PsychRounds: The Psychiatry Podcast

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.

Junhwan Kim, a fourth-year medical student at CMU College of Medicine and an expert on antipsychotic-induced weight gain, discusses critical strategies to mitigate this common side effect. He highlights the link between antipsychotics and metabolic dysfunction, emphasizing personalized treatment plans. The conversation covers the potential of GLP-1 agonists in promoting weight loss, the challenges patients face accessing these medications, and the importance of non-pharmacological interventions like cognitive-behavioral therapy for effective weight management.

Dr. John Kane, a distinguished psychiatrist with decades of experience, dives deep into clozapine, a revolutionary medication for treatment-resistant schizophrenia. He shares its tumultuous history, including safety concerns that challenged its FDA approval. Dr. Kane highlights the drug's underutilization and intricate monitoring requirements that complicate patient access. The discussion extends to new advancements in schizophrenia treatments, underscoring the urgent need for comprehensive education for patients and families in navigating these complex issues.

Join us and we discuss a newer anti-psychotic medication, Lumateperone, brand name Caplyta.

Dive into the world of cariprazine, a unique antipsychotic with a notable affinity for the D3 receptor. Discover how it tackles negative symptoms of schizophrenia more effectively than some traditional treatments. Safety concerns and side effects are explored, alongside its pharmacokinetics and dosing guidelines. There's a critical look at its performance compared to risperidone and the implications of its cost in clinical practice. Join the conversation on balancing effectiveness and patient care!

Welcome back! Brexpiprazole, also known by its brand name Rexulti, is a relatively new medication. Join us for a brief discussion.