The Journal of Clinical Psychiatry Podcast

In this episode of The JCP Podcast, host Dr. Ben Everett speaks with Dr. Pierre N. Tariot, director of the Banner Alzheimer’s Institute and research professor of psychiatry at the University of Arizona College of Medicine. Dr. Tariot, who has studied agitation and dementia for nearly four decades, chaired an expert consensus panel behind a new report on recognizing, assessing, and treating agitation in Alzheimer’s disease, published in The Primary Care Companion for CNS Disorders.

With most people living with dementia managed in primary care and long waits to see dementia specialists, the panel’s central message is that the goal is not a quieter patient but a safer, more engaged one. Dr. Tariot reviews decades of trial data on carbamazepine, divalproex, atypical antipsychotics, quetiapine, and trazodone, and explains why sedation should not be mistaken for efficacy. The conversation covers ruling out reversible causes, nonpharmacologic approaches including the DICE framework, practical assessment tools, the two FDA-approved therapies, brexpiprazole and dextromethorphan-bupropion, cross-tapering from off-label agents, and emerging treatments on the horizon.

🎯 KEY EPISODE HIGHLIGHTS:

🪞 THE INTRUDER IN THE MIRROR [21:30]

“She saw herself in the mirror when she went into her room and thought that image was an intruder and that she needed to defend herself.”

A home-visit case shows how a careful look at the environment can resolve nightly agitation without any medication at all.

🗣️ AGITATION AS COMMUNICATION [22:36]

“They're communicating that their needs are not being met.”

Reframing disruptive behavior as an expression of unmet needs guides clinicians toward pain, sensory deficits, and other treatable contributors before reaching for a prescription.

🤝 THE MOST ESSENTIAL ELEMENT [37:30]

“If I were to identify the most essential element for therapeutic success, is the willingness of the medical practitioner to engage with the patient and family on this.”

Sustained clinician engagement lowers family anxiety, builds tolerance for setbacks, and anchors a target-symptom approach to treatment over time.

CHAPTERS:

00:00 – Introduction and Dr. Tariot’s Path Into Agitation Research

04:31 – Why This Consensus Report Was Written for Primary Care

07:15 – Four Decades of Trials: Carbamazepine, Divalproex, and the Atypicals

12:17 – Primary Care as the Front Line: Lessons From Depression

16:08 – Sedation Is Not Efficacy

19:33 – Talking With Care Partners and Identifying Unmet Needs

23:52 – Revisiting the Evidence for Quetiapine and Trazodone

28:09 – Two FDA-Approved Options: Brexpiprazole and Dextromethorphan-Bupropion

32:09 – Older Versus Newer Agents and the Boxed Warning

35:03 – Preparing Patients and Families for the Primary Care Visit

40:20 – Measuring Agitation: IPA Criteria, DICE, and Practical Assessment Tools

45:00 – Switching From Off-Label Agents: Cross-Tapering and Practical Barriers

48:30 – What’s Next: Novel Mechanisms, Disease Modification, and One Takeaway

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep28-treating-alzheimers-agitation-not-just-quieting-pierre-n-tariot/

The Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Targeted Treatment of Agitation in Alzheimer’s Dementia: Prioritizing Function and Safety Over Sedation and Other Serious Harms

https://www.psychiatrist.com/pcc/targeted-treatment-agitation-alzheimers-dementia/

The consensus panel report chaired by Dr. Tariot, published in The Primary Care Companion for CNS Disorders.

Dr. Pierre N. Tariot – LinkedIn

https://www.linkedin.com/in/pierre-tariot-13557ba/

The Primary Care Companion for CNS Disorders

https://www.psychiatrist.com/pcc/

#AlzheimersDisease #AgitationInDementia #PrimaryCare #GeriatricPsychiatry #Psychopharmacology

In this bonus episode, Dr. Ben Everett speaks with Scott Thompson, PhD, professor of psychiatry at the University of Colorado School of Medicine, where he directs the Novel Therapeutics in the Brain and Behavior Innovation Center and leads the Psychedelic Public Policy Partnership. Drawing on more than 40 years of synaptic research, Dr. Thompson describes how an unexpected finding on SSRI action led his lab to show in mice that psilocybin's antidepressant-like effects persisted even when the 5-HT2A receptor was blocked, and what that finding means for the question of whether the psychedelic experience itself is the medicine.

As psychedelic compounds advance through late-stage development, clinicians face open questions about mechanism, trial design, safety, and access. This conversation covers functional unblinding and the search for objective endpoints such as anhedonia, what it takes to run Schedule I research inside an academic medical center, and real-world outcome and safety data from more than 2,300 people who received regulated psilocybin services in Colorado and Oregon. Dr. Thompson also discusses the role of psychotherapy, the evidence on microdosing, and phase III programs including Definium's DT120 LSD formulation and Beckley Atai's intranasal 5-MeO-DMT.

KEY EPISODE HIGHLIGHTS: A SUPERCHARGED SSRI [45:30]

“psychedelics do what SSRIs do. They just do it more potently and more quickly.”

Dr. Thompson's working hypothesis frames psychedelics as faster, stronger versions of a mechanism clinicians already use every day, which shapes how his lab tests whether the trip is required.

A DOSE CEILING IN REAL-WORLD DATA [27:31]

“people who got doses of psilocybin less than thirty milligrams displayed the same improvement in symptoms as people who got doses more than thirty-five”

Outcome data from more than 2,300 regulated psilocybin clients suggest a threshold rather than a linear dose-response, challenging the assumption that higher doses yield greater benefit.

MICRODOSING AND EXPECTANCY [31:00]

“There's strong evidence now that microdosing is primarily a placebo effect.”

Placebo-controlled studies show benefit tracks what participants believed they received rather than what they actually took, useful context when patients ask about microdosing.

CHAPTERS:

00:00 – Introduction: Is the Experience the Medicine?

02:00 – From Basel and Zurich to Psilocybin and Synaptic Plasticity

07:30 – Psychedelic Research and Policy at CU Anschutz

10:30 – Functional Unblinding and the Search for Objective Endpoints

15:00 – Facilitator Support, Placebo Response, and Predictive Biomarkers

20:00 – Building Safety Into Colorado's Regulated Psilocybin Services

24:30 – Real-World Outcomes From Colorado and Oregon Psilocybin Clients

28:00 – Dose Thresholds, MEQ-30 Scores, and the Evidence on Microdosing

32:00 – Running Schedule I Research: Regulation, Funding, and INDs

36:30 – Safety Signals: Psychosis, Suicidality, and Adverse Event Follow-Up

43:00 – Blocking the 5-HT2A Receptor: Is the Trip Necessary?

47:30 – Cost, Access, and Shorter-Acting Psychedelics

50:30 – Receptor Promiscuity and Non-Hallucinogenic Compounds

53:30 – The Role of Psychotherapy in Psychedelic Treatment

59:30 – Definium's DT120: Phase III Data, Payer Realities, and Dose Selection

01:07:00 – Beckley Atai's 5-MeO-DMT and Other Short-Acting Compounds

01:09:30 – Clinical Takeaways

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep27-psychedelic-research-academic-medical-center-scott-thompson/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Dr. Scott Thompson – LinkedIn

https://www.linkedin.com/in/scott-thompson-241a1a15/

Harnessing Psilocybin (Hesselgrave et al., PNAS, 2021)

https://doi.org/10.1073/pnas.2022489118

Dr. Thompson's mouse study showing psilocybin's antidepressant-like effects persisted despite 5-HT2A receptor blockade.

Colorado Natural Medicine Program

https://dpo.colorado.gov/NaturalMedicine

State program for regulated psilocybin services discussed in this episode.

Definium Therapeutics

https://definiumtx.com

Developer of DT120, the LSD formulation with phase III results in MDD and GAD.

#Psilocybin #PsychedelicMedicine #LSD #Neuroplasticity #FunctionalUnblinding

Jenny Guidi, PsyD, PhD, associate professor of clinical psychology at the University of Bologna and director of psychometric and clinimetric studies at Massachusetts General Hospital, joins host Ben Everett, PhD, to discuss her new systematic review in The Journal of Clinical Psychiatry. The review examines more than 30 years of research on the Diagnostic Criteria for Psychosomatic Research (DCPR), covering all 14 DCPR syndromes across 96 studies.

Traditional psychiatric diagnosis can overlook psychosocial factors that shape the course and outcome of medical illness. Dr. Guidi explains why DCPR syndromes were found more often than formal psychiatric diagnoses in many clinical settings, how demoralization differs from major depressive disorder and why that distinction changes treatment, and how allostatic overload links a patient's lived experience to measurable biological change. The conversation closes with practical considerations for bringing the semi-structured DCPR interview into routine clinical care.

🎯 KEY EPISODE HIGHLIGHTS:

🔍 WHAT STANDARD PSYCHIATRIC ASSESSMENT CAN MISS [09:39]

“Our results suggested that the DCPR captured distinct clinical phenomena rather than merely symptomatic manifestations or attenuated forms of psychiatric disorders.”

Many medically ill patients with meaningful psychological distress meet no psychiatric diagnostic category, yet DCPR syndromes can identify them and inform prognosis and treatment.

💊 WHEN AN ANTIDEPRESSANT IS THE WRONG TOOL [20:30]

“On the other hand, if you misdiagnose demoralization as major depression, you are likely to prescribe unnecessary pharmacological treatment for what is essentially a psychological problem.”

Recognizing demoralization redirects care toward psychotherapeutic approaches such as well-being therapy rather than medication with no evidence of benefit.

🧬 BIOGRAPHY WRITTEN INTO BIOLOGY [24:06]

“The concept of allostatic overload provides a theoretical bridge between biography and biology.”

Allostatic overload gives clinicians a measurable way to connect chronic stress and life events to changes across multiple biological systems.

CHAPTERS:

00:00 – Introduction and Dr. Guidi's Path to the DCPR Review

05:00 – What the DCPR Detect Beyond DSM and the 2017 Revision

09:16 – DCPR Syndromes Across Cardiology, CL Psychiatry, and Primary Care

14:32 – Distinguishing Demoralization From Major Depression

18:08 – Recognizing and Treating Demoralization

23:03 – Allostatic Overload: Where Biography Meets Biology

29:02 – Bringing the DCPR Into Routine Clinical Practice

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep26-thirty-years-dcpr-psychosomatic-research-jenny-guidi/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Thirty Years of the Diagnostic Criteria for Psychosomatic Research (DCPR): A Systematic Review and Discussion of Clinical Implications

https://www.psychiatrist.com/jcp/Thirty-years-Diagnostic-Criteria-Psychosomatic-Research-systematic-review

Dr. Guidi's systematic review of all 14 DCPR syndromes across 96 studies, the focus of this episode.

The Demoralization Construct in Clinical Practice and Research (de Figueiredo)

https://www.psychiatrist.com/jcp/demoralization-construct-clinical-practice-research/

Companion commentary on distinguishing demoralization from depression, discussed in the episode.

Biography Inscribed in Biology (Horwitz)

https://www.psychiatrist.com/jcp/biography-biology-diagnostic-criteria-psychosomatic-research-embodiment-lived-experience/

Companion commentary on allostatic overload and the embodiment of lived experience.

Dr. Jenny Guidi - LinkedIn

https://www.linkedin.com/in/jenny-guidi-psyd-phd/

#DCPR #Demoralization #AllostaticOverload #PsychosomaticMedicine #Clinimetrics

In this bonus episode, host Ben Everett, PhD, reconnects with Ilan Melnick, MD, chief medical officer of Passageway, a South Florida forensic community control program, who also maintains a private concierge practice. Dr. Melnick chaired a JCP consensus panel of early adopters of xanomeline-trospium chloride (XT), and nearly two years after approval, he shares what clinicians have learned putting this first-in-class muscarinic agent into everyday practice.

Unlike dopamine D2 blockers, XT activates M1 and M4 muscarinic receptors to lower presynaptic dopamine, while trospium limits peripheral cholinergic effects. The conversation covers EMERGENT trial findings on positive, negative, and general psychopathology symptoms; early use in first-episode psychosis; titration to maintenance doses; prophylactic ondansetron and empty-stomach dosing; distinguishing cholinergic from anticholinergic adverse events; class-specific cross-titration; and antipsychotic dose sparing. Dr. Melnick also reviews two new Psych Congress posters: a real-world prescriber survey and a post hoc analysis of EMERGENT-5 examining GI side effects and treatment retention.

