Podcasts about Mirtazapine

In this episode, Tristan J. Barber, MA, MD, FRCP, and Glenn J. Treisman, MD, PhD, discuss the importance of screening, diagnosing, and treating PTSD in people with HIV. They illustrate their discussion through a patient case and provide strategies for accomplishing this, sharing their own experiences and approaches to thinking about PTSD, structuring appointments, and integrating care. Presenters:Tristan J. Barber, MA, MD, FRCPConsultant in HIV MedicineRoyal Free London NHS Foundation TrustHonorary Associate ProfessorInstitute for Global HealthUniversity College LondonLondon, United KingdomGlenn J. Treisman, MD, PhDEugene Meyer III Professor of Psychiatry and MedicineJohns Hopkins University School of MedicineBaltimore, MarylandDownloadable slides:https://bit.ly/4dBu929Program:https://bit.ly/3WB2VCO

In this episode, Bradley N. Gaynes, MD, MPH, and Glenn J. Treisman, MD, PhD, discuss the importance of screening, diagnosing, and treating depression in people living with HIV. They illustrate their discussion through a patient case and provide strategies for accomplishing this, including creation of a virtual network and employment of measurement-based care.Presenters:Bradley N. Gaynes, MD, MPHRay M. Hayworth, MD and Family Distinguished ProfessorProfessor of Psychiatry and EpidemiologyDirector, Division of Global Mental HealthCo-Director, Physician Scientist Training ProgramDepartment of PsychiatryUniversity of North Carolina School of MedicineChapel Hill, North CarolinaGlenn J. Treisman, MD, PhDEugene Meyer III Professor of Psychiatry and MedicineJohns Hopkins University School of MedicineBaltimore, MarylandDownloadable slides: https://bit.ly/3YgqqSOProgram: https://bit.ly/3WB2VCOTo get access to all of our new infectious disease podcast episodes, subscribe to the CCO infectious disease podcast channel on Apple Podcasts, Google Podcasts, or Spotify.  

Join us for a brief discussion on mirtazapine.

High Yield Psychiatric Medications Antidepressants Review for your PANCE, PANRE, Eor's and other Physician Assistant exams. Review includes SSRI's, SNRIs, TCAs, MAOIs, Atypical antidepressants, Serotonin modulators. TrueLearn PANCE/PANRE SmartBank:https://truelearn.referralrock.com/l/CRAMTHEPANCE/Discount code for 20% off: CRAMTHEPANCEIncluded in review: Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Desvenlafaxine, Duloxetine, Levomilnacipran , Milnacipran, Venlafaxine, Amitriptyline, Clomipramine, Doxepin, Imipramine, Trimipramine, Desipramine, Nortriptyline, Protriptyline, Tranylcypromine, Isocarboxazid, Phenelzine Selegiline, Bupropion, Mirtazapine, Trazodone

In this edition of Insomnia insight, Coach Daniel shares three teachings that apply when we wan't to come off medications like Ambien, Trazodone and Mirtazapine. We learn about delegation, conflict and how to practically proceed - MAPASTI — Would you like a roadmap from Insomnia to immunity? Download using below link. https://www.thesleepcoachschool.com/h...  Would you like to work with one of our certified sleep coach? Awesome! Here are some great options:  The Insomnia Immunity Group Coaching Program.  BedTyme, a sleep coaching app for iOS and Android offering 1:1 text based coaching.  Zoom based 1:1 coaching with Coach Michelle or Coach Daniel.   The Insomnia Immunity program is perfect if you like learning through video and want to join a group on your journey towards sleeping well. BedTyme is ideal if you like to learn via text and have a sleep coach in your pocket.   The 1:1 Zoom based program is for you if you like to connect one on one with someone who has been where you are now. Find out more about these programs here: https://www.thesleepcoachschool.com/  Do you like learning by reading? If so, here are two books that offer breakthroughs! Tales of Courage by Daniel Erichsen https://www.amazon.com/Tales-Courage-... Set it & Forget it by Daniel Erichsen https://www.amazon.com/Set-Forget-rea... — Would you like to become a Sleep Hero by supporting the Natto movement on Patreon? If so, that's incredibly nice of you

#Mirtazapine #remeron #antidepressants Welcome to my channel, where I share my personal experiences and insights on various topics, including mental health. In this video, I want to discuss a significant decision I made that had a profound impact on my well-being. Today, I'll be sharing why I decided to stop taking Mirtazapine, an antidepressant, due to the weight gain I experienced during my medication journey

 This week we're talking about the drug Mirtazpine (Remeron) , if it helps with depression and anxiety plus ADHD. We'll be discussing what it feels like, what are the side effects and if it's the right drug for you. Only a health care professional will be able to offer you the appropriate advice on this medication so please remember this is a personal reflection.  Thank you for listening, and we'll see you next time on A Dopamine Kick!If you'd like to support the show please consider subscribing: https://www.buzzsprout.com/1898728/supporters/new Stick around till the end to hear what we adhd'd this week!See you next week for another episode of shenanigans!NEW EPISODE EVERY SUNDAY EVENINGOur Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.comSupport the showIf you'd like to support the show please consider subscribing to us, it starts at $3 a month:BUZZSPROUT Subscriptionhttps://www.buzzsprout.com/1898728/supporters/newBuy Me A Coffeehttps://bmc.link/adopaminekickThanks so much to anyone that donates to us, we really appreciate it.Our Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.com Support the show

This is the 10th podcast episode for the Psychiatric Medication Podcast Series. Series Description: Current literature indicates that podcasts can be an effective educational format to reach health professionals across the continuum of medical education, addressing a myriad of topics pertinent to providers. This episode serves as an overview of Mirtazapine/Remeron. This podcast season is the second released by East Carolina University's Office of Continuing Medical Education and may be beneficial for physicians, residents, fellows, nurse practitioners, physician assistants, and nurses. This podcast season is comprised of approximately 30 episodes, each focusing on different psychiatric medications for the non-psychiatric provider. Those tuning into the podcast's second season will receive a primer on the "bread and butter" behavioral health medications for primary care: antidepressants, antipsychotics, and mood stabilizers. Episodes will be released weekly on Wednesdays.Nathan Harper, MD & Amrish Pipalia, MD

