Psychiatry Tomorrow

The FDA cleared TMS for depression in 2008, yet by one estimate fewer than 1% of the patients who would qualify for it ever get treated. Dr. Will Sauvé sits down with Dr. Scott West, the psychiatrist who brought TMS to Tennessee in 2010, to ask why a treatment that works remains this hard to reach. West argues the real barrier isn't efficacy or even insurance, it's that patients and the clinicians...

Ben Leopold spent years on 10 different antidepressants, each one trading his lowest lows for a flatline existence that erased his personality. It wasn't until a psychiatrist stopped prescribing and started digging into the childhood trauma underneath his depression that things began to shift. In late 2020, already armed with years of therapeutic tools he couldn't access through the fog, Ben start...

Most of Brittany Albright's treatment-resistant depression patients test positive for obstructive sleep apnea. Some longstanding ADHD cases turn out to be sleep apnea too—treated, the diagnosis comes off. Dr. Avinesh Bhar, a sleep medicine physician who founded Sliiip, joins Will Sauvé and Brittany Albright to discuss why sleep disorders hide behind psychiatric diagnoses. They cover how sleep apne...

What if one of psychiatry's most effective treatments for treatment-resistant depression emerged from watching childbirth breathing techniques? Around 30-48% of depression patients become treatment-resistant after failing two or more antidepressants. For those who've exhausted every option—medication after medication, therapy combinations, even ECT—psychiatrists face a clinical impasse. But vagal...

Nine out of twenty patients in Dr. Brittany Albright's psychiatry practice were taking GLP-1 medications—not for weight loss, but because metabolic and psychiatric disease share the same pathophysiology. About 43% of patients with major depression have obesity, and GLP-1 receptors throughout the brain's mesolimbic reward system explain why these medications reduce alcohol cravings, tobacco craving...

Dr. Martha Koo bought her first TMS machine in 2009 when colleagues thought she was "crazy"—now she runs 11 centers across California as immediate past president of the Clinical TMS Society. Her biggest revelation came when longtime therapy patients said "I'm good, but I'm not my true full self," showing how psychiatrists often settle for partial recovery. Unlike medications, TMS doesn't require p...

Summary Dr. Nicholas Fabiano, a third-year psychiatry resident at the University of Ottawa with 70,000+ X followers, explains how exercise can match antidepressants for mild-to-moderate depression through muscle-released proteins called myokines that act like "miracle grow for the brain." He introduces the FIT framework (Frequency, Intensity, Type, Time) for systematically discussing exercise with...

After a young patient died by suicide, many psychiatrists might retreat to safer cases—Dr. Matt Bernstein took a different path, choosing to treat our field's highest-risk patients in their communities rather than behind hospital walls. Drawing from his experience at McLean Hospital's acute unit and now at Ellenhorn's community-based program, he shares practical insights on balancing clinical risk...

Dr. Husseini K. Manji takes us behind the scenes of esketamine's development, from basic neuroscience research to FDA approval. Learn about the science of targeting NMDA receptors, the rigorous clinical trial process, and the potential of esketamine as a first-line treatment for depression. Dr. Manji discusses the challenges of bringing a novel psychiatric drug to market, including regulatory hurd...

Charles Miller, CRNA, founder of Scenic City Neurotherapy, takes us through his journey of starting a ketamine infusion therapy clinic from scratch. From cashing out his 401k to navigating complex licensing requirements, Charles shares the ups and downs of building a successful practice. He discusses the importance of patient education, the challenges of insurance reimbursement, and the role of te...

In this episode of Psychiatry Tomorrow, Dr. Carlene MacMillan hosts a panel of experts to discuss the FDA's pending decision on MDMA-assisted therapy for PTSD. The conversation explores the current landscape of clinical enthusiasm and regulatory caution, key challenges facing approval, and potential regulatory requirements. Panelists Dr. Owen Muir, Dr. Boris Heifets, and Andrew Penn share their in...

In this captivating episode, we explore Dr. David Feifel's unconventional journey from quantum physics to pioneering psychiatrist. Dr. Feifel shares how his fascination with consciousness led him to psychiatry, hoping to witness a "golden era" of breakthrough treatments. However, his early career was marked by disillusionment as the field remained stagnant, prompting him to seek innovative solutio...

