What is Interventional Psychiatry
Interventional psychiatry is a non-pharmacalogical way to treat depression that may be resistant to other treatments. Dr. Lou Ann Eads, geriatric psychiatrist at the UAMS Psychiatric Research Institute, discusses interventional psychiatry.
Featured Speaker:
Lou Ann Eads, MD
Dr. Lou Ann Eads is a geriatric psychiatrist at the UAMS Psychiatric Research Institute. Transcription:
What is Interventional Psychiatry
Scott Webb (Host): Psychiatric disorders can often be challenging to diagnose and treat. One of the more recent advances in the field of psychiatry includes interventional treatment for psychiatric disorders. Let’s talk to Dr. Lou Ann Eads, a Geriatric Psychiatrist at the UAMS Psychiatric Research Institute. This is UAMS Health Talk from the University of Arkansas for Medical Sciences. I’m Scott Webb. Dr. Eads, thanks for joining me today. This is such a fascinating topic. So interesting. What is interventional psychiatry?
Lou Ann Eads, MD (Guest): Interventional psychiatry is a way to look at treating depression that falls into what we call treatment resistant depression. And that usually means that the individual has tried several different medications and was unable to tolerate them well and or did not respond well to them and they are still struggling with psychiatry. So, it’s more of a nonpharmacological way to go about trying to get good control of depression.
Host: And is this a revolutionary approach to this, the nonpharmaceutical approach?
Dr. Eads: ECT is actually part of interventional psychiatry and it’s been a treatment modality in the United States for the past 70 to 80 years and has been perfected and refined throughout those years. But we’ve also recently, the last 10 years, had the emergence of what’s called TMS or transcranial magnetic stimulation which is also considered an interventional type modality. And then over the last few years, there’s been more and more interest in ketamine whether that’s been by an IV infusion of by nasal administration. Which is also a different way to think about treating depression.
Host: Wow, it’s all so fascinating when you consider that it’s been worked on for 70 to 80 years and I imagine the field of psychiatry is hundreds of years old. Who is a candidate for interventional psychiatry?
Dr. Eads: The ideal candidate is someone that falls within the treatment resistant range meaning that they’ve been under psychiatric care, they’ve tried therapy at times, and they’ve tried and failed different antidepressants. Different insurances may specify how many they need to have tried and failed before we can move on to a more aggressive or a different approach managing depression. A part is going to depend on your insurance.
Host: That’s interesting. So, insurance is a factor and it’s not necessarily that the patient comes in and requests this but it’s really more of doctor factoring what’s been tried, what insurance you have and so on. So, talk about some of the commonly used treatment options like electroconvulsive therapy or transcranial magnetic stimulation. How do those work?
Dr. Eads: Electroconvulsive therapy started about 70 to 80 years ago. We induce a seizure with a small amount of electricity. The seizure itself starts changes in the brain that helps reboot the brain somewhat so they can respond to medications. It is a series of treatments. It is not like what the movies usually depict it. And it’s been known to be helpful for a long time. Throughout the years, the machines have gotten better, the settings have been perfected to where there’s much less concern of side effects. There is still considered a rare side effect of some possible memory issues that might not resolve. There is a little bit of a risk from a cardiovascular risk. So, that can be addressed and minimized but you are going under general anesthesia for each treatment. It is still considered the gold standard however, for treatment of depression meaning that when everything else seems to fail us, ECT is something we really look towards. It is considered the most effective and the quickest acting, much more so than medications that we have to offer.
Host: That’s so cool that you referenced the movies and rebooting the brain. I had no idea that that was an actual thing that you can literally sort of reboot the brain. That’s really cool. What do patients report after having gone through these treatments?
Dr. Eads: Somewhat individual from patient to patient. But they do go under general anesthesia, so they are going to be drowsy for a while and we advise people not to drive or work or do anything that they need to be at the top of their game as far as being able to think and reason and logic and that kind of stuff. Ideally, they probably should do that – that the whole should kind of plan on minimal activities as far as work and that stuff throughout the series which is usually six to twelve treatments every other day or Monday, Wednesday, Friday.
Host: Dr. Eads is there anything else you’d like the listeners to know about interventional psychiatry or the UAMS Psychiatric Research Institute? What else can we tell listeners?
Dr. Eads: TMS is a modality that emerged about ten years ago and is a way to treat depression by using a magnet. It is similar to what you would see with an MRI machine that is placed on the skull and the magnetic impulses stimulate changes in the brain and over time, and that’s a different way to treat it. the advantages of TMS or transcranial magnetic stimulation is that you do not go under anesthesia. We do not have the risk of the – rare risk of memory concerns with TMS that we do with ECT. It can be helpful but it’s not helpful for everybody. So, it’s a different way to look at this. They usually spend twenty minutes in the TMS chair a day. They are treated daily for about 30 treatments total and then tapering out for a little bit after that.
