The Carlat Psychiatry Podcast

By Pocket Psychiatry: A Carlat Podcast

Alternative Health Medicine

What's The Carlat Psychiatry Podcast about?

From the editors of The Carlat Psychiatry Report, this weekly podcast brings clear, engaging, and practical updates on clinical psychiatry. Through expert interviews and authoritative reviews, we cover all things psychiatric with an independent eye. The Carlat Report has operated free of pharmaceutical support since its inception in 2003. Hosted by Chris Aiken, MD, and Kellie Newsome, RN.

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Do Benzos Treat Depression?

04.05.2021

Around 50 controlled trials have tested benzodiazepines in depression, and the results are surprising. They seem to work. In this episode we look at the controversies surrounding this research and what it means for practice. Published On: 4/5/2021 Duration: 25 ...

The Carlat Psychiatry Podcast episodes:

04.05.2021 Do Benzos Treat Depression? Around 50 controlled trials have tested benzodiazepines in depression, and the results are surprising. They seem to work. In this episode we look at the controversies surrounding this research and what it means for practice. Published On: 4/5/2021 Duration: 25 ...
03.29.2021 COVID, Benzos, and Opioids Overdose deaths have been rising during COVID, but simply stopping the drug causes problems of its own. In this episde, Ashwin Patkar and Richard Weisler discuss how to reduce the risk of opioid deaths in psychiatric patients. Their Current Psychiatry ...
03.22.2021 How to Stop Benzos and Stimulants Swapnil Gupta, author of Deprescribing in Psychiatry, shares tips on how to help patients taper off benzodiazepines and psychostimulants. She adds a special therapeutic ingredient, but it’s not a medication. Then we digress into one of the oldest medications known ...
03.15.2021 In Memoriam: Hagop Akiskal and the Bipolar Spectrum DSM-5 has adopted many of the concepts from Hagop Akiskal’s Bipolar Spectrum, but not in the way he had planned. Here we trace his thinking back to the early 1970’s, when Dr. Akiskal reshaped the way we think about depression ...
03.08.2021 What Works Best in Treatment Resistant Depression Part 1 What works best when the first antidepressant fails? And the second? Today, we bring you part 1 in our special series on treatment resistant depression. Published On: 3/7/21 Duration: 16 minutes, 1 second Got feedback? Take the podcast survey (http://www.thecarlatreport.com/podcastsurvey).
03.01.2021 Duty to Warn: Antidepressants in Children and Adolescents For nearly 17 years, since the FDA black box warning about suicidality with antidepressants, our community has been quoting data that downplays this concern. We were wrong. We were deceived. Antidepressants can be lifesaving, but there really is a duty ...
02.22.2021 How Buspirone Mixed with Melatonin to Make an Antidepressant In 2012, psychiatrists at Harvard’s Massachusetts General Hospital discovered a novel antidepressant. It seemed to improve depression and cognition without causing any significant side effects. There was only one problem. The ingredients were practically free, and there was no way ...
02.15.2021 When Depression Gets Worse on an Antidepressant Bupropion and restless legs syndrome: a randomized controlled trialWhen a patient complains that their mood got worse on an antidepressant, it doesn’t necessarily mean they are sensitive to medications. In this episode, we detail 6 other reasons why depression can ...
02.08.2021 Deprescribing Part 1 An interview with Swapnil Gupta on when and how to come off psychiatric medications. Plus, tips on cross-tapering antidepressants, and the word of the day: Ephedra. Published On: 2/8/2021 Duration: 17 minutes, 1 second
02.01.2021 The Antidepressant Calendar: How to “Just Do It” Behavioral activation came about in the 1990’s as a challenge to the CBT model of depression. The basic strategy behind this therapy blends well with brief medication visits, and we explain how to use it in this professional guide. Check ...
01.25.2021 The Birth of Lamotrigine Richard Weisler tells the tale of science and serendipity that lead to his discovery of lamotrigine for bipolar depression 30 years ago. He shares a few dosing tips, and touches on how he works with patients and their families. Plus, ...