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: July 18, 2017 Clumsiness can be hard to localize. But in a patient with a remote history of cancer, you should be suspicious for a number of things. In this week's clinical case, we discuss a patient who was cured of Hodgkin lymphoma but returns with progressive dysmetria. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. The content in this episode was vetted and approved by Joseph Berger. REFERENCES Abate G, Corazzelli G, Ciarmiello A, Monfardini S. Neurologic complications of Hodgkin's disease: a case history. Ann Oncol 1997;8(6):593-600. PMID 9261529 Alstadhaug KB, Croughs T, Henriksen S, et al. Treatment of progressive multifocal leukoencephalopathy with interleukin 7. JAMA Neurol 2014;71(8):1030-5. PMID 24979548 Bellizzi A, Anzivino E, Rodio DM, Palamara AT, Nencioni L, Pietropaolo V. New insights on human polyomavirus JC and pathogenesis of progressive multifocal leukoencephalopathy. Clin Dev Immunol 2013;2013:839719. PMID 23690827 Cettomai D, McArthur JC. Mirtazapine use in human immunodeficiency virus-infected patients with progressive multifocal leukoencephalopathy. Arch Neurol 2009;66(2):255-8. PMID 19204164 Felli V, Di Sibio A, Anselmi M, et al. Progressive multifocal leukoencephalopathy following treatment with rituximab in an HIV-negative patient with non-hodgkin lymphoma. A case report and literature review. Neuroradiol J 2014;27(6):657-64. PMID 25489887 García-Suárez J, de Miguel D, Krsnik I, Bañas H, Arribas I, Burgaleta C. Changes in the natural history of progressive multifocal leukoencephalopathy in HIV-negative lymphoproliferative disorders: impact of novel therapies. Am J Hematol 2005;80(4):271-81. PMID 16315252 Hoppe RT, Advani RH, Bierman PJ, et al. Hodgkin disease/lymphoma. Clinical practice guidelines in oncology. J Natl Compr Canc Netw 2006;4(3):210-30. PMID 16507269 Pavlovic D, Patera AC, Nyberg F, Gerber M, Liu M; Progressive Multifocal Leukeoncephalopathy Consortium. Progressive multifocal leukoencephalopathy: current treatment options and future perspectives. Ther Adv Neurol Disord 2015;8(6):255-73. PMID 26600871 Van Assche G, Van Ranst M, Sciot R, et al. Progressive multifocal leukoencephalopathy after natalizumab therapy for Crohn's disease. N Engl J Med 2005;353(4):362-8. PMID 15947080  We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

In this episode, Dr. Phelps discusses a study on the efficacy and safety of mirtazapine for treating agitation in patients with dementia. Would prescribing mirtazapine be worth the risk?  Faculty: Jim Phelps, M.D.  Host: Jessica Diaz, M.D. Learn more about Premium Membership here Earn 0.5 CMEs: Quick Take Vol. 38 Study of Mirtazapine for Agitated Behaviors in Dementia (SYMBAD): A Randomised, Double-Blind, Placebo-Controlled Trial    

Bupropion-dextromethorphan combo in depression. Lithium for COVID-19. The top med for nicotine cessation. Mirtazapine in OCD. Mediterranean diet in depression. CME: Podcast CME Post-Tests are available using this subscription. If you have already enrolled in that program, please log in.Published On: 07/04/2022Duration: 20 minutes, 21 secondsReferenced Article: Chris Aiken, MD, Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Un nouvel épisode du pharmascope est maintenant disponible! Dans de ce 93ème épisode, Nicolas, Sébastien et Isabelle reçoivent un invité pour discuter de tout ce qu'il y a à savoir sur les effets indésirables sexuels liés aux antidépresseurs.  Les objectifs pour cet épisode sont les suivants: Décrire les effets indésirables sexuels potentiels associés aux antidépresseursExpliquer les bénéfices et les inconvénients des diverses stratégies pouvant améliorer les plaintes sexuelles liées à la prise d'un antidépresseur Ressources pertinentes en lien avec l'épisode Serretti A, Chiesa A.  Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis.  J Clin Psychopharmacol. 2009 Jun;29(3):259-66. Reichenpfeider U, Gartlehner G, Morgan LC, et coll. Sexual dysfunction associated with second-generation antidepressants in patients with major depressive disorder: results from a systematic review with network meta-analysis. Drug Saf. 2014 Jan;37(1):19-31. Watanabe R, Omori IM, Nakagawa A, et coll. Mirtazapine versus other antidepressive agents for depression. Cochrane Database Syst Rev. 2011 Dec 7;(12):CD006528. Thase ME, Haight BR, Richard N et coll. Remission rates following antidepressant therapy with bupropion or selective serotonin reuptake inhibitors: a meta-analysis of original data from 7 randomized controlled trials. J Clin Psychiatry. 2005; 66(8): 974-81. Delgado PL, Brannan SK, Mallinckrodt CH et coll. Sexual functioning assessed in 4 double-blind placebo- and paroxetine-controlled trials of duloxetine for major depressive disorder. J Clin Psychiatry. 2005; 66(6): 686-92. Clayton A, Kornstein S, Prakash A et coll. Changes in sexual functioning associated with duloxetine, escitalopram, and placebo in the treatment of patients with major depressive disorder. J Sex Med. 2007; 4(4 Pt 1): 917-29. Montejo-González AL, Llorca G, Izquierdo JA et coll. SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J Sex Marital Ther. 1997; 23(3): 176-94. Jacobsen PL, Mahableshwarkar AR, Chen Y et coll. Effect of Vortioxetine vs. Escitalopram on Sexual Functioning in Adults with Well-Treated Major Depressive Disorder Experiencing SSRI-Induced Sexual Dysfunction. J Sex Med. 2015; 12(10): 2036-48. Taylor MJ, Rudkin L, Bullemor-Day P et coll. Strategies for managing sexual dysfunction induced by antidepressant medication.Cochrane Database Syst Rev. 2013; (5): CD003382. Clayton AH, Warnock JK, Kornstein SG et coll. A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor-induced sexual dysfunction. J Clin Psychiatry. 2004 Jan;65(1):62-7. Aizenberg D, Zemishlany Z, Weizman A. Clin Neuropharmacol. Cyproheptadine treatment of sexual dysfunction induced by serotonin reuptake inhibitors. 1995; 18(4): 320-4. Fava M, Dording CM, Baker RA, et coll. Effects of Adjunctive Aripiprazole on Sexual Functioning in Patients With Major Depressive Disorder and an Inadequate Response to Standard Antidepressant Monotherapy: A Post Hoc Analysis of 3 Randomized, Double-Blind, Placebo-Controlled Studies. Prim Care Companion CNS Disord. 2011; 13(1): PCC.10m00994. Ravindran AV, Kennedy SH, O'Donovan MC, et coll. Osmotic-release oral system methylphenidate augmentation of antidepressant monotherapy in major depressive disorder: results of a double-blind, randomized, placebo-controlled trial. J Clin Psychiatry. 2008 Jan;69(1):87-94. Fooladi E, Bell RJ, Jane F, et coll. Testosterone improves antidepressant-emergent loss of libido in women: findings from a randomized, double-blind, placebo-controlled trial. J Sex Med. 2014 Mar;11(3):831-9. Lorenz TA, Meston CM. Exercise improves sexual function in women taking antidepressants: results from a randomized crossover trial. Depress Anxiety. 2014 Mar;31(3):188-95.

