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The Journal of Clinical Psychiatry Podcast

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Podcast Overview

The Journal of Clinical Psychiatry Podcast explores the science, practice, and human side of mental health care. Hosted by Dr. Ben Everett, Senior Scientific Director at Physicians Postgraduate Press, the series brings together leading voices in psychiatry, neuroscience, and behavioral medicine to discuss the evidence shaping clinical care today. Each episode features thoughtful conversations with JCP authors, academic experts, and frontline clinicians exploring disorders across the mental health continuum, from schizophrenia and mood disorders to anxiety, depression, and sleep-related conditions. By bridging research and real-world practice, the podcast delivers insights that empower psychiatrists, nurse practitioners, physician associates, and primary care clinicians to deliver better care for patients with mental illness. Insightful. Evidence-based. Human-centered.

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10/24/2025

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Recent Episodes

Episode thumbnail for The Art of Deprescribing: A Framework for Ending Medication

June 16, 2026

The Art of Deprescribing: A Framework for Ending Medication

<p>In this episode, Dr. Ben Everett is joined by Dr. Joseph F. Goldberg, clinical professor of psychiatry at the Icahn School of Medicine at Mount Sinai and deputy editor-in-chief of the Journal of Clinical Psychiatry. Dr. Goldberg recently completed his term as president of the American Society of Clinical Psychopharmacology (ASCP), during which he led a 45-member international task force that produced a landmark series of consensus statements on deprescribing psychotropic medications, the principal findings of which were published in JAMA Network Open. </p><p>The decision to stop a medication is among the most common—yet least formalized—clinical acts in psychiatry. Despite decades of prescribing guidance, the field has lacked systematic frameworks for determining when, why, and how to discontinue treatment. This episode examines the ASCP task force's Delphi methodology, the areas of consensus and expert disagreement, and the practical implications for managing polypharmacy, navigating discontinuation phenomena, counseling pregnant patients, and training the next generation of prescribers. </p><p> </p><p><strong>🎯 KEY EPISODE HIGHLIGHTS:</strong> </p><p><strong>📋 MEDICINES AS EMPLOYEES: THE PERFORMANCE REVIEW FRAMEWORK [03:30]</strong> </p><p>“I often like to think of medicines like employees on a payroll, and from time to time, it's a good thing to do a performance review of everybody on the payroll and ask what's your job, and are you doing it well, and is your job still there, or is that niche no longer present?” </p><p>Dr. Goldberg's core framework reframes deprescribing as a structured, periodic clinical evaluation—shifting the default from indefinite continuation to deliberate reassessment. </p><p><strong>⚠️ PSEUDOTREATMENT RESISTANCE: THE LAI LITMUS TEST [22:00]</strong> </p><p>“Up to eighty percent of people don't take their medicines as prescribed, and oftentimes that could be quite substantial. It does run the risk of erroneously concluding this drug didn't work for you.” </p><p>Before deprescribing in schizophrenia, the task force emphasizes