, https://t.co/uaoP3ZvxU7

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Friends change, w/kids or w/o becomes a big distance, afraid or not to go out becomes a big distance. What to do? Change your expectation and take a crisis as an opportunity, this is called “crisitunity”. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

What keeps people from finding romance? Lack of confidence, finds it troublesome, fear of rejection. In most people something eventually sparks, but not all… Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

Some people hold on desperately to some past life event, “If I could just get over this I’d be fine!”. They actually need to garner something positive from the event or realize it isn’treally related to their current troubles. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

“I don’t want kids” is a common statement. Yes, there could be good rational not to have them-as long as you won’t regret this decision later. Always try to see the timeline of your life! Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

What is “Baby Rage”? It's when mom-in-law gets livid about daughter-in-law’s way of caring for a new baby. What to do? Try to make grandma think she is giving great advice and do it your way later. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

Why would anyone want to date their best friend’s girlfriend?: she’s beautiful & men are lonely and horny causing a “natural addiction” to women. The problem is that dating your friend’s GF is likely to blow-up in your face. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

Even suicidal people vacillate on getting medications for help, even when depression is chronic and there are no stressors. Anchored beliefs often run against logic. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

When deciding what caused a drug response we would need to control one's lifestyle, dosing regimen, stress, and other factors. Until this is studied in a blinded fashion we are left with a subjective rating.

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