🎤 Advanced Psychiatric Intervention Protocols

Speaker Companion Guide

Slides 1-3: TRD Overview & Staging

đź“ť Speaker Notes

  • Emphasize "augmentation over switching" paradigm shift
  • Stage II = critical decision point (TMS consideration)
  • DTD concept: managing expectations for chronic disease model

Slides 4-5: Augmentation & Neuromodulation

đź“ť Speaker Notes

  • Lithium: Emphasize anti-suicidal properties—unique among options
  • SAINT protocol: Revolutionary but not universally available
  • Compare standard TMS vs SAINT timelines and outcomes

đź’¬ Anticipated Questions

Q: "When should I refer for ECT?"

A: Catatonia, psychotic features, severe suicidal risk, or failure of Stage III. Earlier is better—don't wait until "nothing else works."

Slide 6: Safety

đź“ť Speaker Notes

  • MAOI washout: This is LIFE-OR-DEATH information
  • Fluoxetine's long half-life catches people off guard
  • Emphasize checking ALL serotonergic agents (tramadol, linezolid)