Podcasts about clinical psychopharmacology

Dr. Jose de Leon speaks with Dr. Julia Ann Koretski, the Journal of Clinical Psychopharmacology's Digital Editor, about practical strategies for clinicians prescribing clozapine. This discussion builds on another podcast episode in which Dr. de Leon and a panel of authors and editors discuss recommendations to the FDA to make important changes to the drug's product label to reflect current knowledge about the drug's pharmacology, safety profile, and proper titration. Dr. de Leon, Professor of Psychiatry at the University of Kentucky College of Medicine, is the lead author of two articles on the topic in the May-June 2025 issue of JCP. In this podcast, Dr. de Leon elaborates on some of the complexities involved in managing clozapine use, given individual differences in clozapine metabolism as well as genetic and ethnic variabilities among groups. He stresses, however, that clozapine is a life-saving tool that can reduce the risk of suicide in people with schizophrenia.       Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts Worldwide. Part I   Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts.  Part II

It has been more than 35 years since clozapine was approved by the FDA for use in the United States. Since then, there have been major advances in pharmacokinetics as well as a substantial accumulation of real-world evidence about its use. In two articles in the May-June 2025 issue of the Journal of Clinical Psychopharmacology, Dr. Jose de Leon and dozens of colleagues call on the FDA to make important changes to the drug's product label to reflect current knowledge about the drug's pharmacology, safety profile, and proper titration. The stakes are high: The medication can be used effectively for treatment-resistant schizophrenia, but there has been concern that it has been underused, resulting in poorer outcomes for patients, including a high rate of suicides. Updating the package insert would help to educate clinicians on its proper use and monitoring for adverse effects. In this podcast, Dr. Julia Ann Koretski, JCP's digital editor, leads a panel discussion on the articles by Dr. de Leon and colleagues. In addition to Dr. de Leon, the other panelists include Dr. Larry Alphs, author of an editorial about the topic, Dr. Richard Balon, a coauthor and JCP Associate Editor, and Dr. Anthony Rothschild, a coauthor and Editor-in-Chief of the journal.   Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts Worldwide. Part I   Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts.  Part II   Incorporating Real -World Treatment Data Into Clozapine's Product Label

Dr. Donald C. Goff, Marvin Stern professor of psychiatry at NYU Grossman School of Medicine, gives an overview of a new combination drug recently approved by the U.S. Food and Drug Administration for the treatment of schizophrenia. It will be marketed as Cobenfy, and its component active ingredients are xanomeline and trospium chloride, representing the first non-dopaminergic antipsychotic approved by the FDA. Dr. Goff briefly explores the decades of pharmaceutical treatment of schizophrenia and lays out the steps toward developing the new combination drug. He offers details on next steps, treatment, more extensive trials of the new drug, related approaches, and refers listeners to his editorial for prescribing information. His guest editorial, “At Last, a Nondopaminergic Agent for the Treatment of Schizophrenia: The Combination of Xanomeline and Trospium (Cobenfy),” is published in the March-April 2025 issue of The Journal of Clinical Psychopharmacology.

"Designer benzodiazepines" are lab-created chemical derivatives of prescription benzodiazepines. They have not been approved for medical use and there is limited information on their safety and toxicity. More potent than their prescription counterparts, this subset of novel psychoactive substances have been growing in popularity in recent years and pose the potential for dangerous levels of intoxication. In this podcast, Dr. Sahil Munjal, program director of the Atrium Health Wake Forest Baptist psychiatry residency program, leads a discussion of the article “Clinical Management of Designer Benzodiazepine Intoxication: A Systematic Review," with his coauthors Dr. Gregory Noe, Katelyn Li, and Nicholas McDuffee. They provide an overview of designer benzodiazepines in comparison to prescription benzodiazepines and describe the findings from their review of 35 case reports. They discuss clinical presentations of designer benzodiazepine intoxication, common approaches to clinical management, and key takeaways from their review of the literature. Their article appears in the March-April 2025 issue of The Journal of Clinical Psychopharmacology.

Valproic acid is one of the most frequently prescribed mood-stabilizing agents for bipolar disorder, and in some regions of the world, it now competes with lithium as the preferred treatment of choice for bipolar maintenance. There may soon be restrictions on the use of valproic acid, however, because of the risk in neural tube defects and major congenital malformations in children born to mothers and fathers who take it. In this podcast, Dr. Samuel Dotson, from the Northeast Georgia Health System in Gainesville, Georgia, and Emory University in Atlanta, and Dr. Andrew Nierenberg, from the Dauten Family Center for Bipolar Treatment Innovation at Massachusetts General Hospital and Harvard Medical School, discuss the current state of research regarding the benefits and risks of valproic acid in comparison to lithium use. They also discuss the importance of informing patients about their options, noting that lithium use has sometimes been perceived as riskier than it is. Dr. Dotson and Dr. Nierenberg are the authors of a Guest Editorial titled “Growing Concerns Over Valproate Teratogenicity Present an Opportunity for Lithium” in the March-April 2025 issue of The Journal of Clinical Psychopharmacology.

This podcast features Dr. Chadi Calarge, a child psychiatrist at Baylor College of Medicine and, for over 20 years, a researcher focused on long-term psychiatric medication safety with regard to height growth and metabolic abnormalities. He gives an overview of past and forward-looking research questions related to growth, growth hormones, and such drugs as selective serotonin reuptake inhibitors and stimulants. He discusses the journal article, “Fluoxetine and Sertraline Inhibit Height Growth and Growth Hormone Signaling During Puberty,” which was written with 10 co-authors and is published in the November-December 2024 issue of the Journal of Clinical Psychopharmacology.

According to the US Centers for Disease Control and Prevention, products containing psychoactive compounds such as cannabis or mushroom extracts are increasing in availability though they may have undisclosed ingredients, contaminants, and adulterants. Elisa Nguyen, and Drs. Abraham Qavi and Minh-Ha Tran, authors of the letter to the editor “Health Alert: Microdose Products Leading to Acute Illness and Hospitalizations Across the United States” offer general information on personal use availability of Schedule 1 controlled substances such as psilocybin, cannabis, and lysergic acid diethylamide. The letter details recent occurrences of illness, hospitalization, and deaths. Outside of the confines of carefully conducted clinical trials, consumers place themselves at risk of adverse effects through consumption of unregulated products available in nearly half of the United States. The letter to the editor is published in the November-December 2024 issue of the Journal of Clinical Psychopharmacology.

Dr. Julia Ann Koretski, a psychiatrist and Digital Editor of Journal of Clinical Psychopharmacology (JCP), discusses the editorial “Psychopharmacologic Laziness” with its author, Dr. Anthony Rothschild, who is Editor-in-Chief of JCP. He contends that psychotropic medications with well-established efficacy for the treatment of various psychiatric conditions are underprescribed due in part to what he provocatively refers to as prescriber "laziness." Under discussion are lithium, clozapine, and long-acting injectable second-generation antipsychotics. Dr. Rothschild notes that there seems to be a reluctance to treat patients with medications that entail taking blood levels or dosage monitoring, extra patient education, attentiveness to interactions and side effects, or a step outside a comfort zone.   The podcast concludes with suggestions of medication-specific fixes and a rethinking of a psychiatric resident's training to include proficiency in treating with remedies that have a strong evidence base but are viewed as extra work. The editorial is published in the November-December 2024 issue of the Journal of Clinical Psychopharmacology.

It has been hypothesized that alterations in the gut microbiota may play a part in the pathophysiology of schizophrenia, including immune system dysfunction. Preliminary evidence suggests that people with schizophrenia have decreased relative abundance of butyrate-producing bacteria in the gut microbiota. Butyrate plays a critical role in maintaining the integrity of the gut-blood barrier and has anti-inflammatory effects. A proof-of-concept study published in the Journal of Clinical Psychopharmacology was designed to assess whether treatment with an oligofructose-enriched inulin prebiotic could increase the production of butyrate. The study demonstrated that the treatment selectively increased the level of plasma butyrate in people with schizophrenia. The article, titled “Prebiotic Treatment in People with Schizophrenia,” appears in the September-October 2024 issue of the journal. The podcast provides a “somewhat more detailed background rationale for the study” than in the article, according to Dr. Robert W. Buchanan, professor of psychiatry at the Maryland Psychiatric Research Center in Baltimore, first author of the paper, who discusses the results of this study and ongoing research in a larger cohort.

The symptoms of irritability associated with autism spectrum disorder (ASD) include aggression, tantrums, self-injury, and disruption. Propranolol, a beta-blocker, has accumulated much anecdotal evidence as a promising option for symptoms of these disorders, but well-designed studies are rare. Dr. Eric London is the lead author of the article “High-dose propranolol for severe and chronic aggression in autism spectrum disorder: A pilot, double-blind, placebo-controlled, randomized crossover study,” which is published in the September-October 2024 issue of the Journal of Clinical Psychopharmacology. The article describes its effectiveness in decreasing aggression in individuals with ASD. As this was a small study, a larger clinical trial is needed. Dr. London is director of Autism Treatment Research at the New York State Institute for Basic Research. In this podcast, he offers extensive background on treatment challenges and the difficult core symptoms of ASD.

Ketamine and esketamine represent significant advancements for patients with treatment-resistant depression. Their rapid action provides much needed relief for patients who do not respond to traditional antidepressants. Their use, however, introduces challenges that necessitate ongoing research and careful consideration to maximize their potential, which Dr. Balwinder Singh, MD, MS, details in this podcast. Important challenges include unregulated or poorly monitored use of these potentially addictive products and risks related to the creation of compounded ketamine options. Dr. Singh is an assistant professor of psychiatry at the Mayo Clinic in Rochester, Minnesota, and the medical director of the mood program at the Mayo Clinic Depression Center. His guest editorial, titled “Ketamine and Esketamine for Depression in Daily Practice: Opportunities and Challenges,” is published in the September-October 2024 issue of the Journal of Clinical Psychopharmacology.

There are two distinct and unrelated definitions of the word “floxing.” In this podcast, the author of an editorial in the July-August 2024 issue of the Journal of Clinical Psychopharmacology discusses both, while providing an interesting lesson about potential drug-drug interactions that psychiatrists should be mindful of.   The author is Dr. Richard Shader, who is Founding Editor-in-Chief Emeritus of the Journal of Clinical Psychopharmacology. Dr. Shader describes the two definitions in a conversation with Dr. Julia Ann Koretski, a psychiatrist at Mass General Brigham Newton-Wellesley Hospital and Digital Editor of Journal of Clinical Psychopharmacology,   In recent decades in genetics and biology, floxing has meant to insert or sandwich a specific DNA sequence in a targeted gene. The current lay or street language term is, however, the topic of the podcast. Here, floxing refers to serious side effects attributed to the use of fluoroquinolone antibiotics. The Food and Drug Administration (FDA) refers to these effects as fluoroquinolone-associated disability or FQAD. The podcast focuses on those disabilities and the need for prescribers to guard against drug-drug interactions of the widely used antibiotic ciprofloxacin with widely prescribed psychotropic medications including clozapine, duloxetine, and fluvoxamine. Dr. Shader calls for case studies to demonstrate toxicity and to ferret out causality. Clinicians should direct instances of interaction to FDA's reporting portal www.fda.gov/medwatch.

Psychotic bipolar depression (PBD) is a prevalent yet understudied psychiatric illness with no specific guidelines or Food and Drug Administration-approved medications for its treatment. Recent studies suggest that some antipsychotics and mood stabilizers may be effective in managing bipolar depression; however, their effectiveness for PBD remains unclear. With an urgent need for more focused research for managing PBD, several authors conducted a literature review to piece together existing literature on the topic.   In this podcast, Dr. Julia Ann Koretski, Digital Editor of the Journal of Clinical Psychopharmacology (JCP), discusses the review with two of its authors, Dr. Maité Cintrón Pastrana and Dr. Anthony Rothschild, who is Editor-in-Chief of the Journal of Clinical Psychopharmacology. Both authors are from the University of Massachusetts Chan Medical School. A third author, Jessica C. Irizarry Flores, is from the Ponce Health Science University Medical School in Puerto Rico.   The article appears in the July/August 2024 issue of the journal.

In this episode, we share Martina's keynote lecture on novel advances in clinical trials, which she gave at the annual meeting for the American Society of Clinical Psychopharmacology at the end of May 2024 in Miami, Florida.

