Child Mental Health for Pediatric Clinicians

Elise Fallucco M.D.
  • 4.7 (35)
  • MEDICINE
  • UPDATED WEEKLY

Child Mental Health for Pediatric Clinicians podcast - formerly PsychEd4Peds -is the child mental health podcast designed for pediatric clinicians - helping you help kids. The host, Dr. Elise Fallucco, M.D., is a board-certified child and adolescent psychiatrist and mom of three who teaches pediatric clinicians to identify, manage, and support kids and teens with mental health problems.  Dr. Fallucco interviews experts in the fields of child psychiatry, psychology, and pediatrics to share practical tools, tips, and strategies to help pediatric clinicians take care of kids and teens.

  1. 4D AGO

    70. Anxiety that has failed 2 SSRIs: How to switch and which med to choose next with Dr. Strawn

    Send us Fan Mail SSRI Switching in Pediatrics: When to Try a Third SSRI, When to Use Luvox, and Key Metabolism Pearls Dr. Elise Fallucco continues her discussion with child psychiatrist Dr. Jeffrey Strawn (University of Cincinnati; co-author of Stahl’s DePrescribing) on practical tips regarding how to stop/decrease an SSRI and switch to another SSRI (or SNRI) for pediatric anxiety.  Highlights from the Episode: After trying 2 different SSRIs for pediatric anxiety, in most cases, it makes sense to try a third SSRI as opposed to an SNRIRationale: SSRIs tend to be more effective and have fewer side effects than SNRIs"We Don't Talk about LUVOX": Luvox can be a great option for youth with OCD OR anxiety (generalized, social, separation)Dosing strategy: start at 25mg with the plan to titrate up to a target dose of 150-200mgConsider grouping 3 of the SSRIs by their similar metabolic pathways (2C19): Sertraline, Citalopram, and EscitalopramIf your patient develops significant side effects on a low dose of one of these 3 meds, they MIGHT be a 2C19 poor metabolizer, which means that you may want to avoid trials of the other 2C19 meds in the groupFluoxetine has a LOOOOONg half-life: and it's related 2D6 inhibition will persist 4–5 weeks after stopping Fluoxetine - and affect the metabolism of other 2D6-metabolized meds during that timeThe 2D6 group includes meds like Fluoxetine, Paroxetine and 2 of the SNRIs: Duloxetine and Venlafaxine-- And Check Out  Dr. Jeffrey Strawn's new book which I highly recommend - Stahl's Deprescriber's Guide available on Amazon! 00:00 Introduction of Dr. Jeffrey Strawn 00:38 Preview of Episode: Switching SSRIs, when to use FluVOXamine or SNRIs, plus 2D6 and 2C19 metabolism of antidepressant medication 01:59 Try 2 different SSRIs or Duloxetine? 03:45 CYP 2D6 Inhibition with Fluoxetine 04:28 Clinical Pearl: Fluoxetine 2D6 inhibition continues 4-5 weeks after stopping 05:05 2D6 Metabolized Antidepressants: Venlafaxine, Duloxetine, Paroxetine 05:31 Choosing a Third SSRI 05:48 SSRIs generally more effective, fewer side effects than SRNIs in youth 06:49 Only 1 SNRI for child anxiety 07:27 People forget about Fluvoxamine 08:30 Sertraline and Es/Citalopram 2C19 metabolism 09:32 Fluoxetine to FluVOXamine cross-titration 11:16 Gratitude for Dr. Strawn 11:31 Check out Stahl's DEPrescribing Guide 12:23 Recap of Advanced SSRI and SNRI case discussion Check out our website PsychEd4Peds.com for more resources. Follow us on Instagram @psyched4peds

    17 min

  2. MAR 24

    69. How to Switch SSRIs with Dr. Jeffrey Strawn

    Send us Fan Mail 3 Ways to Switch SSRIs in Kids: Direct Switch vs Taper vs Cross-Titration  Dr. Elise Fallucco continues a conversation with child psychiatrist and anxiety GURU Dr. Jeffrey Strawn about evidence-informed ways to switch SSRIs in pediatric patients when an adequate trial hasn’t led to remission.  They review 3 strategies: 1.    direct stop/start a.    Stop SSRI#1 then start SSRI#2: best for patients with side effects on the 1st SSRI, but creates a gap in antidepressant coverage during the transition 2.    taper-then-switch a.    Taper SSRI#1 off then start SSRI#2: best for patients who are highly sensitive to medication changes, but leaves a LONG time without effective antidepressant/SSRI coverage  3.    cross-titration a.    Continue SSRI#1 while adding SSRI#2 with the plan to later taper down on SSRI#1: best for patients without side effects on 1st SSRI as it allows for optimal SSRI coverage in the transition between meds; watch out with SEROTONERGIC SIDE EFFECTS (nausea, vomiting, diarrhea, flushing) while 2 SSRIs on board Clinical Pearl: Dr. Strawn emphasizes that higher starting doses don’t speed time to steady state, so start the new medication at LOW doses Clinical Case: Teen on sertraline 150 mg switches to fluoxetine ·      How to cross-titrate ·      How to monitor for serotonergic side effects  ·      How to taper sertraline Bonus Psychopharm: They receptor pharmacology considerations and the need to distinguish withdrawal effects from new-medication side effects, illustrated by an atomoxetine (Strattera) -to- fluvoxamine (LUVOX) switch affecting ADHD symptoms. Check out our website PsychEd4Peds.com for more resources. Follow us on Instagram @psyched4peds