In this podcast, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) provide an overview of the May 2022 issue of DTB. They talk about drug bulletins across the world and the role of the International Society of Drug Bulletins in supporting bulletins and ensuring that they are intellectually and financially independent (https://dtb.bmj.com/content/60/5/66). They review a study that assessed the use of mirtazapine for treating agitation in people with dementia (https://dtb.bmj.com/content/60/5/68). The editors also discuss the evidence behind two new oral antivirals that have been licensed for the treatment of covid-19 (https://dtb.bmj.com/content/60/5/73). Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). Thank you for listening.

Do you love your medical podcasts, but sometimes wish your favourite shows would just team up for the odd awesome episode??Your ears are definitely in the right place.Jon and Barney are joined by brilliant MDTea hosts Dr Iain Wilkinson and Dr Stephen Collins. Together they deliver a masterclass in many aspects of elderly care and we uncover the greatest medical literature in the world! (From the last few months).1) Physical Activity in Hopital patients - They do too little but you can help.2) Bisphosphonates meta-analysis - harm v benefit.3) Mirtazapine in  patients with dementia - should we use?4) Subsegmental PEs - who cares about them?5) Lifelong anticoagulation - hard decisions need these facts. 6) Athletes at higher risk of AF - sorry!7) POCUS- can it change outcomes?Subscribe / rate on Spotify / Apple. Follow us on Twitter / Instagram. Send us FEEDBACK JournalSpotting@gmail.com. Share with your pals/colleagues/random groups on WhatsApp. 

Currently recorded with the power of AI but please reach out if you would rather I read out the posts myself with my beautiful (HAHA) accent Hope this is helpful and would love to see you guys over on my Instagram and youtube page where I dive deeper into all things mental health Help below - SamaritansHours: Available 24 hours. Learn more 116 123 https://www.samaritans.org/about-samaritans/research-policy/our-latest-work/?gclid=Cj0KCQjwvO2IBhCzARIsALw3ASqiB-2UUfGzR6JEP9_oZkBFjMUl3xm4mRbcgRNp5YNvwKWuKf1F1QMaAoKVEALw_wcB sending all the love Molly (ocdanme) x https://www.youtube.com/channel/UCvj1tsh0EwD4bkchVTyfxhg https://www.instagram.com/ocdanme/ This episode is also available as a blog post: https://ocdanme.wordpress.com/2021/07/17/weight-gain-success-sort-of/ This episode is also available as a blog post: https://ocdanme.wordpress.com/2021/07/18/starting-a-youtube-channel-what-the-hell-is-editing/

A recent study calls into question the safety of mirtazapine in the elderly, an antidepressant often recommended in the elderly for treatment of senile cachexia due to the medication's appetite stimulation properties. This episode reviews the SYMBAD trial with guest Sarah Grady, PharmD.Guest:Sarah Grady, PharmDDrake UniversityRedeem your CPE or CME credit here!Pharmacist membersCMENeed a membership?Join for CPE CreditJoin for CME Credit References and resources: Banerjee S, High J, Stirling S, et al. Study of mirtazapine for agitated behaviours in dementia (SYMBAD): a randomised, double-blind, placebo-controlled trial. Lancet. 2021 Oct 23;398(10310):1487-1497. doi: 10.1016/S0140-6736(21)01210-1. PMID: 34688369; PMCID: PMC8546216.Continuing Education Information:Learning Objectives: Describe the results of the SYMBAD study and its implications in the care of geriatric patientsDiscuss the adverse effects found in the SYMBAD study Dr. Sarah Grady reports no actual or potential conflicts of interest associated with this episode.0.05 CEU | 0.5 HrsACPE UAN: 0107-0000-21-401-H01-PInitial release date: 12/20/21Expiration date: 12/20/22Additional CPE & CME details can be found here (www.ceimpact.com/podcast)