Tachyphylaxis is a phenomenon described as the loss of response to a medication that was previously effective at an established dose. In a case report letter to the editors, Stefanie Cavalcanti, MD, Olga A. Lopez, MD, Simon Kung, MD, Jennifer L. Vande Voort, MD, Kristin Somers, MD, Mark A. Frye, MD, and Balwinder Singh, MD, MS, from the department of psychiatry and psychology at the Mayo Clinic, in Rochester, Minnesota, discuss “A Case of Tachyphylaxis After Long-Term Intravenous Racemic Ketamine for Treatment-Resistant Depression” in the May/June 2024 issue of the Journal of Clinical Psychopharmacology. In this podcast about the case report, two co-authors, Dr. Singh and Dr. Cavalcanti, discuss the compelling history of one 56-year-old woman with treatment-resistant recurrent major depressive disorder. Her depression, ongoing for 10 years, featured prominent symptoms of depressed mood, social isolation, low energy, decreased appetite, and anhedonia. Past medication trials included selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, mood stabilizers, antipsychotics, benzodiazepines, and bitemporal electroconvulsive therapy with limited benefit. Ketamine, which is used increasingly for treatment-resistant depression (TRD), and other psychiatric disorders, was tried next. Sustained clinical response was observed for the first 2 years of intravenous ketamine treatment despite ongoing life stressors. In the following years, a gradual reduction of response to subsequent ketamine infusions was observed in the patient, who required more frequent infusions to obtain the same response. The authors emphasize that “the extension of ketamine's antidepressant effect with an increased dosage remains uncertain. … Ketamine has an addiction potential; thus, it is important to be mindful that increasing the ketamine dosage to address ketamine tachyphylaxis may enhance the potential for undesired consequences. Urgent studies investigating strategies to prolong ketamine's efficacy in adults with TRD are required.”

The glucagon-like peptide 1 (GLP-1)–based diabetes and obesity drug semaglutide, with trade names Ozempic and Wegovy, will become the second best-selling drug in 2024, with estimated worldwide Ozempic sales of US ~$16 billion. Finally, the pharmacological treatment of obesity seems to have a breakthrough after decades of setbacks, with previous weight-loss medications withdrawn from the market because of serious side effects. In this podcast, the co-author of a guest editorial, “Glucagon-Like Peptide 1 Receptor Agonists in Psychiatry,” Hubertus Himmerich, MD, reviews the implications of GLP-1 drugs for psychiatry and healthcare globally. The article is published in the May/June 2024 issue of the Journal of Clinical Psychopharmacology. Dr. Himmerich, who is from the department of psychological medicine, Institute of Psychiatry, Psychology & Neuroscience at King's College in London, authored the editorial with Dr. Susan L. McElroy, of the Lindner Center of HOPE, Mason, OH, and the Department of Psychiatry and Behavioral Neuroscience at the University of Cincinnati College of Medicine.

Among most prescribers, bupropion is considered a substance of low misuse potential, with some studies showing lesser misuse potential than caffeine. However, several case reports exist of recreational bupropion misuse and diversion. This podcast, a discussion by authors of their bupropion systematic review, reports that snorting and intravenous injection of bupropion occur almost exclusively in patients with a substance use disorder history, with a preponderance of patients with stimulant use disorder or multiple substance use disorders. Users who divert bupropion from prescribed use describe a brief cocaine-like high of approximately 30 seconds to 5 minutes. The systematic review highlights the bupropion misuse potential in certain patient populations and serves to increase awareness among clinicians of unhealthy results of abuse. Additional patient screening, monitoring and follow-up, surveillance, and further research are needed to investigate and prevent bupropion misuse in at-risk patient populations.   Sahil Munjal, MD, moderates a discussion conducted with his systematic review co-authors Greg Noe, BS, Kaushal Shah, MD, MPH, and Samantha Ongchuan, MD, on bupropion misuse. The article appears in the May/June 2024 issue of the Journal of Clinical Psychopharmacology. The authors are from Wake Forest University School of Medicine, the Department of Psychiatry at Atrium Wake Forest Baptist Health, and the Department of Psychiatry at Wake Forest University in Winston-Salem, NC.

Finally, new prospects in depression treatment! Listen in as Dr. Jennifer Reid and Dr. Michael Thase discuss antidepressants, ketamine, psychedelics, and much more!Professor Thase is renowned as a teacher, mentor, administrator, researcher and clinician. One of the world's most highly cited psychiatrists, he has more than 1300 publications, as well as 18 books, including the award-winning Learning Cognitive Therapy, now in its second edition.Dr. Michael Thase is a Professor of Psychiatry in the Perelman School of Medicine of the University of Pennsylvania, and a member of the medical and research staff of the Corporal Michael J Crescenz Veterans Affairs Medical Center:Some questions Dr. Thase considers: 1)   You have been treating patients with depression for decades. How would you describe how your work has changed since you first started your career?2)   Looking back, do you think there were any missed opportunities when it comes to depression treatment?3)   How do you conceptualize difficult-to-treat depression, and is this something you discuss with patients? 4)   You're coauthor on a paper titled “The Neglected Role of Psychotherapy for Treatment-Resistant Depression.” What is its role?7)   What are your opinions about ketamine treatment in its various formulations: IV, sublingual, Esketamine?8)   What about psychedelics? Cannabis?9)   What are you hopeful about in the field of psychiatry?Thank you for checking out Our Reflective Minds. This post is public, so feel free to share it with anyone who may benefit from listening!A 1979 graduate of The Ohio State University College Medicine, Professor Thase completed internship, residency, chief residency, and post-doctoral training in clinical research at the University of Pittsburgh Medical Center (UPMC), where he rose to the rank of Professor of Psychiatry and was Chief of the Division of Academic Adult Psychiatry until 2007, when he moved to Philadelphia.  He is a Distinguished Life Fellow of the American Psychiatric Association, a Fellow of the American College of Neuropsychopharmacology and a member of the American College of Psychiatrists. He is a Past President of the American Society of Clinical Psychopharmacology, for which he was a member of their Board of Directors for more than two decades.  A Founding Fellow of the Academy of Cognitive Therapy, Professor Thase is a member of advisory boards for the Anxiety and Depressive Disorders Association, the National Network of Depression Centers, the Depression and Bipolar Support Alliance and the American Foundation for Suicide Prevention. In 2018 he was elected to the membership of Penn Medicine's Academy of Master Clinicians, an honor bestowed to only 2% of the medical school's faculty. Professor Thase's research has been continuously funded by various federal agencies for the past 37 years and currently focuses on novel therapies for difficult to treat depressive disorders and dissemination and implementation of cost-effective forms of cognitive behavior therapy.Jennifer Reid, MD on Instagram: @JenReidMDLooking for more from The Reflective Doc? Subscribe today so you don't miss out!Also check out Dr. Reid's regular contributions to Psychology Today: Think Like a ShrinkThanks for reading Our Reflective Minds! Subscribe for free to receive new posts and support my work.**********************Seeking a mental health provider? Try Psychology TodayNational Suicide Prevention Lifeline: 1-800-273-8255Dial 988 for mental health crisis supportSAMHSA's National Helpline - 1-800-662-HELP (4357)-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.Disclaimer:The views expressed on this podcast reflect the host and guests, and are not associated with any organization or academic site. The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thereflectivemind.substack.com

Welcome back, dear listeners, before we get into today's episode I wanted to invite you to a live online workshop that I'm hosting called Journaling for Chronic Pain Relief. Journaling was a hugely important tool in my recovery, and I'm going to teach you how to release emotions, tension and pain from your body through writing in a way that's gentle and safe and won't overwhelm your nervous system. I hope that you'll join me, I would love to see and meet you there. The workshop will take place online on Thursday May 2nd at 12pm Eastern (and yes, there will be a replay, but it's only available to you if you register. And you can do that by going to: www.annaholtzman.com/WritingWorkshop And now, I have a really special episode for you today and you'll be interested to hear it if you have any teenagers in your life who struggle with chronic symptoms, or if you experienced chronic symptoms in the teenage years yourself. My guest today is Dr. Jin Lee, PsyD, MSCP, BCB, a licensed pediatric psychologist with a deep specialization in chronic pain and functional neurological disorder in children and adolescents. With extensive training, including a Doctor of Psychology (PsyD) and Master's degree (MA) in Clinical Psychology from Pepperdine University and a Postdoctoral Master of Science (MS) in Clinical Psychopharmacology from Fairleigh Dickinson University, Dr. Lee has honed her expertise to become a leading expert in the field. Her passion for pediatric psychology and dedication to improving the lives of young patients are evident through her clinical practice, teaching, and research endeavors. As a founder of her private practice based in Colorado, Your Pediatric Psychologist, Dr. Lee delivers direct clinical care to pediatric patients and collaborates closely with medical teams, school personnel, and community providers to ensure comprehensive care coordination and treatment. Moreover, as the founder of Teen FND Academy, Dr. Lee provides an innovative online psycho-education program and coaching support to adolescents and their families, focusing on resolving chronic pain and functional neurological disorders. Through evidence-based intervention approaches and compassionate care, she empowers teens and their parents to overcome challenges related to chronic pain and FND and achieve better outcomes. Dr. Lee's impact in the field extends beyond her clinical practice through her work as an educator, clinical supervisor and policy advocate in her field. I was so thrilled to have this conversation with Dr. Lee, so without any further intro, I'll invite you to listen in.   You can find Dr. Lee at: Website: https://www.yourpediatricpsychologist.com/ Group program: https://www.teenfndacademy.com YouTube: https://www.youtube.com/@TeenFND   And you can find me at: Instagram: ⁠⁠⁠⁠⁠⁠@anna_holtzman⁠⁠⁠⁠⁠⁠ Email: anna@annaholtzman.com Website: ⁠⁠⁠⁠⁠⁠www.annaholtzman.com⁠ --- Support this podcast: https://podcasters.spotify.com/pod/show/from-chronic-pain-to-pass/support

Two articles in the March-April 2024 issue of the Journal of Clinical Psychopharmacology present research on glucagon-like peptide-1 receptor agonists (GLP-1 RAs),  a class of medications that has drawn considerable media attention in recent months for their ability to promote significant weight loss. The articles in JCP consider their use in specific populations of patients: individuals with bipolar disorder or eating disorders (in this case, atypical anorexia nervosa). This podcast features a discussion of the articles by authors Susan L. McElroy, MD; Anna Ward, ARPN; and Dr. Anna Guerdjikova, PhD, LISW, from the Lindner Center of HOPE in Mason, OH, and the University of Cincinnati. The first article, Liraglutide in Obese or Overweight Individuals With Stable Bipolar Disorder, reports on a placebo-controlled double-blind trial, which showed that compared with placebo, liraglutide was associated with greater reductions in percent change in body weight, and reductions in weight, body mass index, binge eating and hunger. Obesity is common among individuals with bipolar disorder, possibly contributing to their well-documented higher risk of cardiovascular-related mortality. The second article is titled Semaglutide Misuse in Atypical Anorexia Nervosa – A Case Report. The report presents the case of a patient with a history of an eating disorder who intentionally misused the GLP-1 semaglutide and lost more than 40  pounds in 9 months. The case report is designed to alert clinicians of the importance of reviewing patients' medical and psychiatric histories, being attuned to patient histories of weight fluctuations, and screening for eating dysregulation when prescribing weight-loss approved medications.

“Rapid cycling” in bipolar disorder is defined by the occurrence of at least 4 episodes of mania, hypomania, depression, or mixed states during the preceding 12 months. Episodes are demarcated by partial or full remission for at least 2 months or a switch to an episode of opposite polarity. In this podcast, Dr. Ross J. Baldessarini of McLean Hospital and Harvard Medical School discusses the prevalence of rapid cycling and the challenges in its treatment. Rapid cycling is more common in women and is associated with an elevated risk of suicide. Dr. Baldessarini's comments are informed by recent efforts he and his colleagues undertook to synthesize reviews and meta-analyses on prevalence rates and response rates to treatment, as well as on their recently research on a cohort of 1261 bipolar disorder patients with or without rapid cycling who were followed up for at least 1 year.   The March-April 2024 issue of the Journal of Clinical Psychopharmacology includes a commentary from Dr. Baldessarini, Dr. Alessandro Miola, Dr. Mark A. Frye,  and Dr. Leonardo Tondo titled “Current Status and Treatment of Rapid Cycling Bipolar Disorder.”

