This Is Your Brain On Drugs Psychiatry Podcast

So we had two episodes on the efficacy of antidepressants and I think I may have been a little hard on them, so I decided to make a part 3 where I instill some hope in these medications. They work great for so many people, yet so many people hate them as well. How can that be? And why do their effectiveness numbers look so abysmal? Find out on this episode!

I bet a lot of you have heard of psychogenomic testing or at least seen one. Maybe you are a patient and you got one or are thinking about getting one. Are these things worse the time and money? Listen to this episode to learn about them and get my 2 cents on the topic!

On the last episode on antidepressant efficacy we discussed effect size and placebo. On today's episode I will cover a topic called psychodynamic prescribing. I'll be giving you tips on how to become a prescriber that gets max effect from medications. There's a lot of things that you can to maximize the effect, so tune in to find out what they are.

OK, so we've learned about the antidepressants, how to pick one, and how to dose. Well, how well do they work? I'll be discussing the efficacy of antidepressants on this episode, and I will be exploring the idea of placebo as it relates to these medications. It's more than what you would like, so tune in to find out all about it!

So we've finally gone through the massive topic of nutrition, and today I'll just have this one episode on physical fitness. That's not because it isn't as important, but I think it's just a lot easier. With nutrition there's so much false information out there, but with physical fitness, it's basically just make sure you are moving around and not sedentary, so I will go over the research that ties physical fitness to improved mental health outcomes, I'll go over how much physical fitness you should strive for, and I'll give some tips on things you can do to get you started and how to break through the barriers that are stopping you from maintaining your fitness level, so there's a lot packed in to this one episode. Enjoy!

It's been a few months since my last update episode, and I have several updates in the world of psychiatry. A couple studies of the ketogenic diet for depression and anxiety, a newly approved device for depression, a blood test for Alzheimers, ibogaine in Colorado, pregnancy risk with benzodiazepines and sleep medications like Ambien, a new study on the non-link between Tylenol and autism, and many more. I hope you enjoy these updates of real time information that has come out since November!

Today I will continue talking about potential adverse effects of stimulant medications. Last time I discussed several adverse effects, but today I will mostly be focusing on cardiac (heart) effects because those have gotten a lot of press, especially with a previous black box warning for this. I will also talk about use in pregnancy in this episode. Next time I will discuss substance abuse issues which will round out all of our potential adverse effects.

So today I wanted to do an episode about deception in health information. How do these deceptions work and how to detect them. We don't all have the knowledge or time to go through the literature with a fine toothed comb, and even those like me that do have more knowledge and more time can still be misled, and we are often misled by well intentioned folks that think they have correctly interpreted the data and are revealing some kind of new controversial truth to us. I mean governments and businesses have an incentive to mislead us and have in the past, so it isn't surprising to think that they are doing it again. However, we can also be misled by those that are making these accusations against governments and businesses. How confusing! Today I will talk about this and I will also make some corrections of things that I have said during this series on nutrition and some of them are big ones!

Today I do a deep, deep dive on Adderall, aka Mixed Amphetamine Salts, and I attempt to answer my own questions, "Why are there 4 different salts in Adderall?" I mean I get that there is a mixture of levo and dextro, but why the sulfate, aspartate monohydrate, etc.? Well, for those of you that are wondering this is well, I think I have the answer. This is not stated anywhere that I could find, it is my best guess hypothesis. It's interesting because as far as I am aware, other than Xywav, there is no other medication that is a mixture of salts of the same active drug, and in the case of Xywav, the purpose is to minimize sodium intake. For Adderall, there is no sodium, so the explanation is completely different and actually pretty fascinating. Have a listen!

So, we've talked about every stimulant medication for ADHD under the sun and we understand them pretty well. Next, I will be discussing the adverse or side effects of these medications. What are the most common ones? Which should we take more seriously? And what can we do about them when they happen? I'll be discussing how to mitigate these adverse effects so that patients can take their stimulant medication that works for them, while not having to suffer from the side effects at the same time. I will go over most of the major ones today, but I will discuss cardiovascular effects and abuse potential on subsequent episodes.