PsyDactic

I briefly explore how to treat patients with OCD.  Choosing first-line treatment is relatively straight-forward, but there is less clarity on how to proceed if my patient does not respond.  It is imperative, then, to make sure that I understand my patient’s symptoms and their goals very well. Please leave feedback at https://www.psydactic.com or send any comments to feedback@psydactic.com. Referen...

This episode explores the brain space of obsessive compulsive disorder (OCD) with a creative journey through neuroanatomy and brain circuitry.  I try to make it much less boring than it sounds.  After listening to this episode, it is my goal that the listener will understand the complex interactions of the cortico-striatal-thalamo-cortical (CSTC) circuit and have a fuller appreciating of how the b...

In previous episodes, I’ve hacked a path through Electroconvulsive Therapy and Transcranial Magnetic Stimulation, trying to reveal some of the secrets in those jungles.  Now I am turning my machete to a different landscape: Obsessive Compulsive Disorder or OCD for short.  The name is confusing, because the writers of the DSM decided to name a personality disorder Obsessive Compulsive Personality D...

This episode is dedicated to all the med studs and residents who cringe every time they have to go to journal club. I report the results of an initial trial of a special kind of Transcranial Magnetic Stimulation of the brain that might be the future of depression treatment, at least for the treatment resistant or severe varieties.  I also use this as an opportunity to explain a little more about h...

I wanted to do this episode, because when I did my episodes on electroconvulsive therapy (or ECT), I feel like I sounded a tiddly-bit dismissive of it, and I wanted to clarify what I meant when I said, “TMS, short for Transcranial Magnetic Stimulation of the Brain, as of yet is not nearly as efficacious as ECT.”  If you haven’t listened to the ECT episodes, you should still be able to follow this...

In the last episode, I gave a brief discussion about how electroconvulsive therapy (ECT) works by causing convulsive seizures and discussed some of the proposed mechanisms by which seizures might result in benefit.  In this episode, I discuss who you should consider sending for ECT, some of the considerations for different patient populations, and how you might approach explaining to a patient tha...

A brief and exciting history of electroconvulsive therapy.  You will learn how a method for anesthetizing pigs before slaughter was first used on a homeless and psychotic man and how it soon became the gold standard treatment for severe mood disorders. Please leave feedback at https://www.psydactic.com or send any comments to feedback@psydactic.com. References and readings (when available) are pos...

The mechanism of action of electroconvulsive therapy remains elusive, so I am going to describe how ECT induces seizures, discuss the evidence that ECT is not just an elaborate placebo (or in other words, inducing the seizure is what results in the therapeutic benefit), and then briefly discuss some of the many proposed mechanisms by which it might work. Please leave feedback at https://www.psydac...

Dr. O'Leary explains what inspired him to start this podcast, where the first episodes will take you, and why you should be skeptical of everything he says. Please leave feedback at https://www.psydactic.com or send any comments to feedback@psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com .  All opini...