Focus on Neurology and Psychiatry

Latest Episodes:

Rewriting the DSM Feb 23, 2010

Show notes

Guest: Darrel Regier, MD
Host: Bruce Japsen

It's been over 15 years since the publication of the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The DSM-V is due to be published in May 2013, and for the first time, the American Psychiatric Association invited input from the wider medical community and the general public. Anyone could go to the website, view the draft criteria alongside DSM-IV criteria, as well as the rationale behind the proposed changes, and add their comments, through April 20, 2010. Dr. Darrel Regier, executive director of the American Psychiatric Institute for Research and Education and director, division of research, at the American Psychiatric Association, tells host Bruce Japsen about what's due to change in the Manual, and the ramifications for research, treatment, payment, and — ultimately — outcomes.

Cognitive Behavioral Therapy in Adults With ADHD Apr 15, 2009

Show notes

Guest: Mary Solanto, PhD
Host: Vatsal Thakkar, MD

How can cognitive behavioral therapy help alleviate symptoms of ADHD patients, as well as other symptoms of comorbid anxiety or depression in these patients? Is cognitive behavioral therapy more effective than other types of group or individual counseling for these patients? Dr. Mary Solanto, associate professor of psychiatry and director of the ADHD Center at the Mount Sinai School of Medicine, describes some of the benefits ADHD patients may receive from this non-pharmacologic approach to treatment. Dr. Vatsal Thakkar hosts.

Research on Genetic Traits of ADHD Apr 15, 2009

Show notes

Guest: Randy Blakely, PhD
Host: Vatsal Thakkar, MD

Dopamine is an important neurotransmitter in the cortex, essential to movement and activity control, as well as attention and executive function, tying this transporter to ADHD. How are scientists finding the genetic markers that may be transmitted to those with ADHD, and how does this help scientists understand more about the disorder? Dr. Randy Blakely, director of the Center for Molecular Neuroscience at the Silvio O. Conte Center for Neuroscience Research and the Alan D. Bass Professor of Pharmacology and Psychiatry at the Vanderbilt University School of Medicine, describes a genetic mutation that causes the dopamine transporter to run backwards, and how this discovery is helping scientists understand the mechanisms of ADHD. Dr. Vatsal Thakkar hosts.

Non-Stimulant Options for ADHD Patients Apr 02, 2009

Show notes

Guest: Richard Rubin, MD
Host: Vatsal Thakkar, MD

Although stimulant medications are often used to treat ADHD patients, there are patients for whom non-stimulants might also be a viable option. What are the advantages to each type of medication? Dr. Richard Rubin, clinical associate professor at the University of Vermont College of Medicine and adjunct associate professor of child psychiatry at Dartmouth Medical College, joins host Dr. Vatsal Thakkar to discuss medication options for treating patients with ADHD.

Brain Attack: The 'Golden Hour' After a CVA Mar 13, 2009

Show notes

Guest: Ralph Sacco, MD
Host: Shira Johnson, MD

Over 700,000 Americans have a new or recurrent stroke each year. Dr Ralph Sacco, professor and chairman of neurology at the University of Miami's Miller School of Medicine, discusses the leading research on treatment in the 'golden hour' after a stroke occurs. He reviews why thrombolytics have led the way after a dry infarct, but why your patients may need additional care only available in a comprehensive stroke center. As chief of neurology at Jackson Memorial Hospital in Miami and a leading researcher, Dr. Sacco joins host Dr Shira Johnson to talk about the state of the art in care after a CVA.

Investigating Long-Term Effects of Prenatal Exposure to Cocaine Mar 02, 2009

Show notes

Guest: Ira Chasnoff, MD
Host: Jennifer Shu, MD, FAAP

Over the past few decades, there has been grave concern that prenatal exposure to cocaine would result in a population of children with physical, mental and emotional problems. Many of these infants have been carefully studied as they progress toward adolescence and beyond, and data suggests the impact on their development may not be as dramatic as we once thought. Dr. Ira Chasnoff, professor of clinical pediatrics at the University of Illinois College of Medicine and president of the Children's Research Triangle in Chicago, joins host Dr. Jennifer Shu to explore the shift in our thinking about the long-term effects of prenatal exposure to cocaine.

Can We Erase the Past with Beta-Blockers? Feb 26, 2009

Show notes

Guest: James McGaugh, PhD
Host: Michael Greenberg, MD

How can beta-blockers influence the formation of memories? Can beta-blockers erase memories entirely, or do these medications only affect the way or degree to which a memory is imprinted? Dr. James McGaugh, founding director of the Center for Neurobiology and Memory at the University of California, Irvine, explains the way beta-blockers can be used to treat post-traumatic stress disorder. What are the ethical concerns about pharmacologically manipulating our anxieties or stresses? Dr. Michael Greenberg hosts.

Payoffs and Pitfalls of E-Communication in Psychiatry Feb 26, 2009

Show notes

Guest: Richard A. Friedman, MD
Host: Cathleen Margolin, PhD

The continued growth of the Internet, and its increasing pervasiveness in our lives, has many of us considering how we might incorporate Web-based avenues of communication in our practice. The ease and convenience of e-mail, for example, is tempting, but could also open up a Pandora's box. Does e-mail inherently pose new challenges that may not be an issue with phone dialogue or in-person discussion? Dr. Richard Friedman, professor of clinical psychiatry at Weill Cornell Medical College and a regular contributor to the New York Times, shares his experience with e-mail in his practice and a few tips for those who use or are contemplating Web communication for their practice. Dr. Cathleen Margolin hosts.

Are Older Drugs 'In' Again for Depression in Parkinson’s? Feb 25, 2009

Show notes

Guest: Matthew A. Menza, MD
Host: Larry Kaskel, MD

Could tricyclic antidepressants be more effective at treating depression in patients with Parkinson's disease? They have been used since the 1950s for treatment of depression, but in recent years, selective serotonin reuptake inhibitors (SSRIs) have become the predominant form of therapy. New research is suggesting that SSRIs may not be the best antidepressant option for our patients with Parkinson's. The lead author of this research, Dr. Matthew Menza, professor of psychiatry and neurology, and interim chair of psychiatry at the Robert Wood Johnson Medical School, speaks with host Dr. Larry Kaskel about the potential implications of his study on how we care for our Parkinson's patients who are also suffering from depression. Dr. Menza also explores a few other relevant issues: the reticence, among many of those with Parkinson's, to speak with their physician about depression, and the concurrent reluctance, among many in the medical community, to recognize and treat their patients' vulnerability to depression.

Deep Brain Stimulation for Parkinson’s: Risks vs. Benefits Feb 20, 2009

Show notes

Guest: Matthew B. Stern, MD
Host: Jennifer Shu, MD, FAAP

Medication and physical therapy have been mainstay treatments for controlling neurologic symptoms associated with Parkinson's disease. One strategy for mitigating the characteristic tremors, rigidity and slow movement has focused on deep brain stimulation (DBS). What are the risks and benefits of this surgical intervention, when is it indicated, and how does it compare with medical treatment for Parkinson's? Host Dr. Jennifer Shu welcomes Dr. Matthew Stern, the Parker Family Professor of Neurology and director of the Parkinson's Disease and Movement Disorders Center at the University of Pennsylvania School of Medicine, to explore DBS and its indication for your patients with Parkinson's disease. Dr. Stern also offers his view on the question of whether DBS could eventually be considered for treatment much earlier in the disease's progression, or potentially as a first-line therapy for patients with Parkinson's.