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Pearls and Prep

NP Z | PMHNP Boards Prep

There are two kinds of clinicians — the ones who follow algorithms, and the ones who understand the "why."

Be the second: https://www.patreon.com/PearlsandPrep — study guides, psychopharm deep dives & practice questions.

📚 Get the 100 Psychiatric Interview Tips For Your 1st Eval E-Book — $39.99 in the shop (free for Boss Pearl members): https://www.patreon.com/c/pearlsandprep/shop

Pearls and Prep: Psychiatric Case Studies helps you get the why and build clinical confidence. Each episode walks you through a real-world psychiatric case — from chart review to treatment plan — covering psychopharmacology (SSRIs, SNRIs, SGAs, mood stabilizers), DSM-5-TR differential diagnosis, and evidence-based prescribing.

💊 Psychopharmacology breakdowns: mechanisms, half-lives, side-effect pearls
🧠 DSM-5-TR differential diagnosis deep-dives
📌 Memory hooks, screening questions & documentation phrases
🎯 Built for PMHNP students prepping for ANCC/AANP boards — and clinicians sharpening their edge

New episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner.

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  • Avg 21 min
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  • S1 · E33
    August 10 · 22 min

    Insomnia in Psychiatric Patients: Depression, Anxiety, ADHD & Trauma | PMHNP Boards

    💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime: https://www.patreon.com/checkout/pearlsandprep?rid=29362056 🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice. 📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop ⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps! 🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com ✉️ Questions or a case you want covered? Write to NP Z: pearlsandpreppodcast@gmail.com What do you do when your depressed, anxious, traumatized, or ADHD patient cannot sleep — especially when an SSRI or SNRI may feel activating at first? This episode tackles one of the most common dilemmas new PMHNPs face, explaining why every sleepless patient needs a different approach. You will learn the psychopharmacology and differential diagnosis reasoning behind each strategy — the why, not just the what — building clinical confidence for PMHNP boards and real practice alike. 🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner. ⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship. 🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips. 👉 pearlsandprep.com/resources Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

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  • S1 · E33
    August 8 · 17 min

    Effexor (Venlafaxine): When & Why to Choose This SNRI | PMHNP Boards

    💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime: https://www.patreon.com/checkout/pearlsandprep?rid=29362056 🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice. 📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop ⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps! 🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com ✉️ Questions or a case you want covered? Write to NP Z: pearlsandpreppodcast@gmail.com Venlafaxine (Effexor) is far more than just another antidepressant — knowing when and why to choose this SNRI is what separates thoughtful prescribers from algorithm followers. This episode breaks down where Effexor fits in psychopharmacology, including after inadequate response to first-line treatment, with the clinical reasoning behind each decision. You will gain the why that drives confident prescribing and stronger PMHNP boards preparation. 🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner. ⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship. 🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips. 👉 pearlsandprep.com/resources Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

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  • S1 · E27
    August 4 · 29 min

    Metformin for Antipsychotic Weight Gain: An Easy Win | PMHNP Boards

    💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime: https://www.patreon.com/checkout/pearlsandprep?rid=29362056 🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice. 📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop ⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps! 🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com ✉️ Questions or a case you want covered? Write to NP Z: pearlsandpreppodcast@gmail.com Metformin is a cheap, effective answer to antipsychotic-induced weight gain and metabolic harm — yet only about two to three percent of eligible patients ever receive it. This episode makes the case for one of psychiatry's most overlooked wins, explaining the why behind metabolic monitoring and intervention with second-generation antipsychotics. You will build the clinical confidence to act on metabolic risk instead of watching it happen. High-yield PMHNP boards prep with immediate real-world impact. 🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner. ⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship. 🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips. 👉 pearlsandprep.com/resources Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

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  • S1 · E33
    August 3 · 25 min

    Prozac (Fluoxetine) vs Zoloft (Sertraline): Real SSRI Differences | PMHNP Boards

    💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime: https://www.patreon.com/checkout/pearlsandprep?rid=29362056 🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice. 📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop ⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps! 🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com ✉️ Questions or a case you want covered? Write to NP Z: pearlsandpreppodcast@gmail.com Fluoxetine (Prozac) and sertraline (Zoloft) are both first-line SSRIs for depression and anxiety — but they are far from interchangeable. This episode goes beyond the textbook into the practical psychopharmacology reasoning behind choosing one over the other, giving you the why that drives individualized prescribing. You will build clinical confidence with SSRI selection and sharpen exactly the comparative thinking PMHNP boards reward. 🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner. ⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship. 🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips. 👉 pearlsandprep.com/resources Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