🎯 KEY EPISODE HIGHLIGHTS:

💊 ONDANSETRON BEFORE NAUSEA STARTS [31:00]

“One of the things we know about ondansetron is that it's a better preventer than it is a fixer.”

Prophylactic ondansetron at initiation is a simple step that can prevent early GI-related discontinuation.

⚖️ CHOLINERGIC OR ANTICHOLINERGIC? [36:00]

“If they're cholinergic in nature, go up to the one twenty-five. But if they're anticholinergic in nature then we have to see what other medicines are causing that extra anticholinergic effect.”

Identifying the type of adverse event determines whether to titrate up or review concomitant medications such as OTC sleep aids.

📈 STALLING AT 100 MG AND DROPOUT [49:41]

“So those that stay there and don't move up to the 125 milligram dose ended up usually dropping out due to higher GI issues.”

A post hoc EMERGENT-5 analysis suggests that titrating to the higher dose may support retention rather than threaten it.

CHAPTERS:

00:00 – Introduction: Revisiting the XT Consensus Panel

02:04 – Forensic Community Care and a Concierge Practice

05:26 – From Postsynaptic Blockade to Presynaptic Modulation

08:34 – M1/M4 Agonism and the Role of Trospium Chloride

13:03 – EMERGENT Trial Results and Early Cognitive Benefits

18:17 – Inside the Panel: Early Adopters and Experiential Evidence

22:35 – Early Use in First-Episode Psychosis and Dose Titration

28:28 – Patient Selection and Prophylactic Ondansetron

31:47 – Empty-Stomach Dosing and Cholinergic vs Anticholinergic Effects

37:15 – Cross-Titrating From Dones, Pines, and Partial Agonists

40:33 – Antipsychotic Dose Sparing, the ARISE Trial, and LAIs

44:17 – Psych Congress Poster: Real-World Prescriber Survey

49:07 – EMERGENT-5 Retention Data and the Future of Muscarinics

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep25-lessons-early-adopters-xt-schizophrenia-ilan-melnick/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Real-World Implementation of Xanomeline-Trospium in Schizophrenia: A Consensus Panel Report

https://www.psychiatrist.com/jcp/real-world-implementation-xanomeline-trospium-schizophrenia-consensus-report/

The JCP consensus panel report chaired by Dr. Melnick and discussed throughout this episode.

Dr. Ilan Melnick - LinkedIn

https://www.linkedin.com/in/ilan-melnick-516b4468/

#Schizophrenia #XanomelineTrospium #MuscarinicAgonist #FirstEpisodePsychosis #Psychopharmacology

In this episode of the JCP Podcast, host Dr. Ben Everett speaks with Dr. Steven Berkowitz, Professor of Psychiatry at the University of Colorado School of Medicine and Director of the Stress, Trauma, and Adversity Research and Treatment (START) Center at CU Anschutz. Drawing on a career spanning the Yale Child Study Center, Penn, and CU, Dr. Berkowitz discusses how childhood trauma shapes psychiatric illness across the lifespan and what that means for early intervention, assessment, and treatment.

The conversation covers the neurobiology of early maltreatment, the development and outcomes of the CFTSI early intervention model, the debate over developmental trauma disorder and complex PTSD, and how trauma presents differently in autistic youth. Dr. Berkowitz also addresses treatment sequencing for comorbid substance use and ADHD, the central role of sleep in trauma care, sensory processing deficits in children in the child welfare system, and the scientific and ethical questions that would need to be answered before psychedelic research could be extended to children and adolescents with PTSD.

🎯 KEY EPISODE HIGHLIGHTS:

🌱 WE CAN'T TREAT OUR WAY OUT OF THIS CRISIS [07:00]

“I really believe in prevention, and I think unfortunately, given our current set of circumstances, we're never gonna treat our way out of what is a mental health crisis in this country.”

Dr. Berkowitz frames pediatric trauma work as prevention, noting that most adults in outpatient psychiatric care carry a history of childhood trauma.

😴 TRAUMA PSYCHIATRY IS SLEEP PSYCHIATRY [25:42]

“Trauma psychiatry in many ways is about sleep psychiatry. The goal is to get people sleeping.”

Targeting nightmares and nighttime intrusive symptoms first may make it possible for patients to engage meaningfully in trauma therapy.

🧠 PSYCHOTHERAPY IS ESSENTIAL IN YOUTH PSYCHEDELIC RESEARCH [35:32]

“With kids, feeling is it's not even a question. We should absolutely be doing psychotherapy in these sessions as well as before and after.”

Any future psychedelic trials in children and adolescents will require extensive family preparation and integrated psychotherapy, raising design questions the field has yet to answer.

CHAPTERS:

00:00 – Introducing Dr. Steven Berkowitz

01:30 – Forensic Expert Work and Delayed-Onset PTSD

05:00 – Prevention and the Neurobiology of Childhood Trauma

11:00 – Developing the CFTSI Early Intervention Model

16:00 – Developmental Trauma, Complex PTSD, and the Limits of the DSM

19:30 – How Trauma Presents in Autistic Youth

23:30 – Sequencing Treatment for Substance Use, Comorbidities, and Sleep

26:30 – The START Center, Sensory Processing, and the “Trauma-Informed” Debate

32:00 – PTSD Pharmacotherapy and Psychedelic Research in Youth

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep24-trauma-expert-view-psychedelic-medicine-steven-berkowitz/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Dr. Steven Berkowitz – LinkedIn https://www.linkedin.com/in/stevenberkowitz/

CU Anschutz START Center https://www.cuanschutz.edu/home Dr. Berkowitz's family-centered, lifespan trauma research and treatment center.

Child and Family Traumatic Stress Intervention (CFTSI) https://www.nctsn.org/interventions/child-and-family-traumatic-stress-intervention

Brief early intervention model for children and caregivers discussed in this episode.

#ChildTrauma #PTSD #CFTSI #TraumaPsychiatry #PsychedelicResearch

In this episode of the JCP Podcast, Dr. Ben Everett speaks with Dr. Nina Schooler, a social psychologist whose career in psychiatric research spans more than six decades. Dr. Schooler began her work at the National Institute of Mental Health's Psychopharmacology Service Center in the early 1960s and has since contributed to landmark studies on antipsychotic treatment, maintenance therapy, tardive dyskinesia, long-acting injectables, negative symptoms, and coordinated specialty care for first-episode psychosis.

As the field increasingly looks toward a paradigm of meaningful functional recovery that goes beyond symptom control, this conversation traces how today's clinical standards, from dose-reduction strategies to the RAISE early-intervention model, emerged from decades of trial design, unexpected findings, and hard-won methodological lessons.

🎯 KEY EPISODE HIGHLIGHTS:

🔍 THE ACCIDENTAL DISCOVERY IN THE FIRST PLACEBO STUDY [12:30]

“the patients who'd been treated with placebo seemed in some ways to be doing better than the patients who had been treated with drug.”

A counterintuitive early finding shows how unblinding and differential attention, not the drug itself, can distort perceived treatment effects in psychiatric trials.

🚧 WHY THE SICKEST PATIENTS ARE MISSING FROM NEGATIVE SYMPTOM TRIALS [1:04:00]

“the patients we most want to include will not be included in the trial because participating in a clinical trial requires effort”

A structural recruitment paradox helps explain why decades of negative symptom trials have struggled to enroll the patients most affected by the condition.

🤝 SCHIZOPHRENIA CARE AS “A TEAM SPORT” [1:19:30]

“My sense of schizophrenia as a treatment target is that it's a team sport, and that it requires a team of people to engage with patients offering a range of treatments for which I see medication as the absolutely essential platform on which other things, can indeed build.”

After six decades in the field, this framing captures why no single intervention, medication or psychosocial, succeeds alone in treating schizophrenia.

CHAPTERS:

0:00 – Introduction: Six Decades of Schizophrenia Research

2:30 – Joining NIMH's Psychopharmacology Service Center in the 1960s

9:00 – Shifting Terminology and the Boundaries of a Schizophrenia Diagnosis

11:30 – A Social Psychologist's Lens on Early Treatment Outcomes

16:00 – Open Questions on Lifelong Treatment and Parallel VA Research

18:30 – The Hogarty-Goldberg Studies and the Two-by-Two Trial Design

27:30 – Expressed Emotion and the Camberwell Family Interview

32:30 – Controlled Trials Versus Real-World Adherence

34:00 – Tardive Dyskinesia and the Push to Lower Antipsychotic Doses

36:30 – Designing the Treatment Strategies in Schizophrenia Study

40:30 – Results: Medication's Value and a Young, Family-Involved Cohort

45:00 – Long-Acting Injectables: Adherence Myths and the PROactive Study

51:30 – Research Diagnostic Criteria for Tardive Dyskinesia and the AIMS Scale

56:30 – Negative Symptoms, Cognition, and the Risperidone Question

1:02:30 – The FDA Workshop and Consent Challenges in the CONSIST Study

1:06:00 – Digital Interventions, EMA, and Smartphone-Based Treatment

1:09:30 – Designing RAISE: A Cluster-Randomized Approach to First-Episode Care

1:15:30 – RAISE Results and the Challenge of Personalized, Team-Based Care

1:21:00 – From RAISE to SAMHSA: Scaling Coordinated Specialty Care

1:25:30 – Has RAISE Changed Community Practice?

1:28:00 – Toward Meaningful Functional Recovery: What Must Change Next

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep23-six-decades-schizophrenia-care-nina-schooler/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Dr. Nina Schooler – LinkedIn

https://www.linkedin.com/in/nina-schooler-11022870/

NIMH – Recovery After an Initial Schizophrenia Episode (RAISE)

https://www.nimh.nih.gov/research/research-funded-by-nimh/research-initiatives/recovery-after-an-initial-schizophrenia-episode-raise

NIMH overview of the RAISE initiative and coordinated specialty care model discussed at length in this episode.

SAMHSA – Early Serious Mental Illness Treatment Locator

https://www.samhsa.gov/find-help/locators/esmi

Locator for coordinated specialty care programs, funded through the SAMHSA block grants described in this episode.

#Schizophrenia #TardiveDyskinesia #LongActingInjectables #FirstEpisodePsychosis #Psychopharmacology

Dr. Benjamin Brody, an inpatient psychiatrist who built and now directs one of the earliest hospital-based ketamine treatment programs, joins Dr. Ben Everett to unpack the regulatory maze surrounding ketamine and the psychedelics now approaching FDA approval. Dr. Brody traces how he moved generic racemic ketamine from an overlooked anesthetic sitting on the hospital pharmacy shelf to a formally sanctioned inpatient treatment, and explains why esketamine's REMS-regulated pathway looks nothing like the largely unregulated market for take-home ketamine.

As synthetic psilocybin nears a possible FDA decision and the field debates what role psychotherapy should play alongside these treatments, clinicians face fast-moving questions about safety monitoring, staffing, informed consent, and reimbursement. Drawing on his direct experience administering ketamine on the inpatient unit, Dr. Brody discusses self-escalation risk, the paradox reaction his team termed dysphoric dissociation, and what health systems should weigh before building a program of their own.

🎯 KEY EPISODE HIGHLIGHTS:

⚠️ THE NARROW LINE BETWEEN NEUROTROPHIC AND NEUROTOXIC [18:30]

“But at higher doses, it actually becomes neurotoxic and, you know, there's histopathological changes that can be seen.”

At therapeutic doses ketamine is safe and neurotrophic, but Dr. Brody warns that self-escalating doses can quickly cross into neurotoxic and bladder-damaging territory.

🧠 DEFINING DYSPHORIC DISSOCIATION [24:00]

“This is a dysphoric piece or a dysphoric reaction that is layered on top of the dissociative experience for this small minority of patients.”

Dr. Brody explains why his team coined a new clinical term to distinguish ketamine's rare, frightening paradox reaction from a psychedelic “bad trip,” and why naming it matters for informed consent.

🚫 THE CASE AGAINST TAKE-HOME KETAMINE [25:00]

“The unambiguous answer is no, I do not think this is a good idea.”

Citing self-escalation risk, a narrow therapeutic index, and a growing number of ketamine-associated deaths, Dr. Brody explains why he opposes direct-to-consumer telehealth ketamine prescribing.

