Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of extrapyramidal symptoms.

Hosts:

Jo Kikukawa (MS2)

Dr. Matthew Cho (PGY1)

Sena Gok (Scientist)

Audio Editing: Dr. Matthew Cho (PGY1)

References:

Dayalu, P., & Chou, K. L. (2008). Antipsychotic-induced extrapyramidal symptoms and their management. Expert Opinion on Pharmacotherapy, 9(9), 1451–1462. https://doi.org/10.1517/14656566.9.9.1451

Drake, R. E., & Ehrlich, J. (1985).Suicide attempts associated with akathisia. American Journal of Psychiatry, 142(4), 499–501. https://doi.org/10.1176/ajp.142.4.499

Pringsheim, T., Gardner, D., Addington, D., Martino, D., Morgante, F., Ricciardi, L., Poole, N., Remington, G., Edwards, M., Carson, A., & Barnes, T. R. E. (2018). The assessment and treatment of antipsychotic-induced akathisia. Canadian Journal of Psychiatry, 63(11), 719–729. https://doi.org/10.1177/0706743718760288

Poyurovsky, M., Pashinian, A., Weizman, R., Fuchs, C., & Weizman, A. (2006). Low-dose mirtazapine: A new option in the treatment of antipsychotic-induced akathisia. A randomized, double-blind, placebo- and propranolol-controlled trial. Biological Psychiatry, 59(11), 1071–1077. https://doi.org/10.1016/j.biopsych.2005.11.004

Links to Scales Featured in Episode:

https://simpleandpractical.com/wp-content/uploads/2014/09/Barnes-Akathisia-Rating-Scale-BARS.pdf

https://www.psychdb.com/_media/meds/antipsychotics/sas_simpson_angus_scale_modified.pdf

https://www.ohsu.edu/sites/default/files/2019-10/%28AIMS%29%20Abnormal%20Involuntary%20Movement%20Scale.pdf

For more PsychEd, follow us on Instagram (⁠⁠⁠@psyched.podcast⁠⁠⁠), Facebook (⁠⁠⁠PsychEd Podcast⁠⁠⁠), X (⁠⁠⁠@psychedpodcast⁠⁠⁠), and Bluesky (⁠⁠⁠@psychedpodcast.bsky.social‬⁠⁠⁠). You can email us at ⁠⁠⁠[email protected]⁠⁠⁠ and visit our website at⁠⁠⁠ psychedpodcast.org⁠⁠⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.

This episode covers interventional psychiatry with Dr. Sean Nestor, an interventional psychiatrist and clinician-scientist at the University of Toronto, where he serves as Assistant Director of the Psychiatry Program and oversees the Clinician Researcher Track (CResT) residency within the Department of Psychiatry. His research program at Sunnybrook Health Sciences Centre focuses on advancing the clinical application of neuromodulation therapies to improve outcomes across a wide range of psychiatric disorders.

The learning objectives for this episode are as follows

1. Define interventional psychiatry and distinguish it from traditional pharmacologic and psychotherapy-based approaches
2. Describe the role of interventional psychiatry in clinical practice, including identifying patient populations most likely to benefit from neuromodulation treatment
3. Identify pathways to become involved in research and scholarly work within the field of interventional psychiatry

Guest: Dr. Sean Nestor

Hosts: Dr. Pooja Sankar (PGY1), Michael Wang (MS4), Dr. Kate Braithwaite

Audio editing: Dr. Kate Braithwaite

Time Stamps:

(2:25) - Defining Interventional Psychiatry (IP) and its role in Psychiatric practice

(4:20) - Evolution of Interventional Psychiatry (IP)

