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A critique of SSRIs and pharma’s influence on medicine, including SSRI-induced sexual dysfunction, suicidality, and violence. 

Long Summary: Dr. David Healy critiques modern medicine, focusing on SSRIs and psychiatric medicine, including: how pharmaceutical companies manipulate clinical trial data, ghostwrite studies, and influence medical practice, often ignoring patient experiences; highlighting issues like post-SSRI sexual dysfunction (PSSD), the immediate sensory effects of SSRIs, and their potential to induce suicidal or violent behavior; challenging the reliance on randomized controlled trials (RCTs) over individual patient reports; and more.

About the guest: David Healy, MD, PhD, a psychiatrist and pharmacologist, has decades of experience researching the serotonin system and SSRIs, working across Ireland, the UK, Canada, and the US. He is a professor at McMaster University and a vocal critic of pharmaceutical industry practices.

Discussion Points:

• SSRIs cause near-immediate sensory effects, like genital numbing, in most people.
• Post-SSRI sexual dysfunction (PSSD) can persist for years or decades after stopping the drug, affecting many long-term users.
• Healy argues RCTs prioritize averages over individual experiences, often missing serious side effects like suicidality.
• Pharmaceutical companies ghostwrite studies and manipulate data, with journals like the New England Journal of Medicine publishing misleading articles.
• Serotonin theory of depression lacks evidence.
• Industry tactics include dismissing patient reports as anecdotes and using high doses in trials to mask weak efficacy.
• SSRIs can increase suicide risk, not just during initiation but also when adjusting doses or withdrawing, as seen in cases like the Aurora movie theater shooting.
• Regulatory bodies like the FDA often fail to investigate adverse effects due to bureaucratic processes and lack of follow-up.
• Healy emphasizes doctors’ failure to prioritize patient observations, driven by industry-influenced standards of care.

Related episode:

• M&M 88: Depression, Serotonin, SSRIs, Psychiatry & Social Media | Joanna Moncrieff

*Not medical advice.

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Episode Summary: Dr. Andrew Chadeayne discusses the chemistry of psilocybin and other psychedelics, their potential therapeutic applications, and the challenges of commercializing them in a shifting biotech market. The conversation delves into the complexities of magic mushroom composition, debunking myths like "lemon tekking," and uncovers the booming, unregulated alternative products industry, including kratom and synthetic psilocybin analogs sold in vape shops.

About the guest: Andrew Chadeayne, PhD is a chemist who also holds a law degree, specializing in patent law. He is the founder and CEO of CaaMTech, a startup specializing in the development of novel psychedelic compounds. Chadeayne collaborates with academic labs to advance psychedelic science while navigating the commercial landscape.

Discussion Points:

• Psilocybin is a prodrug converted to psilocin, but magic mushrooms contain other psychoactive molecules like beta-carbolines, which may enhance effects by inhibiting degradation.
• Chadeayne’s team develops psilocin prodrugs to shorten psychedelic trips, making clinical administration more manageable without altering effects.
• The "lemon tek" myth—that lemon juice converts psilocybin to psilocin—is false; it enhances absorption by extracting compounds, not altering chemistry.
• Magic mushroom bruising indicates psilocin degradation, as oxidized psilocin forms blue, inactive dimers.
• The multi-billion dollar alternative products industry sells kratom and synthetic psilocybin analogs, often mislabeled, in vape shops, raising safety and regulatory concerns.
• Kratom’s minor alkaloid, 7-hydroxymitragynine, is ~40x more potent than morphine, with no reported overdoses but high habit-forming potential.
• Non-hallucinogenic serotonin 2A agonists, like those developed by CaaMTech’s spinout, show promise for conditions like migraines without requiring a psychedelic trip.

Related episode:

• M&M 71: Chemistry of Magic Mushrooms, DMT Analogues, Entourage Effects in Cannabis & Fungi, Novel Psychedelic Medicines, Psychedelic Startups | Andrew Chadeayne

*Not medical advice.

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Episode Summary: Dr. Michael Wheeler talks about neuroimmune interactions, exploring how the immune system and brain communicate, particularly through the blood-brain barrier and meninges; how chronic stress and inflammation can alter brain circuits, contributing to mood disorders like depression; how drugs like psilocybin and MDMA may reduce inflammation by modulating immune cells in the meninges, offering potential therapeutic benefits.

About the guest: Michael Wheeler, PhD is an Assistant Professor of Neurology at Harvard Medical School. His lab studies how immune responses influence behavior, mood disorders, and addiction.

