General Psychiatry Unbiased coverage of all things psychiatric https://www.thecarlatreport.com/rss en-us 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.

]]> http://www.thecarlatreport.com/blogs/2/post/6395 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 shutterstock_2829698453.jpg 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.

]]> http://www.thecarlatreport.com/blogs/2/post/6394 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 shutterstock_2825741539.jpg 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.

]]> http://www.thecarlatreport.com/blogs/2/post/6387 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 shutterstock_2821771913.jpg The Psychiatric Review of Symptoms The psychiatric review of symptoms (PROS) is an important though often neglected part of the initial psychiatric evaluation The psychiatric review of symptoms (PROS) is an important though often neglected part of the initial psychiatric evaluation



]]> http://www.thecarlatreport.com/articles/6393 Sat, 01 Aug 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6393-the-psychiatric-review-of-symptoms Pharmacological Treatments for Autism No drug targets autism's core symptoms, but medications from antipsychotics to leucovorin can address irritability, sleep, attention, and other co-occurring challenges. No drug targets autism's core symptoms, but medications from antipsychotics to leucovorin can address irritability, sleep, attention, and other co-occurring challenges.


]]> http://www.thecarlatreport.com/articles/6385 Sat, 01 Aug 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6385-pharmacological-treatments-for-autism Adult_ADHD_sm.png When Patients Don’t Know They Are Ill Xavier Amador explains how the LEAP communication strategy helps clinicians build trust with patients whose anosognosia makes them unable to recognize their own illness. Xavier Amador explains how the LEAP communication strategy helps clinicians build trust with patients whose anosognosia makes them unable to recognize their own illness.


]]> http://www.thecarlatreport.com/articles/6384 Sat, 01 Aug 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6384-when-patients-dont-know-they-are-ill TCPR_QA_Amador-Headshot.jpg Mirtazapine Helps Older Adults Sleep, but Side Effects Limit Staying Power A placebo-controlled trial finds mirtazapine modestly improves sleep in older adults, but daytime drowsiness and confusion caused dropout in a notable minority of patients. A placebo-controlled trial finds mirtazapine modestly improves sleep in older adults, but daytime drowsiness and confusion caused dropout in a notable minority of patients.


]]> http://www.thecarlatreport.com/articles/6383 Sat, 01 Aug 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6383-mirtazapine-helps-older-adults-sleep-but-side-effects-limit-staying-power Dextromethorphan as Early Augmentation for Mild to Moderate Depression How long should you wait before concluding that antipsychotic-related sedation isn't going to resolve on its own? A new meta-analysis finally puts a number on it. How long should you wait before concluding that antipsychotic-related sedation isn't going to resolve on its own? A new meta-analysis finally puts a number on it.



]]> http://www.thecarlatreport.com/articles/6382 Sat, 01 Aug 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6382-dextromethorphan-as-early-augmentation-for-mild-to-moderate-depression Exercise Doesn’t Always Work A meta-analysis underscores the importance of choosing metabolically safer medications. A meta-analysis underscores the importance of choosing metabolically safer medications.


]]> http://www.thecarlatreport.com/articles/6381 Sat, 01 Aug 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6381-exercise-doesnt-always-work CME Post-Test, Insight, TCPR, August 2026 By successfully completing the test you will be awarded a certificate for 2 CME credits. By successfully completing the test you will be awarded a certificate for 2 CME credits.

]]> http://www.thecarlatreport.com/articles/6379 Sat, 01 Aug 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6379-cme-post-test-insight-tcpr-august-2026 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.

]]> http://www.thecarlatreport.com/blogs/2/post/6367 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 shutterstock_2818113403.jpg 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.

]]> http://www.thecarlatreport.com/blogs/2/post/6348 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 shutterstock_2810739859.jpg 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.

]]> http://www.thecarlatreport.com/blogs/2/post/6344 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 shutterstock_2806948539.jpg 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.

]]> http://www.thecarlatreport.com/blogs/2/post/6340 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 shutterstock_2803433721.jpg 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.

]]> http://www.thecarlatreport.com/blogs/2/post/6338 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 shutterstock_2800253479.jpg 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.
]]> http://www.thecarlatreport.com/blogs/2/post/6337 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 shutterstock_2796487989.jpg Rethinking 12-Step Referrals How to make a 12-step referral patients will actually try. How to make a 12-step referral patients will actually try. 