Explore the emerging field of metabolic psychiatry and its potential to revolutionize mental health treatment. Discover the inspiring story of the Baszucki family and how a ketogenic diet helped their son overcome severe bipolar disorder. Learn about the science behind the gut-brain connection and the mechanisms by which the ketogenic diet can improve brain health. Gain insights from leading exper...

In this episode of Psychiatry Tomorrow, Dr. Jake Behrens shares his insights on navigating the complexities of diagnosing and treating adult ADHD. He discusses his comprehensive framework for ADHD assessments, the importance of psychoeducation, and strategies for medication management amidst the stimulant shortage. Dr. Behrens also explores the potential of digital health tools, the power of measu...

Dr. Rebecca Allen, a pioneering interventional psychiatrist and president of the Clinical TMS Society, is transforming mental health care delivery through her innovative outpatient clinic in Seattle. By offering a wide range of cutting-edge treatments like ECT, TMS, ketamine, and running COMPASS clinical trials for psilopsybin under one roof, she aims to expand access to life-changing treatments f...

Legal experts Daniel Sternthal and Ethan Minkin explore the legal intricacies surrounding ketamine therapy for psychiatric conditions. They delve into the importance of interdisciplinary respect, the legal challenges and malpractice risks associated with off-label ketamine use, and the vital role of informed consent. The discussion also highlights trends in the ketamine space, including the impact...

Dr. Bergina Isbell, CMO at Led Life Psychiatry, Maryland, combines personal experience and professional innovation to enhance mental health care. Specializing in Ketamine-Assisted Psychotherapy, she offers hope to those with depression, anxiety, and on the Autism spectrum. Dr. Bergina champions restorative justice, seeking healing over punishment and emphasizing mutual understanding and forgivenes...

Explore the dynamic landscape of psychiatric clinical trials through the expert lens of Dr. Michael Banov, a renowned figure with a wealth of experience in over 150 trials. This in-depth blog post delves into his groundbreaking journey, starting with the revolutionary Clozapine trial for depression and extending to the recent developments in Vagus Nerve Stimulators (VNS). Gain an unparalleled unde...

The power of community and networking in private practice psychiatry cannot be overstated. ‍Clinicians often grapple with isolation while staying up-to-date on research, best practices, finding mentors, and collaborative care. Addressing this, a panel of experts from the Osmind Community Advisory Board. The forum, centered on overcoming the challenges of solo practice through community engagement...

Delve into the complexities of starting and thriving in a private mental health practice. Listen to Dr. Kristin Budde, Dr. Erick Sheftic, and Dr. Raghu Appasani share their experiences and insights on integrating the latest treatments into standard practice, the importance of continuous learning, finding your niche, and the power of interdisciplinary collaboration in overcoming access barriers. Th...

Join a panel of renowned experts from Osmind's Community Advisory Board, including Dr. David Feifel, Dr. Tobias Marton, and Dr. Christy Duan, moderated by Dr. Carlene MacMillan and Dr. Alison McInnes. They unveil the future of psychiatry at the intersection of tradition and cutting-edge innovation.  Listen to in-depth discussions on harnessing big data and real-world evidence to revolutionize pers...

Dive into the world of psychiatric care for PTSD with General Stephen Xenakis, M.D., a renowned expert who uniquely combines his extensive military and medical experience. As the Executive Director of the American Psychedelic Practitioners Association (APPA), General Xenakis is pioneering the integration of advanced psychedelic therapies into mainstream mental health treatment, particularly focusi...

Stella's acquisition of Field Trip Health's U.S. assets takes center stage, revealing a strategic merger that combines Stella's innovative Stellate Ganglion Block technique and physical treatement centers with Field Trip Health's experience  and infrastructure for deliverying in psychedelic-enhanced psychotherapy.  Dr. Eugene Lipov and Mujeeb Jafferi delve into the nuances and power of combining t...

Navigating the challenging terrains of psychiatry requires a blend of expertise, vision, and ethical grounding. Dr. Rebecca Brendel, MD, JD, exemplifies these qualities. As the immediate past president of the APA and a luminary at Harvard's Center for Bioethics, she has consistently showcased her commitment to upholding ethics in the ever-evolving field of psychiatry. In this episode, she offers a...

In this insightful episode, Dr. Toby Marton, Chief Medical Officer of Mindful Health Solutions, takes us on a journey through his impactful career in the mental health space and his predictions for the future of mental health treatments. Toby, an expert in brain stimulation techniques for treatment resistant depression, shares his experiences of working with veterans and the efficacy of Ketamine I...