depression and cognitive impairment on benzos, tardive dyskinesia, anticholinergics, and neurotoxicity from high-dose

stimulants. These are the side effects that patients aren't likely to notice until it's too late.

Welcome to the Carlyte Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Akin, the editor-in-chief of the Carlap Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

Last time, on Psychoform Secrets, we talked about times when your patient isn't likely to

appreciate the benefits of a med. If it has a slow build or purely preventative effects,

they aren't likely to notice, like lithium and lomotrogen. And when sleep meds are rewarding

and cause amnesia like benzos and z-hypnotics, they may overestimate the benefits.

But problems can also be hard to pick up on when they have a slow build, or when they are

obscured by rewarding effects. Today, we'll cover three situations where patients are likely to miss

the harm that's happening, with anticholinergics, benzos, and stimulants.

Thank you. with anticholinergic, benzos, and stimulants. Like the proverbial frog in boiling water, your patient is not likely to tell you about side effects that gradually get worse over time.

Take the antich colonergic side effects. These are subtle, but gradually get worse over time. Take the anti-colonergic side effects.

These are subtle, but they get worse as you age, wearing down quality life.

Slowly, their memory gets worse, but they're not going to think it's the med.

A little dry mouth is not a big deal at first, but over time it causes tooth decay and bad breath,

until it's hard to eat and no one wants to kiss

you. Anticholinergics will dilate the pupils and impair papillary accommodation, which sounds benign,

but it means car accidents, falls, and illability to read fine print. The lungs dry up, which you don't

feel at first, but eventually that mucus thickens, clogging

airways and worsening asthma. Anticholinergics make people sweat less. Probably not a big deal

...