01.18.2021 Are Probiotics Ready for Practice? The gut microbiome influences the brain in numerous ways, but can building a better microbiome treat depression? Dr. Ted Dinan walks us through the science in this interview. Published On: 1/17/21 Duration: 27 minutes, 50 seconds Article Referenced: "Probiotics in ...
01.11.2021 Cognitive Enhancers: The Brain on Chess The Queen’s Gambit is Netflix’s critically acclaimed series about a chess prodigy who gets “a little help from her friends.” In this episode we find out what they got right, and wrong, about psychiatric meds and cognitive enhancement. Published On: ...
01.04.2021 Rebuilding Life after Bipolar Brett Stevens has lived through the worst of bipolar and come out standing. Here’s what he did to get his life back. This is the first edition of The Pocket Psychiatrist, a monthly series you can share with your patients ...
12.28.2020 What We Learned in 2020 A look at the top 10 practice-changing highlights from our 2020 journal. Tardive dyskinesia, inflammation, lumateperone, top first-line medications, trazodone in depression, Silexan for anxiety, excellent lithium responders, hormones and mood, and ramelteon’s generic debut. Published On: 12/28/2020 Duration: 26 ...
12.21.2020 Retracted Retractions are on the rise in medical research, and we get to the bottom of it with Ivan Oransky, cofounder of RetractionWatch.com (RetractionWatch.com). Published On: 12/21/2020 Duration: 25 minutes, 12 seconds Got feedback? Take the podcast survey (http://www.thecarlatreport.com/podcastsurvey).
12.17.2020 Melatonin Supplements in Middle Age [60 Sec Psych] Most of the research on melatonin has involved older adults, and there it seems to work pretty well, just a little less effective than most prescription sleep meds. So how well does melatonin work in middle aged adults? This new ...
12.14.2020 Therapy in the Med Visit: An Interview with Donna Sudak Donna Sudak shares her tips for weaving cognitive behavioral therapy (CBT) into the 30-minute psychotherapy session with medication. The article on rating scales she references - Free, Brief, and Validated - is available here (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310476/pdf/nihms-589127.pdf). Published On: 12/14/2020 Duration: 19 ...
12.12.2020 Night Eating in Bipolar Disorder [60 Sec Psych] Not only do we get more urges to eat at night, but we tend to overeat and lean more towards junk food. So how does that play out in bipolar disorder? This new study by Francisco Romo-Nava and colleagues at ...
12.10.2020 Prazosin Helps Some Stay Sober from Alcohol [60 Sec Psych] There are many reasons why people drink, and one of them is alcohol withdrawal. The withdrawal state causes anxiety, negative mood, and cravings, and these kinds of symptoms lead patients to turn to alcohol once more. Some treatments for alcohol ...
12.07.2020 CBT-Insomnia: A patient guide Cognitive behavioral therapy treats insomnia as well as a sleep med, and it also improves depression and immune function. This special patient podcast introduces the first steps of the therapy, and shows you how to find the full therapy if ...
12.05.2020 Probiotics in Depression: A New Study [60 Sec Psych] Depression and anxiety improve when healthy bacteria are added – whether through diet or probiotics – according to several dozen small randomized controlled trials. However, only a handful of those trials involved full clinical depression. This study adds to that ...
12.02.2020 Ritalin, Provigil, and Caffeine Compared [60 Sec Psych] About 1 in 50 US adults use stimulants like amphetamines (Adderall), methylphenidate (Ritalin), and modafinil (Provigil) without a prescription, and 80% of them take the drugs to enhance cognition, not to get high. The ethics of all this are vexing, ...
11.30.2020 Reimagining ADHD with Edward Hallowell, MD While medication is the mainstay of treating symptoms in ADHD, Edward Hallowell, MD, shares a positive, relationship-based approach to ADHD with practical strategies to help children and adolescents manage ADHD. Published On: 11/30/2020 Duration: 18 minutes, 10 seconds Related Article: ...
11.25.2020 Bad News for Antipsychotics and Circadian Rhythms [60 Sec Psych] Schizophrenia, autism, addictions, borderline personality disorder, nearly every psychiatric disorder is associated with disrupted circadian rhythms. All of these disorders are treated from time to time with antipsychotics, so how do antipsychotics affect sleep and circadian rhythms? This new systematic ...