(8:40) - Patients who will benefit from IP modalities

(12:35) - Other factors to consider when assessing a patient for IP 

(15:30) - rTMS

(19:15) - Description of a typical rTMS session

(23:50) - ECT

(26:45) - Ketamine

(29:05) - Other Investigational Modalities

(30:45) - Maintenance treatment

(35:30) - Medication and IP

(37:55) - Addressing stigma of ECT

(43:15) - Discussion on place of IP in Depression management decision tree

(47:00) - How to get involved in IP

(50:10) - Rewarding aspects of working in IP

(52:25) - Challenges of working in IP

(53:40) - Future of the field 

Resources:

⁠Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) | Stanford Health Care⁠

⁠CTMSS | International medical society dedicated to optimizing clinical practice, supporting research, and increasing access to high quality, evidence-based Transcranial Magnetic Stimulation

⁠The Interventional Psychiatry Consortium⁠

References:

Andrade, J. & Brito, M.. (2023). When the SAINT goes marching in – A novel transcranial magnetic stimulation protocol shows miraculous promise. European Psychiatry. 66. S835-S835. 10.1192/j.eurpsy.2023.1768. 

⁠Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 Update on Clinical Guidelines for Management of Major Depressive Disorder in Adults | CANMAT⁠

Conway, C. R., & Sackeim, H. A. (2022). Interventional Psychiatry: The revolution has arrived. Brazilian Journal of Psychiatry. ⁠https://doi.org/10.47626/1516-4446-2022-0046⁠ 

Rakesh, G., Cordero, P., Khanal, R., Himelhoch, S. S., & Rush, C. R. (2024). Optimally combining transcranial magnetic stimulation with antidepressants in major depressive disorder: A systematic review and Meta-analysis. Journal of affective disorders, 358, 432–439. https://doi.org/10.1016/j.jad.2024.05.037

Yavi, M., Lee, H., Henter, I. D., Park, L. T., & Zarate, C. A., Jr (2022). Ketamine treatment for depression: a review. Discover mental health, 2(1), 9. ⁠https://doi.org/10.1007/s44192-022-00012-3⁠

Zaidi, A., Shami, R., Sewell, I. J., Cao, X., Giacobbe, P., Rabin, J. S., Goubran, M., Hamani, C., Swardfager, W., Davidson, B., Lipsman, N., & Nestor, S. M. (2024). Antidepressant class and concurrent rTMS outcomes in major depressive disorder: a systematic review and meta-analysis. EClinicalMedicine, 75, 102760. https://doi.org/10.1016/j.eclinm.2024.102760 

For more PsychEd, follow us on Instagram (⁠⁠⁠@psyched.podcast⁠⁠⁠), Facebook (⁠⁠⁠PsychEd Podcast⁠⁠⁠), X (⁠⁠⁠@psychedpodcast⁠⁠⁠), and Bluesky (⁠⁠⁠@psychedpodcast.bsky.social⁠⁠⁠). You can email us at ⁠⁠⁠[email protected]⁠⁠⁠ and visit our website at⁠⁠⁠ psychedpodcast.org⁠⁠⁠

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of neuroleptic malignant syndrome.

Hosts: 

Eric Yu (MS3)

Dr. Angad Singh (PGY2)

Dr. Shaoyuan Wang (PGY5)

Audio Editing: 

Dr. Angad Singh (PGY2)

References:

1. Park, J., Tan, J., Krzeminski, S., Hazeghazam, M., Bandlamuri, M., & Carlson, R. W. (2017). Malignant catatonia warrants early psychiatric‐critical care collaborative management: two cases and literature review. Case Reports in Critical Care, 2017(1), 1951965.

2. Simon, L. V., Hashmi, M. F., & Callahan, A. L. (2023). Neuroleptic malignant syndrome. In StatPearls 

[Internet]. StatPearls Publishing.

2. Tan, C. M., & Kumachev, A. (2023). Neuroleptic malignant syndrome. CMAJ, 195(43), E1481-E1481.

4. Trollor, J. N., & Sachdev, P. S. (1999). Electroconvulsive treatment of neuroleptic malignant syndrome: a review and report of cases. Australian & New Zealand Journal of Psychiatry, 33(5), 650-659.

