PAFMG Psychiatry for Primary Care Providers: Recent Episodes
Whitney Landa
We explore psychiatric topics that affect primary care providers in their clinics.Photo credit:Etching vector created by rawpixel.com - www.freepik.com
Erin Hohengarten, LCSW, is an expert in Acceptance and Commitment Therapy (ACT). She teaches us 3 ACT skills that can help our patients move forward and they each take less than 5 minutes.
Lithium is one of our gold standard treatments in psychiatry. It is a highly effective medicine but can be difficult to manage. In this podcast we review when and how to use Lithium.
Photo credit: "003 Lithium - Periodic Table of Elements" by Science Activism is licensed under CC BY 2.0.
We discuss 2 common psychiatric emergencies, suicidal thoughts and mania, as well as medical emergencies in psychiatric patients.
Resources mentioned in the podcast can be found at:
https://sutterhealth.sharepoint.com/sites/BehavioralHealthResourcesandEducation
In this episode we discuss Atomoxetine (Strattera), Guanfacine (Intuniv, Tenex), Clonidine and Viloxazine (Qelbree) for ADHD.
Photo credit: "Mr. ADHD by Roger Hargreaves" by dullhunk is licensed under CC BY 2.0.
In this episode we discuss 2 fraternal twins, one with ADHD and anxiety and one with ADHD and a processing disorder
In this episode we talk about the neurologic underpinnings of ADHD, how that can help us understand it and explain it to our patients. We also review the strengths of having ADHD and the importance of the strengths based approach
Photo credit: "ADHD Bubble and Brain" by amenclinics_photos is licensed under CC BY-SA 2.0.
This is a follow up to our Methylphenidate family podcast focused on the Amphetamines primarily Adderall, Vyvanse and Dexedrine. We discuss their use in uncomplicated ADHD.
Photo Credit: Jynto, CC0, via Wikimedia Commons
In this episode we discuss how to prescribe methylphenidate and dexmethylphenidate in uncomplicated ADHD
In this episode we walk through Cymbalta, a very useful SNRI for your toolkit in the treatment of depression, anxiety and some types of pain.
Photo credit: By Harbin - Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=5568823
Caitlin Terzulli (she/her), a therapist in our Fremont division and I discuss gender, common terms such as cisgender, nonbinary and transgender. We also discuss how we ask patients about gender and tips for using the right pronouns.
Photo credit: Gender Unicorn at https://transstudent.org/
Tan kicks off our case conference sub series with a 71 yo male with a long standing history of anxiety, on chronic benzodiazepines, refractory to multiple medications. We discuss possible treatment plans and how to move forward.
Photo credit: "Magnifying glass and puzzle piece on blue background" by wuestenigel is licensed under CC BY 2.0.
In this episode we walk through breathing techniques and the 3 minute guided meditation presented in Thriving in a Chaotic Workplace, a popular talk Mercedes Kwiatkowski and I gave at our April MPM
Photo credit: "Sunset yoga" by GrahamKing is licensed under CC BY-NC-SA 2.0.
In this episode we walk through Abilify, a helpful medication for a variety of clinical presentations.
Photo credit: "File:Aripiprazole molecule from xtal ball.png" by Jynto (talk) is marked with CC0 1.0.
Photo credit:"Quit" by Fujoshi is licensed under CC BY-NC-ND 2.0
Pilot study for GAD: Bystritsky A, Kerwin L, Feusner JD, Vapnik T. A pilot controlled trial of bupropion XL versus escitalopram in generalized anxiety disorder. Psychopharmacol Bull. 2008;41(1):46-51. PMID: 18362870.
Reference citations for episode:
Kessler RC, Petukhova M, Sampson NA, Zaslavsky AM, Wittchen H -U. Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res. 2012;21(3):169-184. doi:10.1002/mpr.1359
Lebowitz MS, Appelbaum PS. Biomedical Explanations of Psychopathology and Their Implications for Attitudes and Beliefs About Mental Disorders. Annu Rev Clin Psychol. 2019 May 7;15:555-577. doi: 10.1146/annurev-clinpsy-050718-095416. Epub 2018 Nov 16. PMID: 30444641; PMCID: PMC6506347.
Gold KJ, Andrew LB, Goldman EB, et al.: "I would never want to have a mental health diagnosis on my record": a survey of female physicians on mental health diagnosis, treatment, and reporting. Gen Hosp Psychiatry 2016; 43:51–7 Crossref, Google Scholar
Mehta SS, Edwards ML. Suffering in silence: Mental health stigma and physicians’ licensing fears. Am J Psychiatry Residents’ J. 2018;13:2–4.
