Specific Treatments - Medication, Psychotherapy, ECT:

Of Two Minds: Biological Psychiatry vs. Psychotherapy
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File Source: Voices in the Family public radio show
File Date: April 10, 2000

A discussion of two major approaches in the field of psychiatry - biological psychiatry (pharmacological therapy), and psychotherapy. T.L. Luhrmann, a professor of anthropology at the University of California in San Diego, and the author of " Of Two Minds: The Growing Disorder in American Psychiatry ," talks about this growing dichotomy in medicine and medical education, the tendency to treat everything strictly within a biological-disease model, and the relative benefits of psychotherapy versus, or in conjunction with, prescription medication. The program specifically addresses the treatment of several different psychiatric disorders.

New Pills for the Mind - A talk with author Samuel Barondes, MD
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File Source: The Edge, nonprofit information organization
File Date: Dec 4, 2003

Most of the psychiatric drugs we use today are refinements of drugs whose value for mental disorders was discovered by accident decades ago. Now we can look forward to a more rational way to design psychiatric drugs. It will be guided by the identification of the gene variants that predispose certain people to particular mental disorders such as schizophrenia or severe depression. Dr. Samuel Barondes, author of "Better Than Prozac: Creating the Next Generation of Psychiatric Drugs," presents.

For more information on ordering the book "Better than Prozac: Creating the Next Generation of Psychiatric Drugs", please see our Recommended Reading section.

Medicating America's Kids
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File Source: Wisconsin Public Radio
File Date: Feb 5, 2004

Each year nearly 11million prescriptions for antidepressants are written for children. These drugs save lives, that's not being debated. But at hearings in Washington this week, dozens of parents told stories of antidepressants making their children more violent, even suicidal.

The British government, looking at suicide in its drug trials has told its doctors not to medicate children with most antidepressants on the market. The FDA is now doing its own investigation . Anti-depressants - Are they a chance at a better life, or do they raise the risk of losing it?

Patient Opinions of ECT - Interview with Diane Rose
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File Source: National Electronic Library of Mental Health
File Date: Jan 2004

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Dr Diana Rose is co-ordinator of SURE, the Service User Research Enterprise based at the Institute of Psychiatry. The core aim of SURE is to involve service users at all levels of the research process in a collaborative way. In this interview DR Rose talks generally about the work of SURE and specifically about the systematic review of patients' perspectives on electroconvulsive therapy which she recently published in the BMJ. According to this research, although about 80% of study subjects reported satisfaction with ECT treatment, "measures [of the studies]…did not take into account all the factors that may lead patients to perceive it as beneficial or otherwise".

The Post-Psychiatry Model of Treatment Play audio - click here
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File Source: BBC Radio (All In the Mind)
File Date: October 16, 2002

The 'post-psychiatry' model is committed to delivering what the service user needs and wants rather than what the service providers think they need.. It was developed by Pat Bracken and Phil Thomas, two consultant psychiatrists at the forefront of a movement called Critical Psychiatry. They were determined to deliver mental health services which really addressed the problems facing service users, believing that unless you confront the day to day pressures that poverty brings you have little hope of improving a person's mental health.

Mental Hospitals Play audio - click here
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File Source: Voices in the Family public radio show
File Date: April 9, 2001

Host Dr. Gottlieb talks with the producers of "Bellvue Inside-out," a documentary about America's oldest mental hospital (located in New York), as well as with doctors at Bellvue and Dr. Ritamary Hanly from Norristown State Hospital. The hour is a mixed bag - some of it talks about the making of the documentary, and other parts discuss the inner world of mental institutions in general (who gets committed, the treatments, the staff, the demands in terms of care, etc).

Psychiatric Hospitalization: What It's Like on the Inside
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File Type: Windows media audio
File Source: Healthyplace.com radio
File Date: DEC 15, 2001

**NOTE about healthyplace.com - this is a commercial site supported by advertisers. While the information in these radio programs seem largely unbiased (mainly consist of callers and answers by a host psychiatrist), they contain significantly more advertisement segments than public radio programs.

