#54 Obesity Medicine and Lifestyle Psychiatry: Obesity Measurements, Rates, Trends, and Etiologies

Today I will start a new season of This Is Your Brain On Drugs Psychiatry Podcast. I mentioned the dual season of ADHD with Obesity Medicine and Lifestyle Psychiatry. Last week I started with ADHD and today I will start the series on Obesity Medicine. I'll do an introduction where I talk about measuring obesity, rates of obesity, trends over time, and etiologies of obesity. I think you will find the discussion on etiology to be especially interesting. I decided to include my lectures on lifestyle and nutritional psychiatry into this series as well as these treatments can treat obesity but also are very useful in treating depression, anxiety, and other psychiatric conditions. So, there will be a lot on those topics before I start talking about the medications to treat obesity. I'm really excited to do this season. It's the one that I've been waiting to do for a year, so I hope you enjoy!

#53 Attention Deficit Hyperactivity Disorder (ADHD): Background and Pathophysiology

Today I start a new season of This Is Your Brain On Drugs Psychiatry Podcast. I will do a dual season where I will go back and forth each week between a season on ADHD and a season on Obesity Medicine and Lifestyle Psychiatry. Today I will start with ADHD. I will do a background on ADHD and discuss its possible causes. I think you will enjoy this introduction and discussion on the background of ADHD. I'll do the usual where I discuss what the science says and give my opinions and clinical insights. Have a listen!

#52 Depression Differential: When to Consider Bipolar Disorder or Something Else

I had an after thought after finishing the depression season, and that is what happens when someone has depressive symptoms that looks like a depressive disorder but it isn't? We will cover all of these diagnoses and their treatments in the future but I think it is prudent to have a discussion on how depressive symptoms look different in different illnesses and how that can affect the medication that you select. And most importantly we want to consider bipolar disorder, so I do a deep dive on bipolar disorder and talk about the old diagnosis of manic depressive illness from DSM-II days where these illnesses were one in the same and both would be treated with a mood stabilizer. There have actually been several different types of depression or manic depressive illness suggested, so have a listen to learn more.

#51 Procedures: Bright Light Therapy, Vagal Nerve Stimulation, Transcranial Magnetic Stimulation, Cranial Electrotherapy Stimulators

Today I will finish up on psychiatric procedures for depression. I will discuss bright light therapy, vagal nerve stimulation, transcranial magnetic stimulation, and cranial electrotherapy stimulators. Some of these are really cheap, others expensive; some are really invasive, some not at all. So there is a range of accessibility. Most of these are quite effective and adverse effects are generally pretty low. You're probably familiar with some of them and not with others, so take a listen and learn about how these work, how you can give to your patients, and what the evidence is for effectiveness. 

#50 Electroconvulsive Therapy: The Most Effective Treatment in Psychiatry

Today I talk about Electroconvulsive Therapy or ECT. This is the most effective treatment in psychiatry with effect sizes off the charts and comparable to treatments for other medical disorders. It's used a lot more than you probably think but not used enough. I'm no expert in ECT. I've done it under supervision, but I'm not certified in it. But that doesn't mean that I can't tell you all about its virtues. In this podcast that's what I'll do. I'll tell you about its effectiveness, how its done, what it can treat, and how to do a thorough medical review to make sure that a patient is safe to have it done. What I'll leave for the expert to explain is exactly how to perform it, but I think even if you practice ECT that you will learn a lot from this episode, so please have a listen!

Quick Take #2: July Updates!: FDA Denies New Treatment for PTSD, Alcohol Intake Limit Recommendation Ends?, New BBW on SSRIs?, Clozapine REMS Ends!, New Psychedelic for Depression?, and Many More!