CHAPTERS:

00:00 – From Creative Writing to the Inpatient Unit

02:30 – A Day in the Life of an Inpatient Psychiatrist

05:30 – How Dr. Brody Came to Believe in Ketamine

12:00 – Ketamine vs. Classical Psychedelics: A Different Mechanism

14:00 – Two Regulatory Worlds: Racemic Ketamine and REMS-Regulated Esketamine

17:30 – Safety Signals: Self-Escalation and Dysphoric Dissociation

24:30 – The Case Against Take-Home Ketamine

29:30 – Psychedelics Enter the Medical Mainstream

33:30 – What to Expect When Psilocybin Gets FDA Approval

39:00 – Staffing and Consent for Hours-Long Sessions

43:00 – Set and Setting: Lessons from Building a Ketamine Program

48:00 – Is This Psychotherapy? Defining the Clinician's Role

54:00 – What Surprised Dr. Brody About Implementation

57:00 – Advice for Health Systems and Reasons for Optimism

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep22-regulatory-maze-ketamine-psychedelics-benjamin-brody/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

How Do We Get Ketamine Safety Right? Three Questions From a Clinical Service

https://www.psychiatrist.com/jcp/how-do-we-get-ketamine-safety-right-3-questions-from-clinical-service/

Dr. Brody's 2025 JCP commentary on self-escalation, paradox reactions, and the regulatory gap between racemic ketamine and esketamine, discussed at length in this episode.

COMPASS Pathways – COMP360 Psilocybin for Treatment-Resistant Depression

https://compasspathways.com/our-work/comp360-psilocybin-treatment-in-trd/

The investigational psilocybin program discussed throughout the episode, including its phase 3 timeline and proposed psychological support model.

Dr. Benjamin Brody – LinkedIn

https://www.linkedin.com/in/benjamin-brody-md-3576bb4/

#Ketamine #Psychedelics #TreatmentResistantDepression #Psychopharmacology #REMS

Dr. Elizabeth Ballard, Director of Psychology and Behavioral Research and Director of Pre-Doctoral Training at the National Institute of Mental Health's Experimental Therapeutics and Pathophysiology Branch, joins the JCP Podcast to trace the full arc of suicide risk assessment and treatment. Dr. Ballard helped develop the Ask Suicide Screening Questionnaire (ASQ) and was first co-author on the individual patient data meta-analysis establishing ketamine's rapid antisuicidal effect.

Suicide risk is assessed in some form during nearly every patient encounter, yet the tools clinicians use and the evidence behind current treatments remain works in progress. Dr. Ballard discusses the sensitivity-specificity trade-offs built into screening instruments, what ketamine research reveals about suicidality as distinct from depression, emerging biomarkers such as nocturnal wakefulness and electrophysiological signatures of hopelessness, and the ethical case for including suicidal patients in clinical research rather than excluding the population clinicians most need evidence for.

🎯 KEY EPISODE HIGHLIGHTS:

🩺 SCREENING IS A LIFE-OR-DEATH TRADE-OFF [11:00]

“This is literally a life or death situation, and so you don't want people slipping through the cracks that aren't getting identified.”

Ballard frames the sensitivity-specificity trade-off built into suicide screening tools like the ASQ as a stakes-defining design choice, not just a statistical one.

🎯 SUICIDE RISK IS MULTIFACTORIAL, SO WHERE DO YOU START [39:00]

“There's so many factors that lead somebody in a moment of crisis to think about ending their lives.”

Ballard argues clinicians can't treat every contributing factor at once, which is why her research isolates modifiable targets like hopelessness rather than suicide risk as a whole.

❤️ WHEN IN DOUBT, ASK [52:30]

“When in doubt, ask. There's no harm in asking.”

Ballard's single most actionable takeaway: approach suicide risk assessment with curiosity rather than treating it as a documentation exercise.

CHAPTERS:

00:00 – Introduction: Dr. Elizabeth Ballard's Path to Suicide Research

05:30 – Building and Calibrating the ASQ Screening Tool

12:30 – The 2018 AJP Ketamine Meta-Analysis: Pooling Individual Patient Data

17:30 – Disentangling Ketamine's Effect on Suicidality from Depression

20:30 – Ketamine's Response Trajectory and IV vs. Esketamine Comparison

25:30 – Nocturnal Wakefulness as a Warning Sign for Suicidal Ideation

31:00 – MEG and Electrophysiological Signatures of Suicide Risk

34:00 – Concordance Across Suicide Risk Assessment Scales

38:00 – Hopelessness as a Distinct, Modifiable Treatment Target

41:00 – Neurofeedback and Episodic Future Thinking at Neu Hope

45:00 – Ethically Including Suicidal Patients in Clinical Research

52:00 – Closing Clinical Takeaway: Asking with Curiosity

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep21-rethinking-suicide-risk-screening-treatment-elizabeth-ballard/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Ask Suicide-Screening Questions (ASQ) Toolkit – NIMH

https://www.nimh.nih.gov/research/research-conducted-at-nimh/asq-toolkit-materials

Free NIMH toolkit for the screening instrument Dr. Ballard helped develop, discussed at length in this episode.

Dr. Elizabeth Ballard – LinkedIn

https://www.linkedin.com/in/elizabeth-ballard-943245350/

#SuicideRiskAssessment #Ketamine #SuicidePrevention #ClinicalResearchEthics #Hopelessness

Dr. David T. Liebers, MD, MPhil, MPP, a research assistant professor of psychiatry at the NYU Grossman School of Medicine and a research psychiatrist at the Nathan Kline Institute, joins Dr. Ben Everett to explore metabolic psychiatry: the growing evidence linking mitochondrial function, bioenergetics, and whole-body metabolism to psychiatric illness. Building on a previous conversation about GLP-1 receptor agonists, this episode broadens the lens to ketogenic diet interventions, SGLT2 inhibitors, and metformin, tracing how each may support brain energetics in depression, schizophrenia, and bipolar disorder.

This conversation arrives as clinicians increasingly confront the metabolic burden of antipsychotic treatment alongside a widening evidence base for interventions originally developed for diabetes and heart failure. Dr. Liebers discusses recent trial data on ketogenic diets in serious mental illness, the mechanistic case for SGLT2 inhibitors as a psychiatric tool, expanding guidelines for metformin co-prescription, and why brain energetics may represent a legitimate and increasingly tractable therapeutic target, not a replacement for existing models of psychiatric illness, but an additional clinical perspective.

🎯 KEY EPISODE HIGHLIGHTS:

🏛️ THE “ERA OF FOOD AS MEDICINE” ISN’T NEW [12:30]

“We have now entered the era of food as medicine.”

Dr. Liebers traces today's food-as-medicine rhetoric back through nearly two centuries of psychiatric interest in diet's role in mental illness.

🧬 MITOCHONDRIAL DYSFUNCTION AS A TREATMENT TARGET [23:30]

“The big challenge, I think, is identifying those interventions that can reliably improve, metabolic function in a way that can be measured and is suitable for randomized trial designs that let us talk about causation.”

Dr. Liebers frames abnormal brain bioenergetics as a specific, measurable target for a subset of patients underserved by monoamine-based treatments.

⚖️ METFORMIN IS DRAMATICALLY UNDERUSED [55:30]

“I think ten to fifteen percent of the people that should be or would qualify under the new guidelines to get metformin are actually on it.”

Despite expanded 2025 consensus guidelines, Dr. Liebers' EHR data suggest most eligible patients are still not receiving metformin for antipsychotic-associated weight gain.

CHAPTERS:

00:00 – Introduction: Building on the GLP-1 Conversation

02:30 – An Unconventional Path to Metabolic Psychiatry

10:30 – Diet in the Asylum Era: A History of Food as Medicine

18:00 – Why Metabolism Returned to Scientific View

23:30 – Imaging Brain Energetics: Bridging Peripheral and Central Metabolism

28:30 – The Stanford Pilot Trial and the Abrams Follow-On RCT

36:00 – Adherence, Meal Delivery, and the Path to GLP-1s

39:30 – GLP-1 Receptor Agonists in Psychiatric Practice

41:30 – Discovering SGLT2 Inhibitors: A Resident's Chance Encounter

45:00 – The Ketogenic Mechanism Behind SGLT2 Inhibition

49:30 – Trial Emulation and the Empagliflozin Pilot Study

52:00 – Metformin's Expanding Role in Antipsychotic-Associated Weight Gain

56:30 – SGLT2 Inhibitors as a Complement to Ketogenic Therapy

61:30 – Toward a Whole-Person Model: Diet, Drugs, and Exercise

66:00 – Confronting the Treatment Gap: Underused Medications

68:00 – The Future of Metabolic Psychiatry: Integration, Not Revolution

71:30 – Closing Thoughts and Sign-Off

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep20-feeding-mind-metabolism-psychiatry-david-t-liebers/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Dr. David T. Liebers – LinkedIn

https://www.linkedin.com/in/david-liebers-7b9706169/

Metabolic Mind

https://www.metabolicmind.org/

Patient and clinician resource on ketogenic and metabolic therapies for mental illness, recommended by Dr. Liebers in this episode.

The Emerging Role of GLP-1s in Psychiatry with Roger S. McIntyre, MD, FRCPC

Listen to a previous episode from April 21, 2026 covering GLP-1s in Psychiatry

#MetabolicPsychiatry #KetogenicDiet #SGLT2Inhibitors #Metformin #Mitochondria

Dr. Aderonke Pederson, an assistant professor of psychiatry at Harvard Medical School and a psychiatrist in the Depression Clinical and Research Program at Massachusetts General Hospital, joins the JCP Podcast to discuss how contact-based storytelling can function as a clinical intervention for reducing mental illness stigma and medical mistrust.

Stigma and mistrust are measurable barriers that delay care-seeking and worsen outcomes, particularly among Black adults with moderate to severe depression or anxiety who are not currently engaged in mental health services. Dr. Pederson walks through the theoretical foundations of contact-based stigma reduction, her research on religiosity and heterogeneity within Black communities, and a self-administered, video-based mobile intervention now being tested in a randomized controlled trial to help close the engagement gap in primary care.

🎯 KEY EPISODE HIGHLIGHTS:

🧩 STIGMA AS A FUNDAMENTAL CAUSE OF HEALTH INEQUITIES [04:00]

“Stigma has been described as a fundamental cause of health inequities.”

Framing stigma this way means it remains a barrier to care even after every other access issue has been addressed.

🧬 WHY MEDICAL MISTRUST IS AN EXPECTED RESPONSE [05:30]

“We expect mistrust if we have historical factors that have led to that mistrust.”

Clinicians should validate and address the historical roots of mistrust before working to reduce it.

🗣️ NAMING STIGMA TO GET IT OUT OF THE ROOM [53:00]

“It's in the room with you, and the question is, do you acknowledge its presence?”

Recognizing stigma and mistrust as active forces in every clinical encounter is the first step to addressing them with patients.

CHAPTERS:

00:00 – Introduction: When Story Becomes Clinical Intervention

03:30 – Stigma as a Fundamental Cause of Health Inequities

07:30 – From Basic Science to Psychosocial Mechanism: Where Stigma Intervenes

12:00 – The Engagement Gap: Disparities in Depression and Anxiety Care

16:00 – Religiosity and the Limits of Past Contact on Future Stigma

19:30 – Beyond Racial Categories: Heterogeneity and Migration

23:30 – The Power of Story: Why Narrative Changes Behavior

27:30 – Contact Theory: From Allport to the Psychiatric Ward

33:00 – Fisher's Narrative Paradigm and the Neuroscience of Story

36:30 – Shared Identity vs. Story Content

39:00 – Designing the App: A User-Centered Approach

45:00 – Inside the Clinical Trial: Reaching a Hard-to-Enroll Population

49:00 – Primary Endpoints and the Question of Durability

52:30 – Closing Thought: Naming Stigma to Address It

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep19-turning-stigma-into-stories-hope-aderonke-pederson/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Dr. Aderonke Pederson - LinkedIn

https://www.linkedin.com/in/aderonke-bamgbose-pederson-85345315/

#MentalHealthStigma #MedicalMistrust #HealthDisparities #DigitalTherapeutics #BlackMentalHealth

Dr. Crystal T. Clark, Associate Professor of Psychiatry at the University of Toronto and Canadian Research Chair in Reproductive Mental Health, joins the podcast to discuss the evidence-based management of bipolar disorder across pregnancy and the postpartum period. Dr. Clark, recently appointed head of the Department of Psychiatry at Women's College Hospital, has built her research career around closing the pharmacokinetic evidence gap for the mood stabilizers and antipsychotics used during pregnancy.

