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Lumateperone (Caplyta) just got FDA approved for bipolar depression. Find out how it compares to other atypical antipsychotics. CME: Take the CME Post-Test For This Episode Published On: 01/24/2022 Duration: 24 minutes, 09 seconds Chris Aiken, MD, and Kellie Newsome, PMHNP, have disclosed no relevant financial or other interests in any commercial c…
 
Psychoanalyst Dan Buie describes 5 deficits that cause great suffering for people with personality disorders and how to work with them in therapy. CME: Take the CME Post-Test Published On: 01/17/2022 Duration: 18 minutes, 39 seconds Related Article: “Working With Severe Personality Disorders,” The Carlat Psychiatry Report, January 2022 Chris Aiken,…
 
Psychoanalyst Dan Buie describes hateful reactions that are common when working with suicidal patients and how to manage these intense emotions CME: Take the CME Post-Test for this episode Published On: 01/10/2022 Duration: 9 minutes, 16 seconds Chris Aiken, MD, has disclosed no relevant financial or other interests in any commercial companies pert…
 
In 2021 we uncovered some paradoxical effects of medications, including meds that can both cause and treat OCD (antipsychotics), depression (benzodiazepines and antidepressants), and cognitive problems (stimulants and anti-dementia medications). CME: Take the CME Post-Test for this episode Published On: 01/03/2022 Duration: 16 minutes, 0 seconds Re…
 
DHHS recently unveiled the first major overhaul of its documentation guidelines for the E&M codes often used in outpatient psychiatry. We show you how to make those rules work for your patients. CME: Take the CME Post-Test for this episode Published On: 12/27/2021 Duration: 24 minutes, 16 seconds Chris Aiken, MD, and Kellie Newsome, PMHNP, have dis…
 
Gordon Parker suggests changes to the DSM-5 criteria for bipolar disorder, and unveils a new screening instrument that aims to separate hypomania from normal happiness. CME: Clinicians enrolled in our Podcast CME Subscription can access the post-test here. Published On: 12/20/2021 Duration: 16 minutes, 07 seconds Referenced Article: “How to Diagnos…
 
You will hear about and read research your entire career. Headlines report on positive treatment results, and families come in asking about them. So how should we evaluate research, and what makes a study good or flawed? CME: Clinicians enrolled in our Podcast CME Subscription can access the post-test here. Published On: 12/17/2021 Duration: 17 min…
 
For years, we have dreaded seeing our patients develop antipsychotic-induced tardive dyskinesia because there was little we could do about these symptoms. Thankfully, we now have new treatments that produce noticeable improvements in tardive dyskinesia. CME: Clinicians enrolled in our Podcast CME Subscription can access the post-test here. Publishe…
 
Peter Whitehouse on how to prevent dementia and the limits of pharmacotherapy for cognitive decline. And the word of the day: Ultradian cycling. CME: Clinicians enrolled in our Podcast CME Subscription can access the post-test here. Published On: 12/13/2021 Duration: 21 minutes, 12 seconds Referenced Article: “In the News: Aducanumab (Aduhelm),” Th…
 
Pregnant patients with substance use disorder want to do what’s right for their pregnancy, and as clinicians, we need to be supportive and acknowledge our patients courage and vulnerability to seek help. But, what are the best treatments for the various substance use disorders in pregnant women, and which substances have the highest potential for p…
 
From melatonin for sleep-onset insomnia to electroconvulsive therapy for severe adolescent mood disorder to steroid-induced psychosis to the risk of stimulant-induced psychosis in youth with ADHD, and MORE! In this two-part series, Mara and Dr. Feder will tackle various research topics in the field of child psychiatry. CME: Clinicians enrolled in o…
 
Individuals with schizophrenia are at high risk of obesity, elevated lipids, increased insulin resistance, diabetes, and cardiovascular disease. On average, people with schizophrenia die 20–25 years sooner than those without schizophrenia. How can we spot metabolic side effects early in our patients, and what should we be looking for exactly? CME: …
 
From melatonin for sleep-onset insomnia to electroconvulsive therapy for severe adolescent mood disorder to steroid-induced psychosis to the risk of stimulant-induced psychosis in youth with ADHD, and MORE! In this episode, Mara and Dr. Feder will tackle various research topics in the field of child psychiatry. CME: Clinicians enrolled in our Podca…
 
In 2004, the well-known pediatric OCD treatment study also known as POTS study revealed that CBT and sertraline had comparable benefits over 12 weeks of treatment for children with OCD. Yet this study left us with a few unanswered questions. For instance, for those who don't respond to initial CBT therapy, should we continue CBT or switch to an SSR…
 
An interview with Drew Ramsey on nutritional psychiatry. Chris Aiken, MD, Kellie Newsome, PMHNP, and Drew Ramsey, MD, have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity. CME: Clinicians enrolled in our Podcast CME Subscription can access the post-test here. Published On: 11/29…
 
