The Ghaemi Psychiatry Podcast

Ketamine and psychedelics are getting a lot of hype, but they won't live up to it. This episode explains why, the main reason being that these treatments are just symptomatic, like tylenol or aspirin, and not disease-modifying. They thus don't have long-term benefits. They are like super-tylenol, which is not transformative for psychiatry.

In this podcast, I reply to some reactions on Twitter and by email to my prior podcast on the invalidity of adult ADD.

Adult ADD is diagnosed frequently, but this podcast describes how it really represents other conditions, like mood or anxiety states or mood temperaments, or how it reflects normal inattention.  

For further reading, see:  https://psychiatryletter.com/adult-add/

Some of the cited articles are linked in that reading. All the sources also are referenced in SN Ghaemi, Clinical Psychopharmacology, Oxford University Press, 2019 in a detailed appendix chapter on ADD in children and adults. 

For further general reading and links to webinars and other educational materials, go to www.psychiatryletter.com

The serotonin hypothesis of depression is false and it really doesn't matter much.  The "chemical imbalance" approach to understanding and explaining medications if far too simplistic, to the point of simply being false. 

DSM is the diagnostic system of psychiatry, currently in its 5th revision. This podcast discusses why it is mostly false scientifically, and why it is important to change it. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799243/

https://journals.sagepub.com/doi/10.1177/0004867413519504

https://www.psychiatrictimes.com/view/requiem-dsm

https://www.psychologytoday.com/us/blog/mood-swings/201301/dsm-5-if-you-dont-the-effects-look-the-causes

Chronic traumatic encephalopathy (CTE) is an illness that occurs with concussions and subconcussive impacts, leading to depression, manic symptoms, anger, aggression, suicidality, headaches, cognitive impairment, and eventually dementia.  I have proposed that lithium can treat or prevent CTE. In this episode, I explain why and interview Jim Scarborough, who describes his family's struggle with CTE in their son and his decision to begin lithium treatment. 

https://pubmed.ncbi.nlm.nih.gov/30748078/

I discuss my recent article defining psychiatric drugs in two categories: those that improve symptoms and those that affect the underlying disease process. Most psychiatric drugs are symptomatic, and not disease-modifying, and thus should be used less and short-term, in my view. Disease modifying drugs should be used more and long-term. They include lithium and other mood stabilizers.  

The article has generated some discussion on the internet, including some claims with which I don't agree. 

The podcast describes and clarifies the concept. 

The article can be found here:

https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.13459

I discuss my perspective that the diagnosis of ADD, in children and adults, is not scientifically valid, and give reasons why. I also explain that amphetamines, including methylphenidate (Ritalin, Adderall, which is an amphetamine), are biologically harmful to the brain and have other harms. Sources for this podcast are below:

SN Ghaemi, Clinical Psychopharmacology, Oxford University Press, 2019 - see appendix on ADD

https://www.psychiatryletter.net/education/adderall-amphetamines

https://www.psychiatryletter.net/education/adult-adhd-misconceptions

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2522749

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/1378851

https://www.jneuropsychiatry.org/peer-review/adult-adhd-and-amphetamines-a-new-paradigm-neuropsychiatry.pdf

https://pubmed.ncbi.nlm.nih.gov/18052572/

https://www.mdedge.com/psychiatry/article/24418/pediatrics/stimulant-use-adhd-bipolar-discouraged-expert-mood-disorders

https://journals.lww.com/hrpjournal/fulltext/2020/03000/approach_to_evaluating_and_managing_adult.3.aspx

Recently the country musician Naomi Judd, who had been open about years of severe mood illness, died by suicide. Suicide rates are increasing, yet a simple proven solution is being ignored: Lithium, the only drug proven to prevent suicide. Listen to learn more. 

Sources mentioned:

https://pubmed.ncbi.nlm.nih.gov/24919696/

https://www.bmj.com/content/346/bmj.f3646.full.pdf+html

https://pubmed.ncbi.nlm.nih.gov/34787653/

Do serotonin reuptake inhibitors (SRIs) increase the risk of suicide? Why do child psychiatrists keep prescribing them despite a FDA black box warning? A recent New Yorker article highlights the problem of teen suicide, but it missed the key treatment mistakes. 

Sources cited:

https://www.newyorker.com/magazine/2022/04/11/the-mystifying-rise-of-child-suicide

https://pubmed.ncbi.nlm.nih.gov/16520440/

What is depression? How can you tell when it's an illness, or needs medication treatment, and when it isn't an illness, or needs psychotherapy? 

Source:

https://pubmed.ncbi.nlm.nih.gov/22370491/

Welcome. In this first episode, I tell you a little about my background and begin with a discussion of some basic ideas about psychiatry, such as when to use medications and when to use psychotherapies. Join us for this first episode, and stick around for future ones!