Hey All, I'm starting up a new series that will contain several snippets of updates in the psychopharm world. Every month or two I will plan to release an episode where I don't deep dive like normal, but instead cover several important breaking news items that affect psychopharmacology and give my quick take on the news. Some of this will be trial results, FDA updates, interesting papers that were recently published, and anything else I can come up with. Today I have a ton of stuff to tell you about. FDA discussion on BBW on SSRIs for pregnancy, clozapine REMS ends, clozapine semaglutide trial, online ADHD prescription assessment, new psychedelic trial results for treatment resistant depression, change in alcohol intake recommendations, new warning on stimulants, new Alzheimers drug donanemab approved for label change indicating improved safety over competitors, new study on vaping for tobacco cessation, BBW removal for HRT?, FDA decision on brexpiprazole combo for PTSD, and study results on the effects of gabapentin on long-term cognition. I really packed a lot in to this shorter episode. Please have a listen!

#49 NAC, Creatine, Aromatherapy, Unfounded Alternative Treatments, and Complementary Medicine Wrap-Up 

Today I will be finishing up the complementary treatments for depression. I'll briefly cover three more treatments that have some evidence and no risk for effect: n-acetylcysteine, creatinine, and aroma therapy. Then I'll mention a number of treatments that as far as I can tell have no evidence that they work better than placebo, some of which could be harmful. Then I'll do a wrap-up of complementary treatments and discuss how these can be useful for your practice and why you shouldn't just write them off and nonsense or less effective. It went a little longer than I was hoping for but I think you will enjoy this finish to our complementary and alternative medicine series.

#48 Omega-3 Fatty Acids: Are They Good For Mental Health, Too?

Continuing with complementary medicine for depression, I'm moving on to omega-3 fatty acids. I'll give you the full run down of fatty acids and where omega-3s fit in, what differentiates all the types of fatty acids, why omega-3s are so good for you, what foods you will find them in, the three different kinds and how they are different, and most importantly, what they can do for mental health. I'll briefly cover a few journal articles that point to evidence for omega-3s benefit for mental health, and I'll make my final recommendation and verdict on omega-3s for use in mental health, so you'll definitely want to hear about this because I'm sure most of your patients are taking it, have taken it, or are thinking about it. You will want to know how to advise them on the best way to do so, and what they can expect!

#47 Zinc: The Second Most Important Mineral for Mental Health?

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

#46 Magnesium: The Most Important Mineral for Mental Health?

On today's show I will be talking about minerals and specifically magnesium. Magnesium is critical for cell functioning and neurons are certainly no exception. I'll talk about what magnesium does, how you can be deficient, how it's very difficult to measure neuronal levels, what foods contain it, what research there is to support the use of magnesium in depression, and I'll try to help sort out all those crazy different types of magnesium you see online and at the store. This is definitely a mineral to pay attention to and is just one of two that I'll be discussing, so I'm sure you will enjoy.

#45 Vitamin D: Does Supplementation Help With Mental Health?

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

#44 L-Methylfolate (Deplin) and SAMe for the Treatment of Depression

I introduced you to vitamins on the last episode and specifically concentrated on the B vitamins and more specifically, B12 and folate (B9). I touched on L-Methylfolate as the best way to supplement folate and that even if you are not deficient in folate that it may not be getting into your brain. If that's the case, then the patient may need L-Methylfolate. I will go into detail on it today. I will also cover SAMe which is related as it is a chemical in the methylation cycle that the folate cycle is connected to. Let's learn about these two supplements for depression that have pretty good evidence for benefit in patients!

#43 B Vitamins and Why They Are Important for Mental Health

Today we continue our journey through complementary medicine and its impact on depression. Last time I talked about herbal treatments, and today I will start off a short series on vitamins and minerals. On today's episode I'll briefly talk about vitamins in general and then I'll focus on the B vitamins most important for mental health, B12 and folate. I'll talk about why they are so important, how one could become deficient in them, how to check for that, and what to do about it. Many of your patients are probably taking vitamins and thinking they are helping them, so I think it's critical we know as much about them as possible so that we can counsel patients and actual prescribe them when they are actually needed!