CARLAT PUBLISHING The Carlat Report https://www.thecarlatreport.com/rss/articles Adult ADHD 4: Other Causes How to separate adult ADHD from other causes of cognitive problems like bipolar disorder, sleep apnea, medication effects, brain injury, temperament, and malingering. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

How to separate adult ADHD from other causes of cognitive problems like bipolar disorder, sleep apnea, medication effects, brain injury, temperament, and malingering.

]]> Mon, 17 Aug 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6395-adult-adhd-4-other-causes http://www.thecarlatreport.com/blogs/2/post/6395 Adult ADHD 3: The Missing Page in DSM The modern DSM began as a short list of 12 well-validated diagnoses. But the list expanded as the authors changed the goals from validity to reliability. Lost in this history is a missing page that helps separate adult ADHD from its mimics. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

The modern DSM began as a short list of 12 well-validated diagnoses. But the list expanded as the authors changed the goals from validity to reliability. Lost in this history is a missing page that helps separate adult ADHD from its mimics.

]]> Mon, 10 Aug 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6394-adult-adhd-3-the-missing-page-in-dsm http://www.thecarlatreport.com/blogs/2/post/6394 Adult ADHD 2: The Late-Onset Controversy Nine studies have tried to find out whether ADHD can start in adulthood, we dig into the data and find some answers to the controversy. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Nine studies have tried to find out whether ADHD can start in adulthood, we dig into the data and find some answers to the controversy.

]]> Mon, 03 Aug 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6387-adult-adhd-2-the-late-onset-controversy http://www.thecarlatreport.com/blogs/2/post/6387 Adult ADHD 1: The Child Grows Up DSM-5 loosened the criteria for adult ADHD, but did it get too lose? We look at what recent prosecutions of telehealth companies mean for those trying to diagnose this disorder on the front-lines. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

DSM-5 loosened the criteria for adult ADHD, but did it get too lose? We look at what recent prosecutions of telehealth companies mean for those trying to diagnose this disorder on the front-lines.

]]> Mon, 27 Jul 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6367-adult-adhd-1-the-child-grows-up http://www.thecarlatreport.com/blogs/2/post/6367 BPD Series, Episode 3: Dialectical Behavior Therapy — Balancing Acceptance and Change Dr. Shireen Rizvi provides an overview of Dialectical Behavior Therapy (DBT) and the treatment of Borderline Personality Disorder. Dr. Shireen Rizvi provides an overview of Dialectical Behavior Therapy (DBT) and the treatment of Borderline Personality Disorder.

]]> Mon, 20 Jul 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6365-bpd-series-episode-3-dialectical-behavior-therapy-balancing-acceptance-and-change http://www.thecarlatreport.com/blogs/2/post/6365 14 Reasons Why Psychopharmacology Differs in Women, Part 4 Women clear some psychiatric medications more slowly, lose bone density at higher rates, and face greater medical consequences from alcohol and smoking than men. This final episode in a four-part series covers side effects, drug metabolism, drugs of abuse, urine incontinence, and what we do — and don't — know about prescribing for transgender patients. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Women clear some psychiatric medications more slowly, lose bone density at higher rates, and face greater medical consequences from alcohol and smoking than men. This final episode in a four-part series covers side effects, drug metabolism, drugs of abuse, urine incontinence, and what we do — and don't — know about prescribing for transgender patients.

]]> Mon, 13 Jul 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6348-14-reasons-why-psychopharmacology-differs-in-women-part-4 http://www.thecarlatreport.com/blogs/2/post/6348 14 Reasons Why Psychopharmacology Differs in Women, Part 3 Estrogen shapes nearly every neurotransmitter system in the brain, and when it starts to fall, psychiatric disorders often follow. This episode walks through what psychiatrists need to know about the perimenopause: which conditions worsen, which treatments help, and when to call the OB-GYN about hormone replacement therapy. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Estrogen shapes nearly every neurotransmitter system in the brain, and when it starts to fall, psychiatric disorders often follow. This episode walks through what psychiatrists need to know about the perimenopause: which conditions worsen, which treatments help, and when to call the OB-GYN about hormone replacement therapy.

]]> Mon, 06 Jul 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6344-14-reasons-why-psychopharmacology-differs-in-women-part-3 http://www.thecarlatreport.com/blogs/2/post/6344 14 Reasons Why Psychopharmacology Differs in Women, Part 2 Premenstrual hormones can destabilize mood, worsen ADHD, trigger psychosis, and drive binge eating. This episode walks through the tools to manage hormonal fluctuations in female patients, from SSRIs to overlooked supplements to the lamotrigine-contraceptive drug interaction. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Premenstrual hormones can destabilize mood, worsen ADHD, trigger psychosis, and drive binge eating. This episode walks through the tools to manage hormonal fluctuations in female patients, from SSRIs to overlooked supplements to the lamotrigine-contraceptive drug interaction.

