PsychRounds: The Psychiatry Podcast

Welcome back, today we are discussing a deceptively difficult topic: What makes something a psychiatric illness? We are joined by our guest Dr. Mark Ruffalo. He is a psychotherapist in private practice in Tampa, FL, and who also serves as Assistant Professor of Psychiatry at the University of Central Florida College of Medicine as well an Adjunct Assistant Professor of Psychiatry at Tufts University School of Medicine. Dr. Ruffalo's Website: https://www.drruffalo.com/Dr. Ruffalo's LinkedIn: https://www.linkedin.com/in/mark-l-ruffalo-71929063PRISM: https://www.psychiatrictimes.com/view/use-of-the-prism-diagnostic-instrument-in-clinical-practicePRISM Writing Contest: https://www.psychiatrictimes.com/view/prism-writing-contest-more-on-this-new-diagnostic-tool-from-mark-ruffalo-msw-dpsa

Welcome back! Today we are at the highly prescribed and popular benzodiazepine Lorazepam, also known as Ativan. We look at its uses in psychiatry, especially catatonia. But despite anecdotal efficacy, does the evidence hold up? References:https://www.ncbi.nlm.nih.gov/books/NBK532890/https://pubmed.ncbi.nlm.nih.gov/36805317/https://pubmed.ncbi.nlm.nih.gov/6120058/https://pubmed.ncbi.nlm.nih.gov/10229064/https://psychopharmacologyinstitute.com/section/catatonia-diagnosis-the-lorazepam-challenge-2911-5899/

Welcome back! Today we are embarking into the first of hopefully several episodes on the importance of vitamins and minerals in mental health. We will specifically be looking at the role of iron deficiency in psychiatry and do an overview on some of the recent research that's been published. References: https://www.ncbi.nlm.nih.gov/books/NBK557376/https://www.sciencedirect.com/science/article/pii/S0268960X25000827#bb0165https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823909https://www.sciencedirect.com/science/article/pii/S1389945717315599https://pubmed.ncbi.nlm.nih.gov/40841680/https://pubmed.ncbi.nlm.nih.gov/1677067/https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00463-7/fulltexthttps://pmc.ncbi.nlm.nih.gov/articles/PMC6139360/

Dr. Laura Lachance, a psychiatrist and researcher focused on nutritional psychiatry, dives into the fascinating link between diet and mental health. She explains the Antidepressant Food Score, highlighting nutrient-rich foods like leafy greens and seafood. Lachance discusses the EASE-GAD trial, revealing how omega-3s can help alleviate anxiety, and the cost-effectiveness of the Mediterranean diet. She emphasizes the importance of tailored nutrition approaches and advocates for incorporating these principles into clinical practice for better mental health outcomes.

Join Dr. Robert Sapolsky, an esteemed Stanford professor and expert in neuroendocrinology, as he unravels the complexities of stress and its impact on behavior. He explains how chronic stress can harm brain function and shape psychiatric responses. Sapolsky highlights the role of genes and environment in resilience, and explores cultural influences on mental health norms. Delve into provocative ideas about determinism and the implications for justice, urging compassion over blame. This enlightening conversation offers valuable insights into the biological roots of our choices.

The hosts celebrate a milestone while revisiting SSRIs, diving into their historical roots and the evolution of antidepressants. They explore the limitations of the serotonin theory and discuss SSRIs' broader impacts on the gut and neuroplasticity. Adverse effects, such as sexual dysfunction and weight changes, are highlighted, along with concerns about youth suicidality and cautious use in bipolar disorder. The conversation wraps up with reflections on SSRIs' role in modern psychiatry and the implications of overprescription.

This discussion dives into the history of Xanax, tracing its approval for anxiety and panic in the '80s. The hosts explore its rapid effects on the GABA-A receptor and highlight safety concerns, including addiction and withdrawal risks. They emphasize its suitable use for acute anxiety rather than long-term treatment. Intriguingly, they touch on its potential antidepressant effects and regulatory challenges, including a denied depression indication. Comparative efficacy against other medications offers more insight into its role in anxiety management.

Join us today for an episode on the impact of climate change on mental health. We'll be exploring concepts like eco-anxiety, advocacy, the impact of nuclear war and practical tips. We're joined by guest Dr. Ferdnand Osuagwu, who was the former Chair of the Caucus on Climate Change and Mental Health of the American Psychiatric Association (APA) and founder of the Ferdnand Foundation International, an organization dedicated to underserved and marginalized populations and with a particular emphasis on addressing their needs in the areas of health, education, climate change, social justice and resource mobilization. Ferdnand Foundation Website: https://ferdnandfoundation.org/Ferdnand Foundation Youtube Channel: https://www.youtube.com/@FerdnandFoundation/featured

Explore the fascinating world of benzodiazepines, from their historical rise after barbiturates to their complex mechanisms of action on GABA-A receptors. Discover their approved uses, especially for anxiety and epilepsy, and the risks of long-term use, particularly for the elderly. The discussion reveals critical insights on withdrawal symptoms and tapering strategies, as well as the dangers posed by designer benzodiazepines. The benefits versus risks debate takes center stage, shedding light on the careful balance physicians must maintain when prescribing these medications.

Dive into the world of anxiety disorders as hosts explore their rising prevalence and the importance of differentiating between normal anxiety and disorders. Discover the various classifications like specific phobias and GAD, and how symptoms can overlap with other psychiatric conditions. Learn about the neuroanatomy of fear, serotonin's role, and how modern lifestyle contributes to anxiety. The discussion even touches on the evolutionary perspective, questioning whether anxiety is an adaptive trait or a product of modern life. Practical guidance on diagnosis wraps it up!