In a guest editorial in the Journal of Clinical Psychopharmacology, authors Eric G. Smith and Kushani M. Patel discuss how case series and case reports can contribute to psychiatric treatment decisions. Their article in the March-Apil 2024 issue is titled “The Role of Case Series and Case Reports in Evidence-Based Medicine.” Dr. Smith is from the VA Bedford Healthcare System and the UMass Chan Medical School. Dr. Patel is from the Boston University Chobanian & Avedisian School of Medicine.   Case reports and case series are justifiably far down in the hierarchy of evidence-based medicine, but there are specific clinical situations in which referring to case reports or case series can be of value. In this podcast, Dr. Smith discusses some of these circumstances, such as when there is no FDA-approved treatment for a disorder or when treating patients who have declined treatment with medications supported by higher levels of evidence such as randomized controlled trials. Additionally, case reports can assist in evaluating questions of safety.

We have all seen the television commercials imploring viewers to “ask your doctor” about Drug X, Y, or Z. The authors of a study in the Journal of Clinical Psychopharmacology were interested in finding out how such advertising might affect the prescribing of psychotropic medicines. In this podcast, the authors discuss their research with Dr. Julia A. Koretski, Digital Editor for JCP. The authors of the study are Drs. Bennett Wechsler, Richard Balon, Richard Shader; and Anthony Rothschild. Dr. Balon is an Associate Editor of JCP and Dr. Rothschild is Editor-in-Chief. Dr. Shader is the Founding Editor-in-Chief Emeritus. The researchers surveyed psychiatrists to ask how challenging it was for them to convince patients that a medication was not needed, despite what the advertising might suggest. The results of their survey showed that psychiatrists who were newer to their profession (less than 10 years since they completed training) had a more challenging time than those who were more experienced in changing patients' minds. In this podcast, the authors discuss how their study came about and the thorny issues raised by the commercial promotion of psychiatric medications. The article titled “Direct-to-Consumer Advertising Survey of Psychiatrists in Massachusetts and Michigan” is published in the January-February 2024 issue of the Journal of Clinical Psychopharmacology.

In 1954, Dr Heinz Lehmann published the first clinical article on the use of chlorpromazine. Chlorpromazine was the first synthetic drug used to control states of mania and psychomotor excitement, marking the birth of modern psychopharmacology. Seventy years later, the Journal of Clinical Psychopharmacology is highlighting the anniversary of Dr Lehmann's publication. The January-February 2024 issue of the journal includes a guest editorial that offers a brief history lesson on Dr Lehmann's contributions. The authors of the editorial are Drs. Pablo Dutra, Richard Balon, and Antonio E. Nardi. In this podcast, the authors of the editorial are joined by a distinguished group of JCP Editorial Board members to discuss Dr. Lehmann's research and the many profound ways the research environment has changed in the past 70 years. Along with the authors, the podcast participants are Drs. Carl Salzman, Alan Schatzberg, Leslie Citrome, Matthew Byerly, John Davis, and Anthony Rothschild. Dr Julia Koretski, Digital Editor for JCP, leads the discussion. The guest editorial is published in the January-February 2024 issue of the Journal of Clinical Psychopharmacology, in an article titled "Celebrating 70 Years of the First Publication on Antipsychotic Treatment in North America by Heinz E. Lehmann and Gorman E. Hanrahan: Would Their Methodology Still Be Conceivable?"

Dr. Evyn Peters has created pivotal changes for patients arriving at Royal University Hospital's mental health short stay unit, and its emergency department.   With 33 publications and interests spanning psychiatry, psychopharmacology and mood disorders, Peters is often one of the first physicians patients see when they're experiencing a mental health crisis. Peters was finishing his residency at RUH and the University of Saskatchewan's College of Medicine in 2017, when he and his colleagues first proposed ketamine for short-stay patients who had tried multiple antidepressants without success.   After studying best practices in other centres, Peters and his colleagues developed a protocol to treat patients with a ketamine nasal spray. His patients stay conscious, and don't need an intravenous catheter or intensive cardiorespiratory monitoring.   “Not only does it work very quickly but it is twice as effective roughly as your conventional anti-depressants. And what's more impressive is that it's being used for patients typically who've failed to respond to anti-depressants in the past,” Peters said. “It certainly is a cost-effective treatment.”   Until 2020, the only other option for hospitalized patients who didn't respond to other drugs was electroconvulsive therapy (ECT). Hospitals in Saskatchewan sometimes struggle with backlogs, with patients waiting weeks for ECT. A psychiatrist and anesthetist and nurses must oversee the procedures, including treatments which typically stretch over another four weeks. “That's a long time in hospital,” said Peters. “You can get a similar response rate with one or three or four ketamine treatments every second day in about a week in hospital here.”   Peters was the lead author on the 2023 article Intranasal racemic ketamine for patients hospitalized with treatment-resistant depression: A retrospective analysis, published earlier this year in the journal Experimental and Clinical Psychopharmacology, together with his University of Saskatchewan psychiatry colleagues Dr. Katelyn Halpape, Dr. Isaac Cheveldae and Dr. Annabelle Wanson. His patients, on average, were taking 3.5 psychiatric medications when they were admitted. His team made a point of not requiring patients to wean themselves off other anti-depressants during their treatment with ketamine.    “We have a response rate in the hospital here of about 65 per cent, which is what you see in other treatment centres” said Peters. “The vast majority of those patients, about 75-80% get discharged immediately after that treatment.” He said the rest of his patients often face other health and life circumstances complicating their discharge, such as homelessness. On top of that, ketamine is not suitable for anyone who's recently had a heart attack, stroke, blood pressure issues, or who has schizophrenia.   “The goal was just to get it in use, because it was needed,” said Peters. “Now we can answer some of these questions about why does it work, and for whom does it work the best?”  

Welcome to the podcast with Dr. Brendan McCarthy! Sugar is one of the most widely consumed ingredients and for a good reason. It makes things taste sweeter and more appealing to our tastebuds. Plus, sugar is added to many packaged foods and beverages, and we may be unaware we're consuming so much of it. With this constant exposure, it's no wonder why craving sweets is a common experience. But is it all due to personal habits and our culture's influence, or is something else going on? Dr. Brendan McCarthy founded Protea Medical Center in 2002. While he's been the chief medical officer, Protea has grown and evolved into a dynamic medical center serving the Valley and Central Arizona. A nationally recognized as an expert in hormone replacement therapy, Dr McCarthy s the only instructor in the nation who teaches BioHRT on live patients. Physicians travel to Arizona to take his course and integrate it into their own practices. Besides hormone replacement therapy, Dr. McCarthy has spoken nationally and locally before physicians on topics such as weight loss, infertility, nutritional therapy and more. Thank you for tuning in and don't forget to hit that SUBSCRIBE button! Let us know in the COMMENTS if you have any questions or what you may want Dr. McCarthy to talk about next! Check out Dr. Brendan McCarthy's Book! https://www.amazon.com/Jump-Off-Mood-Swing-Hormones/dp/0999649604 --More Links-- Instagram: www.instagram.com/drbrendanmccarthy TikTok: www.tiktok.com/drbrendanmccarthy Clinic Website: www.protealife.com Citations: Shabbir, Faisal, et al. "Effect of diet on serotonergic neurotransmission in depression." Neurochemistry international 62.3 (2013): 324-329. Mahar, Ian, et al. "Stress, serotonin, and hippocampal neurogenesis in relation to depression and antidepressant effects." Neuroscience & Biobehavioral Reviews 38 (2014): 173-192. Moroianu, Lavinia-Alexandra, et al. "Clinical study of serum serotonin as a screening marker for anxiety and depression in patients with type 2 diabetes." Medicina 58.5 (2022): 652. Choi, Wonsuk, et al. "Associations of serum serotonin levels with 12-week and 12-month remission in patients with depressive disorders." Clinical Psychopharmacology and Neuroscience 20.2 (2022): 248..

Replacement therapy is a key tool in the treatment of individuals who abuse opioids. The idea is to replace heroin or morphine with less euphoric and longer-acting substances, such as methadone, under a medication management protocol. The goals of medical-assisted replacement treatment include reducing an individual's craving for abused opioids, preventing medical complications, decreasing criminal behavior and its consequences, and utimately, hopefully, helping the individual become opioid-free. In this podcast, Dr. Richard Balon discusses the potential for replacement therapy for abuse of other types of substances, including cocaine and methamphetamines. In the podcast and in an editorial in the Journal of Clinical Psychopharmacology (JCP), he notes promising but preliminary studies of lisdexamfetamine as a possible replacement agent. Dr. Balon is an Associate Editor of JCP and Professor of Psychiatry at Wayne State University School of Medicine in Detroit, Michigan. In this podcast, he is interviewed by Dr. Julia Koretski, Digital Editor for JCP and a psychiatrist at Mass General Brigham Newton Wellesley Hospital in Newton, Massachusetts. Dr. Balon's editorial is published in the November–December 2023 issue of the Journal of Clinical Psychopharmacology, in an article titled “The Need for Examining the Role of Psychostimulants in Treatment of Methamphetamine Use/Dependence.”

Welcome to the Psychedelic Science conference in Denver, Colorado! In this episode we explore Rick's background and what led him to the Psychedelic Science conference in Denver. We discuss the anti-addictive benefits of psychedelics and highlight the significance of intention, as well as the right set and setting, to harness their therapeutic potential. Additionally, we touch on topics like the twelve-step fellowship, supporting family members battling addiction, addressing the misconceptions around psychedelics, and understanding the associated risks and precautions. Dive in with us for this comprehensive conversation and more! 00:00 - Introduction 01:03 - The Conference 02:09 - Are Psychedelics Addictive? 04:19 - The Set And Setting Matters 06:27 - The Twelve-Step Fellowship 09:00 - Mild Vs Severe Approach 11:34 - Family Reaching Out 12:48 - Spreading The Word 14:57 - Dealing With Pushback 18:48 - Retail/Shopping Addiction 23:19 - Risks And Precautions 26:04 - Outro About Rick: Dr. Rick Barnett, Psy.D., LADC, founded the non-profit organization CARTER, Inc. in 2015 to expand addiction-related resources in Vermont and beyond. Dr. Barnett is Legislative Chair and Past-President of the Vermont Psychological Association, and is a clinical psychologist and addiction specialist in private practice in Stowe, VT. Dr. Barnett has worked as a Clinical Psychologist in nursing homes, hospitals, and outpatient programs and has trained hundreds of health professionals through workshops on addiction and mental health issues over the past 20 years. He is in long-term recovery of alcohol and substance abuse and is an active advocate for addiction treatment and recovery resources. Dr. Barnett holds a Bachelor's degree in psychology from Columbia University, a Doctorate and Master's Degree in Clinical Psychology and a Master's Degree in Clinical Psychopharmacology. He is a Licensed Alcohol and Drug Counselor and holds certificate in Problematic Sexual Behavior (PSB-S) and Gambling Disorder. Dr. Barnett's service goes beyond the clinical world into his community and public policy as he has served on and continues to serve on many community and government boards and committees. Connect with Rick: Website: https://drrickbarnett.com/ Website: https://www.cartervermont.org/ LinkedIn: https://www.linkedin.com/in/dr-rick-barnett Thank you so much for joining us! Psychedelic Conversations Podcast is designed to educate, inform, and expand awareness. For more information, please head over to https://www.psychedelicconversations.com Please share with your friends or leave a review so that we can reach more people and feel free to join us in our private Facebook group to keep the conversation going. https://www.facebook.com/groups/psychedelicconversations This show is for information purposes only, and is not intended to provide mental health or medical advice. About Susan Guner: Susan is a trained somatic, trauma-informed holistic psychotherapist with a mindfulness-based approach grounded in Transpersonal Psychology that focuses on holistic perspective through introspection, insight, and empathetic self-exploration to increase self-awareness, allowing the integration of the mind, body and spirit aspects of human experience in personal growth and development. Connect with Susan: Website: https://www.psychedelicconversations.com/ Facebook: http://www.facebook.com/susan.guner LinkedIn: https://www.linkedin.com/in/susan-guner/ Instagram: http://www.instagram.com/susanguner Twitter: http://www.twitter.com/susanguner Blog: https://susanguner.medium.com/ Podcast: https://anchor.fm/susan-guner #PsychedelicScience2023 #SusanGuner #RickBarnett

Much has been written in recent months regarding the growing use of artificial intelligence (AI) in medicine and the potential benefits and risks of its use. In this podcast, Anthony J. Rothschild, MD, Editor-in-Chief of the Journal of Clinical Psychopharmacology, highlights a paper in the journal by Drs. Jose de Leon and Carlos De Las Cuevas that reports their experiment to see how ChatGPT3 would respond to various questions about clozapine metabolism. The generated text proved to be profoundly unreliable. Dr. Rothschild also discusses his editorial about the journal's policies regarding use of generative AI by authors and reviewers. Authors must disclose any such use; peer reviewers are prohibited from using AI in conducting their reviews. Dr. Rothschild's editorial and the commentary by Drs. De Leon and de Las Cuevas both appear in the September–October 2023 issue of the Journal of Clinical Psychopharmacology.

