Psychopharmacology and Psychiatry Updates

Faculty: Oliver Freudenreich, M.D. Host: Flavio Guzmán, M.D. Learn more about our memberships here Earn 0.75 CMEs: Quick Take Vol. 85 Schizophrenia: Which of Seven Antipsychotics Wins on Acute Efficacy and Safety?

Faculty: Robert Hudak, M.D. Host: Flavio Guzmán, M.D. Learn more about our memberships here Earn 1.25 CME: SSRI Dosing for OCD: Beyond FDA Guidelines Treatment-Resistant OCD: From SSRIs to Augmentation

In this episode, we explore a new meta-analysis reconciling trazodone's real-world reputation with cautious sleep medicine guidelines, examining its effects on sleep architecture and depressive symptoms in patients with comorbid insomnia and depression, alongside its notable side effect profile. Can a decades-old antidepressant be the missing link for restorative sleep? Faculty: Paul Zarkowski, M.D. Host: Flavio Guzmán, M.D. Learn more about our memberships here Earn 0.5 CMEs: Quick Take Vol. 85 Trazodone for Insomnia and Comorbid Depression: Are the AASM Guidelines Relevant?

In this episode, we explore why antipsychotics cause hyperprolactinemia and sexual side effects, a leading reason patients quietly stop treatment. Dr. Oliver Freudenreich breaks down which medications carry the highest risk, the long-term health implications, and practical strategies for monitoring, switching, or augmenting therapy. Faculty: Oliver Freudenreich, M.D., F.A.C.L.P. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Managing Side Effects of Antipsychotics: What Every Psychiatrist Should Know Managing Hyperprolactinemia and Sexual Side Effects from Antipsychotic Use

In this episode, we sit down with Dr. Oliver Freudenreich to unpack EMERGENT-5, the year-long trial tracking Cobenfy's real-world durability and safety in schizophrenia. We explore whether early symptom gains hold up over time, what side effects persist, and why blood pressure monitoring now deserves a permanent spot on your checklist. Faculty: Oliver Freudenreich, M.D., F.A.C.L.P. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CME: Quick Take Vol. 85 Xanomeline-Trospium Long-Term: Does Efficacy and Safety Hold Up After One Year?

In this episode, we sit down with Dr. Oliver Freudenreich to unpack antipsychotic-induced weight gain — why it happens, which medications carry the highest risk, and how to build a proactive ABC strategy using switching, metformin, and emerging GLP-1 agonists to protect your patients' metabolic health. Faculty: Oliver Freudenreich, M.D., F.A.C.L.P. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Managing Side Effects of Antipsychotics: What Every Psychiatrist Should Know Antipsychotic-Induced Weight Gain: Prevention and Management

In this episode, we explore whether EPA, a specific omega-3 fatty acid, can help patients with treatment-resistant depression. Dr. Derick Vergne breaks down the clinical evidence, dosing, and the anti-inflammatory mechanisms that may explain why EPA outperforms DHA in easing stubborn depressive symptoms. Faculty: Derick E. Vergne, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CMEs: Quick Take Vol. 84 Eicosapentaenoic Acid: Effective as Adjunctive for TRD?

In this episode, we explore how liver status shapes medication choice for alcohol use disorder. Dr. Kevin Sevarino breaks down a practical algorithm for selecting between naltrexone, acamprosate, disulfiram, and other options, tailored to hepatic function, from early liver disease through decompensated cirrhosis. Faculty: Kevin A. Sevarino, M.D.C.M., Ph.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Pharmacotherapy of Alcohol Use Disorder Alcohol Use Disorder Algorithm: Medication Selection Based on Liver Status

In this episode, we explore whether GLP-1 agonists like semaglutide can tackle the metabolic toll of antipsychotics in schizophrenia. Can a drug famous for celebrity weight loss actually protect our most vulnerable psychiatric patients from diabetes and obesity before the damage is done? Faculty: Oliver Freudenreich, M.D., F.A.C.L.P. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 84 GLP-1s in Schizophrenia: Should Semaglutide Be Added for Metabolic Management?

In this episode, we explore three off-label but evidence-supported medications — gabapentin, topiramate, and baclofen — for alcohol use disorder, examining their mechanisms, dosing strategies, tolerability challenges, and which patients are most likely to benefit when first-line treatments have failed. Faculty: Kevin A. Sevarino, M.D.C.M., Ph.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CMEs: Pharmacotherapy of Alcohol Use Disorder Gabapentin, Topiramate, and Baclofen for Alcohol Use Disorder

In this episode, we explore the nuanced landscape of benzodiazepine tapering, guided by a major 2024 joint clinical practice guideline. Are we training a generation of psychiatrists too afraid to prescribe one of psychiatry's most effective drug classes? Dr. Scott Beach unpacks the risks, benefits, and clinical realities. Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 84 Benzodiazepine Tapering: Key Takeaways From New Guidelines