]]> http://www.thecarlatreport.com/blogs/1/post/6336 Sat, 13 Jun 2026 16:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6336-rethinking-12-step-referrals 1774530501182.jpeg 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).

]]> http://www.thecarlatreport.com/blogs/2/post/6308 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 RogerSolomon2023.jpg Free Podcast Series: Gender Affirming Care in Exile 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. 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.



]]> http://www.thecarlatreport.com/blogs/1/post/6324 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6324-free-podcast-series-gender-affirming-care-in-exile shutterstock_2775830779.jpg Treatment of Bipolar Disorder in Pregnant and Postpartum Women: A Free Review Sheet Begin preparation at least six months before conception to ensure stability, switch to safer medications, and manage psychosocial stressors. Begin preparation at least six months before conception to ensure stability, switch to safer medications, and manage psychosocial stressors.

       


    ]]>     http://www.thecarlatreport.com/blogs/1/post/6321 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6321-treatment-of-bipolar-disorder-in-pregnant-and-postpartum-women-a-free-review-sheet WMH_Course_Graphic.png     Stimulant Medications for ADHD: Choosing the Right Approach for Adults Free Quick Reference Guide A treament overview of Methylphenidate and Amphetamine medicatoins for ADHD. A treament overview of Methylphenidate and Amphetamine medicatoins for ADHD.


    ]]>     http://www.thecarlatreport.com/blogs/1/post/6320 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6320-stimulant-medications-for-adhd-choosing-the-right-approach-for-adults-free-quick-reference-guide ADHD_Course_Graphic.png     Free Sample Resource - Most Common Clinically Significant Drug Interactions in Psychiatry Drug-drug interactions are critical to monitor in older adults due to the high prevalence of polypharmacy in this population. Drug-drug interactions are critical to monitor in older adults due to the high prevalence of polypharmacy in this population. 



    ]]>     http://www.thecarlatreport.com/blogs/1/post/6319 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6319-free-sample-resource-most-common-clinically-significant-drug-interactions-in-psychiatry HFB1e_Cover3D.png     Free Sample Table: Hyperbolic Taper for SSRIs If a patient is tapering off SSRIs completely — rather than switching to another antidepressant — a hyperbolic taper minimizes the risk of withdrawal. If a patient is tapering off SSRIs completely — rather than switching to another antidepressant — a hyperbolic taper minimizes the risk of withdrawal.



    ]]>     http://www.thecarlatreport.com/blogs/1/post/6317 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6317-free-sample-table-hyperbolic-taper-for-ssris 3DCover_DTTD1e_sm3.png     Free Research Summary: Which Meds Are Best for Panic Disorder (Anxiety and Compulsive Disorder) There are many effective medications for panic disorder, including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs). There are many effective medications for panic disorder, including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs). 


    ]]>     http://www.thecarlatreport.com/blogs/1/post/6316 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6316-free-research-summary-which-meds-are-best-for-panic-disorder-anxiety-and-compulsive-disorder PB5e_Cover_sm.png     Free Research Summary: Dextromethorphan-Bupropion (Auvelity): A Novel Mechanism for Major Depression It's frustrating for both patients and doctors when depression treatments fall short, and unfortunately, this is a common problem. It's frustrating for both patients and doctors when depression treatments fall short, and unfortunately, this is a common problem. 

    ]]>     http://www.thecarlatreport.com/blogs/1/post/6314 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6314-free-research-summary-dextromethorphan-bupropion-auvelity-a-novel-mechanism-for-major-depression PB5e_Cover_sm.png     Hidden Gems Podcast Series When Dr. Chris Aiken opened a psychotherapy practice in Western North Carolina, treatment-resistant depression wasn’t a specialty he planned for — it was what walked through the door. Most patients arrived having already failed one or more SSRIs prescribed in primary care. The standard next steps — raising the dose, switching classes, adding bupropion, buspirone, or a stimulant — often weren’t enough. When Dr. Chris Aiken opened a psychotherapy practice in Western North Carolina, treatment-resistant depression wasn’t a specialty he planned for — it was what walked through the door. Most patients arrived having already failed one or more SSRIs prescribed in primary care. The standard next steps — raising the dose, switching classes, adding bupropion, buspirone, or a stimulant — often weren’t enough.



