PsychEd: Educational Psychiatry Podcast

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of extrapyramidal symptoms.
Hosts:
Jo Kikukawa (MS2)
Dr. Matthew Cho (PGY1)
Sena Gok (Scientist)
Audio Editing: Dr. Matthew Cho (PGY1)
References:
Dayalu, P., & Chou, K. L. (2008). Antipsychotic-induced extrapyramidal symptoms and their management. Expert Opinion on Pharmacotherapy, 9(9), 1451–1462. https://doi.org/10.1517/14656566.9.9.1451
Drake, R. E., & Ehrlich, J. (1985).Suicide attempts associated with akathisia. American Journal of Psychiatry, 142(4), 499–501. https://doi.org/10.1176/ajp.142.4.499
Pringsheim, T., Gardner, D., Addington, D., Martino, D., Morgante, F., Ricciardi, L., Poole, N., Remington, G., Edwards, M., Carson, A., & Barnes, T. R. E. (2018). The assessment and treatment of antipsychotic-induced akathisia. Canadian Journal of Psychiatry, 63(11), 719–729. https://doi.org/10.1177/0706743718760288
Poyurovsky, M., Pashinian, A., Weizman, R., Fuchs, C., & Weizman, A. (2006). Low-dose mirtazapine: A new option in the treatment of antipsychotic-induced akathisia. A randomized, double-blind, placebo- and propranolol-controlled trial. Biological Psychiatry, 59(11), 1071–1077. https://doi.org/10.1016/j.biopsych.2005.11.004
Links to Scales Featured in Episode:
https://simpleandpractical.com/wp-content/uploads/2014/09/Barnes-Akathisia-Rating-Scale-BARS.pdf
https://www.psychdb.com/_media/meds/antipsychotics/sas_simpson_angus_scale_modified.pdf
https://www.ohsu.edu/sites/default/files/2019-10/%28AIMS%29%20Abnormal%20Involuntary%20Movement%20Scale.pdf
For more PsychEd, follow us on Instagram (⁠⁠⁠@psyched.podcast⁠⁠⁠), Facebook (⁠⁠⁠PsychEd Podcast⁠⁠⁠), X (⁠⁠⁠@psychedpodcast⁠⁠⁠), and Bluesky (⁠⁠⁠@psychedpodcast.bsky.social‬⁠⁠⁠). You can email us at ⁠⁠⁠[email protected]⁠⁠⁠ and visit our website at⁠⁠⁠ psychedpodcast.org⁠⁠⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.
This episode covers interventional psychiatry with Dr. Sean Nestor, an interventional psychiatrist and clinician-scientist at the University of Toronto, where he serves as Assistant Director of the Psychiatry Program and oversees the Clinician Researcher Track (CResT) residency within the Department of Psychiatry. His research program at Sunnybrook Health Sciences Centre focuses on advancing the clinical application of neuromodulation therapies to improve outcomes across a wide range of psychiatric disorders.
The learning objectives for this episode are as follows
Define interventional psychiatry and distinguish it from traditional pharmacologic and psychotherapy-based approaches
Describe the role of interventional psychiatry in clinical practice, including identifying patient populations most likely to benefit from neuromodulation treatment
Identify pathways to become involved in research and scholarly work within the field of interventional psychiatry

Guest: Dr. Sean Nestor

Hosts: Dr. Pooja Sankar (PGY1), Michael Wang (MS4), Dr. Kate Braithwaite

Audio editing: Dr. Kate Braithwaite

Time Stamps:
(2:25) - Defining Interventional Psychiatry (IP) and its role in Psychiatric practice
(4:20) - Evolution of Interventional Psychiatry (IP)
(8:40) - Patients who will benefit from IP modalities
(12:35) - Other factors to consider when assessing a patient for IP 
(15:30) - rTMS
(19:15) - Description of a typical rTMS session
(23:50) - ECT
(26:45) - Ketamine
(29:05) - Other Investigational Modalities
(30:45) - Maintenance treatment
(35:30) - Medication and IP
(37:55) - Addressing stigma of ECT
(43:15) - Discussion on place of IP in Depression management decision tree
(47:00) - How to get involved in IP
(50:10) - Rewarding aspects of working in IP
(52:25) - Challenges of working in IP
(53:40) - Future of the field 

Resources:
⁠Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) | Stanford Health Care⁠
⁠CTMSS | International medical society dedicated to optimizing clinical practice, supporting research, and increasing access to high quality, evidence-based Transcranial Magnetic Stimulation
⁠The Interventional Psychiatry Consortium⁠