Key Conversation Points:

• The blood-brain barrier (BBB) is not as impermeable as once thought, allowing immune signals like cytokines to influence brain function even in healthy states.
• Chronic stress can weaken the BBB, increasing inflammation and affecting mood-regulating circuits, potentially contributing to depression.
• Microglia, the brain’s resident immune cells, help maintain neural circuits by pruning synapses and regulating metabolism.
• Psychedelics like psilocybin and MDMA can reduce inflammation by prompting immune cells (monocytes) to leave the meninges, potentially via vascular effects.
• These psychedelics may act in a context-specific “window,” requiring a dysregulated tissue state to exert anti-inflammatory effects, not as broad-spectrum anti-inflammatories.
• Neuroinflammation may underlie some treatment-resistant depression cases, suggesting immunotherapy could complement traditional psychiatric treatments.
• The brain encodes peripheral immune signals, like gut inflammation, in specific circuits, which can “remember” and recreate inflammatory responses.
• Aging may naturally increase blood-brain barrier leakiness, heightening the brain's susceptibility to peripheral inflammation.
• Future research aims to explore how psychedelics influence plasticity and their potential in treating inflammation-related diseases beyond psychiatry.

Related episode:

• M&M 2: Psilocybin, LSD, Ketamine, Inflammation & Novel Psychedelic Medicines | Charles Nichols

*Not medical advice.

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Episode Summary: New research on how dietary fats, particularly omega-6 fatty acids like linoleic acid, influence triple-negative breast cancer progression by activating the mTOR pathway, a key regulator of cell growth; role of the FABP5 protein in enhancing cancer cells’ sensitivity to omega-6 fats; differences between breast cancer subtypes; broader implications of dietary balance for health.

About the guest: John Blenis, PhD is a Professor of Pharmacology at the Meyer Cancer Center at Weill Cornell Medicine. Nikos Koundouros, PhD is a postdoctoral fellow in Blenis’ lab.

Note: Podcast episodes are fully available to paid subscribers on the M&M Substack and everyone on YouTube. Partial versions are available elsewhere. Transcript and other information on Substack.

Key  Points:

• mTOR pathway acts as a cellular “brain,” sensing nutrients like amino acids, glucose, and fats to regulate growth. Its dysregulation can drive cancer.
• High dietary omega-6 fatty acids, like linoleic acid found in seed oils, can fuel triple-negative breast cancer growth by activating mTOR.
• FABP5, a lipid chaperone protein, is overexpressed in triple-negative breast cancer, making these tumors more sensitive to omega-6 fats, suggesting its potential as a therapeutic target.
• Modern diets with high omega-6 to omega-3 ratios disrupt inflammation balance, unlike historical 1:1 ratios, potentially increasing cancer risk.
• Genetic variations and cancer subtypes highlight the need for tailored dietary recommendations, as blanket nutrition advice may not suit all patients.
• While omega-6 fats exacerbate existing triple-negative breast cancer, their role in initiating cancer remains unclear, requiring further study.
• High omega-6 intake may influence other cancers (e.g., prostate, colon) and chronic diseases like obesity, linked to FABP5 and inflammation.

Related episode:

• M&M 200: Dietary Fats & Seed Oils in Inflammation, Colon Cancer & Chronic Disease | Tim Yeatman & Ganesh Halade

*Not medical advice.

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Episode Summary: Dr. Gyorgy Buzsaki discusses the hippocampus’s role beyond memory and spatial navigation, delving into its broader functions in cognition, action planning, and brain-body interactions; how hippocampal rhythms, like sharp wave ripples, influence memory consolidation, glucose regulation, and metabolic health, challenging conventional neuroscience assumptions; the interplay of brain rhythms, sleep, and preconfigured neural dynamics; the history and conceptual foundations of neuroscience; and more.

About the guest: Gyorgy Buzsaki, MD, PhD is a professor at NYU. He leads a lab investigating how neural circuits underpin cognition, particularly through oscillations and brain-body interactions. His work has significantly advanced understanding of memory formation and spatial navigation.

Note: Podcast episodes are fully available to paid subscribers on the M&M Substack and everyone on YouTube. Partial versions are available elsewhere. Transcript and other information on Substack.

Key Conversation Points:

• Hippocampus isn’t just for memory or navigation; it may orchestrate action planning and abstract representations of the world, shaped by evolutionary constraints.
• Brain rhythms, like sharp wave ripples, synchronize neural activity, enabling efficient communication and impacting bodily functions like glucose homeostasis.
• Sharp wave ripples, prominent during non-REM sleep and consummatory states, are critical for memory consolidation and may link sleep disruptions to metabolic disorders.
• Buzsaki challenges the idea of memory as fixed synaptic patterns, proposing it’s more like dynamic, cloud-like sequences, endlessly reconfigurable.
• The brain’s intrinsic dynamics prioritize action generation and learning from consequences over external representations.