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  • S1 · E32
    July 31 · 25 min

    PTSD vs Depression vs Adjustment Disorder: Differential Diagnosis | PMHNP Boards

    💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime: https://www.patreon.com/checkout/pearlsandprep?rid=29362056 🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice. 📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop ⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps! 🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com ✉️ Questions or a case you want covered? Write to NP Z: pearlsandpreppodcast@gmail.com One patient, three possible DSM-5 diagnoses — PTSD, major depressive disorder, or adjustment disorder — and only one is correct. This episode walks through a realistic, challenging differential diagnosis step by step, teaching the DSM-5-TR reasoning that separates these commonly confused conditions. You will learn the why behind each criterion and build the clinical confidence to land the right diagnosis under pressure. Essential PMHNP boards prep for the differentials you will face daily. 🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner. ⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship. 🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips. 👉 pearlsandprep.com/resources Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

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  • S1 · E32
    July 30 · 35 min

    Choosing Antipsychotics for Bipolar Disorder: 4 Prescribing Pearls | PMHNP Boards

    💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime: https://www.patreon.com/checkout/pearlsandprep?rid=29362056 🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice. 📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop ⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps! 🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com ✉️ Questions or a case you want covered? Write to NP Z: pearlsandpreppodcast@gmail.com How do experienced providers actually choose between Seroquel, Abilify, Latuda, Vraylar, Risperdal, Zyprexa, and Geodon for bipolar disorder? This episode shares a real-world framework — four practical prescribing pearls for matching the right second-generation antipsychotic to the right patient. You will learn the psychopharmacology reasoning behind each choice — the why, not a memorized ranking — building clinical confidence for PMHNP boards and for the prescribing decisions that define bipolar care. 🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner. ⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship. 🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips. 👉 pearlsandprep.com/resources Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

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  • S1 · E32
    July 29 · 19 min

    The 6 Reasons Experienced Clinicians Reach for Wellbutrin First

    There are two kinds of clinicians—the ones who follow algorithms, and the ones who understand the “why.” Patients know the difference. Know the WHY! Join our clinical library today on PATREON! 👉 https://www.patreon.com/PearlsandPrep The 6 Reasons Experienced Clinicians Reach for Wellbutrin First | Pearls & Prep Thinking about prescribing Wellbutrin (bupropion)? In this episode of Pearls & Prep, NPZ sits down for one of his favorite types of conversations—the kind that goes beyond randomized controlled trials and dives into how medications actually perform in everyday psychiatric practice. Drawing from years of clinical experience and thousands of psychiatric evaluations, NPZ shares the practical decision-making process behind one of psychiatry's most unique antidepressants. You'll learn the six clinical reasons Wellbutrin frequently earns a place in NPZ's treatment toolbox, including why it stands apart from SSRIs like Prozac, Zoloft, and Lexapro. We discuss why Wellbutrin is often considered for patients concerned about weight gain or sexual dysfunction, why its dopaminergic and noradrenergic effects can be particularly helpful for patients struggling with fatigue, brain fog, low motivation, and anhedonia, and why many clinicians describe it as a medication that helps patients "get moving again." This episode also explores situations where Wellbutrin can serve multiple purposes, including patients with depression who also have symptoms suggestive of ADHD, as well as its FDA-approved role in smoking cessation as Zyban. NPZ discusses where Wellbutrin fits into treatment algorithms, when it works well as an augmentation strategy alongside SSRIs, and why understanding neurotransmitters is only one piece of becoming a confident psychiatric clinician. Of course, no medication is perfect. We also cover important contraindications—including seizure disorders, eating disorders, CYP2D6 interactions, and common reasons patients discontinue Wellbutrin, such as increased anxiety or irritability. Most importantly, you'll learn how experienced clinicians think through these tradeoffs rather than simply memorizing medication facts. Whether you're a PMHNP student, psychiatric nurse practitioner, psychiatry resident, physician assistant, psychiatrist, or another mental health professional looking to sharpen your psychopharmacology skills, this episode is packed with practical clinical pearls you can immediately apply in practice. Topics Covered: Wellbutrin (Bupropion) Clinical Pearls Wellbutrin vs SSRIs Prozac vs Wellbutrin Zoloft vs Wellbutrin Lexapro vs Wellbutrin Depression with fatigue and low motivation Dopamine vs serotonin ADHD and Wellbutrin Smoking cessation (Zyban) Antidepressant sexual dysfunction Weight gain and antidepressants CYP2D6 drug interactions PMHNP education Psychopharmacology Psychiatric medication management Clinical reasoning for new psychiatric providers 🎧 If you're looking for practical psychopharmacology, memorable clinical pearls, and the kind of mentorship conversations that bridge the gap between textbooks and real-world psychiatry, you're in the right place. 32 The 6 Reasons Experienced Clinicians Reach for Wellbutrin First Pearls and Prep pearlsandprep@mail.com https://patreon.com/PearlsandPrep?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink This podcast uses the following third-party services for analysis: Podcorn - https://podcorn.com/privacy

