The Carlat Psychiatry Podcast

Owen Muir, MD, a specialist in TMS and interventional therapies, advocates for prioritizing transcranial magnetic stimulation over antidepressants in treating adolescent depression. He discusses the limited efficacy of youth antidepressants, highlighting how TMS offers quick benefits and reduces suicide risks. Muir points out that adolescents often respond better to TMS due to their crisis presentation. He also touches on FDA's clearance for TMS in teens and critiques the reliance on placebo responses in medication trials.

In this engaging discussion, Dr. Owen Muir, a clinical psychiatrist and expert in interventional therapies, dives into the intriguing world of Transcranial Magnetic Stimulation (TMS). He presents a unique perspective on depression as a 'brain rhythm issue' and explains how TMS acts as a rhythm generator to help resynchronize brain activity. The overlap between psychotherapy and TMS is explored, revealing how both approaches aim to reconnect patients with life. Muir also shares insights on which depression subtypes respond best to TMS and discusses the nuances of different TMS coils.

Working with young adults who are navigating ADHD is rarely straightforward. They’re often dealing with more than just distractibility or missed deadlines. There’s anxiety, identity shifts, life transitions, and sometimes a long history of feeling misunderstood. This isn’t about checking boxes on a symptom list, it’s about understanding how their brain, their environment, and their story all interact. Today, we’re going to unpack that. CME: Take the CME Post-Test for this EpisodePublished On: 10/27/2025Duration: 16 minutes, 14 secondsJoshua Feder, MD, and Geneva Valeska have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

More teens are saying they can’t sleep because they’re worried about the environment. Today, we’re asking: How do we respond to climate anxiety without pathologizing it?  CME: Take the CME Post-Test for this EpisodePublished On: 10/20/2025Duration: 14 minutes, 06 secondsJoshua Feder, MD, and Mara Goverman, LCSW, have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Today, we'll be talking about psychedelics and addiction psychiatry, what they are, how they work, and what the research actually tells us. CME: Take the CME Post-Test for this EpisodePublished On: 10/13/2025Duration: 23 minutes, 38 secondsNoah Capurso, MD, MHS, and Snehal Bhatt, MD, have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Many teens struggle with sleep due to anxiety about the environment. The hosts discuss the differences between climate anxiety and environmental grief, emphasizing that these feelings are valid. They highlight the impact of family silence on youth, making them feel isolated in their concerns. Community actions, like advocacy and tree planting, are recommended to empower teens. Age-appropriate strategies are suggested for addressing these anxieties, all while encouraging resilience and refraining from pathologizing strong emotional responses.

There are two variations of long-acting injectable buprenorphine on the market. But what differentiates them, who might benefit, and how well do they work? Find out in today’s podcast.CME: Take the CME Post-Test for this EpisodePublished On: 09/29/2025Duration: 11 minutes, 36 secondsNoah Capurso, MD, MHS, and Geneva Valeska have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Chris Aiken and Kellie Newsome dive into the art of starting psych medications. They discuss the importance of slow titration for meds like bupropion and trazodone to minimize anxiety and side effects. Special attention is given to adjusting typical dosing for safety, particularly with valproate and antipsychotics. The duo also touches on the unique approach needed for disulfiram and shares insights from a meta-analysis on antidepressant discontinuation, making for an engaging blend of practical tips and research updates.

The discussion dives into the careful titration of clozapine and lamotrigine, emphasizing the importance of slow dosage increases for patient safety. A spotlight on lamotrigine reveals essential guidelines for rash management, particularly in bipolar depression cases. Recent research on panic disorders introduces findings about the effectiveness of sertraline and propranolol for women suffering from panic attacks, highlighting promising treatment options. This insightful conversation emphasizes both the challenges and advancements in psychiatric medication management.

Dr. Josh Feder shares crucial tips for parents on how to discuss school shootings with their kids. He emphasizes the importance of open communication and validating children's feelings. The conversation highlights strategies for ensuring safety and promoting mental health. Additionally, responsible firearm practices are addressed, underscoring their role in creating a secure environment for children.