This Is Your Brain On Drugs Psychiatry Podcast

Ok, so I've exalted the benefits of GLP1s and last time I went over how to customize to your patient. Today I will be going over some of the downsides. I'll cover the really serious stuff first that actually never happens in some cases or rarely happens in others. Then in the second half I'll go over the stuff that actually happens pretty frequently and bothers patients and how to combat it to cus...

 Today continuing with GLP-1 agonists, I will talk about the subtleties of dosing. It's a lot more than what the drug manufacturers publish. Simply following their simple instructions will not work for most patients, so I will discuss how to personalize. Next I will discuss how long patients will need to take the medications, and what to do when it's time to maintain their weight. Lower the dose?...

Today we finally reach the GLP-1 medications! It's been a long slog through obesity medication, but I feel like this is what everyone has been waiting for. I will start off today by telling you how these medications work on the many parts of the body on which they do work. I will then go through the long list of benefits that they have on these various body systems, and I will back it up with the...

Today we will finish up on medications used for weight loss prior to going in to the GLP-1 medications. I will be discussing several medications today. These are medications that you will use less often, but most of them have important roles to play with some patients, so it's important to have them in your arsenal to personalize care. I'll discuss metformin (Glucophage), topiramate (Topamax), orl...

Today is the last episode on ADHD, and I will finish off by talking about the effects of estrogen on ADHD symptoms both during the menstrual cycle and perimenopause. I will discuss using hormone replacement therapy as well as changes to ADHD medications to combat these symptoms. I will also discuss comorbid autism, anxiety, depression, and bipolar disorder as well as treating executive functioning...

Today I will continue with weight loss medications, and we will focus on two of the newer options. First the phentermine/topiramate ER combination pill known as Qsymia. Then I will talk about the naltrexone/bupropion combination pill known as Contrave. You may be thinking to yourself, why even bother with these now that GLP1 medications are so effective and everyone is using them? Well, these medi...

Today we will finish up the medications for ADHD with the remaining non-stimulant medications. There are actually quite a few non-stimulants with more than half being used off label. I will talk about the alpha 2 agonist medications guanfacine and clonidine, which are the FDA approved medications. Then, I will talk about off label options like TCAs and bupropion. Lastly, I will discuss two new med...

We have finally finished going over lifestyle factors for obesity and mental health and will start talking about medications. Today I start with medications that you should be considering first line, including phentermine and several others that you are probably less familiar with like diethylpropion, phendimetrazine, and benzphetamine. I will talk about the amphetamines that have been used for we...

Today we will be moving from the stimulant medications to the so called non-stimulants. Stimulants include methylphenidate and amphetamine as well as modafinil. There are actually quite a few non-stimulants with more than half being used off label. I will introduce the non-stimulants today and then talk in depth about two of them, atomoxetine, brand name Strattera, and one of the newest psychiatri...

We have finally finished going over lifestyle factors for obesity and mental health, and now if that was not enough to help the patient for weight loss and metabolic factors, we will need to consider using medications, but before we start medications, we need to do a medical assessment. Actually you would do this assessment before lifestyle factors, but I think this is a good time to talk about it...

Today I will be wrapping up the lifestyle factors that contribute to health problems like mental health and obesity. I will briefly discuss getting adequate sleep, avoiding toxins like alcohol, tobacco, and drugs, healthy relationships, lifelong learning, and spending time outdoors. I think many of these are overlooked when trying to lose weight or fix mental health problems. Diet and exercise are...

Today I will wrap up the last episode on adverse effects of stimulant medications used to treat ADHD. I will be discussing the black box warning regarding abuse, misuse, and addiction. This risk is very much overstated, and it leads to providers withholding potentially life changing medication from a lot of patients, so today I will be going over the scientific research on how risky these medicati...

So we had two episodes on the efficacy of antidepressants and I think I may have been a little hard on them, so I decided to make a part 3 where I instill some hope in these medications. They work great for so many people, yet so many people hate them as well. How can that be? And why do their effectiveness numbers look so abysmal? Find out on this episode!

I bet a lot of you have heard of psychogenomic testing or at least seen one. Maybe you are a patient and you got one or are thinking about getting one. Are these things worse the time and money? Listen to this episode to learn about them and get my 2 cents on the topic!

On the last episode on antidepressant efficacy we discussed effect size and placebo. On today's episode I will cover a topic called psychodynamic prescribing. I'll be giving you tips on how to become a prescriber that gets max effect from medications. There's a lot of things that you can to maximize the effect, so tune in to find out what they are.

OK, so we've learned about the antidepressants, how to pick one, and how to dose. Well, how well do they work? I'll be discussing the efficacy of antidepressants on this episode, and I will be exploring the idea of placebo as it relates to these medications. It's more than what you would like, so tune in to find out all about it!

So we've finally gone through the massive topic of nutrition, and today I'll just have this one episode on physical fitness. That's not because it isn't as important, but I think it's just a lot easier. With nutrition there's so much false information out there, but with physical fitness, it's basically just make sure you are moving around and not sedentary, so I will go over the research that tie...

It's been a few months since my last update episode, and I have several updates in the world of psychiatry. A couple studies of the ketogenic diet for depression and anxiety, a newly approved device for depression, a blood test for Alzheimers, ibogaine in Colorado, pregnancy risk with benzodiazepines and sleep medications like Ambien, a new study on the non-link between Tylenol and autism, and man...

Today I will continue talking about potential adverse effects of stimulant medications. Last time I discussed several adverse effects, but today I will mostly be focusing on cardiac (heart) effects because those have gotten a lot of press, especially with a previous black box warning for this. I will also talk about use in pregnancy in this episode. Next time I will discuss substance abuse issues...

So today I wanted to do an episode about deception in health information. How do these deceptions work and how to detect them. We don't all have the knowledge or time to go through the literature with a fine toothed comb, and even those like me that do have more knowledge and more time can still be misled, and we are often misled by well intentioned folks that think they have correctly interpreted...

Today I do a deep, deep dive on Adderall, aka Mixed Amphetamine Salts, and I attempt to answer my own questions, "Why are there 4 different salts in Adderall?" I mean I get that there is a mixture of levo and dextro, but why the sulfate, aspartate monohydrate, etc.? Well, for those of you that are wondering this is well, I think I have the answer. This is not stated anywhere that I could find, it...

So, we've talked about every stimulant medication for ADHD under the sun and we understand them pretty well. Next, I will be discussing the adverse or side effects of these medications. What are the most common ones? Which should we take more seriously? And what can we do about them when they happen? I'll be discussing how to mitigate these adverse effects so that patients can take their stimulant...

Well, we've gone through all of the information about nutrition. What's healthy. What't not. How to eat better. As well as the scientific evidence for improved nutrition and mental health. Today on the last episode in the series I will be discussing all the stuff that gets in peoples' way when it comes to eating the way that they want to in order to live a healthier life. I have several factors th...

Today I will finish talking about the methylphenidate formulation medications. This will be part 3 of 3 of the truckload of methylphenidate medications. I'll discuss the now no longer available Adhansia XR, the dexmethylphenidate products, Focalin and Focalin XR, the newest serdexmethylphenidate + methylphenidate product, Azstarys, and the off-label stimulants, modafinil and armodafinil. Once agai...

Well, I've finally made it to the end of my nutrition talks and to round that discussion out, I will be going over the scientific data and evidence for improving your mood through improving your diet. There's actually a fair amount of studies out there, and they are growing. We will go over all that evidence today, so if you've been wondering why I've been talking about nutrition on a psychiatric...