ruling out non-adherence—including a strong recommendation to consider long-acting injectable antipsychotics as a diagnostic and therapeutic step. </p><p><strong>🧠 THE PSYCHOLOGY OF STOPPING: MEDICATION AS TRANSITIONAL OBJECT [34:30]</strong> </p><p>“To say I'm gonna take away this tangible thing that's meant to alleviate your suffering could mean I think you're doing pretty well and you don't need this anymore. Or it could also mean I'm not sure you're really suffering as much as you think you are.” </p><p>The decision to deprescribe carries significant psychological weight for patients—and clinicians who overlook this dimension risk undermining therapeutic alliance and triggering distress independent of pharmacology. </p><p> </p><p><strong>CHAPTERS:</strong> </p><p><strong>00:00</strong> – Introduction and Defining Deprescribing </p><p><strong>07:00</strong> – Why Now: ASCP's Task Force and the Political Landscape </p><p><strong>13:30</strong> – Delphi Methodology: Consensus and Divergence </p><p><strong>15:30</strong> – The Lithium Overdose Dilemma: When Stopping Defies a Rule </p><p><strong>20:00</strong> – Adherence, Pseudotreatment Resistance, and Schizophrenia </p><p><strong>25:30</strong> – Complex Polypharmacy and Medication Performance Reviews </p><p><strong>29:30</strong> – Valproate and Women of Reproductive Potential </p><p><strong>34:00</strong> – The Psychology of Stopping: Medication Attachment and Placebo </p><p><strong>37:30</strong> – Long Half-Life Drugs and Auto-Tapering </p><p><strong>40:30</strong> – Discontinuation Phenomena, Brain Zaps, and Hyperbolic Tapering </p><p><strong>45:30</strong> – Pregnancy, Special Populations, and Relapse Risk </p><p><strong>49:30</strong> – Training Gaps and the Future of Deprescribing Education </p><p> </p><p><strong>LINKS:</strong> </p><p><strong>Full transcript and show notes:</strong> </p><p><u><a href="https://www.psychiatrist.com/jcp/ep17-art-deprescribing-framework-ending-medication-joseph-goldberg/" rel="noopener noreferrer" target="_blank">https://www.psychiatrist.com/jcp/ep17-art-deprescribing-framework-ending-medication-joseph-goldberg/</a></u> </p><p><strong>Journal of Clinical Psychiatry</strong> </p><p><u><a href="https://www.psychiatrist.com/jcp/" rel="noopener noreferrer" target="_blank">https://www.psychiatrist.com/jcp/</a></u> </p><p>Publisher of peer-reviewed research discussed in this episode. </p><p><strong>Dr. Joseph Goldberg – LinkedIn</strong> </p><p><u><a href="https://www.linkedin.com/in/joseph-goldberg-922b5317/" rel="noopener noreferrer" target="_blank">https://www.linkedin.com/in/joseph-goldberg-922b5317/</a></u> </p><p><strong>American Society of Clinical Psychopharmacology (ASCP)</strong> </p><p><u><a href="https://www.ascpp.org/" rel="noopener noreferrer" target="_blank">https://www.ascpp.org/</a></u> </p><p>The organization that convened the 45-member international deprescribing task force discussed in this episode. </p><p><strong>ASCP Deprescribing Consensus Statement — JAMA Network Open</strong> </p><p><u><a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2845497" rel="noopener noreferrer" target="_blank">https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2845497</a></u> </p><p>The parent consensus paper on general principles of deprescribing psychotropic medications. </p><p>#Deprescribing #Psychopharmacology #Polypharmacy #MedicationManagement #ClinicalPsychiatry</p>

