The Journal of Clinical Psychopharmacology Podcast

Valproic acid is one of the most frequently prescribed mood-stabilizing agents for bipolar disorder, and in some regions of the world, it now competes with lithium as the preferred treatment of choice for bipolar maintenance. There may soon be restrictions on the use of valproic acid, however, because of the risk in neural tube defects and major congenital malformations in children born to mothers and fathers who take it.

In this podcast, Dr. Samuel Dotson, from the Northeast Georgia Health System in Gainesville, Georgia, and Emory University in Atlanta, and Dr. Andrew Nierenberg, from the Dauten Family Center for Bipolar Treatment Innovation at Massachusetts General Hospital and Harvard Medical School, discuss the current state of research regarding the benefits and risks of valproic acid in comparison to lithium use. They also discuss the importance of informing patients about their options, noting that lithium use has sometimes been perceived as riskier than it is. Dr. Dotson and Dr. Nierenberg are the authors of a Guest Editorial titled "Growing Concerns Over Valproate Teratogenicity Present an Opportunity for Lithium" in the March-April 2025 issue of The Journal of Clinical Psychopharmacology.

Dr. Julia Ann Koretski, a psychiatrist and Digital Editor of the Journal of Clinical Psychopharmacology (JCP), leads a conversation about the guest editorial "Ethics in Psychedelic Science: Promises and Responsibilities" with its author, Dominic Sisti, PhD, a medical ethicist from the Perelman School of Medicine at the University of Pennsylvania, and a JCP podcast panel of Editor-in-Chief Dr. Anthony Rothschild and Associate Editor Dr. Richard Balon. Dr. Sisti provides an overview of recent regulatory actions in this area and summarizes the history of "utopian hype" in the field. The editorial and the podcast discussion detail what elements are required to build a solid ethics infrastructure for psychedelics research and clinical delivery that is free of hype and bias. Sisti advises moving ahead with caution, while noting that "the range of potentially treatable conditions is wide—including PTSD, major depression, anxiety disorder, obsessive compulsive disorder, anorexia nervosa, and substance use disorders."

The guest editorial is published in the January-February 2025 issue of JCP.

About 20% of women experience depression while they are pregnant, and untreated depression has been associated with increased rates of adverse birth outcomes and complications. In this podcast, Julia J. Rucklidge, PhD, of the University of Canterbury in Christchurch, New Zealand, discusses nutrition, pregnancy, and mental health in detail with psychiatrist and Journal of Clinical Psychopharmacology (JCP) Digital Editor Dr. Julia Ann Koretski. Dr. Rucklidge is the senior author of the article "Broad-Spectrum Micronutrients or Antidepressants for Antenatal Depression: Effect on Maternal and Infant Birth Outcomes in an Observational Secondary Analysis of NUTRIMUM," which is published in the January-February 2025 issue of JCP. The article reports the outcomes of a randomized clinical trial in which women with depressive symptoms were randomized to receive daily micronutrients or a placebo for 12 weeks during their pregnancy. As reported by Dr. Rucklidge and her colleagues, the micronutrients used to alleviate depression in pregnancy may mitigate negative effects of depression on birth outcomes and have more favorable birth outcomes compared with antidepressants.

About 20% of women experience depression while they are pregnant, and untreated depression has been associated with increased rates of adverse birth outcomes and complications. In this podcast, Julia J. Rucklidge, PhD, of the University of Canterbury in Christchurch, New Zealand, discusses nutrition, pregnancy, and mental health in detail with psychiatrist and Journal of Clinical Psychopharmacology (JCP) Digital Editor Dr. Julia Ann Koretski. Dr. Rucklidge is the senior author of the article “Broad-Spectrum Micronutrients or Antidepressants for Antenatal Depression: Effect on Maternal and Infant Birth Outcomes in an Observational Secondary Analysis of NUTRIMUM,” which is published in the January-February 2025 issue of JCP. The article reports the outcomes of a randomized clinical trial in which women with depressive symptoms were randomized to receive daily micronutrients or a placebo for 12 weeks during their pregnancy. As reported by Dr. Rucklidge and her colleagues, the micronutrients used to alleviate depression in pregnancy may mitigate negative effects of depression on birth outcomes and have more favorable birth outcomes compared with antidepressants.

