Nicolas Badre
@BadreNicolas
Followers
3K
Following
12K
Media
397
Statuses
3K
Psychiatrist: Forensic, Clinical, Psychotherapy Co-Author: Essential Psychopathology & Its Treatment, 5th Ed Teacher: Psychiatry, MFT, Law School
Joined January 2022
New Article - Antidepressant Use and Withdrawal "Antidepressant withdrawal reactions may be less rare and more complex, severe, and long-lasting in some patients than previously appreciated." Clinical care points • Avoid reflexively diagnosing relapse; consider withdrawal as
9
45
164
One of my fears with universal mental health screening is that simply educating about disorders like ADHD has significant consequences for on self-perception. In this study, a seemingly innocuous ADHD awareness workshop doubled self-perception of ADHD in healthy young adults
22
39
147
The sad road to polypharmacy often starts with polydiagnosing. Mental illness exists and can be tragic; let’s not turn it into a cacophony of juxtaposed labels. Good care often involves “de-diagnosing.” https://t.co/iDHf0gJOOx
@AllenFrancesMD I review dozens of cases daily for a major payer. every case has 4-5 diagnoses. MDD, PTSD, GAD, and, of course, schizoaffective disorder! And maybe OCD too! Nearly all inpatients now have hallucinations - even standard admits for SI. The field is in a very sorry state.
3
11
46
More clinical care points prior to prescribing antidepressants • Consider non-pharmacological treatments as a first-line option for depression. • Discuss all reasonable alternatives with the patient before prescribing antidepressants. • If prescribing antidepressants, use the
1
1
21
More clinical care points for tapering • Stay up-to-date on emerging evidence regarding safe deprescribing. • Minimize multiple medication changes at once; avoid switching medications while tapering. • Exercise increased caution in certain patients (e.g., pregnancy, suicidal
2
0
19
The 2023 Medicare & Medicaid spending on psychiatric drugs in America equals the 2023 GDP of Iceland: $31B. Based on summing up publicly available CMS gross data. Note that some of this cost is spread among states, fed, enrollees, and may not include certain rebates.
0
0
2
In a new JCP article and podcast episode, Drs. @BadreNicolas and Eric Geier present a practical #anticholinergic equivalence table to help clinicians assess and minimize psychotropic anticholinergic burden. 🎧 Podcast: https://t.co/2yItZ0MEQm 📰 Article: https://t.co/J6JW6wvI0Q
0
1
1
Patients often come in wanting to be told what to do or asking for the “coping skill” that will make their problems go away. I often answer something like, “A better therapy would give you the strength and confidence to find and trust your own answers rather than seeking mine.”
3
2
32
New Podcast: Anticholinergic Side Effects in Psych Meds @JCPjournal Come learn: 1. Why anticholinergic burden matters 2. Our equivalency scale vs. others 3. Sedation ≠ anticholinergic 4. Antihistamine ≠ anticholinergic 5. Surprising findings + practical tips Thank you JCP for
Don’t forget anticholinergics side effects! Unlike opioids or benzodiazepines, anticholinergics side effects—confusion, sedation, even possible dementia risk—often fly under the radar. There had already been attempts at making anticholinergic risk tables; our new paper improves
2
18
82
REFS: • An article from Psych News - https://t.co/ORl41tmRpF • A copy of the DEA letter - https://t.co/W8Qxrz9muk • ADHD data: https://t.co/nDAveq1qLr
https://t.co/bcQE78gSTE Other Metadate CD adverising
0
1
2
"Not Doing Anything Wrong" In 2001, the DEA sent a cease-and-desist letter to the maker of ADHD drug Metadate CD for advertising featuring a superhero saying, “Kids, I’ll be there when you need me!” They responded, "not doing anything wrong," to what was called “the biggest and
8
8
27
More sedatives Butiserpine (sedative + antipsychotic c~1955)
1
0
7
Old psychotropic medication commercials. Stimulants "Suddenly... life was worth living" "If the individual is depressed" "Stay fit and slim" "When the aged patient is depressed" Sedatives "You prescribe sleep" "Relief comes fast and comfortably" "Life without frenzy" "She
9
11
50
A few things that increase your odds of being on psych meds more than a PhD Demographics • Age • Womanhood • Living in America Events • Death of a loved one • Trauma • Unemployment
There is almost no other cause we've ever found that increases your odds of needing psychiatric medication more than being 5 years into your PhD
7
5
34
Childhood Stimulant Use and Future Drug Use In the 1990s, Lambert and Hartsough published a longitudinal study of 492 children over 20 years. They compared ADHD with and without stimulants to controls and examined outcomes in terms of drug dependence in adulthood. The findings
What happens when you ask a Columbia University Psychiatrist to prove ADHD is real? 2 hours of admissions that undermine his entire profession, followed by a frantic email from his research assistant demanding "factual corrections." This is my response on Substack. link in
2
1
4
@RecoveryDoctor For those who know anything about the history of psychiatry, skepticism is the only rational approach to novel treatments.
2
2
33