Episode thumbnail for Forty Years at the PTSD Frontier with Barbara O. Rothbaum, PhD

June 2, 2026

Forty Years at the PTSD Frontier with Barbara O. Rothbaum, PhD

<p><strong>EPISODE DESCRIPTION</strong></p><p>Dr. Barbara O. Rothbaum, PhD, is a tenured professor in the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine, where she holds the Paul A. Janssen Chair in Neuropsychopharmacology. She is director of the Trauma and Anxiety Recovery Program, director of the Emory Healthcare Veterans Program, and as of 2025, science director of the Emory Center for Psychedelics and Spirituality. With more than 400 scientific papers and multiple books to her name, Dr. Rothbaum is one of the foremost authorities on PTSD treatment in the world. In this episode, she joins host Ben Everett to reflect on four decades at the frontier of PTSD research, from the earliest days of the field's recognition as a disorder to the cutting edge of psychedelic-assisted therapy and virtual reality exposure.</p><p></p><p>PTSD remains one of psychiatry's most consequential and undertreated conditions, affecting a substantial portion of combat veterans, survivors of sexual trauma, and countless others who have never received an accurate diagnosis. In this conversation, Dr. Rothbaum covers the evidence base for first-line trauma-focused therapies — prolonged exposure, cognitive processing therapy, and EMDR — and the intensive outpatient model that has dramatically improved treatment retention. She then turns to the stalled landscape of PTSD pharmacotherapy, her translational research combining MDMA with prolonged exposure, the emerging role of psilocybin and ketamine, and the evolution of virtual reality exposure therapy from her laboratory's 1993 pilot to the Brave Mind system now deployed across more than 50 VA health systems.</p><p></p><p><strong>KEY EPISODE HIGHLIGHTS</strong></p><p></p><p><strong>🧠 PTSD TREATMENT IS ABOUT APPROACHING, NOT AVOIDING [09:00]</strong></p><p>"There's no way to the other side of the pain except through it."</p><p>Dr. Rothbaum explains the core mechanism underlying all empirically supported PTSD therapies — and why avoidance is the central obstacle to recovery.</p><p></p><p><strong>💊 SSRIs ARE NOT REALLY THE TREATMENT FOR PTSD [24:30]</strong></p><p>"I personally will think of them like weak coffee for PTSD. Maybe you can get a little bit of effect, maybe on mood, maybe on thinking."</p><p>Despite being the only FDA-approved pharmacotherapy for PTSD, SSRIs fall well short of the evidence base for trauma-focused psychotherapy — and combination treatment offers no advantage.</p><p></p><p><strong>🥽 VIRTUAL REALITY EXPOSURE THERAPY GIVES CLINICIANS TOTAL CONTROL [43:30]</strong></p><p>"If my patient's not ready for turbulence, I can guarantee there won't be turbulence. When they are ready for turbulence, I can guarantee there will be turbulence."</p><p>From fear of heights to virtual Iraq and Afghanistan combat environments, VR allows therapists to precisely calibrate stimulus intensity — closing the gap between imaginal exposure and real-world treatment.</p><p></p><p><strong>CHAPTERS</strong></p><p>00:00 - Introduction and Guest Biography</p><p>03:30 - Career Origins: Starting with Edna Foa</p><p>05:30 - A Career at the Intersection of Therapy, Technology, and Pharmacology</p><p>08:00 - First-Line Psychotherapies: PE, CPT, and EMDR</p><p>13:30 - Comparing the Therapies: Evidence and Patient Fit</p><p>15:30 - The Emory Healthcare Veterans Program and the IOP Model</p><p>21:00 - Recognizing PTSD in Primary Care</p><p>23:30 - Pharmacotherapy: The Limits of SSRIs</p><p>27:30 - Recent Drug Development Setbacks: MDMA and Brexpiprazole</p><p>31:00 - Translational MDMA Research and Combining with Prolonged Exposure</p><p>37:30 - Lessons from Australia's MDMA Approval</p><p>39:00 - The Broader Psychedelic Landscape: Psilocybin, Ketamine, and Others</p><p>43:00 - Virtual Reality Exposure Therapy and the Brave Mind System</p><p>49:30 - Resilience, Hope, and the Future of PTSD Treatment</p><p><strong>LINKS</strong></p><p><strong>Full transcript and show notes</strong></p><p><a href="https://www.psychiatrist.com/jcp/ep16-forty-years-ptsd-frontier-barbara-o-rothbaum/" rel="noopener noreferrer" target="_blank">https://www.psychiatrist.com/jcp/ep16-forty-years-ptsd-frontier-barbara-o-rothbaum/</a></p><p></p><p><strong>Journal of Clinical Psychiatry</strong></p><p><a href="https://www.psychiatrist.com/jcp/" rel="noopener noreferrer" target="_blank">https://www.psychiatrist.com/jcp/</a></p><p></p><p><strong>Dr. Barbara O. Rothbaum — LinkedIn</strong></p><p><u><a href="https://www.linkedin.com/in/barbara-rothbaum-9339546" rel="noopener noreferrer" target="_blank">https://www.linkedin.com/in/barbara-rothbaum-9339546</a> </u></p><p></p><p><strong>Emory Healthcare Veterans Program</strong></p><p><u><a href="https://www.emoryhealthcare.org/lp/veterans-ptsd" rel="noopener noreferrer" target="_blank">https://www.emoryhealthcare.org/lp/veterans-ptsd</a></u></p><p>The intensive outpatient program for post-9/11 veterans discussed throughout this episode.</p><p></p><p><strong>Wounded Warrior Project — Warrior Care Network</strong></p><p><a href="https://www.woundedwarriorproject.org/programs/warrior-care-network" rel="noopener noreferrer" target="_blank">https://www.woundedwarriorproject.org/programs/warrior-care-network</a></p><p>Funds the four IOP programs, including Emory's, discussed in the episode. No cost to veterans.</p><p></p><p>#PTSD #TraumaTherapy #MDMAAssistedTherapy #VirtualRealityTherapy #Veterans</p>

Episode thumbnail for Rethinking Postpartum Depression: Biology, Biomarkers, and New Treatments with Jennifer L. Payne, MD

May 19, 2026

Rethinking Postpartum Depression: Biology, Biomarkers, and New Treatments with Jennifer L. Payne, MD