For decades, clinical practice around perinatal bipolar disorder was shaped by stigma and a lack of data, leaving many women counseled to discontinue effective treatment or avoid pregnancy altogether. Dr. Clark reviews how physiological changes in pregnancy alter the clearance of lamotrigine, lithium, and atypical antipsychotics, why postpartum tapering requires close monitoring, how the Mood Disorder Questionnaire can help distinguish bipolar from unipolar postpartum depression, and what her research reveals about racial disparities in diagnosis among Black women.

🎯 KEY EPISODE HIGHLIGHTS:

🚫 THE STIGMA OF DISCOURAGING PREGNANCY [05:30]

“No, there's no data. This is all stigma.”

Dr. Clark names outright that generations of counseling women with bipolar disorder against having children was never grounded in evidence.

🧪 LAMOTRIGINE CLEARANCE CAN JUMP 300% IN PREGNANCY [16:00]

“Elimination clearance really increases during pregnancy as much as two hundred to three hundred percent.”

This pharmacokinetic shift explains why patients on a stable lamotrigine dose can relapse mid-pregnancy despite full adherence.

📊 HIGHER BIPOLAR PREVALENCE AMONG BLACK POSTPARTUM WOMEN [48:30]

“When you looked at bipolar disorder, there was a higher prevalence amongst Black women.”

This diagnosis-level finding, rare in perinatal mental health research, points to a gap in how bipolar disorder is recognized in Black patients.

CHAPTERS:

00:00 – Introduction: A Career Built on Closing the Evidence Gap in Perinatal Bipolar Disorder

02:30 – The Discontinuation Era and the Stigma of Childbearing with Bipolar Disorder

08:30 – Reweighing the Risk-Benefit Calculus: Untreated Illness as Its Own Danger

13:30 – From Residency to Research: Uncovering the Pharmacokinetic Evidence Gap

18:00 – The Pharmacology of Pregnancy: How Lamotrigine, Lithium, and Antipsychotics Are Metabolized Differently

22:00 – From Algorithm to Practice: Applying and Titrating Lamotrigine Across Pregnancy and Postpartum

28:30 – Lithium in Pregnancy: Monitoring Levels and Revisiting the Ebstein's Anomaly Risk

35:00 – Atypical Antipsychotics: Quetiapine and Risperidone Pharmacokinetics

40:00 – Distinguishing Bipolar from Unipolar Postpartum Depression with the MDQ

45:30 – Racial Disparities in Perinatal Bipolar Disorder Diagnosis

50:00 – Designing a Postpartum Monitoring Plan for High-Risk Patients

54:00 – Future Directions: Formalizing the Lamotrigine Algorithm and Black Maternal Mental Health Research

57:30 – Closing Reflections: The Path Toward Diagnostic Precision

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep18-bipolar-disorder-pregnancy-postpartum-crystal-t-clark/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Dr. Crystal T. Clark – LinkedIn

https://www.linkedin.com/in/crystalclarkmd/

Rates of Major Depressive Disorder and Bipolar Disorder in Black and White Postpartum Women (JCP, 2024)

https://www.psychiatrist.com/jcp/rates-major-depressive-bipolar-disorder-black-white-postpartum-women/

The 2024 study discussed at length in this episode's chapter on racial disparities in perinatal bipolar diagnosis.

A Comparison of Symptoms of Bipolar and Unipolar Depression in Postpartum Women (J Affect Disord, 2022)

https://pubmed.ncbi.nlm.nih.gov/35041868/

The MDQ-based screening study Dr. Clark walks through when discussing how to distinguish bipolar from unipolar postpartum depression.

#BipolarDisorder #PerinatalPsychiatry #Psychopharmacology #PostpartumPsychosis #MaternalMentalHealth

In this episode, Dr. Ben Everett is joined by Dr. Joseph F. Goldberg, clinical professor of psychiatry at the Icahn School of Medicine at Mount Sinai and deputy editor-in-chief of the Journal of Clinical Psychiatry. Dr. Goldberg recently completed his term as president of the American Society of Clinical Psychopharmacology (ASCP), during which he led a 45-member international task force that produced a landmark series of consensus statements on deprescribing psychotropic medications, the principal findings of which were published in JAMA Network Open.

The decision to stop a medication is among the most common—yet least formalized—clinical acts in psychiatry. Despite decades of prescribing guidance, the field has lacked systematic frameworks for determining when, why, and how to discontinue treatment. This episode examines the ASCP task force's Delphi methodology, the areas of consensus and expert disagreement, and the practical implications for managing polypharmacy, navigating discontinuation phenomena, counseling pregnant patients, and training the next generation of prescribers.

🎯 KEY EPISODE HIGHLIGHTS:

📋 MEDICINES AS EMPLOYEES: THE PERFORMANCE REVIEW FRAMEWORK [03:30]

“I often like to think of medicines like employees on a payroll, and from time to time, it's a good thing to do a performance review of everybody on the payroll and ask what's your job, and are you doing it well, and is your job still there, or is that niche no longer present?”

Dr. Goldberg's core framework reframes deprescribing as a structured, periodic clinical evaluation—shifting the default from indefinite continuation to deliberate reassessment.

⚠️ PSEUDOTREATMENT RESISTANCE: THE LAI LITMUS TEST [22:00]

“Up to eighty percent of people don't take their medicines as prescribed, and oftentimes that could be quite substantial. It does run the risk of erroneously concluding this drug didn't work for you.”

Before deprescribing in schizophrenia, the task force emphasizes ruling out non-adherence—including a strong recommendation to consider long-acting injectable antipsychotics as a diagnostic and therapeutic step.

🧠 THE PSYCHOLOGY OF STOPPING: MEDICATION AS TRANSITIONAL OBJECT [34:30]

“To say I'm gonna take away this tangible thing that's meant to alleviate your suffering could mean I think you're doing pretty well and you don't need this anymore. Or it could also mean I'm not sure you're really suffering as much as you think you are.”

The decision to deprescribe carries significant psychological weight for patients—and clinicians who overlook this dimension risk undermining therapeutic alliance and triggering distress independent of pharmacology.

CHAPTERS:

00:00 – Introduction and Defining Deprescribing

07:00 – Why Now: ASCP's Task Force and the Political Landscape

13:30 – Delphi Methodology: Consensus and Divergence

15:30 – The Lithium Overdose Dilemma: When Stopping Defies a Rule

20:00 – Adherence, Pseudotreatment Resistance, and Schizophrenia

25:30 – Complex Polypharmacy and Medication Performance Reviews

29:30 – Valproate and Women of Reproductive Potential

34:00 – The Psychology of Stopping: Medication Attachment and Placebo

37:30 – Long Half-Life Drugs and Auto-Tapering

40:30 – Discontinuation Phenomena, Brain Zaps, and Hyperbolic Tapering

45:30 – Pregnancy, Special Populations, and Relapse Risk

49:30 – Training Gaps and the Future of Deprescribing Education

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep17-art-deprescribing-framework-ending-medication-joseph-goldberg/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Dr. Joseph Goldberg – LinkedIn

https://www.linkedin.com/in/joseph-goldberg-922b5317/

American Society of Clinical Psychopharmacology (ASCP)

https://www.ascpp.org/

The organization that convened the 45-member international deprescribing task force discussed in this episode.

ASCP Deprescribing Consensus Statement — JAMA Network Open

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2845497

The parent consensus paper on general principles of deprescribing psychotropic medications.

#Deprescribing #Psychopharmacology #Polypharmacy #MedicationManagement #ClinicalPsychiatry

EPISODE DESCRIPTION

Dr. Barbara O. Rothbaum, PhD, is a tenured professor in the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine, where she holds the Paul A. Janssen Chair in Neuropsychopharmacology. She is director of the Trauma and Anxiety Recovery Program, director of the Emory Healthcare Veterans Program, and as of 2025, science director of the Emory Center for Psychedelics and Spirituality. With more than 400 scientific papers and multiple books to her name, Dr. Rothbaum is one of the foremost authorities on PTSD treatment in the world. In this episode, she joins host Ben Everett to reflect on four decades at the frontier of PTSD research, from the earliest days of the field's recognition as a disorder to the cutting edge of psychedelic-assisted therapy and virtual reality exposure.

PTSD remains one of psychiatry's most consequential and undertreated conditions, affecting a substantial portion of combat veterans, survivors of sexual trauma, and countless others who have never received an accurate diagnosis. In this conversation, Dr. Rothbaum covers the evidence base for first-line trauma-focused therapies — prolonged exposure, cognitive processing therapy, and EMDR — and the intensive outpatient model that has dramatically improved treatment retention. She then turns to the stalled landscape of PTSD pharmacotherapy, her translational research combining MDMA with prolonged exposure, the emerging role of psilocybin and ketamine, and the evolution of virtual reality exposure therapy from her laboratory's 1993 pilot to the Brave Mind system now deployed across more than 50 VA health systems.

KEY EPISODE HIGHLIGHTS

🧠 PTSD TREATMENT IS ABOUT APPROACHING, NOT AVOIDING [09:00]

"There's no way to the other side of the pain except through it."

Dr. Rothbaum explains the core mechanism underlying all empirically supported PTSD therapies — and why avoidance is the central obstacle to recovery.

💊 SSRIs ARE NOT REALLY THE TREATMENT FOR PTSD [24:30]

"I personally will think of them like weak coffee for PTSD. Maybe you can get a little bit of effect, maybe on mood, maybe on thinking."

Despite being the only FDA-approved pharmacotherapy for PTSD, SSRIs fall well short of the evidence base for trauma-focused psychotherapy — and combination treatment offers no advantage.

🥽 VIRTUAL REALITY EXPOSURE THERAPY GIVES CLINICIANS TOTAL CONTROL [43:30]

"If my patient's not ready for turbulence, I can guarantee there won't be turbulence. When they are ready for turbulence, I can guarantee there will be turbulence."

From fear of heights to virtual Iraq and Afghanistan combat environments, VR allows therapists to precisely calibrate stimulus intensity — closing the gap between imaginal exposure and real-world treatment.

CHAPTERS

00:00 - Introduction and Guest Biography

03:30 - Career Origins: Starting with Edna Foa

05:30 - A Career at the Intersection of Therapy, Technology, and Pharmacology

08:00 - First-Line Psychotherapies: PE, CPT, and EMDR

13:30 - Comparing the Therapies: Evidence and Patient Fit

15:30 - The Emory Healthcare Veterans Program and the IOP Model

21:00 - Recognizing PTSD in Primary Care

23:30 - Pharmacotherapy: The Limits of SSRIs

27:30 - Recent Drug Development Setbacks: MDMA and Brexpiprazole

31:00 - Translational MDMA Research and Combining with Prolonged Exposure

37:30 - Lessons from Australia's MDMA Approval

39:00 - The Broader Psychedelic Landscape: Psilocybin, Ketamine, and Others

43:00 - Virtual Reality Exposure Therapy and the Brave Mind System

49:30 - Resilience, Hope, and the Future of PTSD Treatment

LINKS

Full transcript and show notes

https://www.psychiatrist.com/jcp/ep16-forty-years-ptsd-frontier-barbara-o-rothbaum/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Dr. Barbara O. Rothbaum — LinkedIn

https://www.linkedin.com/in/barbara-rothbaum-9339546

Emory Healthcare Veterans Program

https://www.emoryhealthcare.org/lp/veterans-ptsd

The intensive outpatient program for post-9/11 veterans discussed throughout this episode.

Wounded Warrior Project — Warrior Care Network

https://www.woundedwarriorproject.org/programs/warrior-care-network

Funds the four IOP programs, including Emory's, discussed in the episode. No cost to veterans.

#PTSD #TraumaTherapy #MDMAAssistedTherapy #VirtualRealityTherapy #Veterans

In this episode of the JCP Podcast, host Dr. Ben Everett speaks with Dr. Jennifer L. Payne, Professor of Psychiatry and Neurobehavioral Sciences and Vice Chair of Research at the University of Virginia, where she directs the Reproductive Psychiatry Research Program. Dr. Payne holds a joint appointment in obstetrics and gynecology and has spent her career at the intersection of basic neuroscience and clinical care in perinatal psychiatry. She is widely recognized for her work on the biological underpinnings of postpartum depression, including epigenetic biomarkers that prospectively predict risk, and for her clinical and research contributions to the development of GABAergic therapeutics — from brexanolone to zuranolone — that are reshaping how the field understands and treats this condition.