Guests on the show include a doctor (Dr. Suda Kumar) who works at a psychiatric hospital, and a 29-year-old patient who was hospitalized by her fiancé. They both describe their experiences and impressions of mental hospital facilities.

Psychotropic Medication Adherance Play video - click here
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File Source: Wayne State University grand rounds
File Date: March 10, 2004
Speaker: Rick Berchou, Pharm.D. Assistant Professor, Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine.

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Video and slide presentation discusses the rate of medication adherence in psychiatric vs. other disorders. It explores patient groups with the highest rates of non-adherence, common reasons for non-adherence (esp. side-effects), consequences of non-adherence, and strategies to approach the problem.

New Treatment Insights for Bipolar Disorder
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File Source: UCLA Grand Rounds
File Date: May 14, 2002
Speaker: Terence A. Ketter, M.D., Associate Professor of Psychiatry; Chief, Bipolar Disorders Clinic; Department of Psychiatry and Behavioral Sciences, Stanford University

Dr. Ketter presents various studies about the newest pharmacological treatments for bipolar disorder – newer anticonvulsants such as lamotrigine and topiramate, atypical antipsychotics, etc – as well as some particular considerations and difficulties in the treatment of this disease (for example: is it beneficial to use an antidepressant to treat the depressive phase of bipolar?).

New Treatments in Mania
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File Source: UCLA Grand Rounds
File Date: March 14, 2004
Speaker: Susan L. McElroy, M.D., Professor of Psychiatry; Co-Director of Psychopharmacology Research; Director, Obesity Treatment and Research - University of Cincinnati College of Medicine

Dr. Elroy discusses pharmacological treatment options for the mania episode of bipolar disorder; she compares the efficacy of various monotherapies (using clinical trials as evidence), and also looks at the possible benefits of combination therapy.

Advances in the Pharmacological Treatment of Bipolar Depression (available in audio or video format)
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File Source: 5th International Conference on Bipolar Disorder
File Date: June 2003
Speaker: Paul E. Keck, Jr., M.D. - U Cincinnati College of Medicine, Cincinnati OH

Until relatively recently, there were very few randomized, controlled trials of mood stabilizers, antidepressants or their combination in the treatment of bipolar depression. Thus, many fundamental questions regarding the efficacy, tolerability, risk of mood switching and relapse with specific agents remained unanswered. The speaker presents study results that show the efficacy of various bipolar medications (lamotrigine, lithium, divalproex, and olanzapine) either alone or taken in combination.

What is the Role of Psychotherapy in Bipolar Disorder? (available in audio or video format)
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File Source: 5th International Conference on Bipolar Disorder
File Date: June 2003
Speaker: Jan Scott, M.D., FRCPsych - Institute of Psychiatry, London

The basic aims of any treatments in bipolar disorders (BP) are to alleviate acute symptoms, restore psychosocial functioning, and prevent relapse and recurrence. The mainstay of treatment has been and currently remains pharmacotherapy. However, there is a significant efficacy-effectiveness gap in response rates to all mood stabilizers and even under optimal clinical conditions, prophylaxis is only effective in about 50% of individuals with BP. Furthermore, there is evidence that psychosocial factors may adversely affect prognosis in individuals with BP and evidence of significant inter-episode morbidity. Given this scenario, the development of adjunctive psychotherapies appears both helpful and necessary

Long-Term Use of Mood Stabilizers in Bipolar Disorder
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File Source: Journal of Clinical Psychiatry Audiograph Series (CME)
File Date: N/A

This continuing education activity discusses the rationale for long-term treatment of bipolar disorder (types I and II), reviews the evidence for maintenance treatment with various medications (lithium, anticonvulsants, antidepressants, and antipsychotics), and outlines a maintenance treatment strategy.

Download a pdf booklet to follow along with the speakers on the audio files (mp3 format).

Choose a segment of the presentation below, and click on the link to listen to the mp3 file.