]]> Mon, 29 Jun 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6340-14-reasons-why-psychopharmacology-differs-in-women-part-2 http://www.thecarlatreport.com/blogs/2/post/6340 14 Reasons Why Psychopharmacology Differs in Women, Part 1 Women and men respond to psychiatric medications differently. In this first of a four-part series, Chris Aiken and Kellie Newsome walk through why valproate is risky for women, and when it’s worth using; why the FDA cut the zolpidem dose in half for female patients, and why SSRIs outperform tricyclics in women with depression. Plus: a sneak preview of DSM-6. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Women and men respond to psychiatric medications differently. In this first of a four-part series, Chris Aiken and Kellie Newsome walk through why valproate is risky for women, and when it’s worth using; why the FDA cut the zolpidem dose in half for female patients, and why SSRIs outperform tricyclics in women with depression. Plus: a sneak preview of DSM-6.

]]> Mon, 22 Jun 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6338-14-reasons-why-psychopharmacology-differs-in-women-part-1 http://www.thecarlatreport.com/blogs/2/post/6338 Psilocybin: What You Need to Know Psilocybin is going mainstream: Trump has signed an executive order opening psychedelics to patients with severe mental illness, and one in eight American adults has already tried it. But as we dig into the research, a more complicated picture emerges, one that separates the profound personal experience from the clinical evidence. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Psilocybin is going mainstream: Trump has signed an executive order opening psychedelics to patients with severe mental illness, and one in eight American adults has already tried it. But as we dig into the research, a more complicated picture emerges, one that separates the profound personal experience from the clinical evidence.
]]> Mon, 15 Jun 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6337-psilocybin-what-you-need-to-know http://www.thecarlatreport.com/blogs/2/post/6337 EMDR in Practice: A Clinician's Guide to Trauma Reprocessing with Roger Solomon, PhD Dr. Roger Solomon provides a comprehensive introduction to Eye Movement Desensitization and Reprocessing (EMDR). Dr. Roger Solomon provides a comprehensive introduction to Eye Movement Desensitization and Reprocessing (EMDR).

]]> Mon, 08 Jun 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6308-emdr-in-practice-a-clinicians-guide-to-trauma-reprocessing-with-roger-solomon-phd http://www.thecarlatreport.com/blogs/2/post/6308 Why We Miss Suicide Risk in Autistic Youth What if the patients we assume are safest from suicide are actually the ones we miss? Today we're talking about suicide risk in autistic youth, why it's higher than many clinicians expect, how distress shows up differently, and what small changes in our assessment process and treatment can make a real difference. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

What if the patients we assume are safest from suicide are actually the ones we miss? Today we're talking about suicide risk in autistic youth, why it's higher than many clinicians expect, how distress shows up differently, and what small changes in our assessment process and treatment can make a real difference.
]]> Mon, 01 Jun 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6306-why-we-miss-suicide-risk-in-autistic-youth http://www.thecarlatreport.com/blogs/2/post/6306 Gender Affirming Care in Exile: Origins It's 1979, and Johns Hopkins has just shut down the first gender surgery clinic in the US. But investigations into the biological roots of gender identity are about to reopen those doors — and reshape how medicine thinks about sex, gender, and who gets to decide. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

It's 1979, and Johns Hopkins has just shut down the first gender surgery clinic in the US. But investigations into the biological roots of gender identity are about to reopen those doors — and reshape how medicine thinks about sex, gender, and who gets to decide.
]]> Mon, 25 May 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6294-gender-affirming-care-in-exile-origins http://www.thecarlatreport.com/blogs/2/post/6294 Gender Affirming Care: Fall of the House of Hopkins In 1966, Johns Hopkins opened the first gender surgery clinic in the US. Thirteen years later, a single study shut it down. We examine what the research said, what it didn't say, and how new standards of care emerged from the ashes. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

In 1966, Johns Hopkins opened the first gender surgery clinic in the US. Thirteen years later, a single study shut it down. We examine what the research said, what it didn't say, and how new standards of care emerged from the ashes.
]]> Mon, 18 May 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6293-gender-affirming-care-fall-of-the-house-of-hopkins http://www.thecarlatreport.com/blogs/2/post/6293 Gender Affirming Care in Exile: Targeting the Leader The president of the US branch of WPATH built one of the largest youth gender clinics in the country, then watched it close under political fire. Now she's facing a malpractice lawsuit from a former patient. We examine the unpublished study at the center of the controversy. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

