M.Sikorav MD
@MsikoravMD
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Psychiatrist with manic depressive disorder and ADHD || Private practice in France || 2000+ CME credits
Laval, France
Joined February 2024
I'm writing a substack, but I've never encountered the white page issue yet. On the contrary, every day I have 5+ ideas of topics I want to write about. This is I an example of hyperthymic temperament . - assuming these are good ideas, of course 😁.
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I will be joining a discussion about restraints in psychiatry and how to do without them. Is there any papers you think I should read beforehand ? . Looking for advices. Thank you.
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Also, the number of studies and participants including in a meta analysis is not related to it's quality. When people start with those parameters, it's often a red flag.
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This study is a very good way to judge if someone knows what they're talking about . Most of the time, people citing it didn't even bother to read it, they would otherwise realise how poor and heterogeneous the studies included are . Belongs to the trash can.
"A new review and meta-analysis of 218 studies covering more than 14,000 participants concluded that exercise is as effective as therapy in addressing depression - and that it’s often more effective than antidepressants."
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People told me I should use chatGPT to help me write my book. This may be dumb, but I would rather write poorly than using AI to help me. What do you think ?.
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Quetiapine maintenance vs abrupt discontinuation with placebo vs lithium on patients who responded to an acute episode of depression with quetiapine. Lithium shouldn't perform as good as quetiapine, but it did . Astrazeneca, who funded the study, must have been pissed
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I see everyone talking about "SSRI antidepressants" harming patients. Am I the only one to think "neuroleptics" are a lot harder to stop, and a lot more prone to result in irreversible side effects ?. The data is pretty clear aswell, so what gives ? Am I missing something ?.
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Ah yes, this may very well be the case. There is a bunch of deaths by suicide in my family, but no doubt they all lacked willpower and just needed to get some sun, exercice, and listen to peaceful music. What a bunch of lazy ass idiots they were.
The problem with psychiatry…many of them identify as “mentally ill” and actually believe in what they do 😅.
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Brave thread.
🧵When Patients Feel Harmed by Treatment - Is There More to the Story? 🚨 1/21. This will get backlash. It’s not about denying harm. It’s about understanding how harm is experienced, amplified, encoded, and communicated and . how that understanding can help people move
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I've signed up with an editor to write a book on my experience as a manic-depressive psychiatrist . What do you think would be important points to adress in the book ?.
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After having spent a few months here, it all makes sense:. If we removed all psychiatrists, mental disease would cease to exist. It's a simple solution really. Let's do it before the DSM 6 is published.
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One simple way to make sure you don't write stupid stuff is to make sure patients can access your medical notes anytime . Every patient is sent my notes after an interview. They can also correct things I wrote they do not agree with. Should be mandatory - in France it is not.
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That was Awais's comment to me saying I had never seen a protracted withdrawal going on for years with antidepressants. Even though I'm seeing over 200 patients a week . I'm not saying it doesn't exist, I've just never seen it yet.
Myth busting - When the fundamental understanding of the condition is incorrect, everything that flows from it is incorrect 🚨🚨👇1/2 . Myth 1 👉”FND is a diagnosis of exclusion” ( Horowitz) ❌. Myth busting 👉 “The diagnosis of FND should be 'ruled in' based on the presence of
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Remember, Stephen Stalh got over 3 millions from the pharmaceutical industry. He wrote a book with no mention of effect sizes which will make you prescribe drugs like a madman . Caveat lector
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Yes it's actually simple, just give people the absolute numbers.
🧵 Humans are BAD at Probabilistic thinking - Risk Analysis of SSRIs in Pregnancy 🚨1/12. The recent FDA panel on SSRIs highlighted that clinicians often struggle with probabilistic thinking. For most of human history, binary thinking kept us alive: safe or dangerous?. But in
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