11.23.2020 Psychotherapy Side Effects: An Interview with Michael Linden Can psychotherapy have side effects? Michael Linden believes it can, and he launched some of the key studies that shed light on this under-appreciated phenomenon. [Link] Published On: 11/23/2020 Duration: 26 minutes, 30 seconds Related Article: "Side Effects of Psychotherapy ...
11.21.2020 Olanzapine vs. Asenapine [60 Sec Psych] If we trust the Catie trial, olanzapine is one the most effective antipsychotics for schizophrenia. Why? Despite its trying side effects – particularly weight gain--patients stuck with it the longest, which means it was doing enough good that patients were ...
11.18.2020 How much are we Drinking During COVID-19? [60 Sec Psych] In March of 2020 sales of alcohol increased by 54% in stores and 262% in online purchases compared to 2019. But then again people were stocking up on everything last March as they hunkered down for an indeterminate quarantine. But ...
11.16.2020 The Rise and Sudden Fall of Zimelidine: The First SSRI How the SSRIs were derived from Benadryl, how a forgotten antidepressant almost brought the serotonergic industry to a halt in the 1980’s, and how this all culminated in a Nobel prize and a new theory of dopamine. Published On: 11/16/2020 ...
11.14.2020 A Dangerous Game with Benadryl [60 Sec Psych] The FDA issued a warning in September about a dangerous game that teens have been playing with Benadryl during COVID. [FDA Safety Info (https://www.fda.gov/safety/medical-product-safety-information/benadryl-diphenhydramine-drug- safety-communication-serious-problems-high-doses-allergy-medicine), Study Link (https://pubmed.ncbi.nlm.nih.gov/28562262/)] Published On: 11/14/20 Duration: 2 minutes, 29 seconds Got feedback? Take the ...
11.11.2020 COVID Mortality is Higher with Psychiatric Illness We’re hearing a lot about people at risk for death with COVID – the elderly, African Americans, men, those with medical problems or low vitamin D, and this new study adds people with mental illness to the list. [Link (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2771037)] ...
11.09.2020 How to Set Behavioral Goals in the Med Visit Do you see patients who have no motivation to do anything? Michael Posternak has a novel strategy for working with this depressive symptom during the medication visit. Also, the word of the day: delirium mussitans. Date Published: 11/9/2020 Duration: 17 ...
11.07.2020 How To Spot An Ultraprocessed Food [60 Sec Psych] This month the first systemic meta-analysis of epidemiologic studies of ultra processed foods has come out, and we have a clearer picture of what poor dietary habits do to 300,000 people. [Link (https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/consumption-of-ultraprocessed-foods-and-health-status-a-systematic-review-and-metaanalysis/FDCA00C0C747AA36E1860BBF69A62704)] Published On: 10/3/2020 Duration: 5 minutes, 34 ...
11.04.2020 Ultraprocessed Foods Raise Depression Risk [60 Sec Psych] In 2004 Morgan Spurlock decided to see what would happen when he ate a typical McDonald’s meal for breakfast, lunch, and dinner. Over the next 30 days, we watched as he gained 24 pounds and developed high cholesterol, fatty liver, ...
11.02.2020 The Metformin Recall The FDA keeps recalling medications for contamination with NDMA, and the contamination was recently found in the first-line antidote for antipsychotic weight gain: metformin. Published On: 11/2/2020 Duration: 13 minutes, 13 seconds Got feedback? Take the podcast survey (http://www.thecarlatreport.com/podcastsurvey).
10.31.2020 A New Cause of ADHD [60 Sec Psych] Chemicals from plastics, pesticides, and food processing are linked to ADHD, according to a new paper in JAMA Open Network. [Link (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455852/?report=printable)] Published On: 10/31/2020 Duration: 3 minutes, 1 second Got feedback? Take the podcast survey (http://www.thecarlatreport.com/podcastsurvey).
10.28.2020 A New Medication for Narcolepsy [60 Sec Psych] Xyrem is a branded form of sodium oxybate, the sodium salt of gamma-hydroxybutyrate, or GHB , to precursor to GABA, glutamate, and glycine which is FDA approved for narcolepsy and cataplexy. The news on Xyrem is that the FDA just ...
