Transcript of conference held at Nov 25, 2025 in room first_test@conference.miaiconvo.com Initial people present at 2:10:25 PM: Paul Hershberger Pedram Pouladvand - Doctor Maneesh Patrick Ruz - Patient Transcript, started at 2:10:25 PM: ________________________________________________________________________________ <2:10:25 PM> Maneesh joined the conference <2:10:25 PM> Paul Hershberger joined the conference <2:10:25 PM> Patrick Ruz - Patient joined the conference <2:10:25 PM> Pedram Pouladvand - Doctor joined the conference <2:10:25 PM> Pedram Pouladvand - Doctor: so before we wrap up I just wanted to bring up some concerns that I had with you regarding the antidepressants could you tell me more about how often use them and the reasons why you use them <2:10:44 PM> Pedram Pouladvand - Doctor: it <2:10:45 PM> Patrick Ruz - Patient: I mean I was prescribed them about <2:10:49 PM> Patrick Ruz - Patient: six months ago for just you know I was just feeling kind of down and sad religious <2:10:56 PM> Patrick Ruz - Patient: felt like I had no motivation and everything and so I you know I came here and we discussed treatment options and so I got started on in this antidepressant and then <2:11:10 PM> Patrick Ruz - Patient: about three months ago we increased my dose and yeah I've been taking it ever since <2:11:13 PM> Pedram Pouladvand - Doctor: sure have you I mean I think we when we increase your dose you kind of notice that you became a little bit more happier with the increase of dose and things like that and you kind of you expressed to me earlier that you did enjoy that a little bit more than previously if that makes sense I kind of want to discuss that with you because it's like to some degree that the medication is being overused in this scenario so I just want to make sure that that's not the case <2:11:27 PM> Patrick Ruz - Patient: okay <2:11:49 PM> Patrick Ruz - Patient: um no I guess I wouldn't say it's overused I think it's just <2:11:53 PM> Pedram Pouladvand - Doctor: sure have you noticed kind of you modify your schedule and modifying your routine to kind of try to stay home or try to use your medication a little bit more often than needed or try to get more prescriptions <2:11:56 PM> Patrick Ruz - Patient: okay I mean I feel a little better <2:11:59 PM> Patrick Ruz - Patient: and <2:12:10 PM> Patrick Ruz - Patient: um <2:12:15 PM> Pedram Pouladvand - Doctor: sure <2:12:20 PM> Patrick Ruz - Patient: I guess not I don't I guess I don't really know I'm not sure I just take it whenever I feel sad or down <2:12:29 PM> Pedram Pouladvand - Doctor: sure and how often is that would you say <2:12:31 PM> Patrick Ruz - Patient: ah like <2:12:36 PM> Pedram Pouladvand - Doctor: like you took the medication every day or you feel sad or down every day <2:12:37 PM> Patrick Ruz - Patient: day <2:12:39 PM> Patrick Ruz - Patient: um both <2:12:45 PM> Pedram Pouladvand - Doctor: both <2:12:50 PM> Pedram Pouladvand - Doctor: could you tell me more about the feelings you get before taking the medication how you're sad <2:12:54 PM> Patrick Ruz - Patient: um <2:12:58 PM> Patrick Ruz - Patient: I <2:13:00 PM> Patrick Ruz - Patient: you know just I mean I just haven't you know for a long time I just haven't felt that great I just feel like it's just hard for me to get out of bed hard for me to you know works not going too well or anything and my roommate you know just left so it's just you know things have been hard but I the medication has been helping me so you know I know I have to function I don't have to do stuff so I'm just really relying on the meds to help me kind of get through this kind of hard period that I'm dealing with for a little while <2:13:12 PM> Pedram Pouladvand - Doctor: you <2:13:32 PM> Pedram Pouladvand - Doctor: sure you mentioned your roommate leaving you I finally discussed a little bit before as well but could you go into more detail and how that impacted you <2:13:34 PM> Patrick Ruz - Patient: excuse me <2:13:40 PM> Patrick Ruz - Patient: you know <2:13:40 PM> Patrick Ruz - Patient: trip um I mean obviously it was pretty upset you know now because now I'm by myself and it was nice having someone there <2:13:48 PM> Pedram Pouladvand - Doctor: you know <2:13:53 PM> Patrick Ruz - Patient: I was feeling a little more down or anything <2:13:58 PM> Patrick Ruz - Patient: but <2:14:00 PM> Patrick Ruz - Patient: you know so that's been kind of hard I was kind of surprised me when he left I didn't think he was thinking about leaving so I just made me think harder for me because I feel like I have less support now and then all so I you know it's just more expensive for bills and everything like that so I'm just really having to adjust to that <2:14:18 PM> Patrick