This Is Your Brain On Drugs Psychiatry Podcast

Today I talk about Electroconvulsive Therapy or ECT. This is the most effective treatment in psychiatry with effect sizes off the charts and comparable to treatments for other medical disorders. It's used a lot more than you probably think but not used enough. I'm no expert in ECT. I've done it under supervision, but I'm not certified in it. But that doesn't mean that I can't tell you all about it...

Hey All, I'm starting up a new series that will contain several snippets of updates in the psychopharm world. Every month or two I will plan to release an episode where I don't deep dive like normal, but instead cover several important breaking news items that affect psychopharmacology and give my quick take on the news. Some of this will be trial results, FDA updates, interesting papers that were...

Today I will be finishing up the complementary treatments for depression. I'll briefly cover three more treatments that have some evidence and no risk for effect: n-acetylcysteine, creatinine, and aromatherapy. Then I'll mention a number of treatments that as far as I can tell have no evidence that they work better than placebo, some of which could be harmful. Then I'll do a wrap-up of complementa...

Continuing with complementary medicine for depression, I'm moving on to omega-3 fatty acids. I'll give you the full run down of fatty acids and where omega-3s fit in, what differentiates all the types of fatty acids, why omega-3s are so good for you, what foods you will find them in, the three different kinds and how they are different, and most importantly, what they can do for mental health. I'l...

On today's show I will continue the discussion on minerals with zinc. Like magnesium, zinc is also critical for cell functioning, and neurons are certainly no exception. I'll talk about what zinc does, how you can be deficient, what foods contain it, what research there is to support the use of zinc in mental health, and I'll discuss how to supplement. This is another mineral to pay attention to a...

On today's show I will be talking about minerals and specifically magnesium. Magnesium is critical for cell functioning and neurons are certainly no exception. I'll talk about what magnesium does, how you can be deficient, how it's very difficult to measure neuronal levels, what foods contain it, what research there is to support the use of magnesium in depression, and I'll try to help sort out al...

On the show today I will be wrapping up the vitamins with vitamin D. This is a vitamin that I see ordered all the time, and I see it ordered a lot by mental health. Well, I can't say that I've ever seen correcting it to make a difference in mental health, but that doesn't mean that you shouldn't correct it. We take care of the whole person. Listen in to hear all about vitamin D, the details on evi...

I introduced you to vitamins on the last episode and specifically concentrated on the B vitamins and more specifically, B12 and folate (B9). I touched on L-Methylfolate as the best way to supplement folate and that even if you are not deficient in folate that it may not be getting into your brain. If that's the case, then the patient may need L-Methylfolate. I will go into detail on it today. I wi...

Today we continue our journey through complementary medicine and its impact on depression. Last time I talked about herbal treatments, and today I will start off a short series on vitamins and minerals. On today's episode I'll briefly talk about vitamins in general and then I'll focus on the B vitamins most important for mental health, B12 and folate. I'll talk about why they are so important, how...

Today I'm putting out a special episode that I'm calling a Quick Take where I'm featuring new information that comes out that is not with the topic that I am currently covering. This episode is about a first in class new non-opioid pain medication called suzetrigine. This is an interesting medication and may have potential to replace opioids. On this episode I'll talk about what's known about this...

Today I'll be starting off my series on complementary depression treatments with herbal treatments. St. John's Wort and Rhodiola rosea are probably the most well known and most likely to be helpful so I'll be covering the available research on those and give my opinion on their effectiveness. I'll also be talking about Kanna which is a new one that I've recently heard of and tried myself! It has s...

I touched briefly on discontinuation on this episode, but I found some cool information from RELEASE from the University of Queensland in Australia that have some awesome resources for discontinuing medication. I'll go into more detail on differentiating withdrawal from relapse, when to discontinue, reasons to discontinue, and more details on how to taper. 

We just had several episodes regarding antidepressant use that are unique to females, so today I will have one that will be unique to males. In this episode I will compare and contrast depression with hypogonadism. You will learn how to differentiate these two disorders which have extremely similar symptoms. I will also teach you how to work someone up appropriately for hypogonadism so that you ca...

I actually found out a lot of the L1-L5 ratings have changed. Some of the changes are big, most not. Also, there are a lot of meds that have been given a rating that I previously did not know, so I have added a bonus episode on breastfeeding to go over all these changes and additions. Please listen to this, especially if you listened to the last one because there are a few very important updates!

Today we have the third and final episode on reproductive psychiatry where I will be discussing relative safety of antidepressants as well as some other psychiatric medications with breastfeeding. I will also go over the relatively new L1-L5 rating system. In addition I'll talk about benefits of breastfeeding for baby and mom, and tell you what I tell mom's when they are deciding what to do about...

Today we have episode 2 of our reproductive psychiatry series, and I will be talking about peri-partum psychiatric symptoms with a focus on depression. I will discuss all the factors surrounding treating these patients to include the use of medications. I will talk about the relative safety of the different antidepressants during pregnancy and give you my top choices for the safest ones. I will al...

Today I'm going to be talking about something that I've wanted to talk about for a while. Even though I'm a male, I am very interested in reproductive psychiatry. I like to learn about new things and new medications. I want to find out-of-the-box treatments that have scientific backing to treat my patients because guess what, SSRIs don't fix everything! Also, I absolutely hate referring patients t...

It's time to talk about the differences in using the medications that we have discussed for depression in kids and seniors. I don't have a subspecialty board certification in these fields but I do know a thing or two about how prescribing to these populations differs from prescribing to adults. My guess is that even if you don't see kids that you probably see a number of seniors. There are differe...

There are many subtypes of depression, and this can be important when selecting the best medication. Today I will be going over these subtypes and will be giving you the algorithm for each as to what I would pick first, second, third, and so forth. Knowing this may lead to going with an MAOi or TCA, for example, much sooner than you thought you would, which can lead to faster resolution of symptom...

So you've found an antidepressant that seems to be helping the patient, but not quite as much as you'd both like. It's maxed out or we've topped out on adverse effects and can't take it any higher. Should we change it? Maybe not. We can try adding something to it. But what should we add? That's what I'll be talking about today. I'll go over every augmentation strategy that I can think of, and ther...

We've learned all about the antidepressants. You know each one of them inside and out. You know how to dose them, how to pick them, and how to follow them throughout the life cycle, but how do you change from one to the other if the patient is not tolerating or not getting efficacy from the one they are on? Well that's what this episode is about. I'll go over all the switching strategies, when to...

*This is a republish for spotify because I needed to make some changes. For today's antidepressant category of norepinephrine and dopamine reuptake inhibitor, we just have one medication, bupropion, but it is a very special antidepressant because its adverse effect profile is so much different than all of the other antidepressants we have talked about, and it is this adverse effect profile that ma...

*This is a republish for spotify because I needed to make some changes. Merry Christmas. I have a special song for you today as we start the atypical antidepressants. We've finished with the typical antidepressants and now it's time to learn about the so-called atypical antidepressants, and going in chronological order, first up are the serotonin antagonist and reuptake inhibitors. We have two dru...

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!

Apologies! I accidentally uploaded an old episode. This one is correct. We've gone over all the antidepressants. We've talked about how to pick one. But what do you do when you find the right one? How long should the patient take it? Is it ok to come off? How do you take them off? How likely is it that they will get worse again and how do you respond to that? Well that's what I'll be discussing to...