How does schizophrenia differ between men and women? And are there adjunctive treatments that can improve outcomes for female patients with schizophrenia? In this podcast, Dr. Kulkarni and I will tackle these questions. CME: Clinicians enrolled in our Podcast CME Subscription can access the post-test here. Published On: 11/22/2021 Duration: 23 minu…
 
We break down the three main autism intervention approaches, and provide you with information that will help you improve on your abilities to recognize which particular autism intervention might be best for a specific patient. CME: Clinicians enrolled in our Podcast CME Subscription can access the post-test here. Published On: 11/17/2021 Duration: …
 
Aducanumab (Aduhelm) just got FDA approval in dementia, but many experts think it should not have passed the finish line. We interviewed Peter Whitehouse, professor of neurology at Case Western Reserve University and author of American Dementia, on what went wrong. CME: Clinicians enrolled in our Podcast CME Subscription can access the post-test he…
 
Patients with repeated deliberate foreign body ingestion (DFBI) are among the most challenging we see. In any given room, there’s bound to be some small object that can be swallowed. So how can we reduce the likelihood of foreign body ingestion in these patients? CME Credit: Clinicians enrolled in our Podcast CME Subscription can access the post-te…
 
In this 3-part series, we look at the rise and fall, and rise again of antipsychotics in mania, and sort through which ones work, which we should avoid, and whether their use in mania has gone overboard. Today, we lay out the top 3 antipsychotics for mania, and then throw out the whole idea of a rating system. Published On: 11/01/2021 Duration: 23 …
 
On April 30th of this year, the FDA approved Kloxxado, a naloxone nasal spray that contains 8mg of naloxone per dose, which is twice as much as the most common formulation: Narcan. But what distinguishes Kloxxado distinguishes from the many other ways that naloxone is delivered and why was it developed in the first place? Published On: 8/16/2021 Du…
 
In this 3-part series, we look at the rise and fall, and rise again of antipsychotics in mania, and sort through which ones work, which we should avoid, and whether their use in mania has gone overboard. Today, we lay out the top 3 antipsychotics for mania, and then throw out the whole idea of a rating system. Published On: 10/25/2021 Duration: 15 …
 
In this 3-part series, we look at the rise and fall, and rise again of antipsychotics in mania, and sort through which ones work, which we should avoid, and whether their use in mania has gone overboard. Today, how an anesthetic agent turned into an antipsychotic, and how Bing Crosby lit a spark that would eventually lead psychiatrists to revise th…
 
An interview with Michael Poyurovsky, MD, on the paradoxical effects of antipsychotics in OCD and the many ways that OCD symptoms show up in schizophrenia. Published On: 10/11/2021 Duration: 18 minutes, 3 seconds Related Article: "Can Antipsychotics Worsen OCD?", The Carlat Psychiatry Report, October 2021 Got feedback? Take the podcast survey.…
 
The 21st Century Cures Act (or the “Cures Act'' for short) was a federal law passed in 2016 that included various mental health provisions. This law has significant implications on the way we share information with our patients and their families. Published On: 09/27/2021 Duration: 17 minutes, 39 seconds Related Article: "Welcome to the 21st Centur…
 
Is ketamine a glutamate antagonist or a spiritual kindler? Ketamine has two origin stories, each with its own understanding of how it treats depression. One came from the East, and one from the West, and after the Iron Curtain came down the two met face to face. Today, we tell that story. Published On: 9/20/2021 Duration: 23 minutes, 27 seconds Rel…
 
Phase III clinical trials are beginning to roll out for psychedelic medications like like psilocybin and MDMA – also known as magic mushrooms and ecstasy. But this is not the first time these drugs have been used to treat mental illness, and today we take a dive into the clinical reports on psilocybin from half a century ago. Published On: 9/13/202…
 
Experts in borderline personality disorder and bipolar disorder reach a consensus about the mercurial temperament that underlies borderline personality. The DSM Committee restores a diagnostic code to recognizes those with a “clean bill of mental health,” and the word of the day goes psychedelic over the 5-HT2A receptor. Published On: 9/5/2021 Dura…
 
Nortriptyline + lithium is one of the top combos for keeping patients well after ECT, and in this episode we walk you through how to prescribe it, including side effects, dosing, drug levels, and drug interactions. Then, the word of the day: Antisocial personality disorder. Published On: 8/30/2021 Duration: 28 minutes, 49 seconds Article Referenced…
 
This deep dive podcast breaks through the dogma of autism intervention and helps you to understand the three main branches of autism intervention and their very different mechanisms, the quality of autism research with a huge shift in our understanding of what works, and addresses such questions as how many hours are really needed for intervention?…
 