Dr. Julia Ann Koretski, a psychiatrist and Digital Editor of the Journal of Clinical Psychopharmacology (JCP), leads a conversation about the guest editorial “Ethics in Psychedelic Science: Promises and Responsibilities” with its author, Dominic Sisti, PhD, a medical ethicist from the Perelman School of Medicine at the University of Pennsylvania, and a JCP podcast panel of Editor-in-Chief Dr. Anthony Rothschild and Associate Editor Dr. Richard Balon. Dr. Sisti provides an overview of recent regulatory actions in this area and summarizes the history of “utopian hype” in the field. The editorial and the podcast discussion detail what elements are required to build a solid ethics infrastructure for psychedelics research and clinical delivery that is free of hype and bias. Sisti advises moving ahead with caution, while noting that “the range of potentially treatable conditions is wide—including PTSD, major depression, anxiety disorder, obsessive compulsive disorder, anorexia nervosa, and substance use disorders.”

The guest editorial is published in the January-February 2025 issue of JCP.

Dr. Julia Ann Koretski, a psychiatrist and Digital Editor of Journal of Clinical Psychopharmacology (JCP), discusses the editorial "Psychopharmacologic Laziness" with its author, Dr. Anthony Rothschild, who is Editor-in-Chief of JCP. He contends that psychotropic medications with well-established efficacy for the treatment of various psychiatric conditions are underprescribed due in part to what he provocatively refers to as prescriber "laziness." Under discussion are lithium, clozapine, and long-acting injectable second-generation antipsychotics. Dr. Rothschild notes that there seems to be a reluctance to treat patients with medications that entail taking blood levels or dosage monitoring, extra patient education, attentiveness to interactions and side effects, or a step outside a comfort zone. The podcast concludes with suggestions of medication-specific fixes and a rethinking of a psychiatric resident's training to include proficiency in treating with remedies that have a strong evidence base but are viewed as extra work. The editorial is published in the November-December 2024 issue of the Journal of Clinical Psychopharmacology.

According to the US Centers for Disease Control and Prevention, products containing psychoactive compounds such as cannabis or mushroom extracts are increasing in availability though they may have undisclosed ingredients, contaminants, and adulterants. Elisa Nguyen, and Drs. Abraham Qavi and Minh-Ha Tran, authors of the letter to the editor "Health Alert: Microdose Products Leading to Acute Illness and Hospitalizations Across the United States" offer general information on personal use availability of Schedule 1 controlled substances such as psilocybin, cannabis, and lysergic acid diethylamide. The letter details recent occurrences of illness, hospitalization, and deaths. Outside of the confines of carefully conducted clinical trials, consumers place themselves at risk of adverse effects through consumption of unregulated products available in nearly half of the United States. The letter to the editor is published in the November-December 2024 issue of the Journal of Clinical Psychopharmacology.

This podcast features Dr. Chadi Calarge, a child psychiatrist at Baylor College of Medicine and, for over 20 years, a researcher focused on long-term psychiatric medication safety with regard to height growth and metabolic abnormalities. He gives an overview of past and forward-looking research questions related to growth, growth hormones, and such drugs as selective serotonin reuptake inhibitors and stimulants. He discusses the journal article, "Fluoxetine and Sertraline Inhibit Height Growth and Growth Hormone Signaling During Puberty," which was written with 10 co-authors and is published in the November-December 2024 issue of the Journal of Clinical Psychopharmacology.

Ketamine and esketamine represent significant advancements for patients with treatment-resistant depression. Their rapid action provides much needed relief for patients who do not respond to traditional antidepressants. Their use, however, introduces challenges that necessitate ongoing research and careful consideration to maximize their potential, which Dr. Balwinder Singh, MD, MS, details in this podcast. Important challenges include unregulated or poorly monitored use of these potentially addictive products and risks related to the creation of compounded ketamine options.

Dr. Singh is an assistant professor of psychiatry at the Mayo Clinic in Rochester, Minnesota, and the medical director of the mood program at the Mayo Clinic Depression Center. His guest editorial, titled "Ketamine and Esketamine for Depression in Daily Practice: Opportunities and Challenges," is published in the September-October 2024 issue of the Journal of Clinical Psychopharmacology.

The symptoms of irritability associated with autism spectrum disorder (ASD) include aggression, tantrums, self-injury, and disruption. Propranolol, a beta-blocker, has accumulated much anecdotal evidence as a promising option for symptoms of these disorders, but well-designed studies are rare.

Dr. Eric London is the lead author of the article "High-dose propranolol for severe and chronic aggression in autism spectrum disorder: A pilot, double-blind, placebo-controlled, randomized crossover study," which is published in the September-October 2024 issue of the Journal of Clinical Psychopharmacology. The article describes its effectiveness in decreasing aggression in individuals with ASD. As this was a small study, a larger clinical trial is needed.

Dr. London is director of Autism Treatment Research at the New York State Institute for Basic Research. In this podcast, he offers extensive background on treatment challenges and the difficult core symptoms of ASD.