Host: Wow, what amazing work you are doing. Dr. Eads, thanks so much for your time today. for more information on interventional psychiatry and the UAMS Psychiatric Research Institute please visit www.uamshealth.com. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics that may interest you. This is UAMS Health Talk. Thanks for listening.
What is Interventional Psychiatry
Scott Webb (Host): Psychiatric disorders can often be challenging to diagnose and treat. One of the more recent advances in the field of psychiatry includes interventional treatment for psychiatric disorders. Let’s talk to Dr. Lou Ann Eads, a Geriatric Psychiatrist at the UAMS Psychiatric Research Institute. This is UAMS Health Talk from the University of Arkansas for Medical Sciences. I’m Scott Webb. Dr. Eads, thanks for joining me today. This is such a fascinating topic. So interesting. What is interventional psychiatry?
Lou Ann Eads, MD (Guest): Interventional psychiatry is a way to look at treating depression that falls into what we call treatment resistant depression. And that usually means that the individual has tried several different medications and was unable to tolerate them well and or did not respond well to them and they are still struggling with psychiatry. So, it’s more of a nonpharmacological way to go about trying to get good control of depression.
Host: And is this a revolutionary approach to this, the nonpharmaceutical approach?
Dr. Eads: ECT is actually part of interventional psychiatry and it’s been a treatment modality in the United States for the past 70 to 80 years and has been perfected and refined throughout those years. But we’ve also recently, the last 10 years, had the emergence of what’s called TMS or transcranial magnetic stimulation which is also considered an interventional type modality. And then over the last few years, there’s been more and more interest in ketamine whether that’s been by an IV infusion of by nasal administration. Which is also a different way to think about treating depression.
Host: Wow, it’s all so fascinating when you consider that it’s been worked on for 70 to 80 years and I imagine the field of psychiatry is hundreds of years old. Who is a candidate for interventional psychiatry?
Dr. Eads: The ideal candidate is someone that falls within the treatment resistant range meaning that they’ve been under psychiatric care, they’ve tried therapy at times, and they’ve tried and failed different antidepressants. Different insurances may specify how many they need to have tried and failed before we can move on to a more aggressive or a different approach managing depression. A part is going to depend on your insurance.
Host: That’s interesting. So, insurance is a factor and it’s not necessarily that the patient comes in and requests this but it’s really more of doctor factoring what’s been tried, what insurance you have and so on. So, talk about some of the commonly used treatment options like electroconvulsive therapy or transcranial magnetic stimulation. How do those work?
Dr. Eads: Electroconvulsive therapy started about 70 to 80 years ago. We induce a seizure with a small amount of electricity. The seizure itself starts changes in the brain that helps reboot the brain somewhat so they can respond to medications. It is a series of treatments. It is not like what the movies usually depict it. And it’s been known to be helpful for a long time. Throughout the years, the machines have gotten better, the settings have been perfected to where there’s much less concern of side effects. There is still considered a rare side effect of some possible memory issues that might not resolve. There is a little bit of a risk from a cardiovascular risk. So, that can be addressed and minimized but you are going under general anesthesia for each treatment. It is still considered the gold standard however, for treatment of depression meaning that when everything else seems to fail us, ECT is something we really look towards. It is considered the most effective and the quickest acting, much more so than medications that we have to offer.
Host: That’s so cool that you referenced the movies and rebooting the brain. I had no idea that that was an actual thing that you can literally sort of reboot the brain. That’s really cool. What do patients report after having gone through these treatments?
Dr. Eads: Somewhat individual from patient to patient. But they do go under general anesthesia, so they are going to be drowsy for a while and we advise people not to drive or work or do anything that they need to be at the top of their game as far as being able to think and reason and logic and that kind of stuff. Ideally, they probably should do that – that the whole should kind of plan on minimal activities as far as work and that stuff throughout the series which is usually six to twelve treatments every other day or Monday, Wednesday, Friday.
Host: Dr. Eads is there anything else you’d like the listeners to know about interventional psychiatry or the UAMS Psychiatric Research Institute? What else can we tell listeners?
Dr. Eads: TMS is a modality that emerged about ten years ago and is a way to treat depression by using a magnet. It is similar to what you would see with an MRI machine that is placed on the skull and the magnetic impulses stimulate changes in the brain and over time, and that’s a different way to treat it. the advantages of TMS or transcranial magnetic stimulation is that you do not go under anesthesia. We do not have the risk of the – rare risk of memory concerns with TMS that we do with ECT. It can be helpful but it’s not helpful for everybody. So, it’s a different way to look at this. They usually spend twenty minutes in the TMS chair a day. They are treated daily for about 30 treatments total and then tapering out for a little bit after that.
Host: Wow, what amazing work you are doing. Dr. Eads, thanks so much for your time today. for more information on interventional psychiatry and the UAMS Psychiatric Research Institute please visit www.uamshealth.com. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics that may interest you. This is UAMS Health Talk. Thanks for listening.