Postpartum depression affects roughly one in eight women following childbirth and remains one of the most underdiagnosed and undertreated conditions in medicine. Despite this, care has long defaulted to serotonergic antidepressants developed for major depression rather than agents designed around the biology of the postpartum period. In this episode, Dr. Payne explains why the precipitous drop in neuroactive steroids — particularly allopregnanolone — following delivery may be central to postpartum depression pathophysiology, how the GABA-A receptor is implicated in ways that are distinct from benzodiazepines, what the clinical proof-of-concept established by brexanolone means for the field, and why zuranolone's oral formulation is changing real-world access. Dr. Payne also discusses the epigenetic biomarker test her lab has developed with collaborator Dr. Zachary Kaminsky — work now moving toward FDA review — its ethical implications, and emerging parallels with premenstrual dysphoric disorder.

KEY EPISODE HIGHLIGHTS

🔬 PREDICTING POSTPARTUM DEPRESSION BEFORE IT STARTS [12:30]

"We can take blood in the third trimester, and we can say whether a woman is at high risk of developing postpartum depression by three months postpartum or at low risk."

Dr. Payne describes the epigenetic biomarker test developed with Dr. Zachary Kaminsky — replicated in six independent samples and now advancing toward FDA review — that identifies postpartum depression risk from a third-trimester blood draw, enabling preventive planning before symptoms emerge.

🧠 WHY BREXANOLONE IS NOT JUST A BENZODIAZEPINE [24:15]

"The benzodiazepines don't act on those extrasynaptic GABA receptors. So sometimes people have said to me that allopregnanolone and the new FDA-approved treatments for postpartum depression are really just a benzodiazepine, and that's not true."

Dr. Payne explains the critical mechanistic distinction between benzodiazepines (synaptic GABA-A binding) and neuroactive steroids (extrasynaptic GABA-A binding), clarifying why this difference matters for setting the brain's overall inhibitory tone — a distinction clinicians should be prepared to address with patients.

💊 ZURANOLONE: FOURTEEN DAYS, SUSTAINED RESPONSE [31:00]

"You take [zuranolone] for fourteen days, and you see response rates within three days, which again, is groundbreaking in terms of treating a depressive episode."

The shift from a 60-hour inpatient IV infusion to a 14-day oral course has transformed real-world feasibility. Dr. Payne reviews the clinical profile of zuranolone — including rapid onset, sedation considerations, breastfeeding questions, and the practical barriers that still limit access.

CHAPTERS

00:00 - Introduction and Guest Overview

02:45 - Scientific Origins: From Alzheimer's Disease to Postpartum Depression

06:30 - Why Postpartum Depression Is a Natural Model for Studying Depression Biology

08:00 - Screening, Underdiagnosis, and the Stigma Gap

09:30 - A Personal Account of Postpartum Depression and Advocacy

12:00 - Epigenetic Biomarkers: Predicting Risk Before Delivery

17:15 - Ethics, Autonomy, and the Case for a Predictive Blood Test

20:45 - Allopregnanolone and the Neuroactive Steroid System

23:30 - GABA-A Receptor Subtypes: Why Neuroactive Steroids Are Not Benzodiazepines

25:30 - DoD-Funded Research: Neuroactive Steroid Shunting and GABA-A Reconfiguration

29:30 - Brexanolone: Clinical Proof of Concept and Why It's No Longer Available

31:30 - Zuranolone: Mechanism, Practical Considerations, and Real-World Access

37:00 - PMDD as a Window into Shared Biology

39:30 - The GABAergic Hypothesis and the Future of Depression Subtypes

41:45 - Improving Screening and Educating OBGYNs

43:30 - Closing Remarks

LINKS

Full transcript and show notes

https://www.psychiatrist.com/jcp/ep15-rethinking-postpartum-depression-biology-biomarkers-jennifer-l-payne/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

National Pregnancy Registry for Antidepressants: https://womensmentalhealth.org/research/pregnancyregistry/antidepressants/

Biomarkers:

• DNA methylation biomarkers prospectively predict both antenatal and postpartum depression: https://pubmed.ncbi.nlm.nih.gov/31843207/
• Seeing the Future: Epigenetic Biomarkers of Postpartum Depression: https://pmc.ncbi.nlm.nih.gov/articles/PMC3857665/
• Biomarker or pathophysiology? The role of DNA methylation in postpartum depression: https://pubmed.ncbi.nlm.nih.gov/24059792/

DOD Work in Segment II:

• Metabolites of Progesterone in Pregnancy: Associations with Perinatal Anxiety: https://pmc.ncbi.nlm.nih.gov/articles/PMC10530426/
• Neuroactive steroid biosynthesis during pregnancy predicts future postpartum depression: a role for the 3α and/or 3β-HSD neurosteroidogenic enzymes? https://pubmed.ncbi.nlm.nih.gov/39885361/

#PostpartumDepression #NeuroactiveSteroidsGABA #PerinataMentalHealth #Zuranolone #EpigeneticBiomarkers

Dr. Gary W. Small, Director of Behavioral Health Breakthrough Therapies at Hackensack Meridian Health and Professor of Psychiatry and Behavioral Health at the Hackensack Meridian School of Medicine, shares decades of clinical and research insight as he discusses the early detection and treatment of age-related cognitive decline. In this episode, he explores the continuum from normal aging to mild cognitive impairment to dementia, the real-world role of biomarkers, the promise and limits of current pharmacologic options, and the lifestyle interventions—especially aerobic exercise—with the strongest data behind them.

For most patients, cognitive decline unfolds gradually rather than suddenly, and the tools we have to detect it have outpaced the clarity of what to do next. Amyloid and tau assays, PET imaging, and APOE genotyping are increasingly available in primary care, but they raise as many questions as they answer, and disclosure can have real psychological consequences. Emerging evidence points to inflammation as a shared mechanism across many forms of decline, with anti-inflammatory drugs, curcumin, Omega-3s, sleep, and exercise all converging on the same target. Dr. Small frames a pragmatic, patient-centered approach: educate, contextualize tests, rule out reversible causes, treat symptomatically and aggressively when appropriate, and above all, move.

🧠 PROTECT, DON’T REPAIR [05:10]:

“It’s easier to protect a healthy brain rather than try to repair damage once it becomes extensive.”

Dr. Small articulates the case for early detection and prevention that has shaped his entire career.

🔬 TREAT THE PERSON, NOT THE SCAN [23:40]:

“You don’t treat a blood test, you treat a person. The good news with some of these early anti-amyloid drugs—the brain scan looks great. The bad news is, you’re going to forget this conversation.”

Dr. Small urges clinicians to resist reflexive, biomarker-driven treatment and instead anchor decisions in symptoms, goals, and risk–benefit conversations.

🏃 ONE RECOMMENDATION ABOVE ALL [44:50]:

“Physical exercise. There’s no question about it. We have the strongest data on it… Get on the treadmill, or even better, get outside and take a brisk walk or jog.”

Asked for a single, universal recommendation for brain health, Dr. Small is unequivocal.

CHAPTERS:

00:00 - Introducing Dr. Gary W. Small

02:20 - From Math to Metaphysics to Medicine

03:30 - Finding a Path into Psychiatry

04:20 - The Road to Geriatric Psychiatry and the Case for Early Detection

06:10 - Defining the Continuum: Normal Aging, MCI, and Dementia

09:00 - Interpreting Cognitive Complaints and the Weight of Information

12:30 - The Biology of Cognitive Decline and the Role of Inflammation

16:00 - What Is Lost When We Wait, and the Curcumin Story

20:20 - The PCP’s Role in Early Intervention and Lifestyle Counseling

22:10 - Biomarkers and Imaging: From Research Tool to Clinical Reality

25:00 - Biomarker vs. Surrogate Marker

27:20 - Differential Diagnosis and the Brain as a Rheostat

29:30 - Pharmacologic Treatment: Symptomatic vs. Disease-Modifying Drugs

32:40 - Lifestyle Modification and the Evidence for Aerobic Exercise

35:40 - Train, Don’t Strain: Exercising the Mind Socially

37:50 - Knowing When to Refer and Building Specialist Relationships

41:00 - Comorbid Conditions and the Whole-Person Approach

42:40 - Looking Ahead: The Next 5–10 Years

44:20 - The Single Best Recommendation: Physical Exercise

45:30 - Closing Thoughts

Links:

Full transcript and show notes: https://www.psychiatrist.com/jcp/ep14-early-detection-cognitive-decline-gary-w-small/

Journal of Clinical Psychiatry: https://www.psychiatrist.com/jcp/

Dr. Gary W. Small: https://www.hmhn.org/find-a-provider

#CognitiveDecline #AlzheimersDisease #GeriatricPsychiatry #BrainHealth

Dr. Roger S. McIntyre, Professor of Psychiatry and Pharmacology at the University of Toronto, shares groundbreaking insights as he discusses the profound connection between metabolism and mental well-being. In this episode, he explores how GLP-1s treat psychiatric illness and common metabolic comorbidities.

The historical reliance on serotonin, norepinephrine, and dopamine models has proven incomplete, and many individuals with psychiatric illness continue to struggle with inadequate care. New science suggests a deeper connection between metabolism and brain health which challenges long-held beliefs about disease causes. Emerging research highlights how metabolic disruptions contribute to mental health conditions, and that GLP-1 drugs offer a path forward as they could treat mental health conditions and common metabolic problems. In essence, they have the potential to bring about profound improvements in mental health and overall well-being.

⚠️ BEYOND NEUROTRANSMITTERS [07:53]:

"For seven decades, we've really been at this altar of serotonin, norepinephrine and dopamine… That paradigm has been remarkably durable… but it's not been fully explanatory. Most people do not benefit adequately from current treatments."

Explaining why traditional models are incomplete, Dr. McIntyre shows how new science offers hope.

💊 COMBAT MEDICATION SIDE EFFECTS [45:34]:

"Clinicians would be certainly on a reasonable evidentiary base of practice if they were prescribing a GLP-1 to target, for example, clozapine-induced weight gain or clozapine-induced diabetes, that would be reasonable."

Dr. McIntyre offers a proven strategy for mitigating adverse effects of psychiatric medications.

🚀 TRANSFORMING LIFESPANS [01:04:30]:

"GLP-1s… have the potential to transform the health span and the lifespan of people living with mental illnesses by targeting on-label considerations today and potentially targeting the underlying pathophysiology of the brain-based disorder tomorrow. So stay tuned."

Revealing the future of mental health, Dr. McIntyre presents a vision that offers new hope for long-term well-being.

CHAPTERS:

00:00 - Why GLP-1 Drugs Are Transforming Mental Health Research

03:08 - The Career Shift That Linked Metabolism and Mood Disorders

06:45 - Moving Beyond Serotonin to Metabolism

13:18 - How GLP-1 Drugs Influence Brain Function and Neuroplasticity

23:40 - Can GLP-1 Medications Reach the Brain? What the Evidence Shows

32:00 - The Four Key Brain-Protective Effects of GLP-1 Therapies

34:54 - How GLP-1 Reduces Cravings, Addiction, and Food Noise

42:18 - When Clinicians Should Prescribe GLP-1s in Psychiatry Today

53:10 - Safety Risks and Drug Interactions Psychiatrists Must Consider

01:00:57 - The Future of Treatments in Psychiatry

01:04:27 - Summing Up GLP-1s and Mental Health

Links:

Full transcript and show notes: https://www.psychiatrist.com/jcp/ep13-emerging-role-glp-1s-psychiatry-roger-s-mcintyre/

Journal of Clinical Psychiatry: psychiatrist.com/jcp/

Dr. Roger S. McIntyre: https://www.linkedin.com/in/roger-mcintyre-976bb167/

#GLP1Drugs #AddictionTreatment #DepressionTreatment #MentalIllnessPrevention

Dr. A. John Rush, renowned for leading the famous STAR*D depression study, addresses a critical challenge in modern psychiatry: while physicians often rely on their clinical intuition to treat complex depression, new data proves this approach has a significant blind spot. Experience alone can miss the full extent of a patient's suffering, leaving crucial progress untracked.

