Are psychiatrists trained in Neuropharm??

[JohnBoy2000]

Do they know about drug mechanics and binding profiles etc?

I'm curious as to how exactly psychiatric training differs from neurpharm training.

I asked the last doc I was with about binding profiles, and he held his hands up and said, "don't know 'bout that pal" - and he was a consultant.

How exactly do they deduce what meds to administer to patients?
Do they just have a standard clinical protocol - start with SSRI, if he/she seems the remotest threat to him/herself or others, hit them with some anti-psychotics.
Move onto mirtazapine as an adjunct - then a tricyclic - something like that?

 

[Charles_Voynich]

I'm pretty positive that they receive a decent amount of neuropharmacology, but after doing your job for so many years, you stop caring about the specifics and just about what works and what doesn't for which patients. There's a million topics I've learned over my academic career that I know quite well, I just don't have the patience or the energy to dive into them again when they're not really part of my job anymore. I mean, solving the particle-in-a-box problem is a great exercise that obviously pertains to pretty much every chemical interaction we talk about on here, but after you do it once, you don't really care any more.

And yes, very often there's simply a default treatment protocol that then is modified depending on the needs of the patient. What's probably more important than that is the relationship between doctor and patient and open communication about which things are working and which aren't. Your doctor hearing something like "I don't like being on drug X because I can't sleep," is phenomenally more useful than "I don't like being on drug X because it's an SNRI", if that makes sense.

 

[d1nach]

No.

Its like asking a biology professor about aspirin dosing. They may know alot about the cox enzymes but they dont know how to dose aspirin

 

[JohnBoy2000]

No.

Its like asking a biology professor about aspirin dosing. They may know alot about the cox enzymes but they dont know how to dose aspirin

Isn't
that kind of a conflict of interests?

How can they prescribe something, or a combination of things, they don't fully understand the mechanics or interaction mechanics of.

 

[d1nach]

I dont think that is the right word but yes doctors have to prescribe people medicine knowing it is impossible for them to fully understand the mechanism of medications or mechanics of interactions between medications. And that is why i wouldnt want to be a doctor worrying im going to be sued for messing someone up prescribing medications without it being possible to know how each med works

 

[deadendgame]

not as much as the pharmacist. it's ridiculous how someone with less knowledge is prescribing the medication while someone with more knowledge is simply dispensing it. it should be the other way around.

what i mean to say is, if you have questions about the drug, ask the pharmacist, not the doctor because the pharmacist knows everything. the doctor only has a rudimentary understanding of the drug, but he does not know the mechanism of action. only the pharmacist knows that.

 

[JohnBoy2000]

not as much as the pharmacist. it's ridiculous how someone with less knowledge is prescribing the medication while someone with more knowledge is simply dispensing it. it should be the other way around.

what i mean to say is, if you have questions about the drug, ask the pharmacist, not the doctor because the pharmacist knows everything. the doctor only has a rudimentary understanding of the drug, but he does not know the mechanism of action. only the pharmacist knows that.

lol
Is this for real??

You mean to tell me a consultant psychiatrist, doesn't understand ANY, pharmacology.

What exactly are they basing their prescription impetus on??

Does anyone else think that - if this is really how it works - that it's a dramatic flaw in the system?
No wonder remission rates are as low as they are.

I've asked my pharmacist a bunch of stuff, and, well, specifically regarding neuropharm, they weren't terribly well versed on it.
Binding profiles??

Nuh - nothing.

 

[d1nach]

Yep lol idk what to tell you one of my favorite doctora was outpatient afternmostnof the outpatient staffnbasically laughed off my stupid diagrams with mtorc1 bdnf ngf allosteric nmda ampa ect ect was a psychiatrist after i explained myself he listened for like 30 minutes instead of just laughing me off as some looney and actually said you know what idk there is alot of stuff we dont know and imdomt really understsnd what all these words mean but i believe you