Clozapine is an important drug in the treatment of schizophrenia, and adherence is generally thought to be as good as, if not better than, other antipsychotics. Nonadherence, however, is difficult to detect and potentially dangerous. Tolerance to the cardiovascular effects of the drug is easily lost; restarting at a “normal” dose can prove fatal after a period of abstinence. Nonadherence also increases the risk of self-harm. In this podcast, Dr. Robert Flanagan, a now-retired clinical scientist at Kings College Hospital in London, discusses his study of nonadherence, as measured by plasma levels of clozapine, in samples submitted to a clozapine therapeutic drug monitoring service from 1993–2017. In thousands of submitted samples, nonadherence was 1.1% for men and 1% for women. Dr. Flanagan discusses both the implications of his research as well its limits. The research is published in the September–October 2023 issue of the Journal of Clinical Psychopharmacology, in an article titled “Assessing Adherence to Clozapine: Practical Considerations.” Dr. Flanagan's coauthors are Samora Hunter and Stephen J. Obee, also of Kings College Hospital.

Welcome back to The Trip Report Podcast! Today, we are talking with Dr. Rick Barnett.Rick is the founder of the Center for Addiction Recognition, Treatment, Education, and Recovery in Stowe, Vermont, and the Co-Founder of the Psychedelic Society of Vermont.He is also a clinical psychologist and licensed alcohol and drug counselor with a Master's Degree in Clinical Psychopharmacology.This combination of training, clinical practice, and education made for a really interesting discussion of the emerging use of psychedelics in therapy and drug and alcohol recovery.There is a massive difference between the emerging “psychedelic industry”— clinical trials, drug development, policy reform efforts, and legal retreats—and the reality of the situation outside of these contexts.This dichotomy is one of the most fascinating features of this whole domain. While we wait for the Overton Window to shift—for FDA approval, for VA buy-in, for lawmakers and regulators to get comfortable—the use of psychedelics in unregulated, personal, grey and illegal settings is skyrocketing.This is where the psychedelic industry differs from so many other industries or technologies: there is a major distinction between the so-called “above ground” business and investment landscape, which is dominated by commercial drug development and services designed to fit into the modern healthcare system, and the so-called “underground,” a decentralized, unregulated, bottom-up psychedelic market.The need is for education, support, and community to midwife the mainstreaming of psychedelics, not suppression.In this conversation, we discuss:* The connective tissue of the psychedelic ecosystem.* The integration of psychedelic, ecstatic, and expressive approaches to clinical practice in Western healthcare systems;* Dr. Barnett's experience responding to the cultural interest in psychedelics as a clinical psychologist;* The importance of community among healthcare professionals to increase education and best practices; andIn Greek mythology, the God Hermes is said to have possessed the ability to move freely between different realms—he could travel between the mortal world, the divine realm of Olympus, and the Underworld. This capacity made him unique in Greek Mythology. As a trained psychologist, educator, and community organizer, Dr. Barnett is like a modern-day Hermes—interfacing with the clinical and research worlds as well as the local and digital peer-to-peer community networks of the psychedelic-curious.And now, I bring you my conversation with Dr. Rick Barnett.Listen to the episode on Substack, Spotify, Google or Apple.Credits:* Hosted by Zach Haigney * Produced by Zach Haigney, Erin Greenhouse, and Katelin Jabbari* Find us at thetripreport.com* Follow us on Instagram, Twitter, LinkedIn and YouTube* Theme music by MANCHO Sounds, Mixed and Mastered by Rollin Weary This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thetripreport.com

The COVID-19 pandemic and associated public health measures shifted the way people access health care. In this podcast, Dr. Christine Leong, Associate Professor at the University of Manitoba College of Pharmacy, discusses the research she and her colleagues conducted to study the effects of the pandemic on psychotropic medication adherence. The data were drawn from a claims repository that contains information on health service and medication use for almost all Manitoba residents. The study showed improved adherence to most psychotropic medications in the 9 months after public health restrictions were enacted. Patients who were already adherent to their psychotropic medications were less likely to discontinue them during the pandemic. Findings in this study highlight that, although there were concerns about public health measures restricting access to in-person care, access to medications in Manitoba did not seem to be restricted. The article “Adherence to Psychotropic Medication Before and During COVID-19: A Population-Wide Retrospective Observational Study” is published in the July-August 2023 issue of the Journal of Clinical Psychopharmacology.

The July-August 2023 issue of the Journal of Clinical Psychopharmacology features a helpful tutorial written by Drs. Eric G. Smith and Hannah L. Grigorian. Their article is titled “A System for Rapidly Yet Rigorously Evaluating the Quality of Randomized Controlled Trials.”  The article should be of particular interest to busy clinicians, researchers, and trainees, who must grapple with the never-ending task of keeping up with the medical literature. In this podcast accompanying the article, Dr. Smith provides an overview of criteria that can be used to assess various aspects of trials, including blinding of participants and study personnel, sample size, follow-up, analysis plans, and effect sizes. Dr. Smith is a psychiatrist and clinical and health services researcher at the VA Bedford Healthcare System, Bedford, Massachusetts, and Assistant Professor of Psychiatry and Population and Quantitative Health Sciences at the University of Massachusetts Chan Medical School. Dr. Grigorian is a psychology research fellow at the VA Bedford Healthcare System.

Among individuals with schizophrenia, an estimated 50% to 80% have a partial or even total lack of insight into the presence of their mental disorder. This condition, known as anosognosia, has also been observed in people with other diagnoses, such as bipolar disorder, major depression with psychotic features, obsessive-compulsive disorder, and eating disorders. The May-June 2023 issue of the Journal of Clinical Psychopharmacology features two articles on this topic, a commentary by Rachel Streiff, titled  “Institutional Neglect of Anosognosia Is a Critical Barrier in the Treatment of Psychosis Related Disorders” and an editorial by Editor-in-Chief Anthony Rothschild, MD, titled “Can Psychopharmacology Do More for Our Patients With Anosognosia?” In this podcast, Ms. Streiff, who as cared for a family member with anosognosia, and Dr. Rothschild discuss their articles with Dr. Julia Koretski, Digital Editor of the journal. The articles and podcast are designed to heighten awareness of the scant research on medication treatments for people with serious mental illness who also experience anosognosia.

Hyperammonemia is an adverse effect that poses clinical uncertainty regarding the prescription of valproic acid (VPA) use. The prevalence of symptomatic and asymptomatic hyperammonemia and its relationship to VPA concentration is not well established. In this podcast, clinical pharmacists Michelle Gnrya and Yiu-Ching Jennifer Wong of St. Paul's Hospital in Vancouver discuss their systematic review that summarizes evidence available regarding VPA-associated hyperammonemia and its prevalence, clinical outcomes, and management. Their review is published in the May-June 2023 issue of the Journal of Clinical Psychopharmacology. The review found various risk factors for this common adverse effect, including concomitant medications, liver injury, and defects in carnitine metabolism. With VPA discontinued, most symptomatic patients returned to baseline mental status with normalized ammonia level. Further studies are required to determine the benefit of routine ammonia level monitoring and to guide the management of VPA-associated hyperammonemia.

Wanneer we met een activiteit bezig zijn, zoals de auto wassen of een tentamen maken, kunnen allerlei omgevingsfactoren ons afleiden. Maar ook onze eigen gedachten kunnen dat doen en dit wordt mind-wandering of dagdromen genoemd. In deze aflevering bespreken we op basis van psychologisch onderzoek hoe dagdromen onze gedachten en gevoelens beïnvloedt, of mindfulness een effect heeft op onze neiging tot dagdromen en welke voordelen er aan dagdromen kunnen zitten. Muziek: Rolf ZwaanBronnenKieran CR Fox, Roger E Beaty, (2019). Mind-wandering as creative thinking: neural, psychological, and theoretical considerations, Current Opinion in Behavioral Sciences, 27.Poerio, G. L., and Smallwood, J. (2016), Daydreaming to navigate the social world: What we know, what we don't know, and why it matters. Social and Personality Psychology Compass, 10. 605– 618.Schooler, J.W., Mrazek, M.D., Franklin, M.S., Baird, B., Mooneyham, B.W., Zedelius, C., & Broadway, J.M. (2014). Chapter one - The middle way: Finding the balance between mindfulness and mind-wandering. Psychology of Learning and Motivation, 60, 1-33. Smallwood, J. & Schooler, J. (2015). The Science of Mind Wandering: Empirically Navigating the Stream of Consciousness. Annual Review of Psychology 66, 487-518Zwaan, R.A., & Truitt, T.P. (1998). Smoking urges affect language processing. Experimental and Clinical Psychopharmacology, 6, 325-330. Hosted on Acast. See acast.com/privacy for more information.

Clozapine is a unique antipsychotic with superior efficacy in treatment-resistant schizophrenia (TRS). Unfortunately, approximately 40% to 70% of patients on clozapine continue to experience psychotic symptoms. Nevertheless, there is a concern about how high of a dose to prescribe because adverse effects are related to plasma levels of the drug. In this podcast, Dr. Jan Bogers discusses his research involving stepwise increases in clozapine doses in severely ill, long-stay patients with TRS. The study, conducted at Rivierduinen Mental Health Organization in the Netherlands, concludes that most patients older than 60 years could not tolerate high clozapine levels and so this should not be attempted in older or otherwise physically vulnerable patients. Increasing clozapine levels to approximately 750 ng/mL in middle-aged patients with longstanding TRS may modestly reduce the severity of positive symptoms and improve the response rate. The article appears in the March-April 2023 issue of the Journal of Clinical Psychopharmacology.

For individuals with treatment-resistant depression, ketamine can be an effective fast-acting alternative to conventional antidepressants. It has been hypothesized that it partly exerts its antidepressant effects by modulating the opioid system. In this podcast, Dr. Brandi Quintanilla discusses her study that explored baseline plasma levels of κ-opioid and dynorphin peptides and changes after ketamine infusion. Participants in this randomized trial included individuals with major depressive disorder and healthy volunteers. The results suggest that κ-opioid and dynorphin levels in plasma may not be a major underlying mechanisms of ketamine's therapeutic effects or its dissociative adverse effects. The study, however, may have been underpowered to detect effects, and additional research is needed. Dr. Quintanilla is a psychiatry resident at the University of Texas Health Science Center at Houston and a special research volunteer in the Experimental Therapeutics and Pathophysiology Branch of the National Institute of mental health. The article by Dr. Quintanilla and colleagues is published in the March-April 2023 issue of the Journal of Clinical Psychopharmacology.

In this follow-up podcast to the in-class, antidepressant lecture in Dr. Suite's Introduction to Clinical Psychopharmacology course at Columbia University, Dr. Suite explores the rationale for the long-term treatment of major depression with antidepressants. Dr. Suite also discusses the best psychotherapies for the treatment of mild and moderate depression.

In this podcast, I share my thoughts on a textbook that I like very much: Handbook of Clinical Psychopharmacology for Therapists. This well-conceived, practical, and highly informative textbook is the required reading for the course I teach at Columbia University.