Dr. Rush reveals a system to fix this clinical blind spot using the psychology of clinical measurement. He explains how doctors can implement simple assessment tools to gather objective data, leading to more precise treatment adjustments. This straightforward method gives physicians the power to see what is truly working and can significantly boost patient remission rates.

🎯 BIGGEST LESSON [12:17]:

"By bringing measurement to the bedside, we bring precision and science. The evidence is very clear right now. We make better decisions about what to do with patients."

🎯 OTHER KEY TAKEAWAYS:

⚠️ THE HIDDEN GAP IN PSYCHIATRIC CARE [8:10]:

"We don't know anything about in what order, in what combination, and by what methodology we implement that 'what'."

Dr. Rush explains why knowing a treatment can work is only half the battle. This is the crucial gap between research and real-world results that most clinicians overlook.

✨ WHY 'PROVEN' TREATMENTS FAIL YOUR PATIENTS [20:45]:

"Does this apply to everybody with depression, no matter how they show up? Absolutely not. That's where it really gets very, very interesting because now we're going from efficacy research to effectiveness research."

Learn the critical difference between a treatment working in a controlled trial versus in your complex, real-world patient population.

⚡ THE LAW OF DIMINISHING RETURNS IN DEPRESSION [34:57]:

"The more steps you take, the problem is, the less likely you are to get into remission. So remission rates were like 35% in the first step, 28% in the second step, 15% in the third step, 15% in the fourth step."

Dr. Rush reveals the stark data from the STAR*D study. Use this critical insight to set realistic expectations with patients about the challenges of treatment-resistant depression.

CHAPTERS:

00:00 - Introducing Dr. A. John Rush

02:20 - Why Dr. Rush Chose Psychiatry & a Career in Clinical Research

05:45 - How Cognitive Therapy Shaped Evidence-Based Psychiatry

07:10 - Strategies, Tactics, and the Research Gap

10:59 - Using AI & Clinical Data to Guide Treatment Decisions

18:39 - Why Clinical Trial Results Don't Match Real-World Patients

22:54 - Pragmatic Trials That Reflect Everyday Psychiatric Practice

30:48 - The STAR*D Trial: Sequencing Treatments for Depression

36:32 - Dose Optimization & Long-Term Depression Recovery

39:56 - Building a Learning Healthcare System in Psychiatry

43:48 - Dr. Rush’s Advice for Researchers and Clinicians

Links:

Full transcript and show notes: https://www.psychiatrist.com/jcp/ep12-bridging-research-reality-mental-health-care-a-john-rush

Journal of Clinical Psychiatry: psychiatrist.com/jcp/

Dr. A. John Rush: https://www.linkedin.com/in/a-john-rush-8aa46042/

American Psychiatric Association (APA) Website: https://www.psychiatry.org/psychiatrists/research/registry

#Psychiatry #ClinicalResearch #Depression

Families expect cognitive decline as a normal part of getting older. We watch relatives lose their memories and accept the loss. Past medical trials regarding Alzheimer's disease failed 99 percent of the time, early signs of brain changes were missed, and precious years for early screening and treatment were lost.

But new science changes this reality. Doctors now use blood tests and brain imaging for accurate diagnosis. They prescribe immunotherapy treatments that clear toxic brain plaques and slow cognitive decline by 30 percent. Dr. Marc Agronin shares his exact methods for geriatric psychiatry and dementia care. Learn how early medical intervention stops memory loss as he reveals his new research.

🎯 PRIMARY DISCOVERY[19:51]:

"Someone goes from thinking, ‘I have a terminal disease,’ to ‘I have a manageable disease and I am going to continue to live and do things.’ Their whole mindset changes."

Dr. Agronin reveals the exact medical advancements that give patients their lives back.

🩺 PRACTICE UPGRADE [30:56]:

"We have all sorts of vital signs we check by routine. We need to have a cognitive vital sign that we check, and something like a Mini-Mental, Montreal Cognitive Assessment, something like that is practical to be done in primary care."

Discover how doctors catch memory loss early with simple annual tests.

✨ MEDICAL MILESTONE [46:29]:

"We see over the 18 months of the studies that the rate of decline in terms of both cognition and function is on average about 30 percent slower. And then we know that after 18 months, it is a very slow rate of reaccumulation."

Hear how new monoclonal antibodies melt away brain plaques and stop memory loss.

CHAPTERS:

00:00 - Meet Alzheimer’s Research Leader Dr. Marc Agronin

01:45 - Why a Career in Geriatric Psychiatry and Dementia Care?

06:17 - Why Alzheimer’s Research Is Entering a Breakthrough Era

08:07 - Why Alzheimer’s Disease Is Rising Worldwide

11:04 - How to Explain Alzheimer’s Diagnosis to Patients and Families

16:11 - The Biggest Scientific Breakthroughs in Alzheimer’s Disease

24:30 - How New Biomarker Guidelines Are Changing Alzheimer’s Diagnosis

29:57 - Why Early Screening for Cognitive Decline Matters

36:13 - Brain Health Habits That May Reduce Alzheimer’s Risk

42:50 - Current Alzheimer’s Medications and How They Help Cognition

45:45 - New Anti-Amyloid Treatments That Slow Alzheimer’s Progression

50:01 - Understanding ARIA Side Effects in Alzheimer’s Immunotherapy

54:09 - Emerging Alzheimer’s Treatments and Future Research Directions

01:02:09 - The Role of Empathy and Person-Centered Dementia Care

Links:

Full transcript and show notes: https://www.psychiatrist.com/jcp/ep11-what-clinicians-should-know-about-alzheimers-treatment-marc-agronin/

Journal of Clinical Psychiatry: psychiatrist.com/jcp/

Dr. Marc Agronin: https://www.marcagronin.com/

Figure referenced at 53:35 comes from Figure 1 in the paper “Alzheimer’s Disease Drug Development Pipeline: 2025.”: https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/trc2.70098

#AlzheimersResearch #BrainHealth #GeriatricPsychiatry

Psychiatric hospitals admit patients for severe mental illness and high suicide risk every day. While mental health professionals treat acute suicidality during these intense crises, standard depression medications can take weeks to work. Traditional clinical psychiatry often leaves vulnerable patients in danger after hospital discharge. Medical teams need rapid suicide prevention treatments to help stabilize psychiatric inpatients quickly.

Learn about potential improvements to inpatient suicide care as Dr. Brett Jones, Medical Head of the Bipolar Disorder Clinic at Toronto’s Center for Addiction and Mental Health, reveals the results of his research review into the best evidence-based medical interventions.

🎯 KEY EPISODE HIGHLIGHTS:

🛑 RESEARCH BLINDSPOT [10:25]:

"I think there are a lot of studies out there. I was reading, I was seeing the evidence, but the consensus as to what would be the most effective treatment and for whom really wasn't there."

Hear Dr. Jones explain the massive missing piece in psychiatric care.

🧠 CLINICAL BREAKTHROUGH [23:45]:

"Some of the chronotherapy was something I actually didn't know about. That certainly is a low cost intervention. So that's quite promising if it turns out to be effective."

See how simple sleep treatments change inpatient psychiatry.

🛠️ STRATEGIC ACTION [34:50]:

"We showed a good effect with a digital version of DBT… So we're going to look at trying to replicate that in a multicenter study."

Get the exact details on digital therapy for hospital units.

CHAPTERS:

00:00 - Honoring Dr. Nolan Williams

03:07 - Career Path into Psychiatry and Suicide Research

07:59 - Why Inpatient Suicide Treatment Needs Better Evidence

12:59 - Key Limitations in Suicide Intervention Research

14:57 - Ketamine and Rapid Acting Treatments for Suicidality

19:48 - Emerging Treatments Beyond Traditional Depression Care

25:47 - Translating Research into Real World Inpatient Practice

30:38 - Major Research Gaps and Need for Better Clinical Trials

33:04 - Hospitalization as a Critical Window to Prevent Suicide

37:41 - Up Next: Dr. Marc Agronin

Links:

Full transcript and show notes: https://www.psychiatrist.com/jcp/ep10-inpatient-treatment-suicidality-brett-jones/

Journal of Clinical Psychiatry: psychiatrist.com/jcp/

Inpatient Treatment of Suicidality: A Systematic Review of Clinical Trials:

https://pubmed.ncbi.nlm.nih.gov/39832343/

Dr. Brett Jones: https://www.linkedin.com/in/brett-jones-1b308260/?originalSubdomain=ca

Center for Addiction and Mental Health: https://www.camh.ca

University of Toronto Psychiatry: https://psychiatry.utoronto.ca

#AcuteSuicidality #InpatientPsychiatry #ClinicalResearch

Feeling tired despite a full night's sleep? The problem may not be the hours you get, but the quality of your breathing. According to sleep medicine expert and founding physician of SLIIIP, Dr. Avinesh Bhar, many people dismiss fatigue, snoring, or frequent waking, using caffeine and over-the-counter aids to cope.

This masks a deeper problem. Undiagnosed sleep-disordered breathing, like sleep apnea, is a silent driver of serious health issues, from heart disease to mental health conditions. Ignoring the root cause makes other medical treatments less effective, creating a cycle of declining health. 90% of people with mental health conditions also struggle with sleep issues. Getting help is easy at SLIIIP.com. No travel required. Insurance accepted.

🎯 KEY EPISODE TAKEAWAYS:

⚠️ THE SURVIVAL MODE TRAP [08:49]:

"If you don't sleep well, your whole day changes in perspective. You are in survival mode, and you can't be your best self. You can't perform."

Are you just surviving instead of thriving? Watch this segment to understand the biological cost of poor sleep and why feeling "just okay" is a major red flag for your health.

✨ THE MENTAL HEALTH BREAKTHROUGH [29:24]:

"If you're a therapist or psychiatrist managing mental health, you should also make sure the sleep is evaluated…otherwise, your improvements in mental health aren't going to reach the level that actually makes the patient feel like they've actually turned the corner.”

Unlock better patient outcomes. See how integrating a sleep evaluation can be the missing piece in treating depression, anxiety, and PTSD effectively.

⚡️ THE 2-QUESTION DIAGNOSTIC [59:40]:

"'Are you sleeping well? Are you waking up refreshed?' If you have a 'no' to either one of those questions, the patient needs an evaluation."

This is the simple, powerful framework you need. Listen to this section to learn the exact questions that tell you if it's time to refer a patient (or yourself) to a sleep specialist and how easy it is via www.sliiip.com. SLIIIP is making advanced sleep care fast & convenient, offering patients same week appointments with board-certified sleep medicine physicians instead of the months‑long wait typical of traditional sleep labs.

CHAPTERS:

00:00 - Introducing Dr. Avi Bhar

03:48 - From ICU to Sleep Medicine and What Clinicians Miss

06:52 - What Sleep Does Biologically and Why Quality Beats Hours

13:23 - Sleep Myths That Keep You Sick and Tired

16:24 - Sleep Hygiene That Works

19:54 - When to Suspect a Real Sleep Disorder Beyond Stress

23:00 - How Sleep Apnea Drives Heart, Metabolic, and Inflammatory Disease

27:51 - Sleep and Psychiatry

30:35 - Solving Access With Home Sleep Tests and Step-Based Care

39:33 - The Ideal Telemedicine Sleep Care Pathway

48:28 - Stop Masking Sleep Problems With OTC Aids and Melatonin

52:33 - When to Retest and How Treatment Lowers Long-Term Healthcare Costs

1:01:03 - Up Next: Dr. Brett Jones

Key Takeaways:

"Sleep is a reparative opportunity. It heals and repairs the trauma of the day. It's essential, not optional."

"Quality and quantity of sleep matter. Sleeping 7-8 hours is good, but waking refreshed is key."

"Sleep disturbances don't just coexist with illnesses; they can drive medical and psychiatric morbidity."

"Evaluate sleep in patients with mental health issues. It's both a driver and symptom of psychiatric illness."

"Speed and efficiency in sleep evaluation are crucial. It reflects the urgency and importance of the issue."

