Dr. David Healy is both a critic and a practitioner of psychopharmacology, and today he's going to share with us what he actually does in practice.

Welcome to the Carlatte Psychiatry podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief, and my co-host Kelly Newsom is away on vacation this week.

David Healy is a psychopharmacologist whose career spans back to the early 1980s, where his early

research furthered our understanding of the monoamine system and the norapinephrine and

serotonergic antidepressants that work through it. In the 1990s, Dr. Healy realized that many of

the pioneers of psychopharmacology would not be with us long, and he collected interviews with

them which he turned into a series of key textbooks on the history of psychopharmacology.

I highly recommend them if you haven't read them already.

Since then, Dr. Haley has written critical texts exploring the broader effects of psychiatric meds and diagnoses on our culture, all the while continuing to practice.

He spoke with us about some of his views on the field and shared a rare glimpse of how he

works with patients.

But first, a preview of the CME quiz for this episode.

Welcome to the question. Which effect of SSRIs was not well known when they were first released?

A.

Anxiolytic or anti-anxiety effects.

B.

Antidepressant effects. C, sexual dysfunction, or D, metabolic effects.

In psychiatry, randomized controlled trials are thought of as the gold standard for figuring out what medications do.

But do we miss anything by relying too much on randomized controlled trials?

Well, the guy who did the first randomized controlled trial, Austin Radford Hill, said, you know, in essence what he was saying was, you're to play golf, you need to have a full set of clubs in the back.

You don't just want one good club which you love using.

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