PsyQ: Journal Club

In this episode, we explore the role of olanzapine/samidorphan (OLZ/SAM) in the treatment of schizophrenia and bipolar I disorder . While olanzapine is one of the most effective second-generation antipsychotics, its use has long been limited by substantial weight gain and metabolic side effects. The addition of samidorphan, an opioid receptor antagonist, represents an innovative approach to mitiga...

Combining aripiprazole and haloperidol presents a clinical and pharmacological puzzle. On one hand, you have haloperidol, a potent D₂ antagonist that fully blocks dopamine; on the other, aripiprazole, a partial agonist with high affinity that displaces the antagonist only to provide a weaker signal. This interplay can be dangerous, potentially triggering a "dopamine supersensitivity psychosis" in...

In this episode of PsyQ, we journey from the historical notion of "gut feelings" to the cutting edge of psychiatric research: the microbiota-gut-brain axis. This episode unravels the paradigm shift that recast the gut's microbial inhabitants as a dynamic metabolic organ, actively shaping our mental health. We dissect the core communication network, exploring how neural (vagus nerve), endocrine (HP...

This episode of PsyQ delves into the rare and puzzling condition of non-catatonic mutism in individuals with schizophrenia, a profound silence that is not attributable to the physical inability to speak or the classic signs of catatonia. We explore the case of "Mr. X," a man who was mute for three years, to understand the complexities of diagnosis and the surprising cultural patterns that see this...

The field of psychiatry is at a technological crossroads, with Artificial Intelligence promising to revolutionize care delivery amidst a global mental health crisis. But does this new frontier offer a solution or a source of new, profound harm? This episode of PsyQ: Journal Club takes a critical, evidence-based look at the role of Large Language Models (LLMs) in mental health, moving beyond the hy...

Public perception often creates a direct and frightening link between mental illness and violence, but what does the evidence actually show? In this episode of PsyQ, we challenge common assumptions by exploring the complex reality of violence risk assessment. Using a case study of a patient making homicidal threats, we break down the crucial difference between static risk factors (like history and...

In this episode, we tackle one of psychiatry's most complex challenges: Obsessive-Compulsive Disorder. We begin with a deep dive into the landmark 2005 Foa et al. trial, a methodologically rigorous study that definitively established the superior efficacy of intensive Exposure and Ritual Prevention (ERP) over potent pharmacotherapy with clomipramine. Using this foundational evidence, we build a pr...

We dive into two landmark studies that have dramatically expanded the genetic map of bipolar disorder, identifying nearly 300 risk loci from over 150,000 patients. We explore the game-changing discovery of the AKAP11 gene, which provides a direct molecular link to lithium's mechanism, and unpack the complex genetic architecture that both unites and separates bipolar disorder from schizophrenia and...

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Treating adolescent depression is one of the most significant challenges in mental health, a landscape complicated by the FDA's black box warning about antidepressant-associated suicide risk. This episode dives deep into the landmark Treatment for Adolescents With Depression Study (TADS), the large-scale, NIMH-funded trial designed to bring clarity to this complex issue. We explore the study's cru...

In this episode we explore the landmark MTA study, unraveling its insights into ADHD treatment from childhood to adulthood. We'll cover the initial trial's findings on medication and combined therapy, then trace how these effects evolved, highlighting the surprising persistence of impairment compared to peers and the nuanced impact of long-term stimulant use on height versus symptoms. This episode...

This episode, we delve into the rapidly evolving landscape of GLP-1 receptor agonists in psychiatry. We'll critically appraise Hendershot et al.'s (2025) JAMA Psychiatry study on once-weekly semaglutide for Alcohol Use Disorder, examining its efficacy in reducing alcohol consumption and craving in a randomized clinical trial. We then broaden our scope with Pierret et al.'s (2025) systematic review...

This two-part episode takes a comprehensive look at clozapine, one of psychiatry's most impactful and complex medications. The two parts are (1) context, and (2) clinical pearls. We explore its challenging history, landmark clinical trials, unique pharmacology, practical prescribing guidelines, and the recent evolution of its regulatory oversight. Essential listening for psychiatry trainees and pr...

This week on PsyQ, we dive into the controversial practice of co-administering parenteral olanzapine and benzodiazepines for agitation. We revisit the 2005 FDA warning prompted by post-marketing reports (Marder et al., 2010) and critically examine the causality behind the reported fatalities. Contrasting this, we explore subsequent research, including observational studies (Williams, 2018; Wilson...

This is an AI generated podcast with human review. This episode provides guidance on the prophylactic management of bipolar disorder during pregnancy and postpartum, referencing the Uguz et al. (2023) review. We cover the high relapse risks (particularly postpartum), the core dilemma of balancing maternal health with infant safety, and evidence-based medication choices. Key takeaways include the i...

Timestamps (0:00) Context & Rationale (11:25) Methods & Findings (27:06) Critical Appraisal (43:26) Impact & Clinical Takeaway This is a journal club discussion on the CATIE trial. We cover the study's background and methodology to its critical appraisal and clinical impact. Keep in mind this merely a summary of a journal article and with the use of AI we are susceptible to some hallucination. Ple...