Ep. 9: Three Current Transformations in Psychiatry (and Their Implications)

Ep. 9: Three Current Transformations in Psychiatry (and Their Implications)

Jim Phelps returns for another episode of Psychopharmacology Today, exploring three major shifts reshaping modern psychiatry: 1) the move from categorical to dimensional diagnosis, 2) emerging biological mechanisms underlying bipolar disorder, and 3) the evolving role of lithium in brain health and dementia prevention. Drawing on epidemiologic research, clinical experience, and recent neuroscience findings, Dr. Phelps explains how mood disorders often exist along a spectrum rather than within rigid DSM categories, emphasizing the importance of diagnostic humility when assessing depression, anxiety, trauma, and bipolarity. He also reviews practical treatment implications, including social rhythm therapy, circadian stabilization, blue-light reduction strategies, and the potential therapeutic value of low-dose lithium. Throughout the discussion, Dr. Phelps highlights how advances in chronotherapy, metabolism, inflammation research, and dimensional assessment may fundamentally change how clinicians understand and treat mood disorders in the years ahead.

Ep. 8: RxP and Gender-Affirming Care

In this episode of Psychopharmacology Today, Dr. Daubney Boland offers a practical and compassionate overview of gender-affirming care, emphasizing the critical role prescribing psychologists play in creating inclusive, respectful, and medically informed treatment environments for transgender and nonbinary patients. Drawing on clinical experience and case studies, she explores how affirming language, accurate pronoun use, and culturally competent systems reduce barriers to care, while delayed or withheld treatment can intensify depression, dysphoria, self-harm, and other mental health concerns. Dr. Boland also reviews key psychopharmacology considerations, including hormone therapy risks, informed consent, fertility counseling, and monitoring issues such as testosterone-related polycythemia, highlighting the importance of interdisciplinary collaboration and individualized, patient-centered decision-making in ethical gender-affirming practice.

Ep. 7: Mixed States and the Bipolar Spectrum: Improving Diagnosis and Treatment Decisions

In this episode of Psychopharmacology Today, Dr. James Phelps explores the diagnostic and treatment challenges associated with bipolar spectrum disorders and mixed mood states. Drawing on decades of clinical experience, he explains why traditional categorical diagnoses (such as unipolar depression versus bipolar disorder) often fail to capture the complexity of real-world presentations.  Dr. Phelps introduces the concept of the mood spectrum and highlights the overlapping symptoms between depression, anxiety disorders, ADHD, PTSD, and bipolar mixed states. He emphasizes the importance of evaluating “non-manic markers,” including family history, illness course, and antidepressant response, when determining whether bipolarity may be present.  The episode also discusses practical treatment considerations. Dr. Phelps outlines the risks associated with antidepressants in patients with mixed states and reviews alternative strategies, including social rhythm therapy, mood stabilizers such as lamotrigine and low-dose lithium, and the careful tapering of antidepressants. Throughout the discussion, he argues that prescribing psychologists are uniquely positioned to manage these complex cases due to their combined expertise in psychotherapy and medication management.  The session concludes with a framework for shared decision-making with patients and a practical approach to stabilizing mood symptoms while navigating diagnostic uncertainty.

Ep. 6: Ketamine in the Treatment of Mental Health Conditions: A Primer

Led by ketamine experts Dr. Alexander Papp and Dr. Julie Myers, both faculty of Alliant's MSCP program, this episode of Psychopharmacology Today delves into the use of ketamine as a treatment for various mental health conditions, particularly depression and suicidal ideation. It explores the pharmacological mechanisms behind ketamine's rapid antidepressant effects, its clinical applications, and the importance of neuroplasticity in recovery. Drs. Papp and Myers highlight the growing acceptance of ketamine in clinical settings and the need for further research to optimize treatment protocols and understand long-term effects. They also address complexities of ketamine treatment, focusing on its side effects, practical applications, integration with therapy, best practices, and real-world case studies. Lastly, they emphasize the importance of understanding both the benefits and potential risks associated with ketamine, as well as the significance of proper administration and patient support throughout the treatment process.

Ep. 5: So You Want to Be a Prescribing Psychologist?

In this conversation with faculty colleague Dr. Cheryl Fisher, Alliant MS in Clinical Psychopharmacology program director Dr. George Kapalka discusses his extensive experience and insights into RxP, particularly focusing on pediatric populations. He highlights the evolution of training for psychologists in this field, the challenges faced in prescribing medications to children, and the impact of political changes on pharmaceutical research. The discussion also covers the collaboration between counselors and prescribers, addressing client resistance to medication, and the influence of telehealth on psychopharmacology. Finally, Dr. Kapalka provides valuable advice for clinical counselors and shares his thoughts on future trends in the field based on questions from Alliant students.