Links:

Full transcript and show notes: https://www.psychiatrist.com/jcp/ep9-sleep-issues-psychiatric-practice-avinesh-bhar/

Journal of Clinical Psychiatry: psychiatrist.com/jcp/

SLIIIP: https://sliiip.com/

#SleepApnea #MentalHealth #SleepDisorders

Ben welcomes psychiatrist Dr. Mike Halassa back to the podcast to discuss the shifting landscape of inpatient schizophrenia treatment. An early adopter of Cobenfy, Dr. Halassa shares real-world insights from his research published in Nature Mental Health in this conversation that bridges technical neuroscience with the high-stakes reality of managing acute psychiatric crises.

The discussion focuses on Cobenfy’s muscarinic mechanism, the first novel approach to psychosis in seventy years. Dr. Halassa details his "dose-sparing" strategy, reducing reliance on traditional D2 blockers and their metabolic burdens, and he shares case studies of treatment-resistant patients who succeeded on this agent after clozapine failed. Finally, Ben and Dr. Halassa explore functional recovery, precision psychiatry, and the empathic connection required to treat society's most vulnerable individuals.

Episode Highlights:

00:00 - Welcoming Back Dr. Mike Halassa

01:46 - ‘Spending a Day in Someone Else’s Brain’

04:21 - Empathy, Parenting, and Staying Grounded in Psychiatry

06:37 - Why Inpatient Psychiatry Works: Acuity, Speed, and Team-Based Care

09:31 - Evaluating Acute Psychosis: Intake, Chronicity, and Treatment Decisions

12:46 - Discovering XT as the First Novel Schizophrenia Mechanism in Decades

16:19 - A Remarkable XT Case Study

23:26 - XT Dosing Tolerability and Early Clinical Results

30:15 - From Observation to Evidence: Identifying XT Response Patterns

35:12 - Testing Negative Symptoms in Real Time on the Inpatient Unit

40:33 - XT vs D2 Blockers for Positive and Negative Symptom Control

50:28 - Redefining Success in Schizophrenia Through Functional Recovery

54:15 - The Future of Precision Psychiatry and Treating the Whole Person

56:42 - Up Next: Dr. Avi Bhar

Key Takeaways:

"Inpatient psychiatry demands quick thinking and rapid decisions. It's a critical care type environment."

"I find my kids keep me grounded and empathetic. They're my window into empathy."

"XT offers a fundamentally different way of engaging the system. It's not just another antipsychotic."

"Seeing patients become more socially connected on XT is remarkable. It's a new light in their eyes."

"Negative symptoms have been intractable. XT offers hope for functional recovery."

"The multidisciplinary team is crucial in schizophrenia care. It requires coordination and dedication."

"XT allows for dose sparing of traditional antipsychotics, potentially reducing side effects."

"We must aspire to help patients engage with life fully, beyond just managing symptoms."

Links:

Full transcript and show notes: https://www.psychiatrist.com/jcp/ep8-early-use-xanomeline-trospium-michael-halassa/

Journal of Clinical Psychiatry: psychiatrist.com/jcp/

Dr. Halassa’s Substack: michaelhalassa.substack.com

The Halassa Lab: https://halassalab.tufts.edu/

Preliminary real-world predictors of response to muscarinic targeting in psychosis: https://www.nature.com/articles/s44220-025-00529-w

Real-World Implementation of Xanomeline-Trospium in Schizophrenia: A Consensus Panel Report: https://pubmed.ncbi.nlm.nih.gov/41201439/

Host Ben Everett sits down with Tufts University physician-scientist Dr. Michael Halassa to discuss algorithmic circuit psychiatry. This framework aims to modernize mental health care by mapping subjective experiences onto objective neural computations. By shifting focus to brain circuit mechanics, they explore a new paradigm for treating complex psychotic disorders. This conversation redefines psychiatry as a data-driven, precision-oriented field of medicine.

The episode moves beyond the "chemical imbalance" theory to examine the dynamics of excitation and inhibition. Dr. Halassa explains how large language models and machine learning provide new test beds for analyzing reasoning and belief updating, and that, by using "behavioral clamps" and task-based biomarkers, researchers can now operationalize delusions through the study of counterfactual decision-making. He also notes that causal circuit validation in animal models remains essential for identifying precise drug targets and improving clinical outcomes. The discussion finishes up by touching on emerging muscarinic therapies and the future of psychiatric training.

Episode Highlights:

00:00 – Why Algorithmic Circuit Psychiatry Could Modernize Mental Health Care

02:36 – From Physics to Psychiatry: Building a Scientist-Clinician Lens

05:52 – Decoding Brain Circuits With Computational Models and Modern Tools

10:37 – Returning to Inpatient Psychosis Care and Reframing Clinical Reality

14:47 – Moving Beyond “Chemical Imbalance” Thinking in Schizophrenia Treatment

20:43 – Fixing Computational Psychiatry Limits With Mechanistic, Circuit-Based Models

25:08 – Creating Task-Based Biomarkers to Measure Belief Updating and Reasoning

29:10 – Operationalizing Delusions Through Counterfactual and Decision-Making Tasks

33:59 – Translating Algorithms Into Drug Targets and Better Animal Research

37:54 – Using LLMs and Machine Learning to Test Psychiatric Mechanisms In Silico

44:57 – Redesigning Animal Models to Validate Causal Brain Circuit Algorithms

53:03 – Training the Next Generation for Precision Psychiatry

56:44 – Defining Clinical and Scientific Milestones for the Future of Mental Health Care

Key Takeaways:

"Psychiatry feels different from other fields. We don't have biomarkers to guide decision making."

"The brain functions in packets of information sent between areas. It's more complex than a single synapse."

"In psychiatry, you absolutely need a behavioral clamp. It's not just about resting state measurements."

"Machine learning was inspired by neuroscience. Now, it helps us understand altered thinking in machines."

"The burden is on us to train the next generation to tackle psychiatry's complexity."

"Talking to patients like equals is my default. We're all vulnerable to mental illness."

"Mental health is sidetracked by societal issues. We must agree we're all human beings."

Links:

Full transcript and show notes: https://www.psychiatrist.com/jcp/ep7-algorithmic-psychiatry-michael-halassa/

Journal of Clinical Psychiatry: psychiatrist.com/jcp/

“Developing algorithmic psychiatry via multi-level spanning computational models”:

https://pubmed.ncbi.nlm.nih.gov/40300598/

Dr. Halassa’s Substack: michaelhalassa.substack.com

The Halassa Lab: https://halassalab.tufts.edu/

Dr. David Feifel, Professor Emeritus of Psychiatry at UC San Diego and founding president of the Kadima Neuropsychiatry Institute, joins the JCP Podcast to kick off the new "Psychedelics in Psychiatry" theme. A pioneer in the field who established the world’s first ketamine infusion program for depression, Dr. Feifel sits down to discuss the paradigm shift currently reshaping mental health care.

In this installment of the Behind the Manuscript series, Dr. Feifel breaks down the findings of his recent JCP paper: “Results From a Long-Term Observational Follow-Up Study of a Single Dose of Psilocybin for a Treatment-Resistant Depression”. He explains the significance of the 25mg dose in preventing relapse over 52 weeks and offers a critical look at why traditional SSRIs are no longer enough. Beyond the data, the conversation delves into the nuances of "set and setting," the controversy of microdosing versus "heroic" doses, and the practical challenges clinicians face as the field moves toward interventional psychiatry. Dr. Feifel also challenges the traditional medical view of the placebo effect, arguing that harnessing expectation may be the key to the next generation of healing.

Episode Highlights:

00:00 - Dr. David Feifel and His Breakthrough Career

02:13 - How Early Curiosity Led to Psychiatry Instead of Neurology

07:33 - Balancing Clinical Practice With Research Innovation

11:41 - Psychiatry Entering a Transformational New Era

13:51 - Why SSRIs Fall Short and TRD Demands Better Solutions

17:27 - What Makes Psilocybin the Leading Psychedelic Candidate

20:25 - Why the Psychedelic Renaissance Is Surging Now

25:42 - Microdosing Myths and the Power of Expectancy

33:55 - How Set and Setting Shape Psychedelic Treatment Outcomes

39:51 - Do Psychedelics Really Need Psychotherapy to Work

48:58 - Inside the Phase 2 Study and How TRD Patients Were Enrolled

56:04 - Why 25mg Psilocybin Delivered the Strongest Clinical Results

1:05:39 - What Long-Term Follow Up Reveals About Relapse and Durability

1:11:38 - How Clinicians Can Prepare for Psychedelic Medicine Adoption

1:16:53 - Why the Future of Psychiatry May Rely on Harnessing Placebo Power

Key Takeaways:

"Psychiatry is in the midst of a golden age revolution... I feel like every day I was going to war with Godzilla with a peashooter. Now I feel like we've got some real tools."

"We’re in the midst of what I call the Cambrian explosion of treatments... a massive explosion of life forms after a long time of stagnation."

"The concept of 'one and done' with psychedelics is dead. We aren't going to have patients come in one time and say, 'You're good for life.'"

"Doing ketamine is like doing psychotherapy, but you're both the psychotherapist and the patient at the same time."

Links:

Full transcript and show notes: https://www.psychiatrist.com/jcp/ep6-psychedelic-renaissance-david-feifel/

Journal of Clinical Psychiatry: http://psychiatrist.com/jcp/

Dr. David Feifel: https://www.linkedin.com/in/davidfeifel/

Kadima Neuropsychiatry Institute: https://www.kadimanp.com/

“Results From a Long-Term Observational Follow-Up Study of a Single Dose of Psilocybin for a Treatment-Resistant Episode of Major Depressive Disorder”:

https://www.psychiatrist.com/jcp/long-term-follow-up-study-single-dose-psilocybin-treatment-resistant-episode-major-depressive-disorder/

Dr. Michael Asbach, Associate Director of Interventional Psychiatry at the DENT Neurological Institute and a nationally recognized educator, joins The JCP Podcast to discuss the critical and expanding role of Advanced Practice Practitioners (APPs) in behavioral health. With a background that spans from sports medicine to leading interventional psychiatric programs, Dr. Asbach offers a unique perspective on how the medical model training of Physician Assistants (PAs) uniquely positions them to address the growing psychiatric workforce shortage.

In a nuanced discussion, Dr. Asbach tackles the headlines and controversies surrounding the profession, including the recent British Medical Journal rapid review and the UK’s "Leng Report." He dismantles the concept of "scope creep," arguing instead for a model of "autonomous collaboration" that respects physician expertise while maximizing patient access. From the history of PAs emerging after the Vietnam War to the modern "Build, Baby, Build" approach to healthcare staffing, this episode provides a roadmap for how interdisciplinary teams can alleviate burnout and improve outcomes in the golden age of biologic psychiatry.

Episode Highlights:

00:00 – JCP Podcast Kickoff and Introduction to Dr. Asbach

01:34 – Expanding PA Engagement and Education in Psychiatry

03:22 – Career Origins and Choosing the PA Path Over Medicine

05:11 – Discovering Psychiatry and the Appeal of Interventional Innovation

08:46 – Mentorship, Research Culture, and Advancing Psychiatric Treatment

12:28 – Understanding PA Training Models and Evolving Clinical Competency

16:44 – Addressing Psychiatry Workforce Shortages Through Advanced Practitioners

20:36 – Evaluating PA Outcomes and Challenges in Measuring Quality of Care

29:24 – Rethinking Workforce Assumptions and Challenging Medical Dogma

32:37 – Regulation, Role Clarity, and Key Takeaways from the Leng Report

41:25 – Navigating Scope Creep Concerns and Physician Training Protection

47:51 – Building Effective Interdisciplinary Psychiatric Care Teams

56:44 – Supervision Ratios, Access Disruption, and Real-World Patient Impact

1:00:04 – Burnout, Non-Clinical Career Paths, and Retaining Expert Clinicians

1:08:09 – Future of Advanced Practice Providers and Closing Reflections

Key Takeaways:

"I think the future of advanced practice providers is going to be one that is collaborative, autonomous, and interdisciplinary."

"We are blessed to be able to play such an important role in people's lives... and have this front row seat to their life longitudinally."

"I’m very much a ‘build, baby, build’ approach to housing... Healthcare is very similar where the more people that we bring in as helpers, the better."

"Psychiatry is... in this golden era of kind of firmly returning back to biologic origin... and the PA medical model means that PAs have taken pathophysiology, gross anatomy, fundamentals of medicine."

"The absence of evidence is not the evidence of absence."

"It’s not about replacing physicians... but rather adjusting regulations to reflect the modern healthcare environment."

