Beyond First-Line Psychiatric Treatment | Joshua Berman, MD, PhD

Joshua Berman, MD, PhD, discusses how interventional psychiatry is reshaping care for patients who do not respond to standard treatments for mood disorders. The conversation focuses on clinical judgment: how careful evaluation, patient priorities, and risk–benefit trade-offs guide the use of interventional treatments when conventional approaches fall short. Dr. Berman explains how tools such as ketamine, TMS, ECT, and neurofeedback can be used strategically—sometimes in sequence or combination—to address different vulnerabilities within mood-related brain circuits.

Joshua Berman, MD, PhD, is Associate Professor of Psychiatry and Director of Interventional Psychiatry at NYU Langone Health.

Topics:
• Evaluating patients who have not improved with medications or psychotherapy
• The limitations of existing treatment guidelines for difficult cases
• When and why sequencing or combining interventions may be appropriate
• Emerging approaches such as EEG-guided neurofeedback and focused ultrasound
• Building a comprehensive, patient-centered interventional psychiatry program

This episode offers a clinician-level perspective on how interventional psychiatry is practiced today, and how new technologies may expand options for patients with the most challenging presentations.

Chapters:
00:00 Introduction: Caring for Patients Who Don’t Respond to Standard Treatment
00:47 What Is Interventional Psychiatry?
02:33 Evaluating Treatment-Resistant Presentations
06:31 Precision, Patient Priorities, and Clinical Judgment
09:35 Sequencing and Combining Interventions
10:40 Limits of Treatment Guidelines
12:18 The Future of Interventional Psychiatry
13:23 Emerging Technologies: Neurofeedback and Focused Ultrasound
17:15 Building a Comprehensive Interventional Program
18:13 Tools vs. Understanding Brain Circuits

About the Experts:
Charles R. Marmar, MD: https://nyulangone.org/doctors/196250...
Peter H. Schub Professor of Psychiatry
Director, Center for Precision Psychiatry
NYU Grossman School of Medicine

Joshua A. Berman, MD, PhD: https://nyulangone.org/doctors/171090...
Clinical Associate Professor, Department of Psychiatry, NYU Grossman School of Medicine
Director, Interventional Psychiatry
NYU Grossman School of Medicine

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