For more PsychEd, follow us on Instagram (⁠⁠@psyched.podcast⁠⁠), Facebook (⁠⁠PsychEd Podcast⁠⁠), X (⁠⁠@psychedpodcast⁠⁠), and Bluesky (⁠⁠@psychedpodcast.bsky.social‬⁠⁠). You can email us at ⁠⁠[email protected]⁠⁠ and visit our website at⁠⁠ psychedpodcast.org⁠⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.

This episode covers Working with Borderline Personality Disorder in the Emergency Department with Dr. Bruce Fage, a psychiatrist in Toronto working in emergency and acute care psychiatry, and an Assistant Professor at the University of Toronto. His interests include the relational and systems issues that shape psychiatric care in crisis settings. He is also a former founding member of PsychEd!

The learning objectives for this episode are as follows:

1. Explain how the emergency department environment influences presentations of borderline personality disorder

2. Know when to apply the diagnosis of borderline personality in the emergency setting

3. Demonstrate effective management strategies for patients with BPD in the ED

4. Evaluate appropriate use of emergency and inpatient care for BPD presentations

Guest:

Dr. Bruce Fage

Hosts:

Sara Abrahamson (MS3)

Shelly Palchik (MS4)

Angad Singh (PGY2)

Audio editing:

Angad Singh (PGY2)

For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠), Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of serotonin syndrome.

Hosts: 

Eric Yu (MS3)

Dr. Angad Singh (PGY2)

Dr. Shaoyuan Wang (PGY5)

Audio Editing: 

Dr. Angad Singh (PGY2)

References:

1. Boyer, E. W. (2024). Serotonin syndrome (serotonin toxicity). In UpToDate.

2. Buckley, N. A., Dawson, A. H., & Isbister, G. K. (2014). Serotonin syndrome. Bmj, 348.

3. Dunkley, E. J. C., Isbister, G. K., Sibbritt, D., Dawson, A. H., & Whyte, I. M. (2003). The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. Qjm, 96(9), 635-642.

4. Foong, A. L., Grindrod, K. A., Patel, T., & Kellar, J. (2018). Demystifying serotonin syndrome (or serotonin toxicity). Canadian Family Physician, 64(10), 720-727.

For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠), Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This is our second book club episode centered around the novel Healing: Our Path from Mental Illness to Mental Health by Thomas Insel, MD.

This book is a part memoir / part manifesto written by one of our generation’s most important leaders in neuroscience and psychiatry, Dr. Thomas Insel. Dr. Insel served as the director of the NIMH for 13 years from 2002-2015. Healing is replete with his reflections on personal and clinical experiences as well as epidemiological data, research, and policies related to mental health. Dr. Insel argues that medicine’s failure to significantly reduce the mortality and morbidity of psychiatric illnesses is less due to a lack of scientific progress, and more a result of poor implementation of existing interventions that are already well supported by the evidence.

Guest: Dr. Thomas Insel

Hosts: Dr. Gaurav Sharma - Staff psychiatrist working in Nunavut, Canada

Dr. Kate Braithwaite - Family doctor from South Africa

Ahmad Khan - MS4 at Western University

Dr. Sophie Gregoire-Mitha - PGY1 Psychiatry resident in Manitoba

Audio editing: Dr. Gaurav Sharma

Episode Evaluation: Dr. Angad Singh

Our discussion is divided into 3 main sections:

(2:48): Main themes from the book

(15:58): Clinical application of strategies discussed in the book

(41:30): Reflections on the book in the current Psychiatric landscape

For more PsychEd, follow us on Instagram (@psyched.podcast), Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website at psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers harm reduction principles.