Lithium is considered a standard treatment for bipolar disorder, but it remains underprescribed, in part because of its association with kidney dysfunction. In this podcast, Dr. Balwinder Singh discusses an article he and his colleagues published in the January-February 2023 issue of the Journal of Clinical Psychopharmacology on “real-world” clinical practice involving patients with bipolar disorder (BD) and chronic kidney disease (CKD). In their study, patients with BD and CKD who discontinued lithium use after CKD diagnosis had a higher risk for a relapse of their mood disorder as well as a shorter time to the first mood episode, suggesting a need for more thorough discussion before discontinuing lithium after a diagnosis of CKD.

In a commentary published in the Journal of Clinical Psychopharmacology, Dr. Rishab Gupta (Brigham and Women's Hospital/Harvard Medical School) and Dr. Swarndeep Singh (Government Medical College and Hospital, Chandigarh, India) cast a critical eye on India's regulatory approval for the use of endoxifen for the treatment of manic episodes in patients with bipolar disorder type 1. In their article and in this podcast, they suggest that there are important deficiencies in the research that was used to support the regulatory approval. No other country has approved endoxifen for treating bipolar disorder. They caution that endoxifen should be considered as an option to treat acute mania only after a careful consideration of risks/benefits with the patient and their family and after providing them with a list of alternative medications.

Adult ADD is diagnosed frequently, but this podcast describes how it really represents other conditions, like mood or anxiety states or mood temperaments, or how it reflects normal inattention. For further reading, see: https://psychiatryletter.com/adult-add/ Some of the cited articles are linked in that reading. All the sources also are referenced in SN Ghaemi, Clinical Psychopharmacology, Oxford University Press, 2019 in a detailed appendix chapter on ADD in children and adults. For further general reading and links to webinars and other educational materials, go to www.psychiatryletter.com --- Support this podcast: https://anchor.fm/nassir-ghaemi/support

A 2-part series with researcher, educator, and licensed psychologist Dr. Lenore Walker who coined the term "battered woman syndrome." Dr. Walker has spent more than 4 decades investigating violence against women, publishing peer-reviewed research and authoring several books including "The Battered Woman Syndrome" now in its 4th edition.Together we explore the progress and pitfalls in the domestic violence movement since the 1980s including the emergence of advocacy and shelters for survivors, the evolution of psychotherapy for PTSD and trauma, and the work of the family court system. In part 2, we dive into her controversial work for the defense during the OJ Simpson trial and how that experience led to breakthroughs for domestic violence research findings, publications, prosecutions and how we talk about domestic violence.Dr. Lenore Walker is a licensed psychologist in several states and Board Certified in Clinical Psychology and in Couples and Family Psychology by the American Board of Professional Psychology. She has practiced all over the U.S. and in several other countries around the world. She earned her doctoral degree in psychology from Rutger's, The State University in N.J. in 1972 after attaining an M.S. in Psychology from City College of the City University of New York (CCNY) in 1967 and a B.A. from Hunter College of CCNY in 1962. In 2004, she earned an M.S. in Clinical Psychopharmacology from Nova Southeastern University. She is a retired professor of psychology at Nova Southeastern University and the author of multiple articles and books, including her most recent novel, "Madness to Murder."

A 2-part series with researcher, educator, and licensed psychologist Dr. Lenore Walker who coined the term "battered woman syndrome." Dr. Walker has spent more than 4 decades investigating violence against women, publishing peer-reviewed research and authoring several books including "The Battered Woman Syndrome" now in its 4th edition.Together we explore the progress and pitfalls in the domestic violence movement since the 1980s including the emergence of advocacy and shelters for survivors, the evolution of psychotherapy for PTSD and trauma, and the work of the family court system. In part 2, we dive into her controversial work for the defense during the OJ Simpson trial and how that experience led to breakthroughs for domestic violence research findings, publications, prosecutions and how we talk about domestic violence.Dr. Lenore Walker is a licensed psychologist in several states and Board Certified in Clinical Psychology and in Couples and Family Psychology by the American Board of Professional Psychology. She has practiced all over the U.S. and in several other countries around the world. She earned her doctoral degree in psychology from Rutger's, The State University in N.J. in 1972 after attaining an M.S. in Psychology from City College of the City University of New York (CCNY) in 1967 and a B.A. from Hunter College of CCNY in 1962. In 2004, she earned an M.S. in Clinical Psychopharmacology from Nova Southeastern University. She is a retired professor of psychology at Nova Southeastern University and the author of multiple articles and books, including her most recent novel, "Madness to Murder."

ROBERT J. HEDAYA, MD, ABPN, DLFAPA, IFMCP, is a caring compassionate doctor who is devoted to restoring each of his patients to health.  He gets to know each patient thoroughly – psychologically and medically.  Dr. Hedaya has been at the cutting edge of medical practice, psychiatry, and psychopharmacology since 1979.  He has decades of clinical training and experience, is board certified by the American Board of Psychiatry and Neurology, a Distinguished Fellow of American Psychiatric Association, and is certified as proficient in psychopharmacology by The American Society of Clinical Psychopharmacology.  Dr. Hedaya acquired specialized training in psychiatry at the National Institute of Mental Health.https://wholepsychiatry.com

In small-scale studies, 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy for posttraumatic stress disorder has shown some promise, but exploratory analyses have suggested that recent use of selective serotonin reuptake inhibitors (SSRIs) can dampen the efficacy of this novel therapy. In this podcast, Dr. Collin M. Price, a psychiatric resident at UCLA, and Dr. Allison Feduccia, a neuropharmacologist and CEO of a company that curates CME courses on psychedelics, discuss their new article in the Journal of Clinical Psychopharmacology that provides a selective review of the literature in the basic and clinical neurosciences relevant to the interaction of SSRIs and MDMA. They suggest that there is an urgent need for future work dedicated to addressing this important clinical topic. Their article is published in the September-October 2022 issue of the journal.

In this podcast, Dr. Melvin McInnis discusses lithium toxicity in individuals with bipolar disorder who were infected by the SARS-CoV-2 virus. Lithium is an effective long-term management strategy for treating bipolar disorder, but because acute kidney damage can be a complication of COVID-19, the body's ability to process lithium may be affected. Based on his case report study, coauthored by Dr. Anastasia Yocum and published in the September-October 2022 issue of the Journal of Clinical Psychopharmacology, Dr. McInnis urges proactive monitoring for signs of diminished kidney functions to avoid levels of toxicity, especially during the pandemic.

Panic disorder is a common psychiatric disorder, with generally effective pharmacologic treatments for most patients. However, a subset of patients do not respond,  and roughly 25% of patients have adverse effects. In this podcast, based on his guest editorial published in the September-October 2022 issue of the Journal of Clinical Psychopharmacology, Dr. Antonio Nardi makes the case that the next era of treatments may be inhibitor specific. Because of the amygdala's essential role in the control of anxiety responses, Dr. Nardi suggests that it may be the key to developing such therapies. While acknowledging that his editorial focuses on selective molecules for α2/3-GABAAR, Nardi expresses hope that the two classes of GABAkines in clinical development, studied in conjunction with models of carbon dioxide inhalation in healthy volunteers, might represent the beginning of a new era in treatment for panic disorder.

A recently published book provides sharp criticism of the modern era of clinical psychopharmacology, questioning the validity of psychiatric diagnoses and the effectiveness of psychopharmacologic treatments. In this podcast, Dr. Anthony J. Rothschild, Editor-in-Chief of the Journal of Clinical Psychopharmacology, offers his perspective on the book, The Rise and Fall of the Age of Psychopharmacology. The book “ignores the fact that many people with serious psychiatric disorders have had their lives dramatically improved by psychotropic medications,” Dr. Rothschild says, noting that he vehemently disagrees with how the book's author characterizes the profession. The podcast accompanies Dr. Rothschild's editorial in the July-August 2022 issue of the journal.

  Clozapine is often prescribed for patients with treatment-resistant schizophrenia, but its use is sometimes discontinued if it is suspected of inducing neutropenia. In this podcast, author Laurent Béchard discusses a consecutive case series published in the July-August 2022 issue of the Journal of Clinical Psychopharmacology assessing the continuation or reintroduction of this drug despite a neutropenia episode. In addition to suggesting further research to better define severe vs. moderate cases, Dr. Béchard proposes the use of pharmacovigilance tools to assess possible causes of neutropenia so clinicians can better determine if this highly effective antipsychotic should remain part of a patient's treatment plan.

I discuss my perspective that the diagnosis of ADD, in children and adults, is not scientifically valid, and give reasons why. I also explain that amphetamines, including methylphenidate (Ritalin, Adderall, which is an amphetamine), are biologically harmful to the brain and have other harms. Sources for this podcast are below: SN Ghaemi, Clinical Psychopharmacology, Oxford University Press, 2019 - see appendix on ADD https://www.psychiatryletter.net/education/adderall-amphetamines https://www.psychiatryletter.net/education/adult-adhd-misconceptions https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2522749 https://jamanetwork.com/journals/jamapsychiatry/article-abstract/1378851 https://www.jneuropsychiatry.org/peer-review/adult-adhd-and-amphetamines-a-new-paradigm-neuropsychiatry.pdf https://pubmed.ncbi.nlm.nih.gov/18052572/ https://www.mdedge.com/psychiatry/article/24418/pediatrics/stimulant-use-adhd-bipolar-discouraged-expert-mood-disorders https://journals.lww.com/hrpjournal/fulltext/2020/03000/approach_to_evaluating_and_managing_adult.3.aspx --- Support this podcast: https://anchor.fm/nassir-ghaemi/support

The use of the combination of stimulants and antipsychotic medications is increasing in pediatric patients who suffer from Attention Hyperactivity Disorder (ADHD). In this podcast, Dr. Mohamed Mohamoud discusses how this combination may result in acute hyperkinetic movement disorder in children. Using the FDA Adverse Event Reporting System database, Dr. Mohamoud and his colleagues conducted a case series analysis and identified 36 instances where a pharmacodynamic drug-drug interaction may have resulted in the disorder. Their report is published in the May/June 2022 issue of the Journal of Clinical Psychopharmacology. Prescribing information has recently been updated and this podcast discusses the data upon which that information was changed. Dr. Mohamoud is being interviewed by FDA press officer Charlie Kohler.

In this episode, Ben has a fascinating conversation with Dr. Shrinidhi Subramaniam on the applications of contingency management to drug addiction and poverty with a bit of precision teaching sprinkled on top. She also describes her team's work on reducing viral loads in patients with HIV and shares some great resources.   Continuing Education Units (CEUs): https://cbiconsultants.com/shop BACB: 1.5 Learning IBAO: 1.5 Learning   Show Notes: Georgia Southern University - Armstrong Campus (formerly Armstrong Atlantic State): https://www.georgiasouthern.edu/campuses/armstrong-campus       Miriari Elcoro: https://www.researchgate.net/profile/Mirari-Elcoro   Claire St. Peter: https://www.researchgate.net/profile/Claire-St-Peter  Kenneth Silverman: https://www.hopkinsmedicine.org/profiles/details/kenneth-silverman   Robert Silicano: https://www.hopkinsmedicine.org/profiles/details/robert-siliciano  Steve Higgins: https://www.uvm.edu/cas/psychology/profiles/stephen-higgins-behavioral-pharmacology        Sheppard Kellam: https://publichealth.jhu.edu/faculty/367/sheppard-kellam    Muhummad Yunus: https://www.nobelprize.org/prizes/peace/2006/yunus/biographical   Liz Kyonka: https://www.csueastbay.edu/directory/profiles/psyc/kyonkaliz.html    Maxine Stitzer: https://friendsresearch.org/people/maxine-l-stitzer-ph-d   George Bigelow: https://professorships.jhu.edu/professorship/george-e-bigelow-phd-professorship   Nancy Petry: https://www.jsad.com/doi/full/10.15288/jsad.2018.79.669; https://www.routledge.com/Contingency-Management-for-Substance-Abuse-Treatment-A-Guide-to-Implementing/Petry/p/book/9780415882897    Articles Referenced: Getty, C. A., Subramaniam, S., Holtyn, A. F., Jarvis, B. P., Rodewald, A., & Silverman, K. (2018). Evaluation of a Computer-Based Training Program to Teach Adults at Risk for HIV About Pre-Exposure Prophylaxis. AIDS education and prevention : official publication of the International Society for AIDS Education, 30(4), 287–300. https://doi.org/10.1521/aeap.2018.30.4.287  Holtyn, A. F., Toegel, F., Subramaniam, S., Arellano, M., Leoutsakos, J. M., Fingerhood, M., & Silverman, K. (2020). Financial incentives promote engagement in employment services for unemployed adults in treatment for opioid use disorder. Drug and alcohol dependence, 212, 107982. https://doi.org/10.1016/j.drugalcdep.2020.107982  Holtyn, A. F., Toegel, F., Subramaniam, S., Jarvis, B. P., Leoutsakos, J. M., Fingerhood, M., & Silverman, K. (2020). Abstinence-contingent wage supplements to promote drug abstinence and employment: a randomised controlled trial. Journal of epidemiology and community health, 74(5), 445–452. https://doi.org/10.1136/jech-2020-213761  Silverman, K., Holtyn, A. F., Rodewald, A. M., Siliciano, R. F., Jarvis, B. P., Subramaniam, S., Leoutsakos, J. M., Getty, C. A., Ruhs, S., Marzinke, M. A., & Fingerhood, M. (2019). Incentives for Viral Suppression in People Living with HIV: A Randomized Clinical Trial. AIDS and behavior, 23(9), 2337–2346. https://doi.org/10.1007/s10461-019-02592-8  Silverman, K., Holtyn, A. F., & Subramaniam, S. (2018). Behavior analysts in the war on poverty: Developing an operant antipoverty program. Experimental and Clinical Psychopharmacology, 26(6), 515–524. https://doi.org/10.1037/pha0000230  Toegel, F., Holtyn, A.F., Subramaniam, S. and Silverman, K. (2020), Effects of time-based administration of abstinence reinforcement targeting opiate and cocaine use. Journal of Applied Behavior Analysis, 53, 1726-1741. https://doi.org/10.1002/jaba.702 