Mirtazapine和安慰劑相較之下，並沒有治療失智症激動行為（agitation）的效果，還可能伴隨較高的死亡率。 Mirtazapine屬於具鎮靜效果的抗憂鬱藥，而且在所有的抗憂鬱藥物中，與認知功能惡化相關的抗膽鹼效果較低、對心血管的副作用可能較少，在先前對於老年憂鬱症與失智症的研究指出有良好的抗憂鬱效果。然而，在追蹤12週的嚴謹隨機分派臨床試驗證實，mirtazapine對於失智症的激動症狀改善與安慰劑並沒顯著的差異。   Lancet同時也刊載一篇對這項臨床試驗的評論，完整地介紹相關的背景知識，例如Mirtazapine為什麼在較低劑量具有鎮靜嗜睡的效果？但在高劑量時反而較不想睡？ Mirtazapine對第一型組織胺受體（H1）具拮抗作用，因此和抗組織胺藥物一樣，有緩解焦慮、鎮靜嗜睡的效果，而阻斷血清素受體（5HT2A）則會增加多巴胺。 當劑量增加時，則是主要是藉由阻斷α2 adrenergic或相似的受體，增加血清素、多巴胺與正腎上腺素的濃度。多巴胺與正腎上腺素神經傳導增加，則會使人較不想睡。  

Charlie has hit several speed bumps and is seeing performance anxiety happening. Kyle is worried that not having pretty quick improvement with CBTi would lead to abandoning this method. Logan asks if bedtime restriction will take care of the circiadian rhythm and Neel asks about Mirtazapine.

Research updates on mirtazapine in anxiety, insomnia, methamphetamine abuse, and controversial news about the abuse potential of this antidepressant. Also new side effects and withdrawal symptoms discovered. Published On: 7/19/21 Duration: 16 minutes, 28 seconds Related Article: "Two Negative Studies of Mirtazapine and Riluzole for PTSD in Veterans," The Carlat Psychiatry Report, June/July 2021 Got feedback? Take the podcast survey.

Drs Kurt DeVine & Heather Bell continue the series on drugs felt to be safe, but are not necessarily!  Episode #5 features Mirtazapine (aka Remeron), which is FDA approved for major depressive disorder, often used for insomnia, and also abused for “psychedelic hallucinations."  To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct and Facebook: @theaddictionconnectionhk

Drs Kurt DeVine & Heather Bell continue the series on drugs felt to be safe, but are not necessarily!  Episode #5 features Mirtazapine (aka Remeron), which is FDA approved for major depressive disorder, often used for insomnia, and also abused for “psychedelic hallucinations."  To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct and Facebook: @theaddictionconnectionhk

بودكاست (يوثّايميا) مخصص لعاملي قطاع الطب النفسي من أطباء و مختصين نفسيين و اجتماعيين، البودكاست من منصة إمعان حلقة عن الطب النفسي للأورام من ناحية شمولية للمتخصصين مع د. إبراهيم الفريح  إستشاري الطب النفسي والطب النفسي الجسدي والطب النفسي للأورام بمستشفى الملك خالد الجامعي بجامعة الملك سعود بالرياض   حساب الدكتور إبراهيم في تويتر @Ibrahim_fraih    مقدمي الحلقة @Andejany و @Sami_Y_Saad  محاور اللقاء ١- من هو دكتور إبراهيم الفريح؟   ٢- لماذا الحديث مهم عن الطب النفسي للاورام؟ ليش هو مهم للأطباء و الأخصائيين النفسيين و الإجتماعيين؟  ٣- حسب تجربة الدكتور إبراهيم .. هل الكدر النفسي المتعلق بمرضى السرطان في مجتمعنا مشابه للكدر النفسي الذي شاهده في فترة دراسته بكندا؟   ٤- ما الفرق بين الحزن الطبيعي بعد التشخيص بالورم وبين الاكتئاب المرضي لذلك؟ هل هو أمر مهم للدكتور إبراهيم؟ ٥- أهمية التعاون الطبي بين الفريق النفسي والفريق الطبي للأورام؟ وما أثره النفسي على نفس الفريقين الطبيين؟ ٦- هل في غالب الأمر تشاهد حالات متعلقة بالاضطرابات المزاجية ؟ أم أنه يوجد طيف أوسع من ذلك في حالات الأورام النفسية؟ ٧- حديث عن مقياس الكدر المتضمن في تقييم كل مريض مصاب بالورم   ٨- ما الذي سيصنع فرق بوجود المساعدة النفسية لمريض الأورام من عدمها مثلا في الاكتئاب؟   ٩- أحد الأدوية المحببة في الجانب النفسي للأورام هو دواء الـ Mirtazapine هل في أدوية أخرى أنت تفضلها عن هذا الدواء لحالات تشوفها مصاب بأورام؟ و لماذا؟ حديث عن تداخلات الأدوية ١٠- حديث عن أهمية العلاج النفسي لمرضى السرطان وكذلك عن الشكل المثالي للنموذج العلاجي ١١- من يبلغ مريض الأورام بخبر التشخيص هل هو طبيب الأورام أو الطبيب النفسي؟ ١٢- أقسام رحلة مريض الأورام والجانب النفسي منها ١٣- حديث جميل عن رعاة المريض وأهله والتأثير النفسي عليهم       حساب البودكاست على تويتر @Podeuthymia حساب منصة إمعان @EmaanPlatform للتواصل و الاقتراحات info@emaanpodcasts.com    