    ]]>     http://www.thecarlatreport.com/blogs/1/post/6313 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6313-hidden-gems-podcast-series shutterstock_2742343087.jpg     PTSD 101 Podcast Series In August 2024, the American Journal of Psychiatry published a landmark update on PTSD by Arieh Shalev, MD, and colleagues at NYU — a comprehensive look at the diagnosis, neuroscience, and treatment of one of psychiatry’s most complex conditions. Dr. Chris Aiken, Editor-in-Chief of The Carlat Psychiatry Report, and his co-host Kellie Newsome, PMHNP took a deep dive into that article in this five-part podcast series. In August 2024, the American Journal of Psychiatry published a landmark update on PTSD by Arieh Shalev, MD, and colleagues at NYU — a comprehensive look at the diagnosis, neuroscience, and treatment of one of psychiatry’s most complex conditions. Dr. Chris Aiken, Editor-in-Chief of The Carlat Psychiatry Report, and his co-host Kellie Newsome, PMHNP took a deep dive into that article in this five-part podcast series.


    ]]>     http://www.thecarlatreport.com/blogs/1/post/6312 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6312-ptsd-101-podcast-series shutterstock_2494846601.jpg Stress, anxiety and man in studio with eyes closed for mental health, depression or bipolar with dark background. Illness, sad and male person with ptsd for nightmare, personality or schizophrenia     Podcast Series: Psychopharmacology 10 Commandments Our most-listened-to podcast series is now available in full — all ten episodes, free to stream. Dr. Chris Aiken, Editor-in-Chief of The Carlat Psychiatry Report, and Kellie Newsome, PMHNP distill ten essential principles every prescriber should know about psychopharmacology: the rules that keep patients safe, the pitfalls that catch clinicians off guard, and the evidence that should guide your prescribing every day. Our most-listened-to podcast series is now available in full — all ten episodes, free to stream. Dr. Chris Aiken, Editor-in-Chief of The Carlat Psychiatry Report, and Kellie Newsome, PMHNP distill ten essential principles every prescriber should know about psychopharmacology: the rules that keep patients safe, the pitfalls that catch clinicians off guard, and the evidence that should guide your prescribing every day.


    ]]>     http://www.thecarlatreport.com/blogs/1/post/6311 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6311-podcast-series-psychopharmacology-10-commandments 10_psychopharm_commandments.png     Podcast Series: How to Start a Psych Medication One of our most popular 2025 podcast series is now available in full. Dr. Chris Aiken, Editor-in-Chief of The Carlat Psychiatry Report, and Kellie Newsome, PMHNP share expert tips on drug titration — including psych meds that are better tolerated when started faster, and one that must be launched at a high dose and then tapered down to a low maintenance dose. (Spoiler: it’s not buprenorphine.) One of our most popular 2025 podcast series is now available in full. Dr. Chris Aiken, Editor-in-Chief of The Carlat Psychiatry Report, and Kellie Newsome, PMHNP share expert tips on drug titration — including psych meds that are better tolerated when started faster, and one that must be launched at a high dose and then tapered down to a low maintenance dose. (Spoiler: it’s not buprenorphine.)

    ]]>     http://www.thecarlatreport.com/blogs/1/post/6310 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6310-podcast-series-how-to-start-a-psych-medication shutterstock_2661541013.jpg medication plan checklist doctor     The Benefits of Exercise in Older Adults We tell patients to exercise. We're usually vague about the dose. A 2025 UK Biobank study (Yu K et al, Am J Geriatr Psychiatry 2025;33(5):512–523 https://lnkd.in/eVAh4Dtq) put real numbers on it — using accelerometers, not self-report. The design: 71,556 adults. Mean age 62. No depression or anxiety at baseline. Followed a median of 8 years. We tell patients to exercise. We're usually vague about the dose. A 2025 UK Biobank study (Yu K et al, Am J Geriatr Psychiatry 2025;33(5):512–523 https://lnkd.in/eVAh4Dtq) put real numbers on it — using accelerometers, not self-report. The design: 71,556 adults. Mean age 62. No depression or anxiety at baseline. Followed a median of 8 years.

    ]]>     http://www.thecarlatreport.com/blogs/1/post/6309 Fri, 05 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6309-the-benefits-of-exercise-in-older-adults 1776952141604.jpeg