Related episode:

• M&M 16: Sleep, Dreams, Memory & the Brain | Bob Stickgold

*Not medical advice.

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The biophysics of life, exploring how light & energy shape biology, with biophysicist Dr. Nirosha Murugan.

Episode Summary: Dr. Murugan discusses the role of biophysics in biology, focusing on how light, particularly biophotons emitted by cells, influences processes like wound healing, neural activity, and cancer detection; how microtubules may act as biological fiber optics, the impact of modern light environments on health; her work inducing limb regeneration in frogs using silk hydrogels and growth factors; cancer as an energetic dysfunction; potential of non-invasive photonic diagnostics; the need for new tools to study these phenomena.

About the guest: Nirosha Murugan, PhD is a biophysicist and assistant professor at Wilfrid Laurier University in Waterloo, Ontario. Her lab investigates the biophysics of life.

Note: Podcast episodes are fully available to paid subscribers on the M&M Substack and everyone on YouTube. Partial versions are available elsewhere. Transcript and other information on Substack.

Key Conversation Points:

• Cells emit biophotons, ultra-weak light tied to metabolism, which may carry information for processes like immune response and neural communication.
• Microtubules might function as biological fiber optics, potentially guiding light within cells for signaling purposes.
• Red and near-infrared light can accelerate wound healing and reduce inflammation, likely by modulating mitochondrial activity.
• Cancer cells emit distinct photonic signatures, which could enable non-invasive diagnostics by detecting light differences from healthy tissues.
• Modern light environments, unlike natural sunlight, may subtly affect health by altering biological responses to electromagnetic signals.
• Biological systems act as metamaterials, patterning energy flow in ways that constrain and shape molecular and behavioral outcomes.

Related episode:

• M&M 221: Regenerative Energy & the Light Inside You | Jack Kruse

*Not medical advice.

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Short Summary: Dr. Alex Kwan unpacks the latest neuroscience research on how psychedelics like ketamine & psilocybin reshape the brain.

About the guest: Alex Kwan, PhD, is an associate professor of biomedical engineering at Cornell University. His lab employs advanced imaging to study how psychedelics and other drugs affect the mammalian brain.

Note: Podcast episodes are fully available to paid subscribers on the M&M Substack and everyone on YouTube. Partial versions are available elsewhere. Transcript and other information on Substack.

Episode Summary: Dr. Alex Kwan discusses how psychedelics like ketamine and psilocybin induce rapid neuroplastic changes in the brain, particularly in the prefrontal cortex, contrasting their effects with traditional antidepressants like SSRIs, and exploring their potential for treating depression and chronic pain through structural and functional brain alterations.

Key Takeaways:

• Ketamine & psilocybin rapidly increase dendritic spine density in the prefrontal cortex, enhancing neural connections within days, unlike SSRIs, which take weeks.
• These drugs show sustained neuroplastic changes in mice, lasting weeks to months after a single dose, suggesting long-term brain rewiring.
• Serotonin 2A receptor is critical for psilocybin’s neuroplastic effects, as precise genetic knockouts in adult mice eliminate spine growth.
• Unlike ketamine, psilocybin activates the insula, a brain region linked to chronic pain processing, hinting at new therapeutic potential.
• Both drugs induce similar gene expression patterns in areas like the prefrontal cortex and amygdala, but differ in specific regions like the insula.

Related episode:

• M&M #30: Psilocybin, Ketamine, Neuroplasticity & Imaging the Brain | Alex Kwan

*Not medical advice.

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Short Summary: The flaws of nutrition epidemiology with Dr. John Speakman

About the guest: John Speakman, PhD is a professor at the University of Aberdeen and runs a lab in Shenzhen, China, focusing on energy balance, obesity, and aging. 

Note: Podcast episodes are fully available to paid subscribers on the M&M Substack and everyone on YouTube. Partial versions are available elsewhere. Transcript and other information on Substack.

Episode Summary: Dr. John Speakman explores the pitfalls of nutrition epidemiology, a field that links diet to health outcomes like cancer and obesity but often produces contradictory results. They discuss flawed methods like 24-hour recalls and food frequency questionnaires, which rely on memory and are prone to bias, and introduce Speakman’s new tool using doubly labeled water to screen implausible dietary data. The conversation highlights systematic biases, such as under-reporting by heavier individuals, and emerging technologies like photo diaries and AI for better dietary tracking.

