The Carlat Psychiatry Podcast

By The Carlat Psychiatry Report

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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. Episodes covering child and adolescent psychiatry are hosted by Joshua D. Feder, MD, and Mara Goverman, lICW. The Carlat Report has operated free of pharmaceutical support since its inception in 2003. Hosted by Chris Aiken, MD, and Kellie Newsome, RN.

Episode Date
Should we trust the experts?
<p>Why does the top-selling psychiatric textbook base its recommendations on the lowest grade of medical evidence? Psychiatric practice is often mislead by expert opinion, practice trends, and neurotransmitter theories. In the case of paroxetine (Paxil), venlafaxine (Effexor), and mirtazapine (Remeron), this misinformation has created some popular myths that don't hold up to the evidence.</p> <p>Publication Date: 9/16/19</p> <p>Runtime: 11 minutes, 42 seconds</p> <p>Article Referenced: “<a href="">Mirtazapine Augmentation: Running Low on Rocket Fuel</a>” <i>The Carlat Psychiatry Report</i>, September 2019</p>
Sep 16, 2019
A New Way to Talk About Psych Meds
<p>Psychiatrist Shawn Christopher Shea shares his top tips on engaging patients in their medication treatment. Dr. Shea has been fine tuning the art of doctor-patient communications for over 30 years through best-selling texts on psychiatric interviewing and suicide assessment. His latest book, <i>The Medication Interest Model, </i>presents a unique model for talking with patients about their medications. </p> <p>Publication Date: 9/9/19</p> <p>Runtime: 16 minutes, 7 seconds</p> <p>Articles Referenced: "<a href="">A New Way to Talk to Patients about Medication</a>," <i>The Carlat Psychiatry Report</i>, September 2019</p>
Sep 09, 2019
How to Address School Refusal
<p>School refusal is a common problem, affecting up to 5% of schoolchildren. This episode takes a look at the limited research on the subject and goes over work done by experts at the Yale Child Center to put together some useful advice on how to address this problem in your patients and families.</p> <p>Publication Date: 9/2/19</p> <p>Runtime: 15 minutes, 28 seconds</p> <p>Articles Referenced: </p> <p>"<a rel="noopener" target="_blank" href="">What to Do About School Refusal? A Conversation With Two Experts</a>," The Carlat Child Psychiatry Report, January 2019</p> <p>"<a rel="noopener" target="_blank" href="">Medications for Depression</a>," The Carlat Child Psychiatry Report, May/June/July/August 2019</p>
Sep 02, 2019
A New Treatment for Postpartum Depression
<p>William S. Meyer is a clinical social worker and psychoanalytic psychotherapist who holds faculty positions at Duke in the Departments of Psychiatry and Ob/Gyn. He has spent 20 years working with postpartum depression at the Duke Medical Center. In this interview, he discusses the role of psychotherapy, community, family, and where medications and the new neurosteroid brexanolone (Zulresso) fit in the big picture.</p> <p>Publication Date: 8/26/19</p> <p>Runtime: 15 minutes, 58 seconds</p> <p>Articles Referenced: “<u><a target="_blank" href="">Brexanolone: A New Treatment for Postpartum Depression,</a></u>” <i>The Carlat Psychiatry Report</i>, January, 2019</p> <p>"<a href="" target="_blank" rel="noopener">Brexanolone (Zulresso) for Postpartum Depression,</a>" The Carlat Psychiatry Report, June 2019</p>
Aug 26, 2019
Weight Gain on Psych Meds
<p>Metformin is the top antidote for antipsychotic weight gain, but is it good for patient's health or just their looks? We explore how to use it, delve into its fabled anti-aging effects, and end with a new discovery that may help people lose weight while they sleep.</p> <p>Publication Date: 8/12/19</p> <p>Runtime: 19 minutes, 51 seconds</p> <p>Articles Referenced: "Medication Side Effects Part II: Weight Gain, Akathisia, Hair Loss, and Orthostasis," <i>The Carlat Psychiatry Report</i>, August, 2019</p>
Aug 19, 2019
Is Watching 13 Reasons Why Bad for Teens?