Brower, Kirk J. MD Professional Stigma of Mental Health Issues: Physicians Are Both the Cause and Solution, Academic Medicine: May 2021 - Volume 96 - Issue 5 - p 635-640
doi: 10.1097/ACM.0000000000003998
Image Credit:
"hiding" by PoliCardo is licensed under CC BY-NC-ND 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-nd/2.0/?ref=openverse.
We walk through the advantages of Buspar, any special considerations and how to dose this helpful medication.
Ori Benhamou MD walks us through Naltrexone and it's use in substance dependence.
Photo credit: By Fvasconcellos (talk · contribs) - Own work using: ACD/ChemSketch 10.0, Inkscape and vim, Public Domain, https://commons.wikimedia.org/w/index.php?curid=4734065
In this episode we walk through diagnosis and treatment of Obsessive Compulsive Disorder.
Photo credit: "Some people say I am obsessed with my lawn" by Jez Page is marked with CC BY-NC-SA 2.0.
In this episode we answer all your questions about when to use Lamictal as well as how to start and consent for this very useful medicine.
The most common question I received after our Burn Out podcast was "How do I relax? It isn't that easy." It isn't easy. Relaxing well is a skill. In this podcast we explore active relaxation and I teach you different strategies to help you incorporate relaxation into your life.
Photo credit "Relax" by soukup is marked with CC BY 2.0.
In this podcast we talk through TMS treatment, appropriate referrals for TMS and answer common questions.
Access the TMS referral guide under the resources tab(on vpn or intranet):
https://sutterhealth.sharepoint.com/sites/BehavioralHealthResourcesandEducation
Citations for this episode:
Rush AJ, Trivedi MH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry 163:1905-1917, 2009
Carpenter, Transcranial Magnetic Stimulation (TMS) for Depression: A Multisite, Naturalistic, Observational Study of Transcranial Magnetic Stimulation (TMS) for Patients with Pharmacoresistant Major Depression. Depression and Anxiety, 2012
Dunner, DL, et. al. A Multisite, Naturalistic, Observational Study of Transcranial Magnetic Stimulation (TMS) for Patients with Pharmacoresistant Major Depression: Durability of Benefit Over a One-Year Follow-Up Period. J of Clin Psych, 2014
This episode explores how teen depression varies from typical teen moodiness as well as adult depression. We explore how to help these teens. Resources to help this population can be found at:
https://sutterhealth.sharepoint.com/sites/BehavioralHealthResourcesandEducation
This site must be accessed onsite or through the vpn
Photo credit: "Depression" by shattered.art66
We review what it is, how to prevent it and what to do if you are already burned out.
Photo Credit: "Burnout!" by Skley is licensed under CC BY-ND 2.0
How to effectively taper benzos when patients are already physically and psychologically dependent
"Xanax 2 mg" by Dean812 is licensed under CC BY-ND 2.0
We dive deep into lexapro (escitalopram) during this episode. We answer the common questions about this medicine, how to start it and how to manage side effects.
In this episode we walk through how to start a benzodiazepine successfully
Photo credit: "Don't panic!" by pasukaru76 is licensed under CC BY-NC-ND 2.0
What I do when patients ask to be placed on leave for depression, anxiety or any other mental health condition.
Photo credit: "Tired Man Sitting on Bed" by Mic445 is licensed under CC BY-SA 2.0
Tam Nguyen leads us through an ACT framework to help patients with their medication compliance. This very helpful framework flips the conversation and takes only a few minutes of the appointment time.
In this episode we focus on sertraline and attempt to answer any and all of your questions about this medicine.
Terry Podesta walks us through some CBT techniques you can use to help patients (and yourself) with anxiety.
Photo credit: "Anxiety" by sinclair.sharon28 is licensed under CC BY-SA 2.0
I walk through suicide screening with the C-SSRS and what to do if your patient reports suicidal thoughts and/or behaviors
Nana Adabie, NP, walks us through therapeutic and pharmacologic techniques to help patients with anxiety return to work.
Cait Brady, our co-T1 in Palo Alto psychiatry talks about different mood stabilizing medications including when and how to use them.
This episode covers how to assess a previous ADHD diagnosis and prescription as well as how to choose which stimulant to start for a patient who is not yet on medication.
Photo credit: "ADHD Bubble and Brain" by amenclinics_photos is licensed under CC BY-SA 2.0
Mercedes Kwiatkowski leads us through important tips to us improve sleep for ourselves as well as for our patients
Photo credit: "Sleeping and sleeping / Só dorme" by dannyelbrazil is licensed under CC BY-NC 2.0
This podcast explores my framework for choosing an antidepressant for my patients as well as clinical pearls on how to answer patient questions.