    20 min

  3. MAR 3

    68. Deprescribing - The Science and Art of Stopping Medication with Dr. Jeffrey Strawn

    Send us Fan Mail What is the safest, most effective way to taper or stop psychotropic meds in children and teens? Dr. Elise Fallucco kicks off a new Deprescribing series with guest Dr. Jeffrey Strawn, coauthor of Stahl’s Deprescriber’s Guide.    They discuss how  clinicians and patients “deprescribe” in real life, and what can happen when tapering off or abruptly stopping medication including:  how to distinguish discontinuation (withdrawal) from relapse Focus on timing, symptom pattern (including dysesthesias/“brain zaps” and dizziness), and symptom trajectoryhow to manage cases of discontinuationpause - then more slowly taper off of medicationhow to manage relapsepause - and potentially increase back to the original doseDr. Jeffrey Strawn is a Professor of Psychiatry at the University of Cincinnati (UC) and the Director of Anxiety Disorders Research Program. Stahl's Deprescriber's Guide by Dr. Jeffrey Strawn and Dr. Stephen Stahl available at Amazon: https://www.amazon.com/Stahls-Deprescribers-Guide-Jeffrey-Strawn/dp/1009642200 Check out our website PsychEd4Peds.com for more resources. Follow us on Instagram @psyched4peds

    17 min

  4. FEB 24

    67. From Screen Addiction to Sextortion: Your Guide to Digital Safety with Tech Insider Ashley

    Send us Fan Mail On Part 3 of our Series on Tech and Child Mental Health, Dr. Elise Fallucco continues her conversation with Ashley (Tech Insider, Senior Manager of Global Risk Assessment at Twitch)  about: "Screen addiction" How to talk with kids and teens about online privacy and potential dangers like groomers and sextortion in an age-appropriate way Go-to resources for families navigating the digital world like The Family IT Guy on Social Media and online App/game parental control webpagesCommon Sense MediaHow to take down inappropriate content online Report directly to the app/platform Where/how to report child sexual exploitationThe National Center for Missing and Exploited Children's CyberTip line When to involve the FBIAre kids with ADHD  more vulnerable to problematic screen use and cyberbullying?Can heavy screen use cause inattention, impatience, impulsivity and ADHD-like symptoms? Check out our website PsychEd4Peds.com for more resources. Follow us on Instagram @psyched4peds

    18 min

  5. FEB 17

    66. Keeping Kids Safer Online with Tech-Insider Ashley: Parental Controls, Hidden App Risks, and Tech Alternatives to Smartphones

    Send us Fan Mail How can parents set real boundaries around kids’ screen use when every app has different settings—and kids can get around them? In part two of this tech safety series, Dr. Elise Fallucco continues her conversation with tech trust-and-safety insider (and mom) Ashley, senior manager of global risk assessment at Twitch. They break down why parents need to set parental controls inside each individual app (not just on the device), what to watch for in hidden or unexpected features like messaging and photo uploads (even in seemingly harmless games), and how kids may disguise apps to bypass rules. Ashley also shares practical tips like avoiding identifying details in usernames and profile photos, plus creative alternatives to a smartphone.  They also discuss safer ways for kids to listen to music, including risks on platforms like Spotify and a workaround  Finally, Ashley answers the question, “WHEN IS THE RIGHT time to introduce social media?” She talks about how to weigh factors like child maturity, family values, platform differences, ads, and risks like influencer content and mental health impacts— 00:00 Introduction 01:20 Setting Parental Controls and App Monitoring 02:29 Set Parental controls for EACH app!? 03:20 Monitoring Parental Controls 03:32 Apps in Disguise 04:45 Color By Number Surprises 06:13 Messaging and Grooming Risks 06:49 Practical Tips for Securing Tech Use for Kids 07:36 Username and Profile Picture Safety 09:21 Smartphones: Balancing risks and benefits 13:06 Music Players without graphic content 15:35 Social Media: When is it safe for kids to use? 17:59 Ashley's approach to thinking about Social Media Listen to Part ONE of this Tech Series 65. Digital Dangers: Tips from a Tech Insider https://www.buzzsprout.com/2182143/episodes/18649898 About Ashley: She is Senior Manager of Global Risk Assessment for Twitch, the world’s leading live-streaming platform. Check out our website PsychEd4Peds.com for more resources. Follow us on Instagram @psyched4peds

