SSRI, SNRI – It’s the SAME.  Just say “SRI”

SSRI, SNRI – It’s the SAME. Just say “SRI”

Doctor: I’m giving you Cymbalta (duloxetine). Patient: I got manic and suicidal on SSRIs. Is it an SSRI? Doctor: Don’t worry. It’s a SNRI. Patient: Oh. This 19 year old male had experienced worsened suicidality twice previously with fluoxetine and sertraline. He knew...
Are delusions rational?

Are delusions rational?

A few decades ago, the Harvard psychologist Brendan Maher made an unusual claim. People with delusions use the same rational process as non-delusional people. The distinction between being “psychotic” – that is, having delusions or hallucinations – and being...
Living with uncertainty

Living with uncertainty

When I was in psychiatry residency, one of the consistent teachings we received was that we needed to learn to become comfortable with uncertainty. And that we had to transfer that idea to our patients, because life is uncertain. In later years, I wondered how much of...