In this episode, we explore disulfiram (Antabuse), one of the oldest FDA-approved treatments for alcohol use disorder. Dr. Kevin Sevarino breaks down its mechanism, efficacy data, and critical hepatic safety considerations. Could enforced sobriety be the missing piece for your most treatment-resistant patients? Faculty: Kevin A. Sevarino, M.D.C.M., Ph.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Pharmacotherapy of Alcohol Use Disorder Disulfiram for Alcohol Use Disorder: Mechanisms, Efficacy, and Hepatic Safety Considerations

In this episode, we explore a surprising drug interaction that every lithium-prescribing clinician should know about: can semaglutide, the widely used GLP-1 receptor agonist, push lithium levels into toxic territory — and if so, why? Faculty: Paul Zarkowski, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 83 Can GLP-1 Agonists Elevate Lithium Levels?

In this episode, we explore how naltrexone — the most widely used medication for alcohol use disorder in the US — works, how to dose it safely, and why liver disease may not be the barrier you think it is. Can a medication that doesn't target abstinence still be a game-changer for your patients? Faculty: Kevin A. Sevarino, M.D.C.M., Ph.D Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Pharmacotherapy of Alcohol Use Disorder Naltrexone for Alcohol Use Disorder: Dosing, Monitoring, and Liver Safety

In this episode, we explore the OPTIMUM trial, a landmark study examining how to treat older adults with treatment-resistant depression when antidepressants fall short. When adding a medication outperforms switching entirely — and what that means for the patient sitting across from you — the answer may reshape your clinical approach. Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 83 Antidepressant Augmentation vs. Switching in Geriatric Depression: Key Findings from the OPTIMUM Trial

In this episode, we explore what to do when antidepressants aren't working. How do you systematically approach a patient who isn't getting better — and when do you switch versus augment? Dr. Sagar Parikh walks through CANMAT's evidence-based framework for difficult-to-treat depression. Faculty: Sagar V. Parikh, M.D., F.R.C.P.C. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Rethinking Depression Treatment: An Update of CANMAT's Guidelines Pharmacologic Management of Difficult-to-Treat Depression: First, Second, and Third Line Options

In this episode, we explore whether high-dose olanzapine — beyond the FDA-approved 20 mg ceiling — can be a viable strategy for patients with treatment-resistant schizophrenia when clozapine isn't yet an option. Can pushing the dose bridge the gap between partial response and full remission? Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CME: Quick Take Vol. 83 Treatment-Resistant Schizophrenia: Should You Consider High-Dose Olanzapine Instead of Clozapine?

In this episode, we explore what the CANMAT guidelines say about complementary and alternative medicine (CAM) for depression — from St. John's wort to saffron — and how to have evidence-based, collaborative conversations with patients who prefer a more natural approach to treatment. Faculty: Sagar V. Parikh, M.D., F.R.C.P.C. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Rethinking Depression Treatment: An Update of CANMAT's Guidelines Complementary and Alternative Medicine for Depression: CANMAT Recommendations

In this episode, we explore the growing threat of xylazine — a veterinary sedative increasingly found in illicit drug supplies — and what clinicians need to know when naloxone simply isn't enough. Dr. David Gorelick breaks down the current evidence on diagnosis, treatment, and the critical gaps that remain. Faculty: David A. Gorelick, M.D., Ph.D., D.L.F.A.P.A., F.A.S.A.M. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CME: Quick Take Vol. 82 Xylazine ("Tranq Dope") Overdose: What Clinicians Should Know

In this episode, we explore how to select the right initial treatment for depression using the updated CANMAT guidelines. How do severity, patient preference, and treatment availability shape your first clinical move? Dr. Sagar Parikh breaks down the evidence on psychotherapy, antidepressants, and when to combine both. Faculty: Sagar V. Parikh, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Rethinking Depression Treatment: An Update of CANMAT's Guidelines Selecting the Initial Depression Treatment

In this episode, we explore the hidden dangers of leaving antipsychotics running long after a hospital delirium episode has resolved. Could a medication prescribed to keep your patient safe in the short term actually be harming them months later — and what does the latest evidence say about stopping it? Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CME: Quick Take Vol. 82 Deprescribing Antipsychotics Post-Delirium: Why It Matters

In this episode, we explore the practical dosing, initiation, and conversion strategies for paliperidone palmitate and risperidone long-acting injectables in schizophrenia. How do you manage a missed six-month injection — reload or continue? Dr. Brian Miller breaks down everything you need to know to prescribe these formulations with confidence. Faculty: Brian Miller, M.D., Ph.D., M.P.H. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: Use of Long-Acting Injectable Antipsychotics in Schizophrenia LAIs in Practice: Paliperidone & Risperidone