<p>Join Josh Feder, MD, and Mara Goverman, LICW, for a special episode focused on child psychiatry, suicidality, and the popular Netflix series <i>13 Reasons Why</i>. The show stirred controversy when it portrayed the bullying and suicide of a teenager. Although the program increased awareness of these issues, some clinicians argued that it glamorized the suicide. Netflix has since cut the suicide scene from its streaming service. In July, JAMA published a study of CDC data showing that suicide rates went up 13.3% in the 10 to 19 age group after the suicide episode was originally released in 2017. Evidence suggests portrayals of suicide like this are contagious, but what do clinicians and parents do about it in an age of private streaming media?</p> <p>Publication Date: 8/12/19</p> <p>Runtime: 9 minutes, 5 seconds</p> <p>Articles Referenced:</p> <ul> <li><a href="" title="">Is Watching ‘13 Reasons Why’ Bad for Teens?</a>, CCPR, March 2019</li> <li>Voelker R. Mounting Evidence and Netflix’s Decision to Pull a Controversial Suicide Scene. JAMA. Published online July 24, 2019. doi:10.1001/jama.2019.9492</li> </ul> <p>Audio clips of Edwin Schneidman, MD, provided by Regenerate Films, which is part of the nonprofit <a target="_blank" href="">Regenerate</a>. They were made during Dr. Schneidman's consultation on the Netflix film "My Suicide."</p>
Aug 12, 2019
The Choice: Deplin, Folate, or Folic acid
<p>Folate, folic acid, l-methylfolate, Deplin, folinic acid… How do we choose among the many forms of this vitamin? All have proved useful as add-on therapies in depression, but they differ in important ways. Some may work in bipolar disorder, and there’s even one that might get in the way of a popular treatment for bipolar depression.</p> <p>Publication Date: 8/5/19</p> <p>Runtime: 20 minutes, 26 seconds</p> <p>Article Referenced: <a target="_blank" href="">l-Methylfolate for Depression: Costly Mistake or Good Thinking?</a>, TCPR, August 2019</p>
Aug 05, 2019
The Carlat Report Goes to APA Part II
<p>More highlights from the American Psychiatric Association's 2019 meeting in the final installment of this two-part series. Expert interviews with Manpreet Singh on childhood mood disorders and Nikhil Rao on novel medications for sleep. Learn what to do when children get worse on antidepressants, and how to use clonidine for sleep in patients with PTSD, ADHD, or sleep apnea.</p> <p>Publication Date: 7/29/19Runtime: 12 mins, 17 seconds</p>
Jul 29, 2019
Daniel in the Pharma Den
20 years ago, Danny Carlat signed up to speak for the pharmaceutical industry. Through closed-door meetings and lavish "faculty development programs," he learned how to present their product's data in the most convincing way. The only problem was that he couldn't convince himself, and his industry handlers started to worry that Dr. Carlat was unwell. They were right. To cure his malaise he launched a psychiatric journal that was free of industry funding, but the pharmaceutical industry had one more surprise in store for him.
Jul 22, 2019
How to use Lithium in the Elderly
A new study suggests that lithium might work better in geriatric depression, but prescribing it safely in older patients takes skill. To start with, they require different blood levels. In this episode you'll learn how to manage lithium's risks in the elderly, as well as some newly discovered medical benefits that it carries in this population. <p>Publication Date: 7/15/19</p> <p>Runtime: 14 mins, 46 seconds</p> <p>Article Referenced: "<a href="">Lithium in Geriatric Depression</a>," The Carlat Psychiatry Report, June/July, 2019 (subscriber only)</p>
Jul 15, 2019
The Secret History of Ketamine
<p>In 1985 a Soviet psychiatrist began giving his patients ketamine in hopes to cure their alcoholism. The experiment backfired, but the results tell us something about how ketamine might treat depression. Long buried behind the Iron Curtain, this episode uncovers that early research and traces it back to modern PET-scans, the "default mode network," and the experience of patients in ketamine clinics.</p> <p>Publication Date: 7/8/19</p> <p>Run Time: 12 minutes, 17 seconds</p> <p>Article Referenced: "Esketamine Gets FDA Approval," <i>The Carlat Psychiatry Report</i>, June/July 2019 (<a href=""></a>)</p>