Drs. Steve Dubovsky and Dori Marshall discuss their article reviewing the potential of calcium channel blockers for the treatment of mood disorders, an area of research that the authors assert has received too little attention. Their article, titled Calcium Channel Antagonists for Mood Disorders, appears in the March-April 2022 issue of the Journal of Clinical Psychopharmacology.

“Polypharmacy,” the simultaneous use of multiple medications, has been linked to an increased risk of treatment complications. An article in the March-April 2022 issue of the Journal of Clinical Psychopharmacology takes a systematic look at research studies that have tested interventions to optimize polypharmacy in psychiatric treatment and nursing homes. Improvement of drug-related outcomes can be achieved by interventions such as individualized medication review and educational approaches. Changes in clinical outcomes, however, are often not substantial. Drs. Philip Stötzner and Eva Brandl, two of the authors of the systematic review, discuss their findings and avenues for future research.

Dr. Rick Barnett, Psy.D., LADC, is a clinical psychologist and addiction specialist. today we dive into His work professionally and spiritually in the growing field of psychedelic healing. He is in long term recovery for addiction and he shares an extraordinary tale of how it happened and how he came full circle to understanding the process of recovery in a deeper meaningful way. Dr. Barnett holds aBachelor's degree in psychology from Columbia University, a Doctorate and Master's Degree in Clinical Psychology from Yeshiva University, and a Master's Degree in Clinical Psychopharmacology from Fairleigh Dickinson University. He has been a licensed alcohol and drug counselor since 1999 and has specialized training in problematic sexual behavior (PSB-S) and gambling disorder. In 2021, Dr. Barnett, completed a year-long Certificate Program for Psychedelic Therapy and Research through the CaliforniaInstitute for Integral Studies. In June, 2021, he founded the Psychedelic Society of Vermont which now has over 70 health professionals with a shared interest in psychedelic research and therapy.Dr. Barnett founded the non-profit organization CARTER, Inc. in 2015 to expand addiction-related resources in Vermont. He is Legislative Chair, Federal Advocacy Coordinator, and Past-President of theVermont Psychological Association. In 2020, he served as President of the Society for PrescribingPsychologists (Division 55) of the American Psychological Association. He also served on the Board ofDirectors of the North Central Vermont Recovery Center in 2018-2019. He has served on numerous regulatory boards in the State of Vermont related to health, mental health and addiction recovery. He has worked in various settings including as a geriatric psychologist in nursing homes, lead psychologist in the Alcohol and Other Drug Use Disorder Program at Mt. Sinai in NYC, for the Hazelden-Betty Ford Foundation from 1996-2002, and other outpatient addiction and mental health treatment programs. He has trained hundreds of health professionals through workshops on addiction and mental health issues over the past 20 years. In addition to services provided by CARTER, Inc., Rick maintains a private practice in Stowe, VT and provides supervision to new therapists. In 2021 he began working within a Ketamine Assisted Psychotherapy (KAP) model for select patients. He is an active advocate for mental health and addiction prevention, treatment and recovery. Rick is also in long term recovery from addiction and maintains a regular practice of recovery through meditation, time in nature, helping others, attendance at mutual aid support groups, reading

How can we improve psychopharmacology practice? This podcast features a lively discussion among the authors of two articles in the January-February 2022 issue of the Journal of Clinical Psychopharmacology in which they address that important topic. The participants discuss some weaknesses in current models of psychopharmacology training as well as the challenges clinicians face in keeping up with medication advances.

We're all spending too much time online, but when does too much turn into addiction? How do we create a healthy life/tech balance? We chat with one of the world's foremost experts on the topic, Dr. David Greenfield, founder and clinical director of The Center for Internet and Technology Addiction. Be in the know in 30 minutes.  Dr. David Greenfield is the founder of The Center for Internet and Technology Addiction and Assistant Clinical Professor of Psychiatry at the University of Connecticut School of Medicine where he teaches in the psychiatry residency program courses on Sexual Medicine and Internet Addiction. He is recognized as one of the world's leading voices on process and behavioral addictions and is the author of "Virtual Addiction," which rang an early warning bell regarding the country's growing Internet Addiction problem. He has also authored numerous medical journal articles and book chapters; and serves as an editor for numerous psychiatric and addiction journals. Dr. Greenfield lectures to public and medical groups throughout the world, and has appeared on CNN, Good Morning America, The Today Show, Fox News, ESPN, NPR and HBO. His work has been featured in U.S. News and World Report, Newsweek, People, Time, Washington Post, Wall Street Journal, and The Economist. He is widely credited with popularizing the variable ratio reinforcement schedule of process addiction and the dopamine-behavioral addiction connection. Dr. Greenfield's recent research and clinical work is focused on the neurobiology and psychopharmacology of compulsive Internet and technology use, behavioral addiction medicine, and compulsive Smartphone use. Dr. Greenfield is a member of the American Society for Addiction Medicine, Fellow and Past-president of the Connecticut Psychological Association, The Sexual Medicine Society of North America, and American Society for the Advancement of Pharmacotherapy. He received his doctorate in Psychology from Texas Tech University and recently completed his post-doctoral training in Clinical Psychopharmacology. He resides and maintains an addiction medicine practice in Connecticut. FMC Fast Chat is the award-winning podcast of the Fair Media Council (fairmediacouncil.org), which advocates for quality news and works to create a media-savvy society. FMC CEO and Executive Director Jaci Clement serves as host. FMC Fast Chat features notables in news, media, and business. Guest booking queries should be directed to bookings@fairmediacouncil.org Learn more about your ad choices. Visit megaphone.fm/adchoices

We're all spending too much time online, but when does too much turn into addiction? How do we create a healthy life/tech balance? We chat with one of the world's foremost experts on the topic, Dr. David Greenfield, founder and clinical director of The Center for Internet and Technology Addiction. Be in the know in 30 minutes.  Dr. David Greenfield is the founder of The Center for Internet and Technology Addiction and Assistant Clinical Professor of Psychiatry at the University of Connecticut School of Medicine where he teaches in the psychiatry residency program courses on Sexual Medicine and Internet Addiction. He is recognized as one of the world's leading voices on process and behavioral addictions and is the author of "Virtual Addiction," which rang an early warning bell regarding the country's growing Internet Addiction problem. He has also authored numerous medical journal articles and book chapters; and serves as an editor for numerous psychiatric and addiction journals. Dr. Greenfield lectures to public and medical groups throughout the world, and has appeared on CNN, Good Morning America, The Today Show, Fox News, ESPN, NPR and HBO. His work has been featured in U.S. News and World Report, Newsweek, People, Time, Washington Post, Wall Street Journal, and The Economist. He is widely credited with popularizing the variable ratio reinforcement schedule of process addiction and the dopamine-behavioral addiction connection. Dr. Greenfield's recent research and clinical work is focused on the neurobiology and psychopharmacology of compulsive Internet and technology use, behavioral addiction medicine, and compulsive Smartphone use. Dr. Greenfield is a member of the American Society for Addiction Medicine, Fellow and Past-president of the Connecticut Psychological Association, The Sexual Medicine Society of North America, and American Society for the Advancement of Pharmacotherapy. He received his doctorate in Psychology from Texas Tech University and recently completed his post-doctoral training in Clinical Psychopharmacology. He resides and maintains an addiction medicine practice in Connecticut. FMC Fast Chat is the award-winning podcast of the Fair Media Council (fairmediacouncil.org), which advocates for quality news and works to create a media-savvy society. FMC CEO and Executive Director Jaci Clement serves as host. FMC Fast Chat features notables in news, media, and business. Guest booking queries should be directed to bookings@fairmediacouncil.org Learn more about your ad choices. Visit megaphone.fm/adchoices

Die Episode beschäftigt sich mit der Frage, welcher diagnostischen Kategorie Dermatilomanie und Trichotillomanie zugeordnet werden - also mit der Frage ob sie z.B. zu den Impulskontrollstörungen, Zwangsspektrums- oder Zwangsstörungen gehören. Ganz spezifisch geht es darum, welche Unterschiede und Gemeinsamkeiten die beiden Störungen mit Zwangsstörungen aufweisen und warum es so wichtig ist, dabei genau hinzuschauen. Außerdem erfährst Du in der Folge was es mit den unterschiedlichen Diagnosemanualen (ICD-10, ICD-11, DSM-5) auf sich hat, wo Derma- und Trichotillomanie eingeordnet sind und wodurch eine Zwangsstörung eigentlich gekennzeichnet ist. WICHTIG: Ich beziehe mich in der Studie ausschließlich auf Skin Picking und Hair Pulling, da nur zu diesen beiden eigenständige Diagnosen existieren und zudem zu anderen BFRBs (z.B. Nägelkauen, Wangenbeißen) noch kaum Studien vorliegen. Hier die Referenzen zu den genannten Studien: Grant, J. et al. (2010). Clinical comparison of pathologic skin picking and obsessive-compulsive disorder. Comprehensive Psychiatry, 51: 347-352. Lochner, C. et al. (2005). Obsessive-compulsive disorder and trichotillomania: a phenomenological comparison. BMC Psychiatry, 5:2. Schumer, M. C. et al. (2016). Systematic review of pharmacological and behavioral treatments for skin picking disorder. Journal of Clinical Psychopharmacology, 36(2), 147-152. Stein, D., et al. (2010). Trichotillomania (Hair Pulling Disorder), Skin Picking Disorder, and Stereotypic Movement Disorder: Toward DSM-V. Depression and Anxiety, 27:611-6226. Weitere Infos zu Skin Picking bzw. Dermatillomanie, Trichotillomanie, Nägelkauen und anderen BFRBs findest Du auf meiner Homepage: www.skinpicking-trichotillomanie.de Wenn Du Fragen, Ideen oder Wünsche für bestimmte Themen hast, schreib mir einfach gerne über meine Homepage oder auf Instagram unter: https://www.instagram.com/bfrb.care/

In the effort to prevent relapse in patients who have experienced depressive episodes, it has been common practice to have them continue long-term on antidepressant medications, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs). In this author podcast, Giovanni A. Fava discusses his guest editorial that challenges that custom and suggests alternative approaches for preventing relapse. Dr. Fava's Guest Editorial is published in the November-December 2021 issue of the Journal of Clinical Psychopharmacology.

The link between substance abuse, impulsivity, and violence in psychotic patients remains unclear. In this author podcast, Gabriella Gobbi, MD, PhD, and Stefano Comai, PhD, discuss their study, which was designed to assess whether cannabis use disorder is associated with violent and/or psychotic behavior in patients who are hospitalized in a high-security hospital. The findings show that cannabis and alcohol are often abused (by themselves or together) by psychotic patients with a propensity for violence, but only alcohol is associated with impulsive and violent behavior. The article is published in the November-December 2021 issue of the Journal of Clinical Psychopharmacology.