<p>In this episode of the JCP Podcast, host Dr. Ben Everett speaks with Dr. Jennifer L. Payne, Professor of Psychiatry and Neurobehavioral Sciences and Vice Chair of Research at the University of Virginia, where she directs the Reproductive Psychiatry Research Program. Dr. Payne holds a joint appointment in obstetrics and gynecology and has spent her career at the intersection of basic neuroscience and clinical care in perinatal psychiatry. She is widely recognized for her work on the biological underpinnings of postpartum depression, including epigenetic biomarkers that prospectively predict risk, and for her clinical and research contributions to the development of GABAergic therapeutics — from brexanolone to zuranolone — that are reshaping how the field understands and treats this condition. </p><p>Postpartum depression affects roughly one in eight women following childbirth and remains one of the most underdiagnosed and undertreated conditions in medicine. Despite this, care has long defaulted to serotonergic antidepressants developed for major depression rather than agents designed around the biology of the postpartum period. In this episode, Dr. Payne explains why the precipitous drop in neuroactive steroids — particularly allopregnanolone — following delivery may be central to postpartum depression pathophysiology, how the GABA-A receptor is implicated in ways that are distinct from benzodiazepines, what the clinical proof-of-concept established by brexanolone means for the field, and why zuranolone's oral formulation is changing real-world access. Dr. Payne also discusses the epigenetic biomarker test her lab has developed with collaborator Dr. Zachary Kaminsky — work now moving toward FDA review — its ethical implications, and emerging parallels with premenstrual dysphoric disorder. </p><p> </p><p><strong>KEY EPISODE HIGHLIGHTS</strong> </p><p> </p><p>🔬 PREDICTING POSTPARTUM DEPRESSION BEFORE IT STARTS [12:30] </p><p>"We can take blood in the third trimester, and we can say whether a woman is at high risk of developing postpartum depression by three months postpartum or at low risk." </p><p>Dr. Payne describes the epigenetic biomarker test developed with Dr. Zachary Kaminsky — replicated in six independent samples and now advancing toward FDA review — that identifies postpartum depression risk from a third-trimester blood draw, enabling preventive planning before symptoms emerge. </p><p> </p><p>🧠 WHY BREXANOLONE IS NOT JUST A BENZODIAZEPINE [24:15] </p><p>"The benzodiazepines don't act on those extrasynaptic GABA receptors. So sometimes people have said to me that allopregnanolone and the new FDA-approved treatments for postpartum depression are really just a benzodiazepine, and that's not true." </p><p>Dr. Payne explains the critical mechanistic distinction between benzodiazepines (synaptic GABA-A binding) and neuroactive steroids (extrasynaptic GABA-A binding), clarifying why this difference matters for setting the brain's overall inhibitory tone — a distinction clinicians should be prepared to address with patients. </p><p> </p><p>💊 ZURANOLONE: FOURTEEN DAYS, SUSTAINED RESPONSE [31:00] </p><p>"You take [zuranolone] for fourteen days, and you see response rates within three days, which again, is groundbreaking in terms of treating a depressive episode." </p><p>The shift from a 60-hour inpatient IV infusion to a 14-day oral course has transformed real-world feasibility. Dr. Payne reviews the clinical profile of zuranolone — including rapid onset, sedation considerations, breastfeeding questions, and the practical barriers that still limit access. </p><p> </p><p><strong>CHAPTERS</strong> </p><p>00:00 - Introduction and Guest Overview </p><p>02:45 - Scientific Origins: From Alzheimer's Disease to Postpartum Depression </p><p>06:30 - Why Postpartum Depression Is a Natural Model for Studying Depression Biology </p><p>08:00 - Screening, Underdiagnosis, and the Stigma Gap </p><p>09:30 - A Personal Account of Postpartum Depression and Advocacy </p><p>12:00 - Epigenetic Biomarkers: Predicting Risk Before Delivery </p><p>17:15 - Ethics, Autonomy, and the Case for a Predictive Blood Test </p><p>20:45 - Allopregnanolone and the Neuroactive Steroid System </p><p>23:30 - GABA-A Receptor Subtypes: Why Neuroactive