PsychRounds: The Psychiatry Podcast

Join us for our first review series. We will be discussing several board-style questions based on our previous episodes with special guest, Dr. Bradley Miller.

Discover the fascinating world of mirtazapine, a unique antidepressant with a dual action on noradrenaline and serotonin. Explore its sedative effects, rapid relief for sleep issues, and its controversial 'California rocket fuel' combination. Learn about its pharmacokinetics, minimal interactions, and FDA-approved uses for major depression. The discussion also delves into the benefits for the elderly, such as appetite stimulation, against concerns like weight gain. It highlights ideal candidates for treatment and dispels common misconceptions surrounding this intriguing medication.

Dive into the fascinating world of Bupropion, an NDRI with a rich history as both an antidepressant and smoking cessation aid. Discover its unique effects on neurotransmitters and how it stands out with fewer sexual side effects. The discussion highlights its FDA approvals for seasonal affective disorder and smoking addiction, along with promising off-label uses like treating methamphetamine use disorder. Learn about the potential benefits and risks, including its association with seizures, and why it’s underutilized despite its effectiveness.

Dive into the world of Citalopram as it treats Major Depressive Disorder, especially in older adults. Discover its unique antihistamine effects that may aid the elderly in managing sleep and agitation. Learn about factors influencing its declining popularity, including FDA warnings and the rise of escitalopram as a top choice. Explore the crucial role of the CYP2C19 enzyme in Citalopram's metabolism and its implications for personalized medicine, shedding light on risks of elevated drug concentrations.

Dive into the world of Zoloft as you explore its uses in treating various mental health conditions. Discover its unique pharmacology and safety profile for geriatric patients. Learn about prescribing considerations during pregnancy and the importance of dosing strategies for effective outcomes. Delve into common side effects, particularly gastrointestinal issues, and understand how these compare to other SSRIs. Finally, uncover the flexibility of Zoloft's dosing range and its benefits for treating atypical depression.

The discussion dives into the pharmacokinetics of paroxetine, highlighting its short half-life and the challenges of discontinuation syndrome. It explores the calming effects of Paxil, particularly for anxiety disorders, while addressing safety during pregnancy. The role of paroxetine in managing menopause symptoms, like hot flashes, is also examined. Additionally, the unique application of fluvoxamine for OCD treatment is analyzed, comparing its effectiveness and side effects against other SSRIs, and emphasizing dosing strategies for better patient outcomes.

Dive into the world of Lexapro, a leading SSRI known for its effectiveness in treating depression and anxiety. Discover its minimal drug interactions and ideal dosing for different age groups, especially in geriatrics. The discussion also highlights off-label uses, particularly for OCD, shedding light on safety concerns for both older adults and children. Personal insights provide a deeper understanding of what makes escitalopram a favored choice among SSRIs.

Discover the fascinating world of Fluoxetine, commonly known as Prozac. This discussion reveals its unique properties as an SSRI, including its long half-life and FDA-approved uses. Learn about optimal dosing for conditions like major depressive disorder and obsessive-compulsive disorder, as well as considerations for polypharmacy in older adults. The podcast tackles potential side effects, including gastrointestinal issues and sexual dysfunction, while also emphasizing its effectiveness across various age groups and conditions such as PMDD.

The discussion dives into the history of SSRIs, tracing their roots back to the monoamine hypothesis. It explores how these medications evolved from earlier antidepressants like MAOIs, illuminating their impact on mental health treatment. The relationship between SSRIs and gut health is analyzed, highlighting significant side effects. There's a focus on weight gain and bleeding risks associated with these medications, especially in older patients. Finally, the complexities of prescribing SSRIs for bipolar disorder are examined, questioning the traditional views on chemical imbalances.