In this episode, we explore the surprisingly thin evidence base behind antipsychotic switching — one of psychiatry's most common clinical maneuvers. Dr. Oliver Freudenreich breaks down a landmark systematic review and shares six practical tips to help clinicians switch antipsychotics safely and confidently. Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CMEs: Quick Take Vol. 82 Switching Oral Antipsychotics: Six Strategies and Tips

In this episode, we explore the practical use of long-acting injectable antipsychotics in schizophrenia — specifically aripiprazole and olanzapine formulations. What's the right dose when a patient misses an injection? Dr. Brian Miller breaks down dosing, oral supplementation windows, and dose equivalence for Abilify Maintena, Aristada, and Zyprexa Relprevv. Faculty: Brian Miller, M.D., Ph.D., M.P.H. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: Use of Long-Acting Injectable Antipsychotics in Schizophrenia LAIs in Practice: Aripiprazole & Olanzapine

In this episode, we explore when and why long-acting injectable antipsychotics (LAIs) should be considered for patients with schizophrenia, covering approved indications, ideal candidate profiles, and the critical role of shared decision-making in treatment planning. Faculty: Brian Miller, M.D., Ph.D., M.P.H. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: Use of Long-Acting Injectable Antipsychotics in Schizophrenia Understanding When to Prescribe LAIs

In this episode, we explore a striking new Nature study suggesting that lithium deficiency may play a central role in the onset of Alzheimer's disease. Could a simple, overlooked supplement be the key to prevention? Dr. Scott Beach unpacks the science, the promise, and the important caveats. Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CME: Quick Take Vol. 81 Lithium Orotate: Breakthrough Treatment for Alzheimer's Disease?

In this episode, we explore the nuanced challenge of managing ADHD with stimulant medications during pregnancy. Is stopping the medication always the safer choice — or does untreated ADHD carry risks of its own? Dr. Amanda Koire breaks down the latest evidence to help clinicians make truly informed decisions. Faculty: Amanda Koire, M.D., Ph.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.5 CME: Prescribing in Pregnancy: What Every Clinician Should Know Pregnancy, ADHD, and Stimulants: Making an Informed Choice

In this episode, we examine a surprising repurposing of ondansetron — a common antiemetic — as a potential adjunctive treatment for the notoriously hard-to-treat negative symptoms of schizophrenia. Could a nausea medication help restore motivation and emotional engagement in your patients with residual symptoms despite stable antipsychotic therapy? Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CMEs: Quick Take Vol. 81 Is Ondansetron Effective for Negative Symptoms in Schizophrenia?

In this episode, we explore how to manage SSRI treatment in pregnant patients — addressing common fears around fetal malformations, medication switching, and neonatal withdrawal. Can stopping an antidepressant actually do more harm than continuing it? Faculty: Amanda Koire, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.5 CME: Prescribing in Pregnancy: What Every Clinician Should Know SSRI Treatment During Pregnancy: A Clinical Case

In this episode, we explore a landmark meta-analysis that challenges decades of fear surrounding IV haloperidol and cardiac risk. Could one of medicine's most persistent myths be costing patients their best treatment option for delirium? Dr. Scott Beach breaks down the evidence. Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 80 IV Haloperidol: Are Cardiac Safety Concerns Overblown?

In this episode, we explore the complex risk-versus-risk decision of using lithium during pregnancy and breastfeeding. How do you weigh the near-certainty of mood relapse against fetal cardiac risks? Dr. Amanda Koire provides a practical framework every clinician needs when managing bipolar disorder in reproductive-age women. Faculty: Amanda Koire, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.5 CME: Prescribing in Pregnancy: What Every Clinician Should Know Lithium in Pregnancy and Breastfeeding

In this episode, we explore new international guidelines for clozapine monitoring following the FDA's REMS rescission. Should patients on stable clozapine continue lifelong monthly blood draws, or can we safely reduce monitoring after two years? Dr. Seeber discusses how these evidence-based recommendations balance patient burden with safety. Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 79 New Guidelines for Clozapine ANC Monitoring

In this episode, we explore how pregnancy reshapes the pharmacokinetics of psychiatric medications — and what that means for your patients. Can stopping a mood stabilizer actually put a pregnancy at greater risk than continuing it? Dr. Amanda Koire breaks down the evidence. Faculty: Amanda Koire, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.5 CME: Prescribing in Pregnancy: What Every Clinician Should Know Pregnancy's Impact on Medication Efficacy and Dosing Considerations

In this episode, we explore bright light therapy (BLT) as a powerful adjunctive treatment for bipolar depression — examining the neuroscience behind it, how to implement it clinically, and why it may work faster than medication alone. Could something as simple as light reshape how we treat mood disorders? Faculty: Kristin Raj, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 80 Bright Light Therapy for Bipolar Depression: ISBD Clinical Recommendations

In this episode, we