PsychRounds: The Psychiatry Podcast

On today's episode we have a special international guest, Dr. Pouya Movahed Rad from Lund University in Sweden. We will be discussing Electroconvulsive therapy (ECT) and the Ket-ECT, and ELEKT-D studies. ELEKTD:https://www.nejm.org/doi/full/10.1056/NEJMoa2302399KET-ECT: https://pubmed.ncbi.nlm.nih.gov/35020871/Comparison: https://pubmed.ncbi.nlm.nih.gov/38114073/

Dive into the intriguing world of the Default Mode Network (DMN) and its surprising impact on creativity, memory, and self-awareness. Discover how the DMN influences mental health conditions like depression and anxiety, exploring cognitive distortions and therapeutic methods such as cognitive behavioral therapy and mindfulness. Uncover the relationship between personality traits and mental health vulnerability. Plus, learn about innovative treatments, including psychedelics and physical exercise, that can help balance the DMN's activity for better mental well-being.

The discussion focuses on metformin's application in psychiatry, particularly in combating weight gain from antipsychotic medications. Recent guidelines emphasize careful monitoring for side effects, like gastrointestinal issues and lactic acidosis. The podcast dives into dosing strategies and the findings from recent studies, highlighting individual patient factors in treatment decisions. Seasonal weight trends and their impact on mental health are also examined, along with metformin's intriguing potential benefits for psychiatric symptoms.

On today’s special guest episode, we’ll be exploring the topic of nitrous oxide with Dr. Charles Conway and Dr. Vasilis Hristidis.https://medicine.washu.edu/news/laughing-gas-relieves-symptoms-in-people-with-treatment-resistant-depression/https://pmc.ncbi.nlm.nih.gov/articles/PMC5825282/https://pubmed.ncbi.nlm.nih.gov/34108247/https://pubmed.ncbi.nlm.nih.gov/25577164/

Dr. Joshua Rosenblat, a clinician-researcher at the University of Toronto, discusses the groundbreaking role of ketamine and its derivative, esketamine, in treating treatment-resistant mood disorders. He highlights their quick effectiveness compared to traditional antidepressants and reviews the historical journey of ketamine's usage. Exploring barriers to accessibility in psychiatric care, he advocates for innovative solutions, while also addressing safety and efficacy across different age groups. It's a deep dive into transformative therapies that could reshape mental health treatment.

Welcome back! Today, we are discussing a new branded medication that combines bupropion with dextromethorphan for the treatment of depression.

Dive into the world of tricyclic antidepressants, exploring their history and chemical structure. Learn about the differences between secondary and tertiary TCAs and their effectiveness in treating mood disorders. Discover the pharmacokinetics, including dosing and overdose risks, and why careful monitoring is crucial. Get insights on commonly prescribed TCAs, particularly the versatile amitriptyline. Finally, unearth the potential of nortriptyline for severe depression and the vital considerations for drug interactions.

Dive into the fascinating world of Monoamine Oxidase Inhibitors (MAOIs), starting with their history and surprise mood-boosting effects since the 1950s. Uncover how they block enzymes that regulate neurotransmitters, alongside their risks like serotonin syndrome. Explore individual MAOIs, their unique properties, and the clinical implications, including side effects and dietary restrictions. Finally, compare their effectiveness with first-line treatments and hear a compelling case study of a writer's battle with severe depression.

Delve into the intriguing connections between depression and inflammation from an evolutionary standpoint. The discussion reveals how traits we view as detrimental may have protective advantages. Explore the impact of historical infections on our immune responses and mental health. Anhedonic depression is examined alongside treatment options that consider neurotransmitters and inflammation. The challenges of SSRIs and their emotional side effects are also highlighted. Ultimately, the conversation champions personalized treatment strategies informed by biological markers.

Delve into the intriguing link between depression and inflammation. The discussion reveals the evolution of depression's diagnosis and its complex nature. Explore how inflammation affects cognition and treatment responses. Discover the paradox of inflammation in health and its potential benefits. Additionally, learn about the significance of having a purpose in life and its surprising anti-inflammatory effects, which may influence therapeutic approaches.