The president of the US branch of WPATH built one of the largest youth gender clinics in the country, then watched it close under political fire. Now she's facing a malpractice lawsuit from a former patient. We examine the unpublished study at the center of the controversy.
]]> Mon, 11 May 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6292-gender-affirming-care-in-exile-targeting-the-leader http://www.thecarlatreport.com/blogs/2/post/6292 Gender Affirming Care in Exile: The Trials Medical societies are reversing decades of support for gender-affirming care in youth — but is it the science driving the shift, or the politics? This episode walks through the evidence, from randomized trials to regret rates, and finds a more complicated picture than either side presents. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Medical societies are reversing decades of support for gender-affirming care in youth — but is it the science driving the shift, or the politics? This episode walks through the evidence, from randomized trials to regret rates, and finds a more complicated picture than either side presents.
]]> Mon, 04 May 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6273-gender-affirming-care-in-exile-the-trials http://www.thecarlatreport.com/blogs/2/post/6273 Gender Affirming Care in Exile: The Lawsuits Two malpractice cases — one worth $2 million — are reshaping the standards of gender-affirming care. This episode traces what went wrong, what held up in court, and what every clinician needs to know when referring patients for gender affirming procedures. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Two malpractice cases — one worth $2 million — are reshaping the standards of gender-affirming care. This episode traces what went wrong, what held up in court, and what every clinician needs to know when referring patients for gender affirming procedures.
]]> Mon, 27 Apr 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6262-gender-affirming-care-in-exile-the-lawsuits http://www.thecarlatreport.com/blogs/2/post/6262 Lithium Goes Mainstream In the 1950s, a young Danish psychiatrist named Mogens Schou staked his career — and his family — on a mineral most of his colleagues dismissed as dangerous nonsense. This is the story of how lithium went from fringe curiosity to the gold standard for bipolar disorder, and the bitter scientific battle that nearly derailed it. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

In the 1950s, a young Danish psychiatrist named Mogens Schou staked his career — and his family — on a mineral most of his colleagues dismissed as dangerous nonsense. This is the story of how lithium went from fringe curiosity to the gold standard for bipolar disorder, and the bitter scientific battle that nearly derailed it.
]]> Mon, 20 Apr 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6152-lithium-goes-mainstream http://www.thecarlatreport.com/blogs/2/post/6152 Treating BPD Series, Episode 2: Transference-Focused Psychotherapy—From Splitting to Coherence with Frank Yeomans, MD, PhD In this episode, Dr. Frank Yeomans offers a deep dive into the theory and clinical practice of TFP as a treatment for Borderline Personality Disorder. In this episode, Dr. Frank Yeomans offers a deep dive into the theory and clinical practice of TFP as a treatment for Borderline Personality Disorder.

]]> Thu, 16 Apr 2026 03:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5977-treating-bpd-series-episode-2-transference-focused-psychotherapyfrom-splitting-to-coherence-with-frank-yeomans-md-phd http://www.thecarlatreport.com/blogs/2/post/5977 Lithium: From 7UP to Table Salt Before lithium became a cornerstone of psychiatry, it was in soda, spa water, and salt shakers. Trace lithium’s journey from Victorian health fad to life-saving mood stabilizer, and discover why the uric acid theory that launched it may be making a comeback. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Before lithium became a cornerstone of psychiatry, it was in soda, spa water, and salt shakers. Trace lithium’s journey from Victorian health fad to life-saving mood stabilizer, and discover why the uric acid theory that launched it may be making a comeback.
]]> Mon, 13 Apr 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5925-lithium-from-7up-to-table-salt http://www.thecarlatreport.com/blogs/2/post/5925 When Autism Meets the Legal System: A Clinician’s Guide Legal questions come up in clinical care of autistic children and adults more often than many of us expect. A parent asks for a custody letter; a school requests documentation for services; a patient asks about disability benefits or driving. When autistic patients face legal systems, clinicians can help, but only if we stay within our role. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Legal questions come up in clinical care of autistic children and adults more often than many of us expect. A parent asks for a custody letter; a school requests documentation for services; a patient asks about disability benefits or driving. When autistic patients face legal systems, clinicians can help, but only if we stay within our role.
]]> Mon, 06 Apr 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5904-when-autism-meets-the-legal-system-a-clinicians-guide http://www.thecarlatreport.com/blogs/2/post/5904 Jeffrey Epstein on the Couch: Part IV Narcissism, antisocial, pedophilia… A lot of psychiatric terms have been used to explain Jeffrey Epstein. We’ll look at what fits. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Narcissism, antisocial, pedophilia… A lot of psychiatric terms have been used to explain Jeffrey Epstein. We’ll look at what fits.
]]> Mon, 30 Mar 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5895-jeffrey-epstein-on-the-couch-part-iv http://www.thecarlatreport.com/blogs/2/post/5895 Jeffrey Epstein on the Couch: Part III Narcissism, antisocial, pedophilia… A lot of psychiatric terms have been used to explain Jeffrey Epstein. We’ll look at what fits. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Narcissism, antisocial, pedophilia… A lot of psychiatric terms have been used to explain Jeffrey Epstein. We’ll look at what fits.