    20 min

  6. FEB 10

    65. Digital Dangers: Tips from a Tech Insider

    Send us Fan Mail Just when you thought it was safe to let kids play online... a Tech Insider shares surprising information about online/digital safety.  Dr. Fallucco chats with a seasoned professional in the trust and safety field about... How to balance the benefits of technology while minimizing RISKS like exposure to violence, cyberbullying, and grooming. How to set up a Child Tech contract - that defines WHEN a child can use technology, WHERE they can use it, and HOW they can use it (i.e. which apps/games are safe and approved)The NUMBER one rule for Tech Safety - DO NOT USE SCREENS IN THE BEDROOM.... and why this is so importantSend us YOUR  questions about tech safety! Drop us a comment at our instagram site @psyched4peds, leave us a "chat" on our website, Psyched4peds.com, or reply to our mailing list with YOUR QUESTIONS ABOUT TECH SAFETY! Check out our website PsychEd4Peds.com for more resources. Follow us on Instagram @psyched4peds

    21 min

  7. FEB 3

    64. Mystery Case: 12yo ADHD "acts like she is on speed"

    Send us Fan Mail Let's kick off the new year with a NEW Mystery Case! Dr. Elise Fallucco works through the case of a 12-year-old girl with ADHD and a family history of bipolar. After starting a new stimulant medication, the patient exhibits what seems like 'super ADHD.' Could this be a medication side effect, emerging bipolar, or something else? Dr. Fallucco guides you through a detailed differential diagnosis, exploring possible causes and solutions. Tune in to discover effective strategies for managing ADHD medications and ensuring better outcomes for your pediatric patients! 00:00 Introduction and Case Overview 00:15 Initial Diagnosis and Medication 01:33 Evaluating Symptoms and Differential Diagnosis 03:34 Detailed Symptom Analysis 04:37 Ruling out Bipolar in Children and Teens 08:49 Understanding Rebound Hyperactivity 15:40 Managing Rebound and Treatment Adjustments 16:02 Kids at risk for rebound 21:06 Conclusion and Final Thoughts   Check out our website PsychEd4Peds.com for more resources. Follow us on Instagram @psyched4peds

    21 min

  8. 12/23/2025

    63. Top 3 Things I Learned in 2025

    Send us Fan Mail Dr. Elise Fallucco reviews the highlights from 2025 and the TOP THREE things she learned about Child Mental Health from 2025 podcast episodes. Celebrate surpassing 50 episodes, explore exciting new episode formats like 'mystery cases,' and gain insights from impactful discussions with parents about ADHD and anxiety in children.   Tune in for excerpts from some of the most memorable episodes, including from the MOST downloaded episode of the year! 00:00 Introduction and Year in Review Overview 00:50 Podcast Milestones and Global Reach 02:05 New Episode Formats: Mystery Cases 03:16 03:49 Highlight: ADHD Masking in Children 06:21 Highlight: Hormonal Impact on Mental Health 08:49 Highlight: Gender Differences in ADHD 11:21 Most Downloaded Episode of 2025 12:22 ADHD vs. Bipolar - in Relationships 13:27 Conclusion and Thank You LINKS: Watch this episode on YOUTUBE: https://youtu.be/2fDrk1GIsJs 49. Mystery Case - 9 yo w/ anxiety and sudden behavioral problems https://podcasts.apple.com/us/podcast/child-mental-health-for-pediatric-clinicians/id1696529206?i=1000695757771 54. Masking: Can you hide ADHD with Ashley and Lauren https://podcasts.apple.com/us/podcast/child-mental-health-for-pediatric-clinicians/id1696529206?i=1000723572616 59. PMDD How Hormones can affect teenage girls with Laurina https://podcasts.apple.com/us/podcast/child-mental-health-for-pediatric-clinicians/id1696529206?i=1000733846317 52. ADHD. in Girls - all the things you should know https://podcasts.apple.com/us/podcast/child-mental-health-for-pediatric-clinicians/id1696529206?i=1000718448053 TOP EPISODE OF 2025 - 51. Is it ADHD or Bipolar? with Dr. John Walkup https://podcasts.apple.com/us/podcast/child-mental-health-for-pediatric-clinicians/id1696529206?i=1000700737488 Check out our website PsychEd4Peds.com for more resources. Follow us on Instagram @psyched4peds

    15 min
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4.7
out of 5
35 Ratings

About

Child Mental Health for Pediatric Clinicians podcast - formerly PsychEd4Peds -is the child mental health podcast designed for pediatric clinicians - helping you help kids. The host, Dr. Elise Fallucco, M.D., is a board-certified child and adolescent psychiatrist and mom of three who teaches pediatric clinicians to identify, manage, and support kids and teens with mental health problems.  Dr. Fallucco interviews experts in the fields of child psychiatry, psychology, and pediatrics to share practical tools, tips, and strategies to help pediatric clinicians take care of kids and teens.

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