Psychofarm Podcast

Dive deep into the practicalities of psychiatric medication management for PTSD in this clinical discussion. We explore the often limited evidence base and the necessity of off-label prescribing, focusing on strategies for stabilization, safety, and trust the first stage of trauma treatment. Learn about experience-based approaches using SSRIs like sertraline, sleep aids such as trazodone and gabapentin, the cautious use of antipsychotics, and why benzodiazepines are discouraged. The conversation also touches on managing sleep disturbances and dissociation, situating medication as a supportive tool alongside essential psychotherapy and lifestyle changes, guided by principles like Pierre Janet's three-stage model.

Join us for an in-depth exploration of trauma and Post-Traumatic Stress Disorder (PTSD). This episode moves beyond common language to establish a clinical definition of trauma, detailing the DSM-5 criteria required for a PTSD diagnosis. The hosts break down the core PTSD symptom clusters – intrusion, avoidance, negative alterations in cognitions/mood, and arousal/reactivity – providing clear examples like flashbacks, hypervigilance, and negative self-beliefs. They delve into the concept of dissociation, its role in trauma, and the challenges it presents in assessment. Listeners will gain crucial insights into the diagnostic process, common misdiagnoses (like mistaking PTSD for depression), the vital importance of earning therapeutic trust, and effective interviewing techniques for sensitive topics, ultimately highlighting why accurate identification is key to recovery.

This conversation explores key aspects of forensic psychiatry, including the insanity defense, dissimulating patients, and how clinical practice intersects with legal systems. It highlights the importance of open-ended dialogue, nuanced diagnosis, and maintaining empathy without succumbing to cynicism.

Join us in a conversation about involuntary commitment, and the legal framework behind psychiatric treatment. We discuss real-world scenarios, share insights into how clinicians juggle patient autonomy versus societal protection. Whether you are new to the field or a seasoned professional, this episode offers valuable perspectives on balancing ethical duties, legal obligations, and patient care.

In this episode, we sit down with Dr. Chris Aiken to look at a big question: when do we treat an underlying deficit in psychiatric illness? Focusing on difficult-to-treat depression, our conversation delves into the deficit model and looks at different paradigms, from neuroprotective strategies and lifestyle interventions to the nuanced use of medications like SSRIs, lithium, and thyroid hormones, as well as targeted supplements. Tune in for a thought-provoking discussion that looks at when we approach treating depression by focusing on its underlying causes.

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