Jen’s dog Devin hasn’t eaten in days, and keeps sniffing his food and then walking away. What is going on? Should she worry? Dr. Demian Dressler answers and has some ideas about how to help dogs who won’t eat, eat. Dr. Dressler is co-author of our podcast sponsor, the book The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity.Links and Resources from Today’s Show: The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and LongevityHere is a Deep Dive episode you should check out if you need more ideas about what to do if your dog won’t eat: https://dogcanceranswers.com/dog-wont-eat-what-to-do-dr-sue-ettinger-deep-dive/The medications Dr. Dressler mentioned that help dogs with appetite are Entyce and Mirtazapine.You can reach out to Dr. Demian Dressler directly on his veterinary hospital’s website: https://VetinKihei.com.  To join the private Facebook group for readers of Dr. Dressler’s book “The Dog Cancer Survival Guide,” go to https://www.facebook.com/groups/dogcancersupport/ About Today’s Guest, Dr. Demian Dressler: Dr. Demian Dressler, DVM is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management. A dynamic educator and speaker, Dr. Dressler is the author of the best-selling animal health book The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. Dr. Dressler is the owner of the accredited practice South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. "Your dog does NOT have an expiration date, and there are things ALL cancers have in common that you can help fight. Imagine looking back at this time five years from now and not having a single regret." - Dr. D You can find hundreds of articles Dr. D wrote about dog cancer on his immensely popular website: https://www.dogcancerblog.com/meet-the-veterinarians-dr-dressler/ Follow Dr. D and The Dog Cancer Survival Guide on the Socials:   https://www.youtube.com/dogcancervet https://www.facebook.com/dogcancer/ https://www.facebook.com/groups/dogcancersupport/ https://twitter.com/dogcancervet https://www.instagram.com/dogcancersurvivalguide/ Dog Cancer Answers is a Maui Media production in association with Dog Podcast NetworkThis episode is sponsored by the best-selling animal health book The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity by Dr. Demian Dressler and Dr. Susan Ettinger. Available everywhere fine books are sold. Listen to podcast episode for a special discount code. If you would like to ask a dog cancer related question for one of our expert veterinarians to answer on a future Q&A episode, call our Listener Line at 808-868-3200.Have a guest you think would be great for our show? Contact our producers at DogCancerAnswers.comHave an inspiring True Tail about your own dog’s cancer journey you think would help other dog lovers? Share your true tail with our producers.

Alex has started getting better sleep quality after spending less time in bed, is this the way to go? Haris wonders if he will always have trouble sleeping after the trauma of insomnia. Lea asks how a certain EEG strip can be classified as wakefulness. Rebecca is never feeling sleepy, never yawns, what's going on? Mirtazapine has worked wonders for Navinder, but what will happen when he stops taking it? Hayley is obsessed with sleep, how can she change that? Malena is sleeping longer but feeling more tired, is there a problem with her quality of sleep? Paul is confident bedtime restriction is the way to do, but how does it really work?   Do you have trouble sleeping? Can’t sleep? Have questions about insomnia or sleep? Please leave a comment or send me an email at daniel@insomniainsight.co and I will be happy to share my thoughts as a video or audio reply.   If you want to connect elsewhere I’m on Twitter @ErichsenDaniel, Instagram @Erichsen.Daniel, Facebook as Daniel Erichsen. I have a blog at bedtyme.co.   Here are some playlists that I hope you’ll find helpful.   Core curriculum - a collection of the most important insights, a great place to start. https://www.youtube.com/playlist?list...   Success stories - if you need hope and inspiration, this is for you. https://www.youtube.com/playlist?list...   Insomnia insight - a list of every single episode. https://www.youtube.com/playlist?list...   Talking insomnia - guests with insomnia or experts share their stories / tips. https://www.youtube.com/playlist?list...   Hypnic jerks, sudden awareness of falling asleep and other common issues. https://www.youtube.com/playlist?list...   Fatal insomnia - for those concerned about ffi and sfi. https://www.youtube.com/playlist?list...   Best!   This content does not constitute medical advice, diagnosis, or treatment, and should never replace any advice given to you by your physician or other qualified healthcare providers.

The purrpodcast is back with Dr. Jessica Quimby, a famous cat internal medicine specialist at THE Ohio State University. She teaches, runs the clinical medicine service and does research in her specialty, feline nephrology focusing on weight loss and appetite stimulation in cats with renal disease. Did you know gabapentin was excreted 100% by the kidney? Mirtazapine, the relatively new drug, comes in many routes of administration and dosing and can cause toxicity, including extreme vocalization, tachypnea, tachycardia, being restless and frantic. This is more common in the oral and compounded forms and less likely in the transdermal form that is FDA approved in the US. Cycloheptadiene is the antidote but weirdly enough they both seem to stimulate appetite in cats. Mirtazapine, however, is just so much better at it! This episode is made possible by an educational grant of KindredBio.

Iron status affects the risk of cellulitis - N-acetylcysteine in dermatology - Spironolactone okay to use in breast cancer patients - Save the digit! in nail melanoma - Mirtazapine might work for pruritus - Smoking is bad for flaps and grafts

Dive deep into the psychopharmacology of depression with Dr Patrick Finley, PharmD at UCSF. Learn practical tips including how to switch from one antidepressant to another, what to expect with SSRI and SNRI withdrawal, and how to choose a second (or third) antidepressant for refractory depression. We also summarize the safety around antidepressants in the peripartum period. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Molly Heublein, MD CME questions by: Molly Heublein, MD Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Molly Heublein, MD Edited by: Matthew Watto MD Guest Presenter: Patrick Finley, PharmD BCPP Sponsor Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18. Time Stamps 00:00 Sponsor ACP’s MKSAP 18 00:25 Disclaimer, intro and guest bio 04:33 Guest one-liner, book recommendation, and first patient complaint 08:04 Picks of the week 12:10 Sponsor ACP’s MKSAP 18 14:03 Clinical case of depression; assessing target symtpoms to characterize depression; choice of initial SSRI 17:49 Discussion of iron, ferritin, folate and L methylfolate as they relate to treatment refractory depression 20:12 Postpartum depression, iron, genetics and environmental factors 22:35 How to switch from one SSRI to another; Cross-titration from SNRI to SSRI or from SSRI to SNRI 26:05 Withdrawal symptoms from SSRIs or SNRIs and a bit more on switching and cross titration 31:33 Is paroxetine ever a good idea? 33:03 Ultra-rapid metabolizers of SSRIs and pharmacogenomics 34:43 Postpartum depression and treatment with antidepressants during pregnancy and lactation 39:25 Monitoring response to therapy with antidepressants ie PHQ-9 40:53 Augmentation for partial response; bupropion for augmentation and sexual side effects; 43:58 Counseling patients about discontinuation of therapy 47:00 How to choose an agent for augmentation of antidepressant therapy 51:02 Mirtazapine 52:41 Vortioxetine 53:24 Atypical antipsychotics for augmentation 55:37 Pregabalin and gabapentin for augmentation 57:42 Dr Finley’s take home points 60:48 Outro

