Beyond Psychotropic Medication with Interventional Psychiatry: Enabling Neuroplasticity Though Transcranial Magnetic Stimulation (TMS), Electroconvulsive Therapy (ECT), Psilocybin, Ketamine, and MDMA

In this episode, Ryan discusses his career as an Interventional Psychiatrist, using neuromodulation treatments for clients who are not responding to medications and therapy. He discusses the use of TMS (transcranial magnetic stimulation) which is FDA approved for both depression & OCD and often turned to after multiple antidepressants have not been effective. He discusses how TMS stimulates brain circuits through magnetic pulses, manipulating activity in areas of the brain and stimulating neuroplasticity in specific pathways. He describes how clients often report feeling less reactive, as the process may help balance the connections between the limbic system and the prefrontal cortex, increasing cognitive control and emotional regulation. We also discuss ECT and Ketamine which are other treatments provided through his organization, Mindful Health Solutions, as well as his training in Psilocybin and MDMA assisted therapy, which are not currently approved outside of research settings in California. He discusses how each of these interventions can promote brain changes like neuroplasticity, and how it may be beneficial to pair these interventions with therapy concurrently. He discusses the applications mainly for depression and OCD, but we also touch on and speculate about how brain stimulation & psychedelic treatments could be used to treat a variety of disorders, such as PTSD, borderline personality, ADHD, Social Anxiety, and substance abuse/dependence. Ryan Vidrine, MD is a Board-Certified Psychiatrist who specializes in the treatment of OCD and related anxiety Disorders. He started his career in neuroscience and moved into psychiatry with a particular interest in the field of Interventional Psychiatry and Neuromodulation for treatment resistant conditions, which includes the use of ECT, TMS, ketamine/esketamine, and deep brain stimulation. During his residency training, Ryan worked in the UCSF OCD & Anxiety Specialty Clinic, developing expertise in the diagnosis and treatment of the full range of anxiety disorders, approaching patients from an Acceptance-Commitment Therapy (ACT) framework, which focuses on patient values as the anchor and impetus for behavioral changes. He is currently Director of OCD and Anxiety Services at Mindful Health Solutions and an Assistant Clinical Professor in the Department of Psychiatry at UCSF School of Medicine. Additionally, he completed training through the CIIS Psychedelic Therapy and Research Program in San Francisco, CA.