Sunday, December 10, 2006

My Three Shrinks Podcast 2: Roots

[1] . . . [2] . . . [3] . . . [All]

We'd like to thank our readers and listeners for your kind comments and suggestions about our first podcast. This one's a bit longer, at about 33 minutes. I think we'll get better about the time. About 20 minutes seems to be a good balance.

This is actually the second half of the original podcast, which went long so we sliced it into two podcasts. Don't expect to get a podcast every other day... if we do one every other week, I'll be pleasantly surprised (though I'm striving for every Sunday). Maybe we can be like Digg's Kevin Rose and Alex Albrecht and drink alcohol at the beginning of each podcast... that would be interesting.
Here are the show notes for the podcast:

December 10, 2006: Roots

Topics include:
  • Dr Anonymous is again not mentioned in this podcast (but we do thank him for the idea about the musical bumpers between topics)
  • Thorazine Immunity: Clink reviews a 1992 case in which a prisoner sued the on-call psychiatrist for involuntarily medicating him with chlorpromazine due to violent, self-injurious behavior... but without going through any hearing panels for forced meds [Federal Code: Civil action for deprivation of rights]
  • Dinah brings a duck to the "Shrink Rap Studio" (my kitchen table)
  • FDA hearing on December 13 about adding a black boxed warning on antidepressant labels about the possibility of increased suicidality in adults: Will this reduce access to these drugs, causing undertreatment of depression and actually INCREASE suicide rates? (Check here for background materials)
  • Recent PubMed articles and Corpus Callosum post about this whole antidepressants and suicide issue. Also, Dinah mentioned this, hot-off-the-press, Finnish article, showing an increase risk of attempts and a decreased risk of deaths.
  • Treatment of social phobia [PubMed]
  • Social phobia and alcohol [PubMed]
  • Paxil- and other SSRI-related withdrawal symptoms [PubMed]
  • Sexual dysfunction and SSRIs [PubMed]
  • Putting roots on someone
  • Psilocybin mushrooms for Monk's OCD
  • Maryland psychologists discuss adoptions in gay marriages
  • NYT: Gender dysphoric children

This podcast is available on iTunes. You can also download the .mp3 or the MPEG-4 file from
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Another great podcast; sounds like you've hit your groove. My favourite line: "We don't need to ban McDonalds, it's a punishment in itself."

I'd really like to hear a podcast that focuses on the more commonly prescribed psychiatric medications in terms of risk/benefit. What's your take on benzos? Are certain SSRIs better for certain conditions, and why? And so on. I was a bit surprised to hear (I think it was Clink) say that if someone asked for Paxil, she'd give it to them. It's not exactly harmless, is it?

NeoNurseChic said...

Funny but I'm just finally listening to the mp3 version of the first one and I just have to comment on the propranolol thing! My family doctor had told me that inderal used to be a street drug for musicians to quell their performance anxiety. So during the semester when I was crashing and burning on topamax and having memory/concentration problems, I used to take a propranolol before every performance - even those as simple as lessons and studio class! It slowed my racing heart and calmed my shaky hands, and it truly did help! I did not tell any doctors. If my family doc knew, he would probably be kicking himself for telling me that little detail! I quit doing it once I was put on verapamil for headaches.

But anyway - I probably won't listen to all of the 1st one tonight but over the next few days, I'll listen to both of them! Neat to finally hear what the 3 of you sound like!

Carrie O:-)

Dinah said...

6 Minutes.

Dinah said...

To Seamonkey:
No, paxil (or any other SSRI) isn't without risk. Sometimes someone walks in predisposed to wanting to be on a particular medicine (changed my friend's life) and, after a full history and evaluation, I discuss my thoughts and treatment recommendations. If I don't think a specific medication is right, I say so. If there's an absolute contraindication (hmm, you want high dose Xanax and you've got a long history of addictions... or an anti-depressant might tip your Bipolar depression into Bipolar Mania) then I won't do it. Sometimes people want something and I don't think it will help but there's no enormous risk (remember, starting a medication only obligates you to one dose at a time) I might say that I don't think it's the best, but after a careful talk about risks/benefits/why or why not to use a given agent, if someone wants something specific that I don't have very strong feelings against, I will prescribe it. Over the years, I found that sometimes the patient is right, or that medications I thought wouldn't help Did. Psychiatry isn't alway the place to be stubborn and no one ever demands anything I feel strongly against once I explain why something helped a friend but isn't likely to help them in cases where there's a risk of danger.

Anonymous said...

I just listened to your first & second podcast, and I really enjoyed them.

Keep it up. And, responding to a comment made at the beginning of #2, I definitely prefer the longer format. I am eagerly awaiting the mp3 link for #3.

You're capturing that (early) twit feel pretty well-- I like the informal, conversational tone. Don't worry about cutting the 'slow' sections-- it's easy to fast forward...

Just my two cents. Thanks for the podcast.

Dinah said...

Wow, gee thanks, anonymous.
I don't think anyone has to worry about the next couple of podcasts being anything other than "conversational" and a bit random at that.

Anonymous said...


I just downloaded all the old episodes. Something that really struck me was that many of your patients are suicidal. Of course it's obvious but I didn't realize people actually admitted that.

I sorta thought that if you admitted you are suicidal it's a quick jump to being involuntarily committed. I'm new to this whole 'being crazy' thing. Well I realize I have had bipolar symptoms for 10 years but I'm new to asking for help.

Anyway, I will admit that I have had suicidal feelings in the past but will lie if I am currently feeling that way. I realized I probably don't have to do that. I'm not going to be automatically committed if I admit that I'd rather be dead.

Thanks. It's funny how one little off-hand comment can do that.

Anonymous said...

So I know this comment is 3 years late but I just stumbled upon "My Three Shrinks" and I thought I'd start with the 1st podcast and work my way up. My comment is regarding gay couples being able to adopt. I was really surprised that you believed there was no issue over gay couples being allowed to legally adopt as only about half the states allow it. It's completely ridiculous that there are laws against it of course but that's the society we live in. So anyway, I imagine the purpose of the article was to aid gay couples in court cases where they were being denied these rights.