One of the more common symptoms for people with Parkinson’s is trouble sleeping. Some of us can’t get to sleep, some can’t stay asleep, while others are awaken by tremors, painful dystonia cramping or realistic nightmares.  I can’t stay asleep.  My sleeping journal is more of an awakening journal. One day it reads “up at 3a,” the next “up at 1a,” followed by “up at 3a, up at 3:30a, and up at 4:20a.”  I’ve tried Melatonin, Magnesium Glycinate, light therapy, aromatherapy, silence, music, meditation, reading, more levodopa, later bedtimes, earlier bedtimes and the list goes on. Sleep is important for everyone. When you don’t get enough sleep you are less productive, less attentive, less present, less creative, less active, less everything it seems except tired. WebMD suggests it also puts you at “greater risk for depression, heart attack, stroke, high blood pressure, diabetes and death.” I know you’re not supposed to believe everything you read on the internet, but it’s WebMD. Right? I’m also told by researchers that sleep is the time your brain needs to redistribute chemicals into all of its nooks and crannies and for your mind and body to assimilate after each day’s journey. (Both points seem especially relevant when you have a degenerative brain disease which is triggered by the lack of production of the brain chemical dopamine.) One of my doctors suggested if I don’t get regular REM sleep, I am increasing my risk of a mental meltdown. Needless to say, sleep is an issue that I must address.  My neurologist suggested Mirtazapine, an antidepressant that is also apparently a good sedative. It also causes an increased appetite and weight gain. Neither of which I need right now. I suggested an alternative. As Canada legalizes Cannabis, I asked, “What about CBD Oil?” For transparency, I’m not a pot smoker. I have before, I inhaled, and I liked it well enough. But, I never smoked weed regularly and have not recently.  My neurologist didn’t discourage me and suggested it wouldn’t hurt to try, but it is trial and error. I did some homework. In discussions with users and by reading about CBD Oil, there are a few things I learned.  Cannabis is hit and miss. Some in the Parkinson’s community swear by it and others who’ve tried it never found it to be effective. I’ve heard from several sources it’s a 50/50 proposition. There is no prescription. How much to take, when to take it and how to take it are up to you to discover and debate. It’s fairly intimidating. Some days I feel like I couldn’t make ramen without the instructions on the package. I brought this up to Barinder Rasode, the founder of the National Institute for Cannabis Health and Education. She agreed with me, “I share your frustration about no knowing how much or what type of Cannabis to take.” She had to do trial and error when figuring out her own regiment of CBD oil for her sleeping issues. Rasode is bullish on cannabis as it relates to treating symptoms of Parkinson’s disease, “It reduces both the tremors and some researchers think it actually saves the neurons from further damage caused by Parkinson’s.” She admits those findings are anecdotal at this point, but is hopeful for more scientific trials in the wake of legalization.   The truth is there has been little research on Cannabis and Parkinson’s. So, not much is actually known. However, one trusted medical professional shared with me that while it is very likely CBD oil will make me drowsy, it is less likely to support and promote a regular sleep cycle.  What the heck. I’ll give it a try. Let the adventures into the world of Cannabis begin. Sweet dreams? I hope. We asked our partners at PARKINSON CANADA for their official POSITION on cannabis… “To-date, it has not been conclusively demonstrated by science based evaluation that marijuana can directly benefit people with Parkinson’s disease. There is a need for larger, controlled studies to better understand the efficacy of medical use of marijuana for Parkinson’s. If you are considering medical use of marijuana for Parkinson’s, we recommend you consult with your health care professional to carefully weigh potential risks and/or benefits for your individual situation. We will continue to monitor the topic of marijuana for medical purposes and will update our resources as new information becomes available.” Parkinson Canada offers this resource for people with Parkinson’s who have sleep issues http://www.parkinson.ca/wp-content/uploads/Parkinsons-disease-and-Sleep-issues.pdf  Follow me, Larry Gifford  Twitter: @ParkinsonsPod Facebook: Facebook.com/ParkinsonsPod Instagram: @parkinsonspod Follow Co-host and Producer Niki Reitmeyer Twitter: @Niki_Reitmayer Thank you to my wife Rebecca Gifford and our son Henry. Thank you to the founder of National Institute for Cannabis Health and Education, Barinder Rasode. Follow her on twitter @BarinderRasode. For more information on NICHE Canada try: https://www.nichecanada.com/ and here is a link to the Parkinson’s Foundation Center of Excellence research on Parkinson’s and Marijuana http://parkinson.org/Understanding-Parkinsons/Treatment/Medical-Marijuana For more info on our partner Parkinson Canada head to http://www.parkinson.ca/ The toll free hotline mentioned in this episode is 1-800-565-3000 Or follow them on Twitter Parkinson Canada            @ParkinsonCanada Parkinson Society BC      @ParkinsonsBC Credits Dila Velazquez – Story Producer Rob Johnston – Senior Audio Producer

On this episode, I cover mirtazapine pharmacology. We will review how mirtazapine works in the body and how those cause adverse effects and benefit out patient. I will also look at the side effect profile and why mirtazapine may be harmful or helpful in our patients. We cover drug interactions for mirtazapine in the podcast as well. Mirtazapine is an antidepressant and I mention discontinuation syndrome as well as what I see as being done when converting a patient from one antidepressant to another. Enjoy the show and don't for get to get your free gift by subscribing!