Introduction - play audio

Rationale for the Long-Term Treatment of Bipolar Disorder - play audio

Long-Term Treatment With Lithium - play audio

Long-Term Treatment With Anticonvulsants: Carbamazepine- play audio

Valproate - play audio

Lamotrigine - play audio

Long-Term Treatment With Antidepressants - play audio

Long-Term Treatment With Antipsychotics - play audio

Long-Term Treatment of Bipolar II Disorder - play audio

Conclusion - play audio

Bipolar Disorder: Improving Long-Term Treatment Outcomes in Mania and Bipolar Depression
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File Source: UCLA Grand Rounds
File Date: Jan 14, 2003
Speaker: Lori Altshuler, M.D., Professor; Director, Mood Disorders Research Program, Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA

Dr. Altshuler gives a short introduction to the epidemiology, comorbidity, and course of bipolar disorder, and touches on some common triggers for mania and depression. She then spends most of the hour-long presentation discussing the depressive episode, and how to prevent depression relapse.

Maintenance Treatment of Bipolar Disorders Play video - click here
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File Source: U Chicago Grand Rounds
File Date: March 3, 2003
Speaker: Charles L. Bowden, MD, University of Texas Health Science Center at San Antonio

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Dr. Bowden talks about the various facets of long-term bipolar disorder treatment – problems such as needing multiple drugs to treat multiple symptoms and long-term side effects (such as weight gain), the pros and cons of using an antidepressant for the depressive phase, and various studies that show the long-term efficacy of several common mood stabilizers and antipsychotics.

ECT-Current Practice and Guidelines: A Review and Indications for Use
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File Source: University of New Mexico grand rounds
File Date: March 12, 2004
Speakers: Alya Reeve, MD; Carol Fryer, MD; Roger Hammond, MD; Liz Romero, MD.

A panel of clinical experts discuss the history of ECT treatment, the training required to administer it, and the research that explains what it does and why it works.

Psychiatric Medications(Healthyplace.com radio program, June 1, 2002).
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File Type: Windows media audio
File Source: Healthyplace.com radio
File Date: June 1, 2002

**NOTE about healthyplace.com - this is a commercial site supported largely by advertisers. While the information in these radio programs seem largely unbiased (mainly consist of callers and answers by a host psychiatrist), they contain significantly more advertisement segments than public radio programs.

How can someone that doesn't want to take psychiatric medications become aware that it is good for them to take them? What about quitting on your own; why do people stop taking their meds? Is psychotherapy just as good as antidepressants for the treatment of depression? Psychiatrist co-host, Dr. Kristeen Spratley answered those questions as well as listener questions about specific medications (one call is about Zyprexa). She also talks about prescribing medications vs. psychotherapy or other types of therapy from a psychiatrist's point of view.

Therapy vs. Drugs
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File Source: National Public Radio
File Date: June 22, 1998

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A greater understanding of the brain and its chemistry has given pyschotherapists a whole new battery of chemical weapons - drugs like Prozac, Xanax, Paxil and Risperidone - against a host of mental illnesses, including depression, schizophrenia, and anxiety. Some therapists worry that in light of these advances, and goaded by cost and time constraints imposed by insurance companies, the profession may be forfeiting the time-honored technique of helping patients to talk through their woes to achieve longer term well-being. Others say that pills are helping advance talk therapy by enabling patients to get beyond acute symptoms to personal analysis. Frank Browning's first report in a series on changes taking place in the field of psychiatry.

The Selling of Neurontin Play audio - click here
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File Source: National Public Radio
File Date: Jan 16, 2003

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Drug companies spend billons of dollars each year trying to persuade doctors to prescribe their drugs. There are strict rules about what form that promotion can take. The rules are meant to ensure that drug companies give doctors trustworthy information, so that medications are prescribed appropriately. But drugmakers can get around the rules. In a series of stories, NPR's Snigdha Prakash reports on how one company tried to do that with the antiepilepsy drug Neurontin.