Lindsay Hill - Psych NP Mentor - PMHNP Mentor

Welcome to Courtrooms, Classrooms, and Clinics, a deep dive into the complex, multidisciplinary realities of supporting autistic adolescents today. In this episode, we explore how the challenges autistic youth face extend far beyond traditional therapy, requiring a unified approach across every aspect of their lives.

This episode reviews brexpiprazole's expanding FDA indications, including its approval for agitation in Alzheimer's dementia and mixed results in PTSD augmentation. Dr. Amritha Bhat discusses perinatal mental health, covering antidepressant safety in pregnancy, postpartum psychosis as a bipolar spectrum disorder, and zuranolone for postpartum depression. Also featured: new research on service dogs for PTSD, placebo responses across psychiatric disorders, vitamin D's dose-dependent antidepressant effects, and metformin guidelines for preventing antipsychotic weight gain.

This episode covers topics from the following sources: TCPR_Mar_2026_.pdf.

In this episode, we dive into the critical field of reproductive psychiatry to equip psychiatric nurse practitioners with the latest evidence-based strategies for managing pregnant and postpartum patients.... Listeners will learn how to differentiate psychiatric emergencies like postpartum psychosis from postpartum obsessive-compulsive disorder, and navigate complex medication decisions involving lithium, valproic acid, and novel treatments for postpartum depression like zuranolone.... We explore crucial clinical insights, including the necessity of adjusting lamotrigine and lithium doses during pregnancy and the importance of maintaining antidepressant regimens to prevent high relapse rates.... By understanding the nuanced risks of medication exposure versus untreated maternal illness...

Join this insightful peer consultation session where psychiatric nurse practitioners navigate the complexities of clinical decision-making and private practice dynamics. The group explores the nuances of scope of practice, specifically debating when to manage medical comorbidities like migraines or withdrawal symptoms and the utility of "two-for-one" medications like topiramate. Listeners will gain practical strategies for switching antipsychotics, including specific tips on cross-tapering versus direct switching based on receptor occupancy. The episode also features a deep dive into a severe, treatment-resistant OCD case, examining augmentation strategies, TMS, and the critical role of Exposure and Response Prevention (ERP) therapy. These real-world discussions...

This episode dives into evidence-based strategies for treating Obsessive-Compulsive Disorder when first-line SSRIs fail, exploring augmentation options like ondansetron, memantine, and deep TMS.... We also sit down with Dr. David Jobes to discuss the Collaborative Assessment and Management of Suicidality (CAMS), a transformative framework that empowers patients by focusing on their specific drivers of suffering rather than just risk prediction45. Additionally, the discussion covers the rising popularity of transcranial direct current stimulation (tDCS), offering a clinical verdict on its safety and efficacy for depression compared to established treatments67. Finally, we review a recent meta-analysis regarding antipsychotic dosing, highlighting crucial differences...

Dive into the complex landscape of developmental disorders with a comprehensive look at managing Trisomy 21, Fetal Alcohol Spectrum Disorders (FASD), and clinical dysmorphology. We explore the psychiatric comorbidities of Down syndrome, offering evidence-based pharmacologic strategies for treating depression, anxiety, and ADHD while challenging implicit biases that limit patient potential. Expert insights reveal why over 85% of FASD cases are misdiagnosed and provide practical screening techniques to identify alcohol-related neurodevelopmental deficits that lack physical markers. The discussion extends to recognizing subtle genetic signs, such as those in 22q deletion syndrome, to help clinicians look beyond behavioral symptoms for underlying causes. We also...

In this episode, we critically evaluate the expanding clinical profile of brexpiprazole, analyzing its recent FDA approval for agitation in Alzheimer’s dementia alongside the data behind its rejection for PTSD. We dive into perinatal mental health with Dr. Amritha Bhat, who offers expert guidance on navigating the risk-benefit analysis of psychotropics during pregnancy, the use of zuranolone, and first-line management for postpartum psychosis. Listeners will also discover new consensus guidelines that recommend prescribing metformin concurrently with high-risk antipsychotics to prevent metabolic side effects. We round out the discussion with recent research updates on the dose-dependent antidepressant effects of Vitamin D...

This episode explores the transformative power of integrating wellness-centric interventions into psychiatric practice, moving beyond mere symptom reduction to the cultivation of true mental well-being.... Listeners will discover the neurobiology behind the "HERO" traits—Happiness, Enthusiasm, Resilience, and Optimism—and how specific lifestyle interventions like the WILD 5 Wellness program can target inflammation and improve clinical outcomes.... We discuss practical augmentation strategies that combine traditional psychopharmacology with evidence-based practices in exercise, nutrition (specifically the MIND diet), sleep hygiene, mindfulness, and social connectedness.... You will learn how to implement measurement-based care using tools like the HERO Wellness Scale to track progress and addr...