In this interview, Dr. Rountree and Dr. Hedeya discuss neuropsychiatry, and how hyperbaric oxygen, laser therapy and neural exercise can be used for psychiatry and brain recovery. Dr. Robert Hedaya is board certified by the American Board of Psychiatry and Neurology, a Distinguished Fellow of American Psychiatric Association, and is certified as proficient in psychopharmacology by The American Society of Clinical Psychopharmacology.  He has specialized training in psychiatry at the National Institute of Mental Health and is a Clinical Professor of Psychiatry at Georgetown University Medical Center.Dr. Hedaya is a faculty member at the Institute for Functional Medicine, and has taught at The Walsh Research Institute and Georgetown University School of Medicine as well as through his own training programs. He teaches about Mood disorders, PTSD, Precision Medicine, Genetics, Methylation, Functional Gastroenterology, Endocrinology and Endocrine Disrupting Chemicals, Infectious Medicine and Toxicology, as applied to Neuropsychiatric disorders.Dr. Hedaya has published three books and actively sees patients at The Whole Psychiatry and Brain Recovery Center in Maryland, where he and his team work with patients that struggle with anxiety, DM2, PTSD, fibromyalgia, fatigue disorders, cognitive decline, and traumatic brain injury using functional medicine and his proprietary HYLANE Program.Mentioned in this episodeThe Whole Psychiatry & Brain Recovery CenterFurther Resources:Success with Laser Therapy Flowchart & Checklist InfographicCheck out these FREE Provider ResourcesLearn more about what we offer on the LTI websiteFind out how you can Customize your LTI experienceRelated Podcast for PatientsHealing at the Speed of Light

Why do you feel that when it comes to psychopharmacology, knowing how to really interpret the scientific literature is important for clinicians? Why is it important to know whether the clinical characteristics of the subjects resemble or differ from your own patients and to what extent?  In this episode, Dr. Andrew Cutler interviews Dr. Stephen Stahl and Dr. Joseph Goldberg about their recent book, Practical Psychopharmacology: Translating Findings From Evidence-Based Trials Into Real-World Clinical Practice. Learn more about why it is important to understand how to interpret the scientific literature and apply it to your clinical practice. Joseph F. Goldberg, MD, is a psychiatrist with 25 years of experience in academic research studying the features and treatment of mood disorders, particularly bipolar disorder and other forms of depression. He is a Clinical Professor in the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai, New York, NY. He has spent many years conducting studies of mood disorders at academic medical centers such as the Payne Whitney Clinic/Weill Medical College of New York Presbyterian Hospital, the Zucker Hillside Hospital-North Shore Long Island Jewish Health System, and the Mount Sinai School of Medicine. Presently, he supervises and teaches psychopharmacology to medical students and residents at the Mount Sinai School of Medicine, and maintains a private practice in Norwalk, CT. His goal is to integrate knowledge from that research background by taking a scholarly approach to psychopharmacology and applying it in tailored fashion to the unique needs of an individual patient. He has published over 180 original research publications in major psychiatric journals as well as several books on topics related to mood disorders. He serves on the board of directors of the American Society for Clinical Psychopharmacology and has lectured nationally and internationally at major scientific meetings and conferences. With this special series, brought to you by the NEI Podcast we will address a different theme in psychopharmacology every 3 months. Each theme is split into 3 parts, with one part released each month. This theme is on practical psychopharmacology. Episodes to be released under this theme include: Part 1: Placebo and Nocebo Effects in Psychopharmacology with Dr. Joseph Goldberg Part 2: Mediators and Moderators in Psychopharmacology with Dr. Joseph Goldberg Part 3: Interpreting the Literature in Psychopharmacology with Dr. Joseph Goldberg   https://www.amazon.com/Practical-Psychopharmacology-Translating-Evidence-Based-Real-World/dp/1108450741/ref=sr_1_2?dchild=1&keywords=goldberg+stahl&qid=1631810148&sr=8-2

Individuals with major depressive disorder and suicidal ideation are particularly vulnerable and may not respond as well to standard treatment as patients without suicidal ideation. In this author podcast, Dr. Dong-Jing Fu and Dr. Carla Canuso discuss the results of a pooled analysis of data from the ASPIRE studies, randomized placebo-controlled trials of esketamine, plus comprehensive standard-of-care treatment. The results, published in the September-October 2021 issue of the Journal of Clinical Psychopharmacology, suggest that esketamine can provide rapid relief of depressive symptoms in patients with MDD and acute suicidal ideation or behavior, especially in those with a history of prior suicide attempt.

Dr. Julia Ann Koretski reflects on the critical role of the placenta in drug metabolism and potential near- and long-term effects on postanatal life. The placenta was once viewed as a passive, almost mechanical barrier, but we are continuing to learn of the important ways it influences drug metabolism and development of conditions such as postnatal adaptation syndrome and schizophrenia. Dr. Koretski's commentary is inspired by a Guest Editorial in the journal authored by Dr. Richard Shader, Founding Editor-in-Chief Emeritus of the Journal of Clinical Psychopharmacology. Dr. Koretski is Digital Editor of the journal.

What is the difference between mediators and moderators, and how do they influence treatment response? Why is it so important, as clinicians to understand the distinction between moderators and mediators and to be aware of their influence on treatment outcomes in the literature?  In this episode, Dr. Andrew Cutler interviews Dr. Stephen Stahl and Dr. Joseph Goldberg about their recent book, Practical Psychopharmacology: Translating Findings From Evidence-Based Trials Into Real-World Clinical Practice. Learn more about how moderators and mediators influence clinical outcomes. Joseph F. Goldberg, MD, is a psychiatrist with 25 years of experience in academic research studying the features and treatment of mood disorders, particularly bipolar disorder and other forms of depression. He is a Clinical Professor in the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai, New York, NY. He has spent many years conducting studies of mood disorders at academic medical centers such as the Payne Whitney Clinic/Weill Medical College of New York Presbyterian Hospital, the Zucker Hillside Hospital-North Shore Long Island Jewish Health System, and the Mount Sinai School of Medicine. Presently, he supervises and teaches psychopharmacology to medical students and residents at the Mount Sinai School of Medicine, and maintains a private practice in Norwalk, CT. His goal is to integrate knowledge from that research background by taking a scholarly approach to psychopharmacology and applying it in tailored fashion to the unique needs of an individual patient. He has published over 180 original research publications in major psychiatric journals as well as several books on topics related to mood disorders. He serves on the board of directors of the American Society for Clinical Psychopharmacology and has lectured nationally and internationally at major scientific meetings and conferences. With this special series, brought to you by the NEI Podcast we will address a different theme in psychopharmacology every 3 months. Each theme is split into 3 parts, with one part released each month. This theme is on practical psychopharmacology. Episodes to be released under this theme include: Part 1: Placebo and Nocebo Effects in Psychopharmacology with Dr. Joseph Goldberg Part 2: Mediators and Moderators in Psychopharmacology with Dr. Joseph Goldberg Part 3: Interpreting the Literature in Psychopharmacology with Dr. Joseph Goldberg

How does the therapeutic alliance influence treatment outcomes when it comes to treatment with placebo? What are some of the other patient characteristics that influence placebo responsivity? In this episode, Dr. Andrew Cutler interviews Dr. Stephen Stahl and Dr. Joseph Goldberg about their recent book, Practical Psychopharmacology: Translating Findings From Evidence-Based Trials Into Real-World Clinical Practice. Learn about why understanding more about placebo and nocebo effects is so important for your practice. Joseph F. Goldberg, MD, is a psychiatrist with 25 years of experience in academic research studying the features and treatment of mood disorders, particularly bipolar disorder and other forms of depression. He is a Clinical Professor in the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai, New York, NY. He has spent many years conducting studies of mood disorders at academic medical centers such as the Payne Whitney Clinic/Weill Medical College of New York Presbyterian Hospital, the Zucker Hillside Hospital-North Shore Long Island Jewish Health System, and the Mount Sinai School of Medicine. Presently, he supervises and teaches psychopharmacology to medical students and residents at the Mount Sinai School of Medicine, and maintains a private practice in Norwalk, CT. His goal is to integrate knowledge from that research background by taking a scholarly approach to psychopharmacology and applying it in tailored fashion to the unique needs of an individual patient. He has published over 180 original research publications in major psychiatric journals as well as several books on topics related to mood disorders. He serves on the board of directors of the American Society for Clinical Psychopharmacology and has lectured nationally and internationally at major scientific meetings and conferences. With this special series, brought to you by the NEI Podcast we will address a different theme in psychopharmacology every 3 months. Each theme is split into 3 parts, with one part released each month. This theme is on practical psychopharmacology. Episodes to be released under this theme include: Part 1: Placebo and Nocebo Effects in Psychopharmacology with Dr. Joseph Goldberg Part 2: Mediators and Moderators in Psychopharmacology with Dr. Joseph Goldberg Part 3: Interpreting the Literature in Psychopharmacology with Dr. Joseph Goldberg

Psychotic depression is a severely disabling illness and is more common than is generally realized. Unfortunately, there is no FDA-approved medication for its treatment. In this podcast, the Editor-in-Chief of the Journal of Clinical Psychopharmacology, Anthony J. Rothschild, discusses his opinions as to how this came about and encourages further research and development of a suitable medication with an eye toward FDA approval.

What are the most frequent comorbidities of schizophrenia? Is there any scientific reason to use any antipsychotic in twice-a-day dosing? In this episode, Dr. Leslie Citrome addresses these questions and more of your unanswered questions from the NEI Synapse Half-Day on Novel Strategies to Treat Schizophrenia in this special NEI Podcast Bonus episode! Dr. Leslie Citrome is Clinical Professor of Psychiatry and Behavioral Sciences at New York Medical College in Valhalla, New York and has a private practice in Pomona, New York. He is the Editor-in-Chief of the International Journal of Clinical Practice, published by Wiley. Dr. Citrome was the founding Director of the Clinical Research and Evaluation Facility at the Nathan S. Kline Institute for Psychiatric Research in Orangeburg, New York, and after nearly two decades of government service as a researcher in the psychopharmacological treatment of severe mental disorders, Dr. Citrome is now engaged as a consultant in clinical trial design and interpretation. Dr. Citrome is a member of the Board of Directors of the American Society of Clinical Psychopharmacology. Main areas of interest include schizophrenia, bipolar disorder and major depressive disorder. He is a frequent lecturer on the quantitative assessment of clinical trial results using the evidence-based medicine metrics of number needed to treat and number needed to harm. Dr. Citrome is the author or co-author of over 400 research reports, reviews, and chapters in the scientific literature, is on the editorial board of 13 different medical journals, reviews for over 90 journals, and has lectured extensively throughout the USA, Canada, Europe, and Asia.

