Эпизоды
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I hope you enjoyed the overview of the SNRIs from the last episode. Today I continue with the SNRIs and go through each of the five individually and give you my classic what I like and don't like about each one. So if you aren't quite sure what is different about the drugs in the class, give this episode a listen and find out and also get a healthy dose of my opinions!
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Moving on to the next class of antidepressants after the SSRIs is the SNRIs. In this episode I'll discuss what is unique about these medications and what makes them different from their close cousins the SSRIs. I'll cover them as a class on this episode and individually in the next. Enjoy!
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Пропущенные эпизоды?
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On this episode I continue with the SSRIs. In the last episode we discussed them as a class, but today I'll go over each individual SSRI and highlight the subtle differences, advantages, and disadvantages to each med. I also discuss how the placebo effect has such a strong impact on the effectiveness of these medications and how different providers exert very different boosts in effectiveness of these medications. These are meds that all docs prescribe, and they are pretty straightforward, but I think you'll learn a thing or three on this one. Have a listen!
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Well we've finally reached the most commonly prescribed psychiatric medications. Doctors of all ilks prescribe the SSRIs for a myriad of conditions, but do you know as much about them as you think you do? Well we've already covered the plethora of adverse effects that can come with increasing serotonin, but now we dive into the selective serotonin reuptake inhibitors. On this episode I'll go over basic prescribing tips and tricks, discuss drug-drug interactions and SSRI withdrawal syndrome, and give my advantages and disadvantages of this drug class. I hope you enjoy!
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Most of the serotonin medications are pretty darn safe, but they come with a pretty long list of adverse effects that can make patients really uncomfortable. In the previous few episodes, I went over some of the biggest and most dangerous adverse effects. On this episode I want to go over the rest of them. I'll talk about the adverse effects in general and then each of the ones we haven't gone over yet, and I'll also talk about what to do about them if they happen. How to talk to patients about them and how to manage them if they occur. These effects can occur with any of the medications we've discussed thus far and with many of the ones to come. Serotonin is a major target for depression and anxiety, so it's important to understand these in more depth so that we can educate our patients, so let's go!
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I'm sure you've all heard about serotonin toxicity AKA syndrome, and you might even know what it looks like and how to diagnosis it, but do you know what causes it and what medications to REALLY be concerned about? Have you read a bunch of lists of meds and wondered if they all really contribute to this syndrome? When I was an intern I learned from psychiatry that you would have to take a truck load of SSRIs to die from, but then when I was talking to the senior internal medicine resident about how safe they are, she pointed out, "What about serotonin syndrome?" Well, what about it? All you questions will be answered on this episode, so I hope you enjoy!
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Ever wonder about that pesky "black box" warning on all those antidepressants? Have you ever considered not prescribing to a patient based on that warning or wonder if maybe you shouldn't? Well, then this episode is for you. I'm going to go through the history of this warning, it's intent, and it's consequences. And I hope that after listening that you will feel comfortable prescribing despite the warning because you know what to do with it.
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Last time in Part 1 I went over the mechanism of sexual dysfunction and some treatments. In Part 2 we dive into PDE5 inhibitors like Viagra. These medications are not only useful for sexual dysfunction associated with psychiatric medication use but we all know they are used for this on their own, so I think you will find this episode really informative. You may not know the difference between the PDE5 inhibitors. Well I'll be covering that on this episode! And a little bonus. I'll talk about some of the supplements patients may be buying online or at the gas station. This is a topic we don't get in medical school and it's really important so please have a listen!
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This is a big one! So I chopped it into two episodes. We're talking about sexual adverse effects associated with serotonergic medications. This is a huge adverse effect and it's the one that probably bothers the most patients, but it can be uncomfortable to talk about, so let's talk about it. What can we do about this adverse effect while still getting the positive effect from the medication. Let's start by going over why it happens and some techniques to stop it if it does. Then in Part 2 I'll go into depth on the PDE5 inhibitors like Viagra.
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Today I'm talking about QTc prolongation. This is an adverse effect of many medications and medical conditions, and psych drugs are right up at the top of the list. I think about antidepressants and antipsychotics when I think QTc and psych drugs, so before we go further with antidepressants, let's learn more about QTc prolongation. What is it? What do I do about it? When do I do something about it? How? I mean I'm not a cardiologist. Well, you can handle this. Let me help you by listening to this episode!
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Let's get to know the second generation antidepressants, otherwise known as receptor selective antidepressants. These antidepressants started in the 1980s with the newest one coming out just last year. They tend to only mingle with one or two receptors and have much lower adverse effects than the MAOis and TCAs. They are what most of us think about when we think about antidepressants. In this episode we do an overview of them from FDA approved uses to off label uses. And at the end a little bonus content. I talk about contraindications of the TCAs which I missed in the last episode.
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Trailer to the new podcast This Is Your Brain on Drugs.
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Now that we better understand the neuroreceptors in our brains, let's tackle the tricyclic antidepressants. These used to be a mainstay of psychiatric medication treatment for depression. Not so anymore as we have safer medications that have WAY less adverse effects, but they're still used; not as much for depression but for their other effects like with chronic pain, poor sleep, and more. I'd wager primary care uses them more than psychiatrists. They can help but they sure can hurt as well. Let's find out more about them!
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Taking a short break from the antidepressants to talk about all of the receptors in the brain (and some outside) that I think about when I'm thinking about psychiatric medications. The next podcast is about tricyclic antidepressants and I think this is a good time to introduce this concept. The tricyclics have complicated interactions with these receptors as do the antipsychotics that we will talk about later, but most psychiatric medications do what they do through a variety of combinations and strengths at these receptors to include the MAOis that we talked about in the last episode. Let's learn more about them!
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It's episode 6 and we're talking about the first antidepressants, the MAOI's! How do this things work? Aren't they really dangerous and not used anymore? No and No!! You too can use these medications to treat depression. Listen and find out how!
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In this shorter episode I'll give the back story on antidepressants. What was used before they were around? How do they work? Join me to find out!
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Today I'll start talking about treatments for depression. I'll go over lifestyle modification recommendations, psychotherapy, complementary treatments, and somatic treatments. I'll cover the last two in more detail later in the depression series, and I'll start the next episode with an overview of antidepressants.
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I'm hitting my stride here in episode 3 where I continue with introducing depression. In this episode I'll discuss how to diagnose and assess depression in preparation for deciding on what treatment will work best for the patient. Tune in to find out my approach to this fundamental element that will prepare you for picking the right med or no med.
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Let's get started learning some basics about depression before we dive into medication treatments. From what exactly is it to where do we think it comes from, even if you are a seasoned veteran I'm betting you will learn something from this introduction to the most frequently prescribed psychiatric medications.
