We just had several episodes regarding antidepressant use that are unique to females, so today I will have one that will be unique to males. In this episode I will compare and contrast depression with hypogonadism. You will learn how to differentiate these two disorders which have extremely similar symptoms. I will also teach you how to work someone up appropriately for hypogonadism so that you can rule it out if you are suspicious. It would be silly to send someone to another practitioner to do the work up and then put your evaluation on hold for depression in the meantime, and treating someone with hypogonadism with antidepressants could actually make things worse! So let's learn how to differentiate the two diagnoses, do the work-up, and if you are bold, I will teach you how to treat and monitor hypogonadism as well. Low T has become so popular in society, so why not learn more about it?

I actually found out a lot of the L1-L5 ratings have changed. Some of the changes are big, most not. Also, there are a lot of meds that have been given a rating that I previously did not know, so I have added a bonus episode on breastfeeding to go over all these changes and additions. Please listen to this, especially if you listened to the last one because there are a few very important updates!

Today we have the third and final episode on reproductive psychiatry where I will be discussing relative safety of antidepressants as well as some other psychiatric medications with breastfeeding. I will also go over the relatively new L1-L5 rating system. In addition I'll talk about benefits of breastfeeding for baby and mom, and tell you what I tell mom's when they are deciding what to do about breastfeeding, their mental health, and taking medications. This is the final episode on reproductive psychiatry for antidepressants, however I will have an installment when I go over each other category of medication in subsequent seasons. I hope you enjoy!

Today we have episode 2 of our reproductive psychiatry series, and I will be talking about peri-partum psychiatric symptoms with a focus on depression. I will discuss all the factors surrounding treating these patients to include the use of medications. I will talk about the relative safety of the different antidepressants during pregnancy and give you my top choices for the safest ones. I will also talk about post-partum depression and two of the newest psychiatric medications which have recently been approved for this condition, Brexanolone (Zulresso) and Zuranolone (Zurzuvae).This is such a critical time in the life of mothers and growing fetuses. It is so important to treat psychiatric symptoms as it can have an impact for the rest of the child's life, so we want to make sure to treat and not treat at the right time and with the right medications. Suicide is also a leading cause of death during pregnancy and post-partum. So please have a listen!

Today I'm going to be talking about something that I've wanted to talk about for a while. Even though I'm a male, I am very interested in reproductive psychiatry. I like to learn about new things and new medications. I want to find out-of-the-box treatments that have scientific backing to treat my patients because guess what, SSRIs don't fix everything! Also, I absolutely hate referring patients to other specialists to receive treatments that I am perfectly capable of handling myself. So, today we will be learning about depressive symptoms centered around the menstrual cycle. We will be learning about birth control pills, estrogen, progestin, testosterone, tamoxifen, bazedoxifen/estrogen (Duavee), and fezolinetant (Veozah) to help with those suffering from PMDD and peri-menopausal symptoms. And the good news is that these treatments are really effective! More so than much of what we have already discussed, and there's nothing I enjoy more than treating someone and them getting a lot better quickly, so tune in to find out more!

It's time to talk about the differences in using the medications that we have discussed for depression in kids and seniors. I don't have a subspecialty board certification in these fields but I do know a thing or two about how prescribing to these populations differs from prescribing to adults. My guess is that even if you don't see kids that you probably see a number of seniors. There are different factors to consider when prescribing to these populations, so tune in to find out more!

There are many subtypes of depression, and this can be important when selecting the best medication. Today I will be going over these subtypes and will be giving you the algorithm for each as to what I would pick first, second, third, and so forth. Knowing this may lead to going with an MAOi or TCA, for example, much sooner than you thought you would, which can lead to faster resolution of symptoms for the patient. I'll talk about Treatment-Resistant Depression, Atypical Depression, Melancholic Depression, Anxious Depression (Depression with anxiety distress), Depression with Mixed Features, Psychotic Depression, Seasonal Affective Disorder, and I'll briefly mention catatonia and peri-partum depression which I will go into more detail later. So, if you aren't familiar with all of these and you aren't aware of the differences in med choices for each, you'll definitely want to listen to this episode!

So you've found an antidepressant that seems to be helping the patient, but not quite as much as you'd both like. It's maxed out or we've topped out on adverse effects and can't take it any higher. Should we change it? Maybe not. We can try adding something to it. But what should we add? That's what I'll be talking about today. I'll go over every augmentation strategy that I can think of, and there's a lot of them, and I bet you haven't heard of more than a few of them, so listen in and find out what I think about adding medications to a patient's antidepressant regimen.

We've learned all about the antidepressants. You know each one of them inside and out. You know how to dose them, how to pick them, and how to follow them throughout the life cycle, but how do you change from one to the other if the patient is not tolerating or not getting efficacy from the one they are on? Well that's what this episode is about. I'll go over all the switching strategies, when to use each one, and how to execute them, so you'll definitely want to check this one out!

*This is a republish for spotify because I needed to make some changes.

For today's antidepressant category of norepinephrine and dopamine reuptake inhibitor, we just have one medication, bupropion, but it is a very special antidepressant because its adverse effect profile is so much different than all of the other antidepressants we have talked about, and it is this adverse effect profile that makes bupropion often my first choice for patients not only for depression but also anxiety. Listen and find out why!