Presented by Psychedelic Grad.This episode is with Dr. Rick Barnett. He's a clinical, mental/behavioral health and addiction specialist and founder of the addiction rehabilitation facility, Carter Inc., in Vermont. In this episode, we cover his path from patient to practitioner, the meanings of addiction, the 12 step program, the opioid epidemic, and the role psychedelics play in the healthcare field.More about Dr. Rick Barnett:Dr. Rick Barnett, Psy.D., LADC, founded the non-profit organization CARTER, Inc. in 2015 to expand addiction-related resources in Vermont and beyond. Dr. Barnett is Legislative Chair and Past-President of the Vermont Psychological Association and is a clinical psychologist and addiction specialist in private practice in Stowe, VT. Dr. Barnett has worked as a Clinical Psychologist in nursing homes, hospitals, and outpatient programs and has trained hundreds of health professionals through workshops on addiction and mental health issues over the past 20 years. He is in the long-term recovery of alcohol and substance abuse and is an active advocate for addiction treatment and recovery resources.Dr. Barnett holds a Bachelor's degree in psychology from Columbia University, a Doctorate and Master's Degree in Clinical Psychology, and a Master's Degree in Clinical Psychopharmacology. He is a Licensed Alcohol and Drug Counselor and holds a certificate in Problematic Sexual Behavior (PSB-S) and Gambling Disorder. Dr. Barnett's service goes beyond the clinical world into his community and public policy as he has served on and continues to serve on many communities and government boards and committees.You can learn more about Dr. Barnett on social media:twitter.com/drrickbarnettlinkedin.com/in/dr-rick-barnett/Or on his website: cartervermont.orgTo learn more about Psychedelic Grad, go to psychedelicgrad.com. Music by: alexkahnmusic.com

Guest Bio: Dr. Maguire is a Distinguished Fellow of the American Psychiatric Association (DFAPA). Dr. Maguire is listed in the “Best Doctors in America” and in the past as “Orange County Physician of Excellence” as recognized by his peers. He also serves as the Chair for the National Stuttering Association and in the past, as Vice Chair of the International Stuttering Association. He has received numerous teaching awards at both UC Riverside and UC Irvine. His research in areas such as stuttering, schizophrenia, bipolar disorder, and Alzheimer's dementia has appeared in various publications, including The Lancet Neurology, NeuroReport, Comprehensive Psychiatry, Annals of Clinical Psychiatry, American Journal of Psychiatry and the Journal of Clinical Psychopharmacology. He served as an investigator on the National Institute of Mental Health CATIE trial for schizophrenia. Dr. Maguire has presented his research at various conferences and symposia, including the American Psychiatric Association, US Psychiatric Congress, the American Speech and Hearing Association, Collegium Internationale Neuropsychopharmacologicum, and The American College of Neuropsychopharmacology. Resources and Links: Gerald Maguire UCR Health StutterTalk Podcast  Host Bio: Uri Schneider, M.A. CCC -SLP passionately explores and develops practical ways for us to create our own success story. Delivering personalized experiences of communication care informed by leading professionals and influencers, Uri is re-imagining the next-level of speech-language therapy for people to benefit in real life. Uri Schneider, M.A. CCC -SLP is co-founder and leader at Schneider Speech Pathology and faculty at the University of California, Riverside School of Medicine. For more, visit www.schneiderspeech.com

Forrest Toegel, Ph.D., BCBA-D joins Kylan Heiner, BCBA to discuss his recent study published in the Journal of Applied Behavior Analysis on April 6th, 2020 titled Effects of time-based administration of abstinence reinforcement targeting opiate and cocaine use. References and links mentioned in this podcast:Addiction SIG at ABAI: https://www.abainternational.org/constituents/special-interests/special-interest-groups.aspxDallery, J., Silverman, K., Chutuape, M. A., Bigelow, G. E., & Stitzer, M. L. (2001). Voucher-based reinforcement of opiate plus cocaine abstinence in treatment-resistant methadone patients: Effects of reinforcer magnitude. Experimental and Clinical Psychopharmacology, 9(3), 317–325.Toegel, F., Holtyn, A.F., Subramaniam, S. and Silverman, K. (2020), Effects of time‐based administration of abstinence reinforcement targeting opiate and cocaine use. Jnl of Applied Behav Analysis. doi:10.1002/jaba.702

Have you read the Ashton Manual? Do you know what it is? Do you know who Prof. Ashton is? Well, if you or anyone you know is dependent on benzos, you should. In today's feature, we focus on Professor C. Heather Ashton, her work with benzo withdrawal patients, and her life-saving manual. And we say a heartfelt thank you, for all she has done. We also touch on some news, discuss GABA receptors and the doctor dilemma, and share the first benzo story from one of our listeners. https://www.easinganxiety.com/post/the-ashton-manual-who-wrote-it-and-why-you-should-read-it-bfp007Video ID: BFP007 Chapters 03:02 Mailbag11:42 Benzo News14:18 Benzo Story19:08 Feature: The Ashton Manual30:17 Closing  Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. MAILBAG: GABA Receptors The Ashton ManualNew South Wales Government: Health Fact Sheet on BenzodiazepinesAddictionBlog.org – “Five (5) Facts About Benzodiazepine Withdrawal (You Need to Know)” BENZO NEWS Benzodiazepine Information Coalition (BIC)“Want to Prevent Suicides? Stop Ignoring Benzo Patients” on BIC BlogBenzo Free: Resources Page (including Suicide Hotlines) FEATURE – The Ashton Manual The Ashton ManualWorld Benzodiazepine Awareness Day (W-BAD)W-BAD: “Who Is Dr. Ashton?”W-BAD: “Reminder to Please Support Nomination for Prof. Ashton: UK Queen's Honour List 2019” (Which includes letter by Wayne Douglas about Prof. Ashton)Benzo.org.uk: Professor C Heather Ashton  Episode Summary This is the last of our launch episodes, next week we start with our regular weekly schedule releasing a new episode each Wednesday. Today's feature is focused on Prof. Ashton and the Ashton manual and we also have a lot to share in our Mailbag, Benzo News, and Benzo Stories sections.  Introduction Today's introduction, in contrast to our last episode, was quite short. So, let's move on.  Mailbag This is where we share questions and comments from our listeners. Can you tell me when the podcast episodes will be released each week? This question was submitted by Elizabeth in the comments for episode 5. I released the first 5 episodes on Wednesday, Feb. 21st The next week, this week, I am doubling up on episodes. I released episode 6 on Tuesday, Feb. 26th. And I am releasing this one, episode 7, on Thursday, Feb. 28th. Starting next week, we will be on our regular weekly schedule going forward. A new episode will be released every Wednesday. Depending on the speed at which the providers, such as Apple Music, Stitcher, Google Play, Spotify, and TuneIn approve new episodes, they will be available online Wednesday or Thursday. What are GABA receptors? I keep reading about them online, but I still don't really understand what they are, or how they work. Rather than repost the entire description here, I will share a link to the Basics of Benzos page on the Benzo Free Website. Scroll down to “How Do Benzos Work?” for an explanation. COMMENT: Regarding our discussion on doctors in our last episode, “Dependence, Disbelief, and the Doctor Dilemma.” Here are a few excerpts from the comment that I shared on the podcast. You are very fortunate in your experiences with doctors. When I was going through acute benzo withdrawal, my doctors treated me like a criminal. They accused me of having taken more than was prescribed and then they accused me of having conversion disorder. They treated me like I was paranoid. I was told that benzo withdrawal symptoms only last a few weeks. I went through absolute hell for 14 months and have debilitating symptoms to this day although I have had improvements. The only good thing to come of this is that I vowed I would make a difference for other people and change the way the medical system treats patients like me. Now I'm halfway through an MSW program and intend to go back to the HMO, the next time with LCSW credentials and copies of work on benzo damage that I will eventually publish, and lay it out for them again, this time from the standpoint of a mental health professional who has been iatrogenically harmed. Meschelle from Alexandria, Virginia  Benzo News “Want to Prevent Suicides? Stop Ignoring Benzo Patients” I shared highlights from a blog post on the website of the Benzodiazepine Information Coalition (BIC). Here are a few of my comments. Please visit the BIC's website to view the article. BIC WebsiteDirect Link to the Blog Post  Benzo Story We finally have our first story to share in our Benzo Stories section. I just ran across your podcast and I have listened to the first 3. My story. I'm 57. I have been on Xanax for 33 yrs, basically my entire adult life. I have 2 grown children and 5 grandchildren [and] a very supportive husband (a wonderful hard working, easy going man of few words). We live in a very rural area in SE Kansas. My first panic attack was when I was 7. I really don't know how I made it through school. I had to learn how to hide my panic. No one knew about it, not friends or family. After my children were born, I finally couldn't cope so I went to my doctor and he put me on Xanax. Finally, I could relax. I started working at a mental health clinic where I started talking to the staff and physiatrist. I have been to the Mayo clinic in Scottsdale, KU medical center, doctors in Tulsa and so many therapists and counselors that I can't remember all of them. I was taking up to 8 mg a day until about 18 months ago. I was also on Ambien, buspiron, and imipramine. I was again transferred to another counselor who said I needed to get off of it. I'm now down to 4.5 mg a day of Xanax and am still on the others. No one ever told me about these drugs. I like you finally started to do research while going from 5 down to 4.5 and suddenly I started feeling symptoms of withdrawal. Now along with yet another therapist we are continuing the taper but she wants me to wait another couple of weeks before tapering down by .25 mg because of the symptoms. I know I have a long way to go. I have been house bound since the first of Feb. I have been relying on my faith to get through this. I am already on disability since 1997 and am really thankful for that, but the panic “disorder” is what I get disability for. I could go on and on but I'm sure you have heard it all before. My taper is going to be long and slow at first to see how I handle it. I made my first taper by myself and it was too much for me. My doctor told me I could go back up by .25 mg but I didn't want to do it so I didn't. When I get through this with the grace of God I, want to help others. I appreciate you and what you are doing. I think the handling of this medication is one of the most underestimated and uninformed there is. Keep up your good work! I'll be listening and reading your book. And God Bless you! Cheryl Cheryl, from SE Kansas, USA  Feature Today's featured topic: The Ashton Manual – Who Wrote It and Why You Should Read It This feature topic is a sort of homage to Prof. Ashton and the Ashton Manual. Benzo Free, along with its host, support The Ashton Manual and recognize the number of lives it has saved over the past many years. Please be advised that Professor Ashton is now fully retired and no longer based at Newcastle Univeristy. She is therefore unable to deal with personal email enquiries with regard to benzodiazepine-related problems. Please also note that Professor Ashton does not support or endorse any internet support group. benzo.org.uk CAREER ACCOMPLISHMENTSHere are some highlights of Prof. Ashton's career: Graduate of the University of Oxford where she obtained a First Class Honours Degree (BA) in Physiology in 1951.Postgraduate Doctor of Medicine degree (DM) in 1956Member of the Royal College of Physicians, London in 1958Fellow of the Royal College of Physicians, London in 1975A National Health Service Consultant in Clinical Psychopharmacology in 1975A National Health Service Consultant in Psychiatry in 1994.A researcher, lecturer, senior lecturer, reader, and professor at the University of Newcastle upon Tyne.A patron of the Bristol & District Tranquilliser ProjectInvolved in the UK organization, Victims of Tranquilizers (VOT)Has submitted evidence about benzodiazepines to the House of Commons Health Select Committee.Has a Facebook page dedicated to her titled: “Tribute to Professor Heather Ashton” CLINICAL WORK For twelve years I ran a benzodiazepine withdrawal clinic for people wanting to come off their tranquillisers and sleeping pills. Much of what I know about this subject was taught to me by those brave and long-suffering men and women…It is interesting that the patients themselves, and not the medical profession, were the first to realise that long-term use of benzodiazepines can cause problems. — Prof. Ashton I shared some highlights from a letter written by Wayne Douglas, co-founder of World Benzodiazepine Awareness Day (W-BAD), regarding the nomination of Prof. Ashton for Queen's Honours. You can read the letter via the link below.W-BAD Web Page with Letter THE ASHTON MANUAL The manual itself consists of four chapters: CHAPTER I: The benzodiazepines: what they do in the bodyCHAPTER II: How to withdraw from benzodiazepines after long-term useCHAPTER III: Slow withdrawal schedulesCHAPTER IV: Benzodiazepine withdrawal symptoms, acute & prtracted Here are a few words from the 2011 supplement to The Ashton Manual: It is important to remember that by far the greatest majority of long-term benzodiazepine users do recover from withdrawal – given time. Even protracted symptoms tend to decrease gradually, sometimes over years. The individual needs to know that the actual drug withdrawal is only the first step towards recovery. It may be followed by a prolonged period of convalescence during which the damage caused to the person's body – and often to his whole life – needs to be repaired as far as possible. But the brain, like the rest of the body, has an enormous capacity for adapting and self-healing. That is how life survives and how ex-benzodiazepine (quote) ‘addicts' can be optimistic about their future. — Prof. Ashton Until you have been through the ordeal of benzo withdrawal, and found yourself so desparate for information and guidance, you'll never know the type of life raft that this manual has been too us. Prof. Ashton, thank you.  The PodcastThe Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.comMAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://www.youtube.com/@easinganx DISCLAIMERAll content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. CREDITSMusic provided / licensed by Storyblocks Audio — https://www.storyblocks.com Benzo Free Theme — Title: “Walk in the Park” — Artist: Neil Cross PRODUCTIONEasing Anxiety is produced by…Denim Mountain Presshttps://www.denimmountainpress.com ©2022 Denim Mountain Press – All Rights Reserved