Hosts: Dr. Andrew Nguyen, Dr. Zakia Hussain, and Shelly Palchik

Audio editing: Dr. Kate Braithwaite

Episode Evaluation: Dr. Angad Singh

Resources:

1. Chapter 4: Substance Use and Addictive Disorders. In Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences

2. Serving Clients Who Use Substances: A guide for community workers

3. A Harm Reduction Approach (Alberta Health Services)

References:

1. Alberta Health Services. A Harm Reduction Approach: Key Principles.

2. BC Centre for Disease Control (2023). Harm Reduction Services & Supply Guidelines.

3. Canadian Mental Health Association Ontario. Harm Reduction.

4. Ontario Ministry of Health (2018). Substance Use Prevention and Harm Reduction Guideline.

5. NL Centre for Applied Health Research (2020). Harm Reduction 101.

6. Public Health Agency of Canada. Reducing Stigma Toward People Who Use Drugs.

For more PsychEd, follow us on Instagram (@psyched.podcast), Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website at psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.

This episode covers psychiatry and ethics in the Ontario context with Dr. Suze Berkhout, a clinician investigator and practicing psychiatrist working in acute inpatient psychiatry at University Health Network. She is an Associate Professor at the University of Toronto in the department of psychiatry and affiliate faculty with the Institute for the History & Philosophy of Science and Technology. Her research draws on critical creative methods in ethnography, art-science collaborations, and feminist science and technology studies, to consider the politics of diagnosis and social lives of interventions and emerging technologies in biomedicine. She works with artists, service users, clinicians and scientists to understand how serious illness experiences impact our sense of identity and our social roles, and she studies the impacts of novel and emerging technologies on experiences in healthcare settings. Suze loves coffee and finding new ways to think with stories.

The learning objectives are as follows:

1. Gain familiarity with key ethical concepts in psychiatry, including how ethics differs from law and the major ethical frameworks used in clinical reasoning.

2.  Identify and analyze common ethical challenges in psychiatric practice, such as autonomy, confidentiality, boundaries, and justice.

3. Apply practical strategies for ethical decision-making in clinical encounters.

Guest: Dr. Suze Berkhout

Hosts: Dr. Matthew Cho (PGY1), Dr. Annie Yu (PGY4) and Sena Gok (MD)

Audio Editing: Angad Singh (PGY2)

Resources from our guest:

Bioethics for the People Podcast: https://www.bioethicsforthepeople.com/

Mimi Khúc Open in Emergency: https://www.mimikhuc.com/projects/open-in-emergency

For more PsychEd, follow us on Instagram (@psyched.podcast), Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website atpsychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of sleep hygiene.

Hosts: Jo Kikukawa (MS2) and Grant Yao (MS4)

Audio editing: Grant Yao

Timestamps:

(0:33) - Background

(2:07) - Core principles and strategies

(5:37) - Counselling on sleep

(6:18) - When to get help with sleep

(7:29) - Summary

References:

• Centre for Addiction and Mental Health. Sleep disorders. CAMH.
• Harvard Health Publishing. Sleep hygiene: Simple practices for better rest. Harvard Health.
• Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD. Management of chronic insomnia disorder in adults: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–133.
• Sleep Foundation. Sleep hygiene. SleepFoundation.org.
• Spielman AJ, Caruso LS, Glovinsky PB. Behavioral treatment of insomnia: A clinical case series. Sleep. 1987;10(1):87–92.

For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠),  Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ ⁠⁠psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers Types of Substances

Hosts: Sara Abrahamson, Shaoyuan Wang and Kate Braithwaite.

Audio Editing: Kate Braithwaite

References:

American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5, text revision (DSM-5-TR). 5th ed. Washington, D.C.: American Psychiatric Association Publishing; 2022.

CAMH. (2013). Inhalants. Inhalants | CAMH

CAMH. (2010). Cocaine and Crack. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/cocaine

CAMH. (2012). Amphetamines. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/amphetamines#:~:text=Chronic%20use%20of%20amphetamines%20can,can%20also%20cause%20amphetamine%20psychosis.