Steroids Are Not Benzodiazepines </p><p>25:30 - DoD-Funded Research: Neuroactive Steroid Shunting and GABA-A Reconfiguration </p><p>29:30 - Brexanolone: Clinical Proof of Concept and Why It's No Longer Available </p><p>31:30 - Zuranolone: Mechanism, Practical Considerations, and Real-World Access </p><p>37:00 - PMDD as a Window into Shared Biology </p><p>39:30 - The GABAergic Hypothesis and the Future of Depression Subtypes </p><p>41:45 - Improving Screening and Educating OBGYNs </p><p>43:30 - Closing Remarks </p><p> </p><p><strong>LINKS</strong> </p><p>Full transcript and show notes </p><p><a href="https://www.psychiatrist.com/jcp/ep15-rethinking-postpartum-depression-biology-biomarkers-jennifer-l-payne/" rel="noopener noreferrer" target="_blank">https://www.psychiatrist.com/jcp/ep15-rethinking-postpartum-depression-biology-biomarkers-jennifer-l-payne/</a> </p><p> </p><p>Journal of Clinical Psychiatry </p><p><a href="https://www.psychiatrist.com/jcp/" rel="noopener noreferrer" target="_blank">https://www.psychiatrist.com/jcp/</a> </p><p>Publisher of peer-reviewed research discussed in this episode. </p><p> </p><p>National Pregnancy Registry for Antidepressants: <u><a href="https://womensmentalhealth.org/research/pregnancyregistry/antidepressants/" rel="noopener noreferrer" target="_blank">https://womensmentalhealth.org/research/pregnancyregistry/antidepressants/</a></u> </p><p> </p><p>Biomarkers: </p><ul><li>DNA methylation biomarkers prospectively predict both antenatal and postpartum depression: <u><a href="https://pubmed.ncbi.nlm.nih.gov/31843207/" rel="noopener noreferrer" target="_blank">https://pubmed.ncbi.nlm.nih.gov/31843207/</a></u> </li><li>Seeing the Future: Epigenetic Biomarkers of Postpartum Depression: <u><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3857665/" rel="noopener noreferrer" target="_blank">https://pmc.ncbi.nlm.nih.gov/articles/PMC3857665/</a></u> </li><li>Biomarker or pathophysiology? The role of DNA methylation in postpartum depression: <u><a href="https://pubmed.ncbi.nlm.nih.gov/24059792/" rel="noopener noreferrer" target="_blank">https://pubmed.ncbi.nlm.nih.gov/24059792/</a></u> </li></ul><br/><p>DOD Work in Segment II: </p><ul><li>Metabolites of Progesterone in Pregnancy: Associations with Perinatal Anxiety: <u><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10530426/" rel="noopener noreferrer" target="_blank">https://pmc.ncbi.nlm.nih.gov/articles/PMC10530426/</a></u> </li><li>Neuroactive steroid biosynthesis during pregnancy predicts future postpartum depression: a role for the 3α and/or 3β-HSD neurosteroidogenic enzymes? <u><a href="https://pubmed.ncbi.nlm.nih.gov/39885361/" rel="noopener noreferrer" target="_blank">https://pubmed.ncbi.nlm.nih.gov/39885361/</a></u> </li></ul><br/><p> </p><p>#PostpartumDepression #NeuroactiveSteroidsGABA #PerinataMentalHealth #Zuranolone #EpigeneticBiomarkers </p>

18 total episodes available

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What is The Journal of Clinical Psychiatry Podcast?

The Journal of Clinical Psychiatry Podcast explores the science, practice, and human side of mental health care. Hosted by Dr. Ben Everett, Senior Scientific Director at Physicians Postgraduate Press, the series brings together leading voices in psychiatry, neuroscience, and behavioral medicine to discuss the evidence shaping clinical care today.

Each episode features thoughtful conversations with JCP authors, academic experts, and frontline clinicians exploring disorders across the mental health continuum, from schizophrenia and mood disorders to anxiety, depression, and sleep-related conditions. By bridging research and real-world practice, the podcast delivers insights that empower psychiatrists, nurse practitioners, physician associates, and primary care clinicians to deliver better care for patients with mental illness.

Insightful. Evidence-based. Human-centered.

How often does this podcast release new episodes?

This podcast updates daily.

Where can I listen to this podcast?

This podcast is available on 4 platforms including Apple Podcasts, Spotify, and more. You can also use the RSS feed directly.

Does this podcast accept guests?

Yes, this podcast regularly features guests.

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