This episode equips psychiatric nurse practitioners with advanced strategies for managing complex withdrawal syndromes and identifying medical mimics in clinical practice. Listeners will explore evidence-based protocols for treating buprenorphine-precipitated withdrawal—including the efficacy of administering additional buprenorphine—and review a novel inpatient pathway for methamphetamine withdrawal. We also dive into the diagnosis and management of Functional Neurological Disorder (FND), emphasizing the importance of identifying positive physical signs and providing clear patient education. Furthermore, the episode details how to distinguish psychiatric symptoms from medical conditions like anti-NMDA receptor encephalitis and acute intermittent porphyria to prevent misdiagnosis. Finally, we discuss practical interventions for...

In this episode, we explore culturally competent assessment strategies with Dr. Dakota Carter, demonstrating how to bridge Western medicine with diverse family beliefs through the lens of a First-Generation youth case study. We also dive into Neuroscience-Based Nomenclature (NbN), a pharmacological classification system that reduces stigma and improves patient education regarding off-label prescribing. Dr. Laelia Benoit joins us to reframe climate anxiety not as a pathology to be cured, but as a rational response that requires validation and collective action. Additionally, we review the latest clinical updates on pediatric mania, comparing the efficacy and metabolic profiles of ziprasidone, lithium, and...

In this episode, we uncover the high rates of misdiagnosis in Fetal Alcohol Spectrum Disorders (FASD) and provide specific screening questions, such as the "4Ps Plus" method, to improve detection in your clinical practice. We dive into the psychiatric management of Trisomy 21, outlining appropriate pharmacologic interventions for comorbidities like anxiety, ADHD, and autism-related irritability while addressing the impact of implicit bias on care. The discussion extends to dysmorphology essentials, highlighting when to suspect genetic conditions like 22q deletion syndrome in patients presenting with behavioral challenges. We also navigate the legal and ethical landscape of decision-making for young adults with intellectual...

This episode provides a comprehensive guide to managing complex psychiatric challenges in autistic youth, specifically addressing irritability, suicidality, and psychosis. We explore a step-by-step treatment algorithm for irritability that prioritizes functional goals and evidence-based off-label pharmacotherapy, such as guanfacine, memantine, and low-dose naltrexone, to help you avoid premature escalation to antipsychotics. Listeners will gain critical insights from Dr. Paul Lipkin on adapting suicide risk assessments using the ASQ tool and from Dr. Kristin Cadenhead on distinguishing true psychotic symptoms from baseline autistic traits. The discussion also reviews recent research on ADHD interventions, offering practical takeaways to enhance your diagnostic precision...

🧠 Brain Energy: The "Cliff Notes" Version ⚡

🚨 The Big Reveal

Hold onto your neurons—Dr. Christopher Palmer is flipping the script. The central thesis is a game-changer: Mental disorders are not just chemical imbalances or psychological issues; they are metabolic disorders of the brain.

Whether it's anxiety, depression, ADHD, or schizophrenia, the root cause traces back to the same biological problem: your brain cells aren't getting the right energy at the right time.

🦠 The Tiny Villains (and Heroes): Mitochondria

Remember hearing that mitochondria are the "powerhouses of the cell" in high school b...

In this episode, we explore the addiction treatment continuum to help you determine when to prioritize pharmacotherapy versus psychotherapy for opioid, stimulant, and alcohol use disorders. We provide a deep dive into Brixadi, a new long-acting injectable buprenorphine, comparing its weekly and monthly dosing options to Sublocade and discussing its potential role in rapid induction protocols34. Expert insights on Motivational Interviewing and 12-Step Facilitation offer practical communication strategies to resolve patient ambivalence and improve engagement with recovery communities56. You will also learn about emerging evidence for microinduction strategies in hospitalized patients and the safety of initiating injectables in the emergency...

Episode Description Imagine sending your 10-year-old to live on Mars. They aren't evolved for the low gravity, the alien environment, or the isolation. According to social psychologist Jonathan Haidt, this is exactly what we did to Generation Z when we traded a "play-based childhood" for a "phone-based childhood" in the early 2010s. In this episode, we dive into Haidt’s The Anxious Generation to understand the sudden, global surge in adolescent mental illness and, more importantly, how we can bring our children back to Earth.

Key Topics Covered:

• The Great Rewiring (2010–2015): How the rapid adoption of sma...

Join us as we explore the critical medical complications of eating disorders through the lens of Dr. Jennifer Gaudiani’s "Sick Enough," a vital resource for psychiatric nurse practitioners managing the intersection of mental and physical health. We examine the physiological impacts of starvation and purging, including "cave person brain" adaptations, hypoglycemia, and the dangerous fallacy of relying solely on normal lab results or BMI to assess disease severity.... Listeners will gain actionable clinical insights on managing gastroparesis with metoclopramide, treating bone density loss with transdermal estrogen rather than oral contraceptives, and utilizing spironolactone to manage pseudo-Bartter syndrome during purging ce...