Chae J, Marsden J and Sutherland A. (2024, August 21). Benzodiazepine Withdrawal. Emergency Care BC. Benzodiazepine Withdrawal : Emergency Care BC

ChildHealthBC. (2023, September 21). Common Street names for Substances. https://childhealthbc.ca/mhsu/common_streetnames_substances/printfile

Jauch EC. (2023, January 18) Inhalants Clinical Presentation. Medscape. Inhalants Clinical Presentation: History, Physical, Causes

Kaye, AD, Staser, AN, Mccollins, TS, Zheng, J, Berry, FA, Burroughs, CR, Heisler, M, Mouhaffel, A, Ahmadzadeh, S, Kaye, AM, Shekoohi, S, & Varrassi, G. (2024). Delirium Tremens: A Review of Clinical Studies. Cureus, 16(4), e57601. https://doi.org/10.7759/cureus.57601

Long N. (2020, November 3). GHB toxicity. Life in the Fast Lane. GHB toxicity • LITFL • Toxicology Library Toxicant

Medx. (2025, November 26). Understanding What is the MOA of Alcohol: A Pharmacological Perspective. What is the MOA of Alcohol? Explained: Receptors and Effects

Mendelson, J. H., & Mello, N. K. (1996). Management of cocaine abuse and dependence. The New England journal of medicine, 334(15), 965–972. https://doi.org/10.1056/NEJM199604113341507

Nichols DE. Hallucinogens. Pharmacol Ther. 2004 Feb;101(2):131-81. doi: 10.1016/j.pharmthera.2003.11.002.

Nickson C. (2024, December 18). Sedative toxidrome. Life in the Fast Lane. Sedative Toxidrome • LITFL • CCC Toxicology

Porter RS, Kaplan JL, Homeier BP, editors. The Merck manual of diagnosis and therapy. 20th ed. Kenilworth (NJ): Merck Sharp & Dohme; 2018.

PsychDB. (2021, March). Opioid Intoxication. Opioid Intoxication - PsychDB

PsychDB. (2023, October). Opioid Withdrawal. Opioid Withdrawal - PsychDB

PsychDB. (2023 February). Cannabis Withdrawal. Cannabis Withdrawal - PsychDB

Roth BL, Gumpper RH. Psychedelics as Transformative Therapeutics. Am J Psychiatry. 2023 May 1;180(5):317-20.

Vollenweider FX, Kometer M. The neurobiology of psychedelic drugs: implications for the treatment of mood disorders. Nat Rev Neurosci. 2010 Sep;11(9):642-51. doi: 10.1038/nrn2884.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.

This episode covers the psychiatric case presentation with Dr. Justin Delwo, a staff psychiatrist at Toronto Western Hospital where he works in the emergency department and urgent care settings.

The learning objectives for this episode are as follows:

1. What is the goal of a psychiatric case presentation?
2. What are some ground rules for a case presentation?
3. What are the key sections of a case presentation and what should you include under each? 
4. How can you tailor your case presentation to the setting

Guest: Dr. Justin Delwo

Hosts: Dr. Matt Cho (PGY1), Dr. Daamoon Ghahari (PGY2), and Dr. Angad Singh (PGY2)

Audio editing: Dr. Angad Singh (PGY2)

Episode evaluation: Shelly Palchik (MS4)

Time Stamps:

(1:50) - Goals of a case presentation

(4:49) - Ground rules for presenting

(7:56) - General overview

(19:44) - Identifying Data

(23:16) - Chief complaint and reason for referral

(25:42) - History of presenting illness

(38:38) - Review of systems

(42:16) - Safety

(49:42) - Past psychiatric history

(53:54) - Medications

(55:55) - Past medical history

(59:14) - Allergies

(1:00:13) - Family psychiatric history

(1:02:07) - Personal history

(1:06:23) -  Mental status exam

(1:09:45) - Impression

(1:14:20) - Plan

(1:18:43) - Tailoring to different settings

For more PsychEd, follow us on Instagram (@psyched.podcast),  Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website atpsychedpodcast.org.