]]> Mon, 23 Mar 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5893-jeffrey-epstein-on-the-couch-part-iii http://www.thecarlatreport.com/blogs/2/post/5893 Jeffery Epstein on the Couch: Part II Does money lead to happiness? What kind of stress causes depression? Why the FDA change their requirements for new drug approvals? And what happened between Jeffrey Epstein and Ghislaine Maxwell that launched an enterprise of abuse? p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Does money lead to happiness? What kind of stress causes depression? Why the FDA change their requirements for new drug approvals? And what happened between Jeffrey Epstein and Ghislaine Maxwell that launched an enterprise of abuse?

]]> Mon, 16 Mar 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5892-jeffery-epstein-on-the-couch-part-ii http://www.thecarlatreport.com/blogs/2/post/5892 Jeffrey Epstein on the Couch: Part I Narcissism, antisocial, pedophilia… We examine the diagnoses people invoke to explain Jeffrey Epstein and determine if any fit. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Narcissism, antisocial, pedophilia… We examine the diagnoses people invoke to explain Jeffrey Epstein and determine if any fit.

]]> Sun, 08 Mar 2026 03:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5891-jeffery-epstein-on-the-couch-part-1 http://www.thecarlatreport.com/blogs/2/post/5891 Hidden Gems: Pramipexole Part II Pramipexole has moved up the in our algorithm for treatment resistant depression. Today, learn how to use this dopamine agonist. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Pramipexole has moved up the in our algorithm for treatment resistant depression. Today, learn how to use this dopamine agonist.


]]> Mon, 02 Mar 2026 02:00:00 -0500 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5889-hidden-gems-pramipexole-part-ii http://www.thecarlatreport.com/blogs/2/post/5889 Hidden Gems: Pramipexole Part I New research moves pramipexole up in the algorithm for treatment resistant depression. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

New research moves pramipexole up in the algorithm for treatment resistant depression.




]]> Mon, 23 Feb 2026 00:00:00 -0500 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5844-hidden-gems-pramipexole-part-i http://www.thecarlatreport.com/blogs/2/post/5844 Wounded Healers: Steven Hayes Part II We interview Steve Hayes, originator of Acceptance and Commitment Therapy, on the personal struggles that inspired the treatment. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

We interview Steve Hayes, originator of Acceptance and Commitment Therapy, on the personal struggles that inspired the treatment.




]]> Mon, 16 Feb 2026 02:00:00 -0500 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5842-wounded-healers-steven-hayes-part-ii http://www.thecarlatreport.com/blogs/2/post/5842 Wounded Healers: Steve Hayes, from Panic to ACT An interview with Steve Hayes, originator of Acceptance and Commitment Therapy (ACT), on how his struggle with panic disorder inspired his work. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

An interview with Steve Hayes, originator of Acceptance and Commitment Therapy (ACT), on how his struggle with panic disorder inspired his work.




]]> Mon, 09 Feb 2026 02:00:00 -0500 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5840-wounded-healers-steve-hayes-from-panic-to-act http://www.thecarlatreport.com/blogs/2/post/5840 Treating Anxiety and Sleep Issues in Children and Adolescents A parent sits across from you and asks, "Why can't my child just take the same anxiety medicine that helps me?” Sounds reasonable, but the evidence tells a very different story. p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

A parent sits across from you and asks, "Why can't my child just take the same anxiety medicine that helps me?” Sounds reasonable, but the evidence tells a very different story.




]]> Mon, 02 Feb 2026 02:00:00 -0500 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5837-treating-anxiety-and-sleep-issues-in-children-and-adolescents http://www.thecarlatreport.com/blogs/2/post/5837