In this insightful episode, Dr. Toby Marton, Chief Medical Officer of Mindful Health Solutions, takes us on a journey through his impactful career in the mental health space and his predictions for the future of mental health treatments. Toby, an expert in brain stimulation techniques for treatment resistant depression, shares his experiences of working with veterans and the efficacy of Ketamine Infusion Therapy (KIT) for PTSD. 

The conversation dives into the evolution of his passion for rapid acting treatment and the role of treatments like TMS, ECT, and esketamine in the long-term management of treatment-resistant depression (TRD). Toby discusses the challenges of scaling treatments like MDMA and offers valuable insights on the future of psychiatry, the role of AI, and the integration of psychiatric care into general healthcare systems. 

This episode promises a comprehensive exploration of the cutting-edge frontiers of mental healthcare, from the perspective of a leader in the field.

Shownotes/Timestamps:

3:00: Toby’s inspiration for pursuing Psychiatry and his choice for an MD in Psychiatry and a PHD in Neuroscience over neurology. His interest in consciousness as a complex subject.

6:45: Toby discusses the prevalence of learned helplessness and nihilism in Psychiatry.

7:40: Insights Toby gathered about the brain from Electroconvulsive Therapy (ECT).

9:00: The motivations behind Toby's shift from bench research to clinical work.

12:30: Exploration of Toby’s research on rapid-acting antidepressants and testing new treatments at the VA.

14:16: Delving into the misleading interpretations of a Naltrexin paper which suggested that ketamine's action was akin to that of an opioid. This conclusion was drawn from a single study with a small sample size.

18:31: Characteristics of patients who didn’t respond as quickly to ketamine treatments for Depression

29:14: The payer/operational decisions on which treatment to try first between ketamine, TMS, and esketamine

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37:57: Cosmetic psychiatry and discussion on if the dissociative experience is paramount to the antidepressant effects of ketamine

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42:40: Preparing for MDMA-assisted therapy45:02: Challenges of scaling psychedelic-assisted therapies and how tech can help.

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