Psychiatrist, Engineer, Inventor, Business owner.

For drugs, go to: CostPlusdrugs.com For labs, go to: laboratoryassist.com For imaging use: Radiologyassist.com

@vrexec Security

I'm doing some back of the envelope math on buying vs renting. Say you buy a $1M house with 20% down at about 6% mortgage rate and plan to stay there for five years. Your principal paydown in the first five years is about $57,000, but you've paid about $230,000 in interest. You've also paid roughly $100,000 in property taxes, insurance, and maintenance. Say the house appreciated 2.5% every year — so when you sell it's worth about $1.13 million. Your all-in costs to sell are about 7.5% — brokerage commissions, transfer taxes, attorney fees, title insurance, and the inevitable post-inspection negotiation. On a $1.13M sale that's about $85K in fees. So you net about $1.046M. You still owe $743K on the mortgage. You walk away with about $303K in cash — your $200K down payment back, your $57K in principal, and about $46K in net profit from appreciation. Your non-recoverable costs — interest, property tax, insurance, maintenance — were about $330K over five years, or about $5,500/month. That's your effective rent. But you "made" $46K selling, or about $770/month — so your effective rent was about $4,700/month. Not bad, but you tied up $200K for five years to get there. And if appreciation was 1.5% instead of 2.5%, that net gain basically disappears and you're paying $5,400+/month in effective rent. And this assumes there's appreciation at all — and that something doesn't go wrong with your house that needs a major remodel or repair. On a five-year horizon at 6% rates, you need everything to go right on appreciation just to make ownership competitive with renting. The transaction costs eat most of your upside. What am I missing? Anything?

All-cause and cause-specific mortality in gambling disorder: Evidence from a nation-wide matched and sibling cohort study in Taiwan buff.ly/lSU8JGN

@elonmusk @LeahLibresco Function is cool

@LeahLibresco Something way cooler than a minivan is coming

MAKE A MINIVAN, ELON.

@CharlesLutzMD Why are there 51 rankings?

New York is the worst!

The largest review of medicinal cannabis for mental health was just published in The Lancet Psychiatry. 54 RCTs testing CBD, THC, and combined formulations. 2,477 participants. 45 years of data. - Anxiety: 6 trials. No significant effect. - PTSD: 3 trials. No significant effect. - Depression: Zero trials. Not tested once. 27% of adults in the US and Canada have used cannabis medically. 50% use it for mental health. thelancet.com/journals/lanps…

Low-dose naltrexone has grown in popularity for depression, but the second randomized trial just turned up negative. Get the full details on this anti-inflammatory set-back: psych-partners.com/low-dose-naltr… #psychiatry #pmhnp #naturopathic #therapy #naturopathicmedicine

Two new reviews reinforce previous conclusions about cannabinoids for mental health: "Given the scarcity of evidence, the routine use of cannabinoids for the treatment of mental disorders and SUDs is currently rarely justified." thelancet.com/journals/lanps… jamanetwork.com/journals/jamai…

Hmm, thats peculiar. $btc down and $kas up. For the first time in a long time. Just a couple of hours, but seemingly not something I can recall happening recently.

The association between sleep disturbance and stimulant use: A cross-lagged examination onlinelibrary.wiley.com/doi/full/10.11…

Dextromethorphan augmented #clozapine in new randomized trial of #schizophrenia with a large effect. With few options in clozapine-resistant cases, even a small trial is a worthy addition. More details: psych-partners.com/clozapine-dext… #psychiatry #pmhnp

Changes over time in hallucinogen-related emergency department visits in Ontario, Canada buff.ly/gFfX73R

First fecal transplant in bipolar depression failed; small-db RCT: pubmed.ncbi.nlm.nih.gov/41785480 Undaunted, authors speculate sham had active benefits But 3 probiotic bipolar RCTs = negative, despite positive in non-bipolar depression using these strains: chrisaikenmd.com/supplements

Old drug, new hope: Acetazolamide, a carbonic anhydrase inhibitor, reverses opioid withdrawal, induces synaptic plasticity in the NAcc & reduces drug-seeking. A repurposable, non-opioid strategy to prevent relapse in OUD / @guptasubhash2 nature.com/articles/s4138…

New consensus on deprescribing features many pearls, like ▪ Taper potent anticholinergics over 2-4 wk ▪ Avoids rebound: Anxiety, insomnia, confusion, sweats, drooling, diarrhea ▪ eg: Clozapine, tricyclics, some sleep meds: acbcalc.com pubmed.ncbi.nlm.nih.gov/41739481

@ManOfFocus_ Who me?

As a man, what is your personal philosophy? (In 3 words or less)

This is why we are in Iran. Brace For Impact. youtu.be/5umJ63d3rzQ?si… via @YouTube

@Vivek4real_ Darn, this guy is usually wrong. I was so hopeful.

TOM LEE JUST SAID LIVE ON CNBC THAT BITCOIN AND CRYPTO IS ABOUT TO GO PARABOLIC IN THE NEXT 20 DAYS HERE WE GO 🚀