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  • S1 · E26
    July 28 · 20 min

    Antipsychotic Switching: Key Concepts & Clinical Considerations | PMHNP Boards

    💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime: https://www.patreon.com/checkout/pearlsandprep?rid=29362056 🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice. 📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop ⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps! 🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com ✉️ Questions or a case you want covered? Write to NP Z: pearlsandpreppodcast@gmail.com Switching antipsychotics demands far more than a taper schedule. This episode examines why patients switch — efficacy versus side effects — and why understanding receptor dynamics is essential for safe, successful transitions between second-generation antipsychotics. You will learn the psychopharmacology reasoning that prevents destabilization, grasping the why behind each switching strategy. High-yield PMHNP boards prep that builds the clinical confidence to manage one of prescribing's riskiest maneuvers. 🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner. ⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship. 🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips. 👉 pearlsandprep.com/resources Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

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  • S1 · E32
    July 26 · 25 min

    Psychopharmacology Made Simple: The Grocery Store Trick | PMHNP Boards

    💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime: https://www.patreon.com/checkout/pearlsandprep?rid=29362056 🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice. 📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop ⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps! 🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com ✉️ Questions or a case you want covered? Write to NP Z: pearlsandpreppodcast@gmail.com Every psychiatric medication can be understood by answering just two questions — and once you see psychopharmacology through the lens of a grocery store, you will never look at it the same way. This memorable framework replaces rote memorization with genuine understanding, giving you the why behind every drug class. You will build lasting clinical confidence and a mental model that serves PMHNP boards prep and every prescribing decision after. 🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner. ⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship. This podcast uses the following third-party services for analysis: Podcorn - https://podcorn.com/privacy

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  • S1 · E32
    July 24 · 25 min

    The Bipolar Medication Mistake That Keeps Patients Relapsing

    There are two kinds of clinicians—the ones who follow algorithms, and the ones who understand the “why.” Patients know the difference. Know the WHY! Join our clinical library today on PATREON! 👉 https://www.patreon.com/PearlsandPrep The Polarity Index may be one of the most underutilized concepts in bipolar disorder—and once you understand it, choosing maintenance medications becomes dramatically easier. In this episode, I break down the Polarity Index into plain language and show you how to stop memorizing drug lists and start thinking like an expert clinician. You'll learn why acute treatment and maintenance treatment are not the same decision, how to identify a patient's predominant pole (mania vs. depression), and how that single insight can transform your medication selection. Through realistic mock patient cases, we'll walk through when to choose lamotrigine, lithium, quetiapine, aripiprazole, lurasidone, cariprazine, and Symbyax, while tying every decision back to receptor pharmacology and long-term relapse prevention. In this episode you'll learn: What the Polarity Index actually measures The difference between acute stabilization and maintenance treatment How to identify a patient's predominant pole Why treating today's episode isn't always the same as preventing tomorrow's relapse When to choose lamotrigine, lithium, quetiapine, aripiprazole, lurasidone or cariprazine. The receptor mechanisms that explain why these medications work Clinical pearls that can immediately improve your bipolar prescribing Whether you're a PMHNP student, psychiatry resident, psychiatric nurse practitioner, physician assistant, psychiatrist, or anyone looking to master psychopharmacology, this episode provides a practical framework you'll use every time you treat bipolar disorder. OG article on polarity index: https://www.sciencedirect.com/science/article/abs/pii/S0924977X11002616?via%3Dihub This podcast uses the following third-party services for analysis: Podcorn - https://podcorn.com/privacy

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  • S1 · E32
    July 23 · 18 min

    Why Abilify Isn't an Antidepressant (But Helps with Depression)

