The Plague of Athens | The Frontier Psychiatrists

Narrated by Owen Scott Muir, M.D. Schizophrenia is a really challenging illness. There's been a lot of progress made recently, I will note. I've already written about novel treatments like Cobenfy (https://open.substack.com/pub/thefron..., and using accelerated transcranial magnetic stimulation for negative symptoms and positive symptoms in schizophrenia (https://open.substack.com/pub/thefron.... One of the most bothersome of those “positive symptoms”—things that shouldn't be there, in someone's mind, but are—are auditory hallucinations. If you imagine having invisible AirPods that are playing a terrible podcast that you'd rather not be listening to, and that everyone else can't hear, you get a sense of how distracting it might be to have auditory hallucinations.
In my previous article about the treatment of auditory hallucinations with transcranial magnetic stimulation (https://open.substack.com/pub/thefron...) (TMS), one of my favorite forms of brain stimulation, I highlighted promising results from early studies. Now we have a much larger Study, phase 3 trial, conducted over many years in Germany. (https://www.sciencedirect.com/science...) We are even at the level of meta-analysis at this point!
It’s a considerable study:
138 adults with treatment-persistent auditory verbal hallucinations and schizophrenia spectrum disorder were randomly assigned (1:1) to receive 15 sessions of active (n=70) or sham cTBS (n=68) administered sequentially as 600 pulses to the left and 600 pulses to the right temporo-parietal cortex over a 3-week period.
I called friends of the podcast—Dr. David Garrison (https://www.urmc.rochester.edu/people..., Dr. Will Sauve (  / william-sauvé-md-45009813  , and my mom, Vita Muir (https://litchfieldperformingarts.org/..., to talk through this paper together, and what it might mean for individuals suffering from psychotic disorders. In the meantime, the team at Radial (https://www.meetradial.com), where we provide such treatment, does some funny, tough-guy faces with our Ampa One system:

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