Challenge your beliefs on the efficacy of pervasive treatments used in dementia with expert Eric Widera, MD, Professor and clinician-educator in the Division of Geriatrics at the University of California-San Francisco. We explore the use of cholinesterase inhibitors, antipsychotics for behavior disturbances, feeding tubes, medications and supplements used for weight gain (inspired by Choosing Wisely and the American Geriatric Society’s “Ten Things Clinicians and Patients Should Question”). Plus, we introduce our new correspondent, Dr. Leah Witt, Geriatrics Fellow at UCSF. Written and produced by: Jordana Kozupsky, NP, Nora Taranto, MS3, Leah Witt, MD; Edited by: Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Self Assessment Questions Take the quiz now!  Time Stamps 00:00 Disclaimer 00:37 Guys set up the show 02:00 Dr Widera’s bio 03:15 Getting to know our guests 13:10 Picks of the week 16:40 Clinical case: new diagnosis of dementia 17:40 Discussing dementia with patients and caregivers 23:42 Cholinesterase inhibitors 27:35 Stopping cholinesterase inhibitors 33:35 Follow up to therapy 36:05 Dealing with behavior disturbances 39:15 DICE approach 44:17 Risks of antipsychotic medications 48:00 Use of benzos or sedative hypnotics 49:45 Melatonin for delirium or sleep 52:00 Mirtazapine 53:54 Clinical case: patient with dementia not eating 54:40 Feeding tubes 59:40 Dysphagia and NPO orders 62:04 Misinformation on malnutrition and girth creep 65:10 Thickened liquid challenge 70:25 Appetite stimulants 72:38 Megestrol 73:54 Take home points from Dr Widera 79:17 Outro Tags: dementia, donepezil, cholinesterase, inhibitor, antipsychotic, behavior, disturbance, agitation, benzodiazepine, supplement, feeding, tube, restraints, thickened, liquids, geriatric, choosing, wisely, american, society, ags, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Clumsiness can be hard to localize. But in a patient with a remote history of cancer, you should be suspicious for a number of things. In this week's clinical case, we discuss a patient who was cured of Hodgkins Lymphoma but returns with progressive dysmetria. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision making in routine clinical practice. The content in this episode was vetted and approved by Joseph Berger. REFERENCES 1. Bellizzi A, Anzivino E, Rodio DM, et al. New insights on human polyomavirus JC and pathogenesis of progressive multifocal leukoencephalopathy. Clin Dev Immunol 2013;1-17. 2. Garcia-Suarez J, de Miguel D, Krsnik I, et al. Changes in the natural history of progressive multifocal leukoencephalopathy in HIV-negative lymphoproliferative disorders: Impact of novel therapies. Am J Hematol 2005;80(4):271-81. 3. Felli V, DiSibio A, Anselmi M, et al. Progressive multifocal leukoencephalopathy following treatment with Rituximab in an HIV-negative patient with non-Hodgkin lymphoma: A case report and literature review. Neuroradiol J 2014;27(6):657-64. 4. Van Assche G, Van Ranst M, Sciot R, et al. Progressive multifocal leukoencephalopathy after natalizumab therapy for Crohn’s disease. N Engl J Med 2005;353:362-8. 5. Abate G, Corazzelli G, Ciarmiello A, et al. Neurologic complications of Hodgkin’s disease: A case history. Ann Oncol 1997;8(6):593-600. 6. Hoppe RT, Advani RH, Bierman PJ, et al. Hodgkin disease/lymphoma. Clinical practice guidelines in oncology. J Natl Compr Canc Netw 2006;4(3):210-30. 7. Pavlovic D, Patera AC, Nyberg F, et al. Progresive multifocal leukoencephalopathy: current treatment options and future perspectives 2015;8(6):255-73. 8. Cettomai D and McArthur JC. Mirtazapine use in human immunodeficiency virus-infected patients with progressive multifocal leukoencephalopathy. Arch Neurol 2009(2):255-258. 9. Alstadhaug KB, Croughs T, Henriksen S, et al. Treatment of progressive multifocal leukoencephalopathy with interleukin 7. JAMA Neurol 2014;71(8):1030-35.

Iain talks coming off Mirtazapine, Paul Akinbola has advice for U2, the search for Spock, Gatford falls asleep at Schindler’s List, Did Foggy imagine Ian Beale watching dirty movies, Songs with men’s names in and Charles Manson theories