Links:

Journal of Clinical Psychiatry: psychiatrist.com/jcp/

Michael Asbach: https://www.dentinstitute.com/michael-asbach/

White Coats of the Round Table: https://healthpodcastnetwork.com/show/white-coats-of-the-round-table/

Fluctuating ADHD Across the Lifespan with Margaret Sibley, PhD

Dr. Margaret Sibley, Professor of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine and a clinical psychologist at Seattle Children’s Hospital, joins The JCP Podcast to discuss the evolving understanding of the trajectory of ADHD across the lifespan. The recipient of the 2024 Paul Wender Best Paper Award, Dr. Sibley shares her journey from political science to clinical psychology and offers a behind-the-scenes look at the landmark Multimodal Treatment of ADHD (MTA) study.

Challenging the traditional binary view of ADHD persistence versus remission, Dr. Sibley details the findings of her award-winning paper, revealing that for the majority of patients, ADHD follows a fluctuating course into adulthood rather than a static one. The conversation explores the critical role of "environmental fit," the complex interplay between anxiety and symptom management, and the distinct clinical profiles of those with persistent versus fluctuating ADHD. Today’s thoroughly enlightening episode offers vital nuances on how patient environments and comorbidities shape long-term outcomes beyond childhood diagnosis.

Episode Highlights:

00:00 – Introducing Dr. Margaret Sibley and the Paul Wender Best Paper Award

02:41 – From Political Science to Psychology: A path to public health

04:55 – The importance of engaging with patient advocacy groups like CHADD

08:06 – A historical look at the Multimodal Treatment of ADHD (MTA) study

11:59 – Why childhood treatment doesn't always predict adult outcomes

20:17 – Challenging the myth of permanent remission vs. persistence

24:53 – Defining the "Fluctuator": The most common ADHD profile

28:15 – The "Gas and Brakes" analogy: The role of comorbid anxiety

29:48 – Understanding comorbidities in severe, persistent ADHD

31:45 – Clinical Pearls: Environmental fit and rising to the occasion

34:09 – What’s next for the MTA study

Key Takeaways:

"The fluctuators are really kind of like your bread and butter people with ADHD."

"We should be thinking about environmental fit as a potential way to help people manage their ADHD better.”

"Make sure that you read the Reddit threads about what people are saying that have a condition that you're working with."

"Most people were looking at persistence as a finality, a single outcome... But it seems very dynamic."

"The persistent ADHD group have many more comorbidities... and are much more impaired in their daily lives. And so this is sort of our severe ADHD profile.”

"People do better in behavior therapy for ADHD if they have comorbid anxiety."

"Parental psychopathology was a strong predictor of being in that 10% stable ADHD group."

"When environmental demands were higher, people were more likely to be experiencing remission."

“Make sure that you go out there and try to be non-judgmental about the lenses people see aspects of mental health through, even if it's different than what you were trained in or even what the science says.”

Links:

1. Journal of Clinical Psychiatry: psychiatrist.com/jcp/
2. Dr. Margaret Sibley: https://www.margaretsibley.com/
3. Dr. Sibley’s Award-Winning Paper: https://www.psychiatrist.com/jcp/fluctuating-adhd-multimodal-treatment-of-adhd-mta-study/

Dr. Stephen Brannan brings decades of experience from both academic psychiatry and leadership roles at top pharmaceutical companies to the JCP Podcast today. He details his transition from university research to industry, offering a candid look at the forces that drive innovation in mental health care. 

Dr. Brannan unpacks the complex process of bringing a new drug to market, using his work on treatments like Cobenfy (xanomeline-trospium) as a case study. The discussion covers the critical decisions in clinical trial design, from selecting the right patient populations to establishing meaningful endpoints that satisfy both regulatory bodies and clinical needs. He also addresses some of the most persistent hurdles in psychiatric research including the high placebo response rates that can obscure a drug's true efficacy and the operational complexities of running large, multinational studies. For clinicians seeking to better understand the evidence behind new medications, Dr. Brannan’s insights provide a unique level of enlightenment in the pragmatism, science, and collaboration required to advance patient care.

Episode Highlights:

00:00 - Introducing Dr. Stephen Brannan

01:56 - From Pre-Med Doubts to a Career in Psychiatry

06:51 - The "Push and Pull" from Academia to Industry

08:50 - Advice for Young Psychiatrists Considering Industry

10:56 - Pitfalls and Misconceptions of Pharmaceutical Work

14:37 - Balancing Real-World Applicability and Regulatory Realities

20:40 - The Science and Strategy Behind Cobenfy

22:10 - Understanding and Mitigating the Placebo Effect

28:57 - The Role of Expert Steering Committees

32:38 - Designing Trials

42:37 - The Nuances of Safety Surveillance in Clinical Trials

53:27 - Reflections on the Future of Psychiatric Treatment

Key Takeaways:

"I will not sacrifice quality for the sake of speed."

"I've learned how to talk with people rather than just sort of barking an order."

"We're a hell of a lot more alike than we're different."

"The better we understand that and we're able to pick treatments based on biomarkers...that's going to make a huge impact."

"That's extremely useful in psychiatry because it's rare when you first see somebody...you absolutely know what's going on. It usually takes time and patience and a tolerance for ambiguity."

"You also want to be able to talk to people who will tell you what's wrong with your thinking."

"You want your beachhead. And your beachhead is...what's the best segment of patients?"

Links: 

• Full transcript and show notes: https://www.psychiatrist.com/jcp/ep3-academia-to-pharma-stephen-brannan
• Journal of Clinical Psychiatry: psychiatrist.com/jcp/ 
• Dr. Stephen Brannan: https://www.linkedin.com/in/steve-brannan-b7376019/

Dr. Joseph Goldberg, Clinical Professor at the Icahn School of Medicine at Mount Sinai and immediate past president of the American Society of Clinical Psychopharmacology (ASCP), shares insights from his remarkable career, from his beginnings in neuroscience to his influential leadership roles. Along the way, he explores the future of mental health, focusing on mentorship, innovative education, and translating research into patient-centered care.

Throughout the episode, Dr. Goldberg recounts his unique journey into psychiatry, which began with studying frogs and led to a focus on bipolar disorder. He offers an insider’s view of the ASCP, detailing initiatives from his presidency, including task forces on ketamine and de-prescribing. A key highlight is ASCP’s revolutionary AI-enhanced "living textbook," a new approach to medical education designed to transform how clinicians learn about psychopharmacology, ensuring the latest knowledge is always accessible.

Episode Highlights:

00:00 - Introducing Dr. Joseph Goldberg, MD

01:13 - From Frogs to Psychiatry: A Scientist’s Origin Story

02:51 - Why Bipolar Became the Focus: Early Pharmacology Momentum

04:20 - ASCP’s Patient-Centered Mission & Why It Became “Home”

05:08 - Mentorship Pipeline: NCDEU Roots and Career Breaks

08:10 - Leadership Model in Action & New President Anita Clayton

11:17 - ASCP Task Forces: Ketamine/Esketamine and Deprescribing Guidance

14:13 - CME 2.0 & AI “Living Textbook” (edYOU) for Psychopharm Education

18:43 - Limbic Learning & Nasrallah Award: Make Education Stick

20:18 - Early-Career Lift: Posters, Committees, New Investigator Awards

23:18 - What’s Next in Psychopharm: Tangible Advances for Patients

25:44 - ASCP × JCP Synergy & Membership Call to Action

27:40 - Looking Ahead: Bridging Bench to Bedside with Future Guests

Key Takeaways:

"The frogs brought me to med school, brought me to research in psychiatry and psychopharmacology, and, well, here I am today."

"ASCP has always been my professional home, intellectually, scientifically, even socially."

"It's really about the pragmatic translation of findings into clinical care, which just really spoke to my interest in the kind of 'so what' factor of what it is we do."

"It's a living textbook in psychopharmacology, so it can be continually updated. We hope it's going to revolutionize the way we teach psychopharmacology."

"Steve and I both call this 'limbic learning.' You remember things when they're presented in an impactful kind of way. It's almost like PTSD in reverse."

"We live in a time and an era of true advances. We have things in our pharmacopeia now that did not exist 5 years ago."

"This is a home. This is a place where I think you will find like-minded people. You'll make friends for life."

"If you interact with ASCP or JCP, you will not ask the question, 'What does this have to do with my patients?'"

Links: 

• Full transcript and show notes: https://www.psychiatrist.com/jcp/ep2-clinical-psychopharmacology-joe-goldberg/ 
• Journal of Clinical Psychiatry: psychiatrist.com/jcp/ 
• Dr. Joseph Goldberg, MD: https://www.josephgoldbergmd.com/
• American Society of Clinical Psychopharmacology: https://ascpp.org/

In its inaugural episode, the JCP Podcast features a foundational conversation with Dr. Marlene Freeman, Editor-in-Chief of The Journal of Clinical Psychiatry, in which she discusses the journal's core mission to empower busy mental health professionals with cutting-edge, evidence-based research. Providing insights into academic publishing, from the peer review process to the journal's vision for psychiatric education, today’s discussion offers essential listening for those at the intersection of clinical practice and scientific discovery.

Dr. Freeman details her professional journey into women's mental health and perinatal psychiatry, and goes on to explore how the journal balances scientific rigor with clinical relevance to support shared decision-making in patient care. Navigating the complex publication landscape, the episode addresses industry-sponsored studies, the importance of diverse voices, and emerging trends like digital therapeutics, biomarkers, and the potential impact of artificial intelligence on psychiatric research. 

Episode Highlights:

00:00 - JCP Podcast Mission for Busy Clinicians

00:37 - Introducing Dr. Marlene Freeman, Editor-in-Chief

02:36 - Choosing Psychiatry for Patient-Centered Impact

04:19 - JCP’s Purpose: Clinician-Ready, Evidence-Based Guidance

08:03 - Faster Access to Research: Summaries, Email TOCs, Podcasts, Specialty Sections

11:33 - Shared Decision-Making in Practice & ASCP Corner Quick Reviews

15:11 - What JCP Publishes & How Peer Review Ensures Clinical Quality

25:11 - Promoting Diversity, Inclusion, and Ethical Publication Standards

27:00 - Emerging Priorities: Novel Treatments, TRD, and Real-World Effectiveness

30:24 - Digital Therapeutics & Biomarkers Must Prove Clinical Utility

36:02 - AI in Publishing: Verify References and Read Full Papers

40:00 - Clinician-First Perspective: Practice Informs Editing & Research

42:03 - Editorial Impact and Evolving Ethical Responsibilities

45:18 - Reflections on Leadership, Legacy, and Lifelong Learning

Key Takeaways:

"I really want to emphasize that a rejection of a paper doesn't mean it isn't high quality."

"We want to be user-friendly to authors. We want to save them time. So if we're not a good fit for their paper, I'm very comfortable looking at whatever people want to send me in advance."

"We want to make sure that we're making collaborative decisions with patients, but we have to make sure that we're offering good choices."

"The work could not be done without peer reviewers."

"You get so much out of reading the full paper. The introduction section is like a mini review of that topic and gives you so much more information."

"We want to make sure that what we're putting out there is not a result of the financial investment that a company has made. We want it to be based purely on the research and what it has to add for patients."

"We want to make sure that we are providing treatments that everyone can access."

"I think that all the roles inform each other, but at the heart of it, I'm a clinician."

Links: 

• Full transcript and show notes: psychiatrist.com/jcp/ep1-mission-jcp-marlene-freeman 
• Journal of Clinical Psychiatry: psychiatrist.com/jcp/ 
• Interested in becoming a peer reviewer? psychiatrist.com/jcp/reviewers/ 

The Journal of Clinical Psychiatry Podcast explores the science, practice, and human side of mental health care. Hosted by Dr. Ben Everett, Senior Scientific Director at Physicians Postgraduate Press, the series brings together leading voices in psychiatry, neuroscience, and behavioral medicine to discuss the evidence shaping clinical care today.

Each episode features thoughtful conversations with JCP authors, academic experts, and frontline clinicians exploring disorders across the mental health continuum, from schizophrenia and mood disorders to anxiety, depression, and sleep-related conditions. By bridging research and real-world practice, the podcast delivers insights that empower psychiatrists, nurse practitioners, physician associates, and primary care clinicians to deliver better care for patients with mental illness.

Insightful. Evidence-based. Human-centered.