Key Takeaways:

• Nutrition epidemiology studies often contradict each other due to unreliable methods.
• Common techniques like 24-hour recalls & food frequency questionnaires suffer from memory issues, portion size issues, and systematic biases, often underestimating food intake.
• Heavier individuals (higher BMI) under-report food intake more, skewing associations between diet & obesity.
• Speakman’s tool, based on 6,500 doubly labeled water measurements, predicts energy expenditure to flag implausible dietary survey data.
• Emerging technologies, like smartphone photo diaries and AI food identification, promise more accurate dietary tracking than traditional surveys.
• Randomized controlled trials, not surveys, provide the most reliable dietary insights; single-day intake surveys linked to outcomes years later are dubious.
• Speakman advises ignoring most nutrition epidemiology headlines due to their inconsistency and lack of prognostic value for behavior change.

Related episode:

• M&M #132: Obesity Epidemic, Diet, Metabolism, Saturated Fat vs. PUFAs, Energy Expenditure,

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Short Summary: Cancer’s metabolic roots with Dr. Thomas Seyfried.

About the guest: Thomas Seyfried, PhD is a professor of biology at Boston College. He has researched cancer metabolism, epilepsy, and lipid biochemistry for over 40 years.

Note: Podcast episodes are fully available to paid subscribers on the M&M Substack and everyone on YouTube. Partial versions are available elsewhere. Transcript and other information on Substack.

Episode Summary: Dr. Thomas Seyfried discusses the mitochondrial metabolic theory of cancer, challenging the dominant somatic mutation theory. He explores how cancer cells rely on fermentation due to defective oxidative phosphorylation, drawing on Otto Warburg’s work. Seyfried explains how ketogenic diets and nutritional ketosis can starve cancer cells by limiting glucose and glutamine, while sharing evidence from nuclear transfer experiments and clinical studies. The conversation also covers environmental factors driving cancer and the importance of metabolic flexibility for prevention.

Key Takeaways:

• Cancer is characterized by dysregulated cell growth, but Seyfried argues it stems from mitochondrial dysfunction, not just genetic mutations.
• Cancer cells ferment glucose & glutamine, unable to use fatty acids or ketones, making ketogenic diets a potential therapeutic tool.
• Nuclear transfer experiments show cancer traits reside in the cytoplasm, not the nucleus, challenging the somatic mutation theory.
• Environmental factors like processed foods, stress, and poor sleep disrupt mitochondrial function, increasing cancer risk.
• Seyfried’s glucose-ketone index helps monitor metabolic states to manage cancer & chronic diseases.
• Cancer rates are rising in younger people, possibly due to obesity, inflammation, and environmental toxins.
• Metabolic flexibility, cycling between ketosis and carb-based states, may mimic ancestral patterns and reduce chronic disease risk.

Related episode:

• M&M #215: Cancer Metabolism: Sugar, Fructose, Lipids & Fasting | Gary Patti

*Not medical advice.

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Short Summary: Heart health and the ketogenic diet, with expert insights from a cardiologist and researcher.

About the guest: Matthew Budoff, MD, is a preventive cardiologist and professor of medicine at UCLA School of Medicine.

Note: Podcast episodes are fully available to paid subscribers on the M&M Substack and everyone on YouTube. Partial versions are available elsewhere. Transcript and other information on Substack.

Episode Summary: Dr. Matthew Budoff discusses cholesterol, heart disease, and his study on the ketogenic diet’s impact on lean, metabolically healthy individuals with high LDL cholesterol. He explains LDL, HDL, and triglycerides, debunking myths about their direct link to heart disease, and emphasizes the importance of coronary calcium scans to assess plaque buildup. Budoff also covers statins, dietary cholesterol, and personalized heart health strategies.

Key Takeaways:

• LDL cholesterol is not a definitive predictor of heart disease; plaque buildup, assessed via coronary calcium scans, is a better indicator.
• Lean metabolically healthy people on a ketogenic diet may have high LDL without increased plaque progression after one year.
• Coronary calcium scans, costing ~$100, are recommended for men around age 40 and women around 45-50 to evaluate heart disease risk.
• Statins effectively lower LDL and can reverse soft plaque, but may be overprescribed for those without plaque buildup.
• Dietary cholesterol has minimal impact on blood cholesterol, as the liver produces ~85% of it.
• Ketogenic diet can aid weight loss & diabetes control but may cause high LDL in some lean individuals, known as lean mass hyper-responders.
• Plaque progression depends more on existing plaque than LDL levels in metabolically healthy ketogenic diet followers.
• Heart health varies widely due to genetics and other unknown factors, underscoring the need for personalized assessments.

Related episode:

• M&M #158: Ketosis & Ketogenic Diet: Brain & Mental Health, Metabolism, Diet & Exercise, Cancer, Diabetes | Dominic D'Agostino

*Not medical advice.

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