    There are two kinds of clinicians—the ones who follow algorithms, and the ones who understand the “why.” Patients know the difference. Know the WHY! Join our clinical library today on PATREON! 👉 https://www.patreon.com/PearlsandPrep Why is Abilify used for major depressive disorder (MDD) augmentation if it isn't actually an antidepressant? This is one of the most confusing concepts for psychiatric nurse practitioner students, physician assistants, psychiatry residents, medical students, and even new clinicians learning psychopharmacology. In this Off the PHARM episode, we break down Abilify (aripiprazole) augmentation using a memorable visual analogy you'll never forget. Imagine major depression as a clogged toilet. The SSRI is the plumber—it comes in to fix the primary problem by increasing serotonin and treating depressive symptoms. But while doing its job, the plumber accidentally creates some collateral damage by bumping into other serotonin receptors, contributing to common SSRI side effects such as sexual dysfunction, nausea, gastrointestinal upset, appetite changes, weight gain, activation, and early anxiety. That's where Abilify comes in. Abilify doesn't "unclog the toilet" by itself. It isn't considered a traditional antidepressant for monotherapy in major depressive disorder. Instead, it serves as an augmentation strategy, helping optimize the overall system and improve outcomes when an SSRI alone isn't enough. In this episode you'll learn: • Why Abilify is FDA-approved as an adjunctive treatment for major depressive disorder. • Why augmentation is different from antidepressant monotherapy. • How SSRIs interact with multiple serotonin receptor subtypes. • Why serotonin receptor activity contributes to both therapeutic benefits and adverse effects. • A simple visual framework for remembering psychopharmacology during clinical practice and PMHNP board preparation. • Practical prescribing pearls you can immediately apply in outpatient psychiatry. Whether you're studying for the PMHNP boards, preparing for psychiatry exams, or simply want psychopharmacology explained in a way that finally sticks, this episode turns a difficult concept into an unforgettable visual story. Keywords: Abilify, aripiprazole, SSRI, antidepressants, augmentation, adjunctive therapy, major depressive disorder, MDD, psychopharmacology, serotonin receptors, 5-HT2A, 5-HT2C, 5-HT3, 5-HT1A, psychiatric nurse practitioner, PMHNP, psychiatry boards, psych NP, depression treatment, visual learning, psychiatry education, dopamine, serotonin, medication side effects, board review. 32 Why Abilify Isn't an Antidepressant (But Helps with Depression) Pearls and Prep pearlsandprep@mail.com https://patreon.com/PearlsandPrep?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink This podcast uses the following third-party services for analysis: Podcorn - https://podcorn.com/privacy

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  • S1 · E32
    July 22 · 15 min

    Why Your Bipolar Patient Keeps Relapsing: The Polarity Index

    There are two kinds of clinicians—the ones who follow algorithms, and the ones who understand the “why.” Patients know the difference. Know the WHY! Join our clinical library today on PATREON! 👉 https://www.patreon.com/PearlsandPrep In this episode of Pearls & Prep, we tackle one of the highest-yield—but least discussed—concepts in bipolar disorder: the Polarity Index. If you've ever wondered why one maintenance medication seems to fit one bipolar patient perfectly while another falls flat, this episode gives you a practical framework you'll use for years. We'll start by breaking down what the Polarity Index is, where it came from, and why researchers developed it in the first place. Then we'll introduce the concept of predominant polarity—a simple way to identify whether a patient's illness has historically been driven more by manic episodes or depressive episodes. From there, I teach you the hard-and-fast rule that makes remembering this concept incredibly easy: high Polarity Index = better at preventing mania; low Polarity Index = better at preventing depression; values near 1 = balanced protection. Once you understand that rule, choosing and remembering maintenance medications becomes dramatically simpler. We'll also review the polarity indices of several commonly used bipolar maintenance medications, discuss how to think about them clinically, highlight a few memorable patient examples, and finish with practical board pearls you can immediately apply in both exam questions and real-world practice. Whether you're studying for the PMHNP boards, preparing for rotations, or simply want a cleaner mental framework for bipolar maintenance treatment, this episode will leave you with one of the most practical prescribing pearls in psychiatry. Topics covered: Bipolar Disorder • Bipolar I Disorder • Polarity Index • Predominant Polarity • Bipolar Maintenance Treatment • Mood Stabilizers • Aripiprazole • Lamotrigine • Lithium • Quetiapine • PMHNP Boards • Psychiatry Education • Psychopharmacology • Clinical Pearls • Psychiatric Nurse Practitioner 32 Why Your Bipolar Patient Keeps Relapsing: The Polarity Index Pearls and Prep pearlsandprep@mail.com https://patreon.com/PearlsandPrep?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink This podcast uses the following third-party services for analysis: Podcorn - https://podcorn.com/privacy

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  • S1 · E27
    July 21 · 20 min

    Naltrexone: Your New Bestie in Alcohol Management. Using the Sinclair Method to Up Your Game In Practice.

