COVID-19 Vaccine Administration and Hesitation Among Psychiatric Emergency Services Patients.

Psychiatric Emergency Services (PES) at Connecticut Department of Veterans Affairs (VACT) began offering the COVID-19 vaccine to eligible veterans in February 2021. From February 10 to March 17, 2021 there were 110 encounters where a veteran was offered the vaccine (96 unique veterans). Of those 96 veterans, 39 (40.6%) were interested in receiving the vaccine. Of those, 23 (60.0%) veterans received the first dose of the Pfizer-BioNTech vaccine and among those, 21 (91.3%) eventually received the second dose. Sixteen veterans were interested but unable to receive the vaccine due to PES-related obstacles. Common themes regarding vaccine hesitancy among this population include vaccine mistrust and concerns about side effects. Offering the vaccine to PES patients allowed VACT to reach a vulnerable subset of veterans who may be at higher risk of contracting the virus and experience worse disease outcomes.

Bupropion as a possible treatment option for restless legs syndrome.

OBJECTIVE: To describe a case of restless legs syndrome (RLS) successfully managed with bupropion. CASE SUMMARY: A 45-year-old female presented to a Veterans Affairs primary care clinic with a history of chronic insomnia. Her complicated history of treatment failure to sedative-hypnotic agents, continued sleep disturbances, and complaints of intolerable leg sensations fostered collaboration between a psychiatrist and pharmacist to identify effective treatment. Further review of her medical history and subjective complaints led to a diagnosis of RLS. Based on this new diagnosis, she was prescribed several Food and Drug Administration-approved and alternative agents recommended for the management of RLS. Unfortunately, each medication resulted in a variety of intolerable adverse effects, limiting the list of treatment options. Although not widely used for RLS, bupropion XL (Wellbutrin XL) 150 mg daily was initiated, resulting in resolution of RLS within 3 days. DISCUSSION: RLS can be an extremely disabling disorder and affects many people. For most patients, dopamine agonists are the treatment of choice for symptomatic relief. However, for patients unable to tolerate this drug class, small trials and case reports have identified alternative agents. This case supports findings from other cases suggesting a beneficial response with bupropion for the management of RLS. CONCLUSION: Bupropion may be a treatment option for patients who have RLS and are unable to tolerate dopamine agonists.