Episode List
Today I do a deep, deep dive on Adderall, aka Mixed Amphetamine Salts, and I attempt to answer my own questions, "Why are there 4 different salts in Adderall?" I mean I get that there is a mixture of levo and dextro, but why the sulfate, aspartate monohydrate, etc.? Well, for those of you that are wondering this is well, I think I have the answer. This is not stated anywhere that I could find, it is my best guess hypothesis. It's interesting because as far as I am aware, other than Xywav, there is no other medication that is a mixture of salts of the same active drug, and in the case of Xywav, the purpose is to minimize sodium intake. For Adderall, there is no sodium, so the explanation is completely different and actually pretty fascinating. Have a listen!
So today I wanted to do an episode about deception in health information. How do these deceptions work and how to detect them. We don't all have the knowledge or time to go through the literature with a fine toothed comb, and even those like me that do have more knowledge and more time can still be misled, and we are often misled by well intentioned folks that think they have correctly interpreted the data and are revealing some kind of new controversial truth to us. I mean governments and businesses have an incentive to mislead us and have in the past, so it isn't surprising to think that they are doing it again. However, we can also be misled by those that are making these accusations against governments and businesses. How confusing! Today I will talk about this and I will also make some corrections of things that I have said during this series on nutrition and some of them are big ones!
Today I will continue talking about potential adverse effects of stimulant medications. Last time I discussed several adverse effects, but today I will mostly be focusing on cardiac (heart) effects because those have gotten a lot of press, especially with a previous black box warning for this. I will also talk about use in pregnancy in this episode. Next time I will discuss substance abuse issues which will round out all of our potential adverse effects.
It's been a few months since my last update episode, and I have several updates in the world of psychiatry. A couple studies of the ketogenic diet for depression and anxiety, a newly approved device for depression, a blood test for Alzheimers, ibogaine in Colorado, pregnancy risk with benzodiazepines and sleep medications like Ambien, a new study on the non-link between Tylenol and autism, and many more. I hope you enjoy these updates of real time information that has come out since November!
So we've finally gone through the massive topic of nutrition, and today I'll just have this one episode on physical fitness. That's not because it isn't as important, but I think it's just a lot easier. With nutrition there's so much false information out there, but with physical fitness, it's basically just make sure you are moving around and not sedentary, so I will go over the research that ties physical fitness to improved mental health outcomes, I'll go over how much physical fitness you should strive for, and I'll give some tips on things you can do to get you started and how to break through the barriers that are stopping you from maintaining your fitness level, so there's a lot packed in to this one episode. Enjoy!
Today I will wrap up the last episode on adverse effects of stimulant medications used to treat ADHD. I will be discussing the black box warning regarding abuse, misuse, and addiction. This risk is very much overstated, and it leads to providers withholding potentially life changing medication from a lot of patients, so today I will be going over the scientific research on how risky these medications are, when to worry about it, and what to do when actual concern exists, so you won't want to miss this one!
Today I will be wrapping up the lifestyle factors that contribute to health problems like mental health and obesity. I will briefly discuss getting adequate sleep, avoiding toxins like alcohol, tobacco, and drugs, healthy relationships, lifelong learning, and spending time outdoors. I think many of these are overlooked when trying to lose weight or fix mental health problems. Diet and exercise are all over the internet now, but I think these factors are neglected and ignored and doing so may just be the reason why things are getting better, so in that regard, these could actually be the most important factors. In fact having healthy relationships and socialization is probably the most important lifestyle factor to good health!
We have finally finished going over lifestyle factors for obesity and mental health, and now if that was not enough to help the patient for weight loss and metabolic factors, we will need to consider using medications, but before we start medications, we need to do a medical assessment. Actually you would do this assessment before lifestyle factors, but I think this is a good time to talk about it right before we talk about obesity medications in the next podcast, so it may not be as exciting of a topic, but we have to screen patients for other causes of obesity as well as factors that will help us know what medication to select because there are contraindications to all medications as well as times when we can kill two birds with one stone, so you definitely should not breeze over this topic!
Today we will be moving from the stimulant medications to the so called non-stimulants. Stimulants include methylphenidate and amphetamine as well as modafinil. There are actually quite a few non-stimulants with more than half being used off label. I will introduce the non-stimulants today and then talk in depth about two of them, atomoxetine, brand name Strattera, and one of the newest psychiatrist medications, viloxazine, brand name Qelbree.
We have finally finished going over lifestyle factors for obesity and mental health and will start talking about medications. Today I start with medications that you should be considering first line, including phentermine and several others that you are probably less familiar with like diethylpropion, phendimetrazine, and benzphetamine. I will talk about the amphetamines that have been used for weight loss as well as ones like Vyvanse that are currently used. I will also talk about fenfluramine and its connection to phentermine and also sibutrimine which was taken off the market. A lot of interesting history and pharmacology in here as well as details on how to use some of the most important medications for obesity!
Copyright ©2026 This Is Your Brain On Drugs Psychiatry Podcast, All Rights Reserved.