PsychRounds: The Psychiatry Podcast

Dive into the fascinating world of orexin antagonists like Suvorexant and Lemborexant. Discover how these medications target sleep disorders and their connection to conditions such as narcolepsy. Learn about their efficacy, safety, and the exciting potential they hold beyond insomnia treatment, including possible benefits for depression and Alzheimer's disease. The discussion also addresses the challenges and considerations in their use, especially for elderly patients. Tune in for an insightful exploration of modern sleep medicine!

Discover the fascinating world of Z Drugs—Zolpidem, Zaleplon, and Eszopiclone—commonly used to tackle insomnia. Delve into their unique pharmacology and mechanisms of action, distinguishing them from traditional benzodiazepines. Learn about their half-lives, dosing guidelines, and the varying safety profiles for different demographics. The discussion also highlights significant risks, including misuse and side effects like sleepwalking. Join the conversation on balancing the benefits and complexities of these medications for effective sleep treatment.

Dive into the world of sleep pharmacology and the role of H1 antagonists in treating insomnia. Trazodone’s mixed efficacy sparks a lively discussion on its clinical use and potential side effects. Discover the nuances of doxepin, the only FDA-approved sleep aid in this category. The dangers of rebound insomnia and the implications of sedating antipsychotics for sleep are critically examined. Experts also highlight the importance of sleep hygiene and cognitive behavioral therapy as vital components in managing sleep disorders.

In conversation with Dr. Barry Krakow, a board-certified sleep specialist, listeners discover the pivotal role of sleep medicine in psychiatry. Dr. Krakow stresses the need to recognize independent sleep disorders in mental health treatment, particularly for conditions like PTSD. He introduces innovative approaches like imagery rehearsal therapy for nightmares. The discussion also covers the complexity of N3 sleep and effective treatments for sleep apnea, highlighting the essential integration of sleep education in psychiatric training.

Dive into the world of Lurasidone, a game-changing antipsychotic now available as a generic, enhancing patient access. Discover its FDA approval journey and how it effectively treats bipolar depression and schizophrenia, especially in adolescents. Learn about its favorable side effect profile, including minimal weight gain and safety in pregnancy. The conversation also touches on new treatments, like the innovative Cobenify, and speculates on future trends at the intersection of psychiatry and sleep medicine.

Ziprasidone stands out among antipsychotics for its low risk of weight gain and intriguing off-label uses. Its unique interactions with serotonin receptors reveal complex pharmacological properties. The discussion highlights dosing guidelines and potential side effects, including the risk of drug-induced mania. Extrapyramidal symptoms and QTc prolongation are critically examined, shedding light on the clinical considerations required for safe usage. Overall, insights into efficacy and health concerns underscore the importance of careful management when prescribing this medication.

Dive into the intricacies of Paliperidone, an antipsychotic for schizophrenia and schizoaffective disorders, and discover its unique approval journey. Learn about its off-label use for bipolar disorder and the nuances of various long-acting formulations. Get insight into dosing, side effects like hyperprolactinemia, and patient experiences with adherence challenges. Delve into the administration of injectable forms, including transitioning from oral options and addressing patient concerns, all while weighing its efficacy against other medications in the market.

Discover the evolution of risperidone, its significance in modern psychiatry, and how it's used across different age groups. Dive into its mechanism as a D2 blocker and the impact of its active metabolite. Learn about dosing strategies, potential adverse effects like hyperprolactinemia, and the advantages of combining it with aripiprazole. Explore recent advancements such as long-acting injectables, their benefits, and how they enhance treatment options. A fascinating analysis of a pivotal antipsychotic medication awaits!

Dive into the world of Fluphenazine, a potent D2 blocker with a fascinating history in psychiatry. Learn about its FDA approval, off-label uses, and crucial dosage guidelines. Hear about the challenges of acute dystonia and essential safety concerns, especially for elderly patients. Explore Fluphenazine's role as a second-line treatment for hard-to-treat psychotic and mood disorders. Gain insights into its formulations, potential side effects, and the importance of monitoring to ensure efficacy and safety.

Delve into the historical roots of Haloperidol, one of the most widely used first-generation antipsychotics. Discover its unique mechanism as a D2 receptor antagonist and explore its effective applications for psychotic disorders and Tourette's. Learn about various formulations and dosing strategies, including transitioning from oral to long-acting injectables. Critical discussions on the efficacy in managing acute mania and the potential risks, especially for those with renal issues, showcase its complex yet vital role in psychiatric care.