Dr Sanil Rege FRANZCP | MRCPsych
@sanilrege • 11,393 subscribers
Psychiatrist blending neuroscience with real-world practice. Insights beyond the textbooks, made actionable. Follow for clear, practical takes.
Videos
It takes a particular kind of person to look at a study showing reduced self-injury in depressed adolescents and respond first with dismissal rather than clinical curiosity. 🚨 The study showed - Depressed adolescents with self-injury showed improvements in anxiety, depression, impulsivity and self-injury severity, with response rates reportedly doubling. And this is not the first time. 🚨 In the interview below when faced with the reality that some people do not “come out of depression” - that some people die by s****de- the response was essentially that people do come out of depression, IF they get through it. That “if” is doing a lot of work. That is not compassion. It is cruelty dressed up as virtue signalling. Ideology over lives.
Dr Sanil Rege FRANZCP | MRCPsych31,191 views • 2 months ago
Aripiprazole and Gambling or other impulse control disorders. 🚨 Aripiprazole, as a dopamine partial agonist, can trigger impulse control issues such as gambling. ( Be mindful of this with all partial DA agonists) This is linked to aripiprazole’s mechanism: though designed to stabilise dopamine activity, ( Dopamine system stabiliser -DSS) it can sometimes tilt towards excessive activation. 🧠 This ‘too hot’ response arises from its high affinity and intrinsic activity at the D2 receptor, similar to what’s seen with Parkinson's medications where dopamine agonism leads to impulsive behaviours. 🔥 Apart from gambling, ARI is also associated with hypersexuality, and in some cases, manic or hypomanic symptoms. It’s also the reason why ARI has the side effect of akathisia. 🚨 While these are risks, it’s on the other hand used as a strategy to address antidepressant-induced sexual dysfunction by acting as a 5HT1A partial agonist and reducing elevated prolactin. ⬇️ This paradox highlights why patient monitoring is crucial: each person’s response to medications is unique, and early detection of activation phenomena can prevent harm. Medication management is not one-size fits-all pharmacology needs to be contextualised for each patient, with careful monitoring to detect and manage side effects early. Aripiprazole and partial agonists Video ( screen share from phone - so sync is bit off) 👉
Dr Sanil Rege FRANZCP | MRCPsych24,244 views • 1 year ago
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