    There are two kinds of clinicians—the ones who follow algorithms, and the ones who understand the “why.” Be the second on Patreon: 👉 https://www.patreon.com/PearlsandPrep Today, we're diving into the fascinating world of the Sinclair Method and how it can totally change the game for folks dealing with alcohol use issues. It's all about understanding the *why* behind drinking, not just the *how much*. We’ve got a mock patient named Marcus, who finds himself reaching for those brews not to escape but to enjoy the buzz. By the end of this episode, you're gonna feel like a pro, armed with the knowledge to help your patients better. So, grab your surfboard and ride the wave of information as we explore how this method can help folks manage their drinking while still having a good time! 27 Naltrexone: Your New Bestie in Alcohol Management. Using the Sinclair Method to Up Your Game In Practice. Pearls and Prep pearlsandprep@mail.com https://patreon.com/PearlsandPrep?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink Takeaways: This episode is all about giving you the lowdown on the Sinclair method for treating alcohol use disorder, which is pretty neat, right? Understanding the difference between drinking for pleasure and drinking to cope can totally change how we approach treatment for our patients. The Sinclair method involves taking naltrexone before drinking, which helps reduce cravings and makes drinking less rewarding—how cool is that? Recognizing the various drinking phenotypes is key to tailoring treatment; not all drinkers are created equal, my friends! Naltrexone can be a game-changer for those who drink mainly for pleasure, giving them a major edge in cutting down on heavy drinking. Don't underestimate the importance of understanding why someone drinks; context is everything in guiding effective treatment strategies. Companies mentioned in this episode: Prozac lithium AA naltrexone Sinclair method predict trial camper state va dod apa aaf aafp This podcast uses the following third-party services for analysis: Podcorn - https://podcorn.com/privacy

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  • S1 · E32
    July 16 · 26 min

    ADHD Stimulants Made Easy: The Only 5 Pearls You'll Ever Need

    There are two kinds of clinicians—the ones who follow algorithms, and the ones who understand the “why.” Patients know the difference. Know the WHY! Join our clinical library today on PATREON! 👉 https://www.patreon.com/PearlsandPrep In this episode of Pearls & Prep, we simplify the entire world of ADHD medications into five memorable clinical pearls that will completely change how you think about stimulant prescribing. Instead of memorizing dozens of brand names, you'll learn the underlying principles that make every medication easier to understand. We cover the two stimulant families—methylphenidates (Ritalin family) and amphetamines (Adderall family)—and explain how medications like Vyvanse, Concerta, Adderall XR, Dexedrine, Focalin, Ritalin LA, Mydayis, Jornay PM, Aptensio XR, Metadate CD, Daytrana, and Xelstrym all fit into one simple framework. You'll also learn: Why there are really only two stimulant molecules How to choose a medication based on hours of symptom coverage The difference between bead technology, OROS osmotic pumps, and prodrug formulations Practical stimulant dose conversions that actually make sense When to switch stimulant classes versus simply increasing the dose How genetics, food, gastric pH, urine pH, and metabolism influence medication duration The truth about afternoon "crashes," booster doses, and long-acting formulations Common stimulant side effects and practical prescribing strategies The evidence behind stimulant treatment and addiction risk When to transition to non-stimulant medications such as atomoxetine, viloxazine, etc. Whether you're a psychiatric nurse practitioner, psychiatry resident, physician assistant, medical student, family medicine clinician, or simply interested in ADHD pharmacology, this episode provides a practical framework you can immediately apply in clinical practice. If you've ever wondered "Should I choose Vyvanse or Adderall?", "Why does Concerta feel different?", "How do stimulant delivery systems actually work?", or "When should I switch classes?", this episode is for you. Keywords: ADHD, ADHD medications, stimulant medications, Vyvanse, lisdexamfetamine, Adderall, Adderall XR, Concerta, methylphenidate, dexmethylphenidate, Focalin, Dexedrine, Jornay PM, Mydayis, atomoxetine, viloxazine, psychiatric nurse practitioner, PMHNP, psychiatry, psychopharmacology, stimulant dosing, ADHD treatment, stimulant conversions, clinical pearls, mental health education, psychiatry podcast. 32 ADHD Stimulants Made Easy: The Only 5 Pearls You'll Ever Need Pearls and Prep pearlsandprep@mail.com https://patreon.com/PearlsandPrep?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink This podcast uses the following third-party services for analysis: Podcorn - https://podcorn.com/privacy

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Showing 21–34 of 34 episodes