Jul 08, 2019
A New Strategy for SSRI Withdrawal
<p>Withdrawal problems rank among patients’ top concerns with antidepressants. They include insomnia, flu-like symptoms, irritability, distractibility, and unusual sensory experiences such as “brain zaps.” Earlier this year, a study examined clinical and biological research on tapers of serotonergic antidepressants. In this episode we discuss what they found.</p> <p>Publication Date: 7/1/19Runtime: 8 mins, 56 secondsArticle Referenced: “A New Proposal for SSRI Withdrawal,” The Carlat Psychiatry Report, June/July 2019 (</p>
Jul 01, 2019
How to Use Amantadine
<p>Rarely used but often studied, amantadine is a medicine that doesn't fit neatly into any boxes. It's thought to work in OCD, autism, depression, cognition, ADHD, weight loss, sexual dysfunction, and traumatic brain injury. But how good is that research, and when should you use it? Chris Aiken and Kellie Newsome guide you through in this edition.</p> <p>Publication Date: 6/24/19Runtime: 12 mins, 24 seconds</p>
Jun 24, 2019
The Carlat Report Goes to the APA Part I
<p>Follow our editor-in-chief Chris Aiken as he brings you practice-changing highlights from the American Psychiatric Association's 2019 meeting. Featuring an interview with Mark Rappaport on inflammation and depression. Learn about a biomarker that predicts antidepressant response, pharmacologic approaches cannabis and opioid abuse, and safe prescribing of omega-3 fatty acids. Part 1 of a 2 part series. </p> <p>Publication Date: 6/17/19Runtime: 11 mins, 20 seconds</p>
Jun 17, 2019
Ginger Ale and Normal Hallucinations
<p>Does ginger ale really help nausea? Are hallucinations ever normal? Some of the answers may surprise as we bring you highlights from the June/July double issue of the Carlat Report. Included are practical tips on how to assess spectrum symptoms of mental illnesses, how to intervene in patients at risk for schizophrenia, and dosage and product recommendations for omega-3 fatty acids (fish oil).</p> <p>Publication Date: 6/10/19Runtime: 13 mins, 41 secondsArticle Referenced: “Medication Side Effects: Nausea, Sweating, and Dry Mouth,” The Carlat Psychiatry Report, June/July 2019</p>
Jun 10, 2019
An Antidepressant Diet
<p>A healthy diet is associated with an approximately 30% reduction in the risk for depression and a 40% improvement in cognition. That’s after controlling for education, income, other health behaviors, and body weight. This podcast discusses a recent interview with Felice Jacka, MD, Professor at Deakin University, Geelong, Victoria, Australia. She is also the Director of the Food and Mood Centre and founder and President of the International Society for Nutritional Psychiatry Research.</p>
Jun 03, 2019
Do Antipsychotics Improve Cognition?
<p>Unlike the typical antipsychotics, atypicals improve both cognitive and psychotic symptoms of schizophrenia, so they must have procognitive effects of their own that can be harnessed in mood disorders, ADHD, and even dementia. The problem is that the data show the opposite.</p>
May 27, 2019
Cash, Guns, and a Lap Dancing Drug Rep
<p>Earlier this month, five Insys Therapeutics pharmaceutical executives were found guilty of racketeering for their attempts to bribe doctors to prescribe the company's Subsys fentanyl spray, which was approved as a pain reliever for cancer patients, to people who didn't even need it. Their scheme included strippers, guns, cash, and even a rap video including a dancing drug bottle mascot. It's also linked to more than 900 overdose deaths.</p>
May 20, 2019
Sexual Side Effects of Psychiatric Medications
<p>Sexual side effects on SSRIs are so common that psychiatrist David Healy once argued these drugs more reliably lower libido than treat depression. Yet the problem isn’t limited to SSRIs, and it’s not unmanageable. In this episode Chris Aiken, MD, and Kellie Newsome, RN, discuss some useful strategies to manage sexual dysfunction on antidepressants, antipsychotics, and mood stabilizers.</p> <p>Publication Date: 5/13/19Runtime: 9 mins, 10 secondsArticle Referenced: “<a href="">Treating Sexual Side Effects</a>,” The Carlat Psychiatry Report, May 2019</p>
May 13, 2019