10.26.2020 How to use Guanfacine and Clonidine We take you through the story of rational drug discovery that lead to the approval of guanfacine and clonidine for ADHD, and share some tips on how to use them. And the word of the day: Dyssymbole. Published On: 10/26/2020 ...
10.24.2020 A Prescription Video Game for ADHD [60 Sec] The hand eye movements of a prescription video game are thought to exercise circuits involved in attention, and this theory did translate to small but real improvements in attention in 5 clinical trials involving over 600 children with ADHD Published ...
10.21.2020 Two Updates on Pimavenserin [60 Sec Psych] Last April we reported on Pimavenserin – Nuplazid – the novel antipsychotic that’s FDA approved in psychosis related to parkinson’s disease. In that article we mentioned a randomized controlled trial from Mass General – the CLARITY trial - that showed ...
10.19.2020 Perimenopausal Depression We interview Ruta Nunacs on perimenopausal depression, and our word of the day – processomania – brings us into the crosshairs of politics and psychiatry. Published On: 10/18/20 Duration: 24 minutes, 42 seconds Article Referenced: "Mood and Menopause (Mood and ...
10.17.2020 Time to Talk About Naloxone [60 Sec Psych] New labeling from the FDA requires physicians to discuss naloxone with patients or caregivers they are prescribing opioids to. The new guideline also recommends that we prescribe naloxone to anyone who is at risk for opioid overdose, even if we ...
10.13.2020 Quarantining with Benzos [60 Sec Psych] Benzo prescriptions have risen 34% during COVID-19, particularly in women. People are also getting benzos outside of prescriptions. Drs. Islam and Choudhry discussed the emerging trend in a commentary in Clinical Psychiatry News. Specifically, they are concerned that people will ...
10.12.2020 How to Measure Cognition on Trintellix Trintellix claims to improve cognition in depression, but what does this effect look like in patient’s lives? We speak with Tom Gualtieri about the cognitive side of antidepressants, and show you how to use a 3 minute cognitive test that ...
10.05.2020 Living Well with Lithium A special edition for patients. Lithium is one of the most effective medications for bipolar and depression, but many of its marvels have remained obscure. Lithium has never benefited from a pharmaceutical ad (because it’s a mineral, not a medicine), ...
10.03.2020 How To Spot An Ultraprocessed Food [60 Sec Psych] This month the first systemic meta-analysis of epidemiologic studies of ultra processed foods has come out, and we have a clearer picture of what poor dietary habits do to 300,000 people. [Link (https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/consumption-of-ultraprocessed-foods-and-health-status-a-systematic-review-and-metaanalysis/FDCA00C0C747AA36E1860BBF69A62704)] Published On: 10/3/2020 Duration: 5 minutes, 34 ...
09.30.2020 26 Medications for PTSD [60 Sec Psych] When it comes to PTSD, pharmacotherapy is second-line and psychotherapy has the more robust evidence. The effect size for therapy is in the large range, while medications are in the small, with one exception…. In studies where patients are allowed ...
09.28.2020 The Mental Toll of Quarantine How did the rate of depression triple over a single month in 2020? In this episode you’ll learn how to distinguish clinical depression from normal stress, so you’re better prepared to take care of the 1 in 3 U.S. adults ...
09.26.2020 New Schizophrenia Guidelines [60 Sec Psych] In September 2020 the APA updated their schizophrenia practice guidelines. Here’s how things have changed since the 2004 edition. [Link (http://www.psychiatry.org/psychiatrists/practice/clinical-practice-guidelines)] Date Published: 9/26/2020 Duration: 4 minutes, 27 seconds Got feedback? Take the podcast survey (http://www.thecarlatreport.com/podcastsurvey).
09.23.2020 The Antipsychotics Weigh In [60 Sec Psych] When it comes to weight gain on antipsychotics, most of what we know is from industry sponsored trials, and most of them were done on Caucasian patients. Few of those studies compare the antipsychotics side by side, which leaves us ...

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