We break down the three main autism intervention approaches, and provide you with information that will help you improve on your abilities to recognize which particular autism intervention might be best for a specific patient. Published On: 8/11/21 Duration: 27 minutes, 21 seconds Related Article: “Effect Size Matters: The Seismic Shift Toward Natu…
 
The APA says that genetic testing isn’t ready for prime time, but is there anything worth salvaging in these panels? We get some answers from John Nurnberger, a co-founder of the International Society of Psychiatric Genetics, the founding editor of the International Journal Psychiatric Genetic, and a Distinguished Professor Emeritus at the Indiana …
 
Research updates on mirtazapine in anxiety, insomnia, methamphetamine abuse, and controversial news about the abuse potential of this antidepressant. Also new side effects and withdrawal symptoms discovered. Published On: 7/19/21 Duration: 16 minutes, 28 seconds Related Article: "Two Negative Studies of Mirtazapine and Riluzole for PTSD in Veterans…
 
Antidepressants get people better from depression, but what keeps them better? In this episode, Dr. Giovanni Fava suggests we may need to stop trying to stamp-out pathology and start finding ways to enhance well-being as patients recover. Published On: 7/12/2021 Duration: 15 minutes, 42 seconds Related Article: "Psychotherapy and Medication in Recu…
 
We interview Vladimir Maletic about the serotonin transporter gene (SERT). It’s supposed to make people more vulnerable to depression, but there’s a bright side to this gene that rarely gets attention. We talk about the strengths it confers, and whether it can predict which antidepressant a patient will respond to. Published On: 7/5/2021 Duration: …
 
New analyses rank disulfiram (Antabuse) among the most effective medications for alcohol use disorders. But why is it so underutilized? In this podcast we explore the history of this therapy – the oldest medication that is still in use in psychiatry. Published On: 6/28/21 Duration: 25 minutes, 23 seconds Got feedback? Take the podcast survey.…
 
On April 2, 2021, viloxazine, brand name Qelbree, received FDA approval for the treatment of ADHD in children and adolescents ages 6-17 years old. The latest issue of The Carlat Child Psychiatry Report includes a News of Note covering this newly approved medication for ADHD. In this podcast, we discuss the advantages and disadvantages of viloxazine…
 
THINC-it is a new app that can help you track and measure your patient’s cognition. This episode includes a special patient edition from the Pocket Psychiatrist that walks patients through the app and offers tips to keep them motivated while they make behavioral changes to improve their cognition. Free download here. Published On: 6/14/21 Duration:…
 
Clinicians are inundated with ads for genetic testing, but is genetic testing currently helpful for informing clinical care? The latest issue of The Carlat Child Psychiatry Report includes an interview with Dr. Aaron Besterman, who’s an adult and child & adolescent psychiatrist at the Rady Children’s Hospital inpatient child and adolescent unit in …
 
Brian Wilson, Lou Reed, and Ian Curtis all created new music genres, and each of them is reputed to have had bipolar disorder. We look at the evidence behind that, and learn a few things about psychiatry and creativity along the way. But it all starts with Lou Reed’s first Velvet Underground concert, performed – of all places – at a psychiatric con…
 
The psychiatric syndromes caused by COVID infection may look like commonplace DSM-5 disorders, but the cause and treatment may be different. Reference: Boldrini M, Canoll PD, Klein RS. How COVID-19 Affects the Brain. JAMA Psychiatry. 2021 Mar 26. Published On: 5/24/2021 Duration: 16 minutes, 11 seconds Got feedback? Take the podcast survey.…
 
We ask the big questions: Is topiramate a drug or a sugar? Do you need to use the FDA-approved combo pill for weight loss? And which of its 13 off-label psychiatric uses are ready for clinical practice? Published On: 5/17/2021 Duration: 25 minutes, 58 seconds Got feedback? Take the podcast survey.By Pocket Psychiatry: A Carlat Podcast
 
Rusty machinery, forged documents, and monkeys in the manufacturing plants. It’s what happens when the FDA stops checking in on things. Katherine Eban talks to us about the current crisis in generic drug safety that this breakdown in oversight is causing. Published On: 5/10/2021 Duration: 23 minutes, 24 seconds Got feedback? Take the podcast survey…
 
A new study looked at what works best after two antidepressants have failed, and it claims to have found some surprising winners. We take a closer look at the data in the final episode of our two-part series on treatment resistant depression (see March 8 2021 for part 1). Published on: 3/3/21 Duration: 19 minutes 49 seconds Got feedback? Take the p…
 
We unpack 6 studies of the hypnotic eszopiclone in depressive and anxiety disorders, and conclude that there’s more going on here than a simple benefit in sleep. Our word of the day tells us something about what’s missing in depression: Present moment awareness. Published On: 4/26/21 Duration: 22 minutes, 52 seconds Got feedback? Take the podcast s…
 
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