Ruz - Patient: it's good <2:14:19 PM> Pedram Pouladvand - Doctor: sure I mean Stephanie a difference situation you know losing someone like that that you could have relied on to help you with things like bills and I could absolutely understand where you're coming from and why you're feeling the way you do so that's absolutely understandable and I don't want you to feel like that's not a normal feeling to have another thing I wanted to discuss with you is kind of moving on from the situation have you made any efforts to move on and kind of try to kind of <2:14:46 PM> Patrick Ruz - Patient: um <2:14:50 PM> Pedram Pouladvand - Doctor: replace your roommate in a way with you know with the bills and kind of other things <2:14:59 PM> Patrick Ruz - Patient: I guess so I mean I'm trying to do more stuff be out be more <2:15:06 PM> Patrick Ruz - Patient: energetic and like <2:15:06 PM> Patrick Ruz - Patient: you know <2:15:08 PM> Patrick Ruz - Patient: just didn't find other things options I can do to help keep me up and kind of you know find different resources that are out there to help me through this but you know it's just kind of hard <2:15:09 PM> Pedram Pouladvand - Doctor: here <2:15:15 PM> Pedram Pouladvand - Doctor: sure <2:15:20 PM> Patrick Ruz - Patient: special since I just have like a lack of energy and everything <2:15:21 PM> Pedram Pouladvand - Doctor: absolutely <2:15:24 PM> Patrick Ruz - Patient: okay <2:15:25 PM> Pedram Pouladvand - Doctor: lack of energy yeah do you ever feel like <2:15:28 PM> Pedram Pouladvand - Doctor: you're kind of at a point where it's just like I don't I don't have any energy I don't want to do anything else just once they at home <2:15:30 PM> Patrick Ruz - Patient: here yeah I mean it's been like that for a while that's kind of why I started the meds so and then with the increase of dose dosage and everything I <2:15:45 PM> Patrick Ruz - Patient: it's been out a little more helpful you know it's it's it's it's hard but <2:15:46 PM> Pedram Pouladvand - Doctor: you <2:15:52 PM> Patrick Ruz - Patient: be <2:15:52 PM> Patrick Ruz - Patient: I'm trying my best I'm trying everything I you know I can do I'm trying to work out more trying to <2:15:57 PM> Patrick Ruz - Patient: on everything but it's just hard <2:15:58 PM> Pedram Pouladvand - Doctor: sure any I mean you mentioned trying to be social and trying to work out and all those things which are great things by the way like great job taking initiative and going after those things have you noticed any differences in your mood when you started doing those things <2:16:12 PM> Patrick Ruz - Patient: oh yeah I definitely when I work out and everything I definitely feel a lot better you know everyone always feels better after a workout sometimes it's just hard to get myself there but every time I'm there and I do my workout or whatever I feel a lot better <2:16:28 PM> Pedram Pouladvand - Doctor: sure that's amazing that's great that means it's working and you want to keep it up and keep up with that routine and you know it's a you know a big step forward in terms of you know kind of alleviating the pain and trying to be less sad and I think the more you do those things it the better so the reason I bring that up is because I also want to discuss with you tapering your medication potentially in the future since we did increase the dose to bring it down so I just wanted to discuss with you and see how you're feeling about that as well <2:16:53 PM> Patrick Ruz - Patient: it happened <2:17:04 PM> Patrick Ruz - Patient: I mean sure we can definitely do that if you think that's what's best stock <2:17:10 PM> Pedram Pouladvand - Doctor: as you get better obviously <2:17:13 PM> Patrick Ruz - Patient: yeah um that's something that you want to do yeah but yeah the doctor so I trust you seem like a tremendous doctor <2:17:15 PM> Pedram Pouladvand - Doctor: it's sure would you <2:17:22 PM> Pedram Pouladvand - Doctor: oh you seem like a tremendous patient another question I want to ask you is when you're you know low moods when you're feeling kind of sad and down do you ever feel like you know harming yourself or other people <2:17:22 PM> Patrick Ruz - Patient: yeah <2:17:31 PM> Patrick Ruz - Patient: uh no never <2:17:36 PM> Pedram Pouladvand - Doctor: no that's great <2:17:38 PM> Patrick Ruz - Patient: oh no <2:17:39 PM> Pedram Pouladvand - Doctor: any feelings of suicide or suicidal ideation ever <2:17:40 PM> Paul Hershberger: okay <2:17:43 PM> Pedram Pouladvand - Doctor: know <2:17:44 PM> Paul Hershberger: we'll stop here <2:17:49 PM> Pedram Pouladvand - Doctor: okay ________________________________________________________________________________ End of transcript at Nov 25, 2025, 2:17:51 PM