Do complaints of insomnia stress you out? Well, never fear. In this episode our guest is Dr. Karl Doghramji, Professor of Psychiatry, Neurology and Medicine and the Medical Director of the Sleep Disorders Center at Thomas Jefferson University Hospital in Philadelphia. With his help we deconstruct the “dread pirate” insomnia (as I call it) so you can dominate it in your daily practice. Disclosures: Dr. Doghramji reports recent relationships with Merck (stock) and consulting work for Merck, Xenoport, Jazz, Inspire, Teva and Pfizer. He has a current research grant from Inspire. Clinical Pearls: *Pathophysiology: Likely biological, neurobehavioral and psychological hyperarousal. Possible genetic component. *Depression, anxiety or PTSD may be their primary disorder. Many insomniacs unaware of their depression. Need a high index of suspicion. *Sleep apnea is probably cause in 10-20% of patients who present with insomnia. *GERD can present with insomnia and night time awakenings as its primary symptom. *CBT works as well as pharmacotherapy and has lasting potential even 1-2 years after discontinuation of therapy. *High yield nonpharmacologic therapy: Get up at the same time every morning. Don’t sleep in, even if bedtime or sleep onset was delayed. *Melatonin: It’s effect depends on time administered (see below). It’s not as safe as you think (insulin resistance, low sperm count) 1. Administer very low dose (under 3 mg) four to five hours prior to bed for delayed sleep phase (usually occurs in teens). 2. Administer higher dose (3-5 mg) one hour before bed for sleep initiation (adults with fragmented sleep). *Agents for sleep initiation: zaleplon, zolpidem, ramelteon *Agents for sleep maintenance: zolpidem ER, eszopiclone, doxepin (low dose of 3mg or 6mg), gabapentin (off label) *Suvorexant (orexin antagonist) treats both sleep initiation and maintenance: Start 10 mg and go up 5 mg every few weeks to max 20 mg daily. Orexins are deficient in narcolepsy. Orexins seem to mediate a switch system between arousal and sleepiness. *Doxepin, gabapentin and ramelteon have very lose risk for abuse.  *Off-label use of diphenhydramine for sleep is not recommended ("dirty drug"). Trazodone and mirtazapine also have uncertain benefit. *Mirtazapine 7.5 mg is the dose for insomnia (more sedating). Lower dose favors histamine receptor. Links from the Show: 1. This is one possible site for online CBT https://www.sleepio.com as referenced in this study 2. Melatonin associated with impaired glucose tolerance http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173928/ 3. American Academy of Sleep Medicine 4. This site below has easy to understand information on sleep related disorders and links to videos explaining sleep hygiene. You can also download sleep logs, get info. SleepEducation.org Website 5. Review on use of mindfulness and meditation for insomnia. http://www.ncbi.nlm.nih.gov/pubmed/26390335

Has your favorite feline been nauseated and not wanted to eat after being diagnosed with chronic renal disease? Join Dr. Vicki Thayer, President of the Winn Feline Foundation, as she interviews Dr. Jessica Quimby about the use of mirtazapine as a therapeutic agent to help appetite stimulation and control nausea in cats with chronic renal disease. Dr. Quimby is a veterinary clinical scientist located at the veterinary teaching hospital at Colorado State University (CSU). She was part of the research team on a Winn Feline Foundation funded project in 2008 that studied the use of mirtazapine in elderly cats with chronic renal disease who did not want to eat and were frequently nauseated. The published work from this study was very valuable to veterinary practitioners everywhere on how they could use mirtazapine best to help their cat patients.

Reboxetine is a selective noradrenaline reuptake inhibitor, whereas mirtazapine acts as an antagonist at noradrenergic alpha(2), serotonin (5-HT2), 5-HT3 and histamine H-1 receptors. In a former study we could demonstrate an inhibitory impact of mirtazapine on cortisol secretion. In the present investigation, the influence of combined administration of 15 mg mirtazapine and 4 mg reboxetine on the cortisol ( COR), adrenocorticotropin ( ACTH), growth hormone (GH), and prolactin (PRL) secretion was examined in 12 healthy male subjects, compared to reboxetine alone ( 4 mg). In a randomized order, the subjects received reboxetine ( 4 mg) alone or the combination of reboxetine ( 4 mg) and mirtazapine ( 15 mg) at 8: 00 a. m. on two different days. After insertion of an intravenous catheter, blood samples were drawn 1 h prior to the administration of single reboxetine or the combination ( reboxetine and mirtazapine), at time of administration, and during the time of 5 h thereafter in periods of 30 min. Serum concentrations of COR, GH, and PRL as well as plasma levels of ACTH were determined in each blood sample by means of double antibody RIA, fluoroimmunoassay and chemiluminescence immunometric assay methods. The area under the curve (AUC) was used as parameter for the COR, ACTH, GH, and PRL response. For statistical evaluation, the Wilcoxon signed-ranks test was performed. There was a pronounced stimulation of COR, ACTH, GH, and PRL concentrations after single administration of reboxetine. When reboxetine was given in combination with mirtazapine, a significant reduction of the COR, ACTH, and PRL stimulation was observed whereas GH secretion patterns remained unchanged, compared to single administration of reboxetine. Apparently, the stimulatory effects of reboxetine on pituitary hormone secretion via noradrenergic mechanisms are counteracted in part by the alpha(2)-blocking properties of mirtazapine and its inhibitory influence on cortisol secretion. Copyright (C) 2004 S. Karger AG, Basel.

Unlike other antidepressants, mirtazapine does not inhibit the reuptake of norepinephrine or serotonin but acts as an antagonist at presynaptic alpha(2)-receptors, at postsynaptic 5-HT2 and 5-HT3 receptors, and at histaminergic H1 receptors. Furthermore, mirtazapine has been shown to acutely inhibit cortisol secretion in healthy subjects. In the present study, the impact of mirtazapine treatment on salivary cortisol secretion was investigated in 12 patients (4 men, 8 women) suffering from major depression according to DSM-IV criteria. Patients were treated with mirtazapine for 3 weeks, receiving 15 mg mirtazapine on day 0, 30 mg on day 1 and 45 mg per day from day 2 up to the end of the study (day 21). Response to mirtazapine treatment was defined by a reduction of at least 50% in the Hamilton Rating Scale for Depression after 3 weeks of therapy. Salivary cortisol concentrations were measured before treatment (day -1), at the beginning of treatment (day 0), after 1 week (day 7) and after 3 weeks (day 21) of treatment with mirtazapine. Saliva samples were collected hourly from 08.00 until 20.00 h. The area under the curve values served as parameter for the salivary cortisol secretion. Following analysis of variance with a repeated measures design, tests with contrasts revealed a significant reduction of cortisol concentrations already after 1 day of mirtazapine treatment that was comparable in responders and nonresponders. In addition to new pharmacological approaches such as CRH1 receptor antagonists, mirtazapine therefore appears to be an effective strategy to decrease hypercortisolism and restore HPA system dysregulation in depression. However, the importance of the acute inhibitory effects of mirtazapine on cortisol secretion for its antidepressant efficacy has to be further clarified. Copyright (C) 2003 S. Karger AG, Basel.