Thursday 29 May 2008


Over the last two weeks I've seen three new patients with acute confusional states (or delirium, as it seems to be called, once again). All presented with disorientation, distress, lethargy and low mood.

Having stopped their amitriptyline, which had been appropriately started by their GPs then they'd been on for ages, I've reviewed them all this week.

They've all improved. A lot. Tiredness, mood and muzzy head causing disorientation, all gone. Great to have days where folk are reviewed and have been cured. Other than use of ECT, it's rare to have those "pick up your bed and walk" cured moments in old age psychiatry, then three come at once!


Anonymous said...

I often wonder (as opposed to your patients who often wander) ...

.. in treatment of depression - does the success of psychopharmacology (and ECT) come about by some unintended application of aversion therapy?

"If you thought it couldn't get worse for you - try this.... Now, would you like some more?"

Anonymous said...

A bit like busses then?

In all seriousness, it is good to hear nice outcomes.

solerso said...

Please let me give my answer to your question about lake cocytus. Is it a good or an evil? To the Medieval Mind (of dante?)it was a good, along with everything else in the pit, because god made it.To the mind of the 1200's that was not even up for debvate.As for "containing",or restraining the evil of the universe, that was not its purpose. The evil was restrained by the unbending will of god, not the lake. The lake was the form and expresion of gods will manifested as the punishment of the traitors. Even Lucifer himself.

Cockroach Catcher said...

First do no harm. If in doubt, stop everything. I thought also CBT works because it was so tedious!!! Many of my patients got better to avoid the diaries. At least drugs are not involved.
The Cockroach Catcher

Petronius said...

All I can say is thank G-d for Shrinks with reservations about psychotropics.

The Shrink said...

Solerso, I'd concur, it's probably a good thing, from our perspective.

More specifically it's a neutral thing, it is after all just "a thing" so has no inherent good or bad ideation or conduct.

But it's utility is of benefit to us, thus we can see it as, "a good thing."