PsychRounds: The Psychiatry Podcast

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!

Join us as we talk about Loxapine, an older medication that’s stood the test of time and found a niche in psychiatric practice. This is a revision of an earlier episode, after Dr. Bradley Miller chatted with Dr. Jonathan Meyer at the 2025 APA Conference. Dr. Meyer joins us at the beginning to provide an addendum to the original episode.

Discover the intriguing world of Pregabalin, known as Lyrica, and how it stacks up against Gabapentin in psychiatric settings. The hosts delve into its unique mechanism of action and impressive absorption advantages. They explore its efficacy for generalized anxiety disorder and contrast its performance with venlafaxine. Tune in for insights on dosing, potential side effects, and concerns about misuse. With a look at its role in bipolar disorder and alcohol use, this discussion highlights essential considerations for prescribing.

Explore the intriguing rise of gabapentin, originally approved for seizures, now often used off-label in psychiatry. Delve into its contentious safety profile, revealing concerns about misuse and overdose risks, especially with opioids. Hear about its varied effectiveness in treating anxiety, alcohol use disorder, and even its limited role in bipolar disorder. The hosts break down the pharmacology behind this complex medication, discussing clinical implications and the evolving landscape of its use in mental health.

In this engaging discussion, Dr. Bruce Perry, a leading child psychiatrist and co-author of acclaimed books on trauma, shares insights about his Neurosequential Model of Therapeutics. He breaks down the complexities of trauma, contrasting 'big T' and 'little T' experiences, and emphasizes how these affect child development. Dr. Perry also delves into the significance of emotional regulation, the impact of modern lifestyles on community connections, and the therapeutic power of rhythm. His holistic approach underscores the necessity of tailored treatments for recovery.

Join Dr. Chris Aiken, Editor-in-Chief of the Carlat Psychiatry Report and Yale-trained psychiatrist, as he explores the intriguing spectrum of mood disorders. He discusses the distinction between bipolar disorder and manic-depressive illness, the impact of individual temperaments on treatment, and innovative non-pharmacological strategies. Dr. Aiken also delves into the potential of the keto diet and the role of nutrition in mental health. Plus, insights on sleep patterns and their effects on mood make for a compelling conversation!

Pramipexole, known for treating Parkinson's, is explored for its unexpected role in treatment-resistant depression. The discussion dives into its mood-enhancing effects and unique mechanisms tied to motivation. Safety concerns arise, particularly regarding side effects like impulse control issues. A revealing study highlights pramipexole's potential as an augmentation therapy for depression, showcasing significant symptom improvement. The conversation also emphasizes the risks and benefits of dopamine agonists, urging safe practices in patient management.