This episode explores the critical crisis of healthcare worker burnout and mental health through the lens of Dr. Jessi Gold's clinical work with medical professionals during the pandemic,,. We discuss tailored treatment strategies for high-functioning clinicians, including the use of SSRIs like sertraline for OCD, beta-blockers for performance anxiety, and the integration of Exposure and Response Prevention (ERP) therapy,,. Listeners will gain valuable insights into managing countertransference, identifying "hidden curriculum" barriers to care, and recognizing subtle presentations of PTSD and moral injury in nursing and medical staff,,,. The episode also details practical interventions for practice, such as utilizing cognitive behavioral...

Show Notes: How Do You Feel? – One Doctor’s Search for Humanity in Medicine

In this episode, we dive into the poignant and revealing memoir How Do You Feel? by psychiatrist Dr. Jessi Gold. What happens when the people trained to save our lives are the ones who need saving? Dr. Gold takes us behind the scenes of her clinic, where she specializes in treating healthcare workers—a group often celebrated as "heroes" but privately struggling with a profound mental health crisis.

Key themes discussed in this episode:

Explore the intersection of high achievement and severe mental illness through the case of Elyn Saks, a tenured law professor living with schizophrenia.... We examine her clinical trajectory from a "grave" prognosis to professional success, analyzing her treatment regimen involving antipsychotics like thiothixene and clozapine combined with long-term psychoanalysis.... The discussion highlights the patient's internal experience of psychosis, the traumatic impact of mechanical restraints, and the complex dynamics of medication adherence and side effect management.... Psychiatric NPs will gain a nuanced perspective on prognosis and the therapeutic alliance, reinforcing the importance of treating the whole person rather than just...

In this episode, we critically evaluate the expanding clinical profile of brexpiprazole, examining its recent FDA approval for agitation in Alzheimer’s dementia alongside its limitations as an augmentation strategy for PTSD.... We are joined by Dr. Amritha Bhat to navigate the complexities of perinatal mental health, offering expert guidance on risk-benefit analysis for antidepressants during pregnancy and the management of postpartum psychosis.... The discussion extends to essential research updates, including the efficacy of service dogs for veterans, the antidepressant properties of high-dose Vitamin D, and new consensus guidelines for using metformin to prevent antipsychotic-induced weight gain.... Listeners will gain ac...

In this episode, we scrutinize Brexpiprazole's expanding clinical profile, examining its modest efficacy for agitation in Alzheimer's dementia and its potential utility as an augmentation strategy for PTSD. We then delve into perinatal mental health with Dr. Amritha Bhat, who shares expert strategies for weighing medication risks during pregnancy and managing postpartum psychosis with lithium. The discussion includes a look at Zuranolone, a novel neurosteroid for postpartum depression, alongside new guidelines recommending metformin to prevent weight gain in patients starting high-risk antipsychotics. We also analyze recent research on the significant placebo response in mood disorders and the dose-dependent benefits of...

In this episode, we take an in-depth look at Stephanie Foo’s acclaimed memoir, What My Bones Know. A successful radio producer for This American Life and Snap Judgment, Foo seemed to have it all on paper, but behind the scenes, she was battling a constant, crushing anxiety she called "the dread".

Join us as we explore her journey from a diagnosis of Complex PTSD (C-PTSD) to her relentless pursuit of healing. Unlike traditional PTSD, which is often linked to a single event, C-PTSD arises from chronic, repeated trauma—in Foo's case, years of severe physical and verb...

Are you a busy clinician looking for bottom-line assessments of the latest psychiatric medications? In this episode, we dive into the Eighth Edition of the Medication Fact Book for Psychiatric Practice. Authored by Talia Puzantian, PharmD, and Daniel J. Carlat, MD, this comprehensive 2026 update is designed to provide "need-to-know" information that can be quickly absorbed during a busy day of seeing patients.

Join us as we explore the latest additions to this essential reference guide, including:

This podcast discusses the emerging field of metabolic psychiatry, which posits that mitochondrial dysfunction is the fundamental biological root of mental illness. Rather than viewing psychiatric conditions solely as neurotransmitter imbalances, this framework suggests that disorders like depression and schizophrenia are manifestations of cellular energy failure in the brain. Research indicates a bi-directional link between metabolic diseases and mental health, where issues like insulin resistance can actually predict future psychiatric decline. Consequently, traditional medications may fail because they only address downstream symptoms instead of the underlying metabolic crisis. To bridge this gap, the text advocates for metabolic interventions such...