References:
Andrade, J. & Brito, M.. (2023). When the SAINT goes marching in – A novel transcranial magnetic stimulation protocol shows miraculous promise. European Psychiatry. 66. S835-S835. 10.1192/j.eurpsy.2023.1768. 
⁠Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 Update on Clinical Guidelines for Management of Major Depressive Disorder in Adults | CANMAT⁠
Conway, C. R., & Sackeim, H. A. (2022). Interventional Psychiatry: The revolution has arrived. Brazilian Journal of Psychiatry. ⁠https://doi.org/10.47626/1516-4446-2022-0046⁠ 
Rakesh, G., Cordero, P., Khanal, R., Himelhoch, S. S., & Rush, C. R. (2024). Optimally combining transcranial magnetic stimulation with antidepressants in major depressive disorder: A systematic review and Meta-analysis. Journal of affective disorders, 358, 432–439. https://doi.org/10.1016/j.jad.2024.05.037
Yavi, M., Lee, H., Henter, I. D., Park, L. T., & Zarate, C. A., Jr (2022). Ketamine treatment for depression: a review. Discover mental health, 2(1), 9. ⁠https://doi.org/10.1007/s44192-022-00012-3⁠
Zaidi, A., Shami, R., Sewell, I. J., Cao, X., Giacobbe, P., Rabin, J. S., Goubran, M., Hamani, C., Swardfager, W., Davidson, B., Lipsman, N., & Nestor, S. M. (2024). Antidepressant class and concurrent rTMS outcomes in major depressive disorder: a systematic review and meta-analysis. EClinicalMedicine, 75, 102760. https://doi.org/10.1016/j.eclinm.2024.102760 

For more PsychEd, follow us on Instagram (⁠⁠⁠@psyched.podcast⁠⁠⁠), Facebook (⁠⁠⁠PsychEd Podcast⁠⁠⁠), X (⁠⁠⁠@psychedpodcast⁠⁠⁠), and Bluesky (⁠⁠⁠@psychedpodcast.bsky.social⁠⁠⁠). You can email us at ⁠⁠⁠[email protected]⁠⁠⁠ and visit our website at⁠⁠⁠ psychedpodcast.org⁠⁠⁠

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of neuroleptic malignant syndrome.
Hosts: 
Eric Yu (MS3)
Dr. Angad Singh (PGY2)
Dr. Shaoyuan Wang (PGY5)
Audio Editing: 
Dr. Angad Singh (PGY2)

References:
1. Park, J., Tan, J., Krzeminski, S., Hazeghazam, M., Bandlamuri, M., & Carlson, R. W. (2017). Malignant catatonia warrants early psychiatric‐critical care collaborative management: two cases and literature review. Case Reports in Critical Care, 2017(1), 1951965.
2. Simon, L. V., Hashmi, M. F., & Callahan, A. L. (2023). Neuroleptic malignant syndrome. In StatPearls 
[Internet]. StatPearls Publishing.
2. Tan, C. M., & Kumachev, A. (2023). Neuroleptic malignant syndrome. CMAJ, 195(43), E1481-E1481.
4. Trollor, J. N., & Sachdev, P. S. (1999). Electroconvulsive treatment of neuroleptic malignant syndrome: a review and report of cases. Australian & New Zealand Journal of Psychiatry, 33(5), 650-659.
For more PsychEd, follow us on Instagram (⁠⁠@psyched.podcast⁠⁠), Facebook (⁠⁠PsychEd Podcast⁠⁠), X (⁠⁠@psychedpodcast⁠⁠), and Bluesky (⁠⁠@psychedpodcast.bsky.social‬⁠⁠). You can email us at ⁠⁠[email protected]⁠⁠ and visit our website at⁠⁠ psychedpodcast.org⁠⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.
This episode covers Working with Borderline Personality Disorder in the Emergency Department with Dr. Bruce Fage, a psychiatrist in Toronto working in emergency and acute care psychiatry, and an Assistant Professor at the University of Toronto. His interests include the relational and systems issues that shape psychiatric care in crisis settings. He is also a former founding member of PsychEd!
The learning objectives for this episode are as follows:
Explain how the emergency department environment influences presentations of borderline personality disorder

Know when to apply the diagnosis of borderline personality in the emergency setting

Demonstrate effective management strategies for patients with BPD in the ED

Evaluate appropriate use of emergency and inpatient care for BPD presentations

Guest:
Dr. Bruce Fage
Hosts:
Sara Abrahamson (MS3)
Shelly Palchik (MS4)
Angad Singh (PGY2)
Audio editing:
Angad Singh (PGY2)
For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠), Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of serotonin syndrome.
Hosts: 
Eric Yu (MS3)
Dr. Angad Singh (PGY2)
Dr. Shaoyuan Wang (PGY5)
Audio Editing: 
Dr. Angad Singh (PGY2)
References:
1. Boyer, E. W. (2024). Serotonin syndrome (serotonin toxicity). In UpToDate.
2. Buckley, N. A., Dawson, A. H., & Isbister, G. K. (2014). Serotonin syndrome. Bmj, 348.
3. Dunkley, E. J. C., Isbister, G. K., Sibbritt, D., Dawson, A. H., & Whyte, I. M. (2003). The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. Qjm, 96(9), 635-642.
4. Foong, A. L., Grindrod, K. A., Patel, T., & Kellar, J. (2018). Demystifying serotonin syndrome (or serotonin toxicity). Canadian Family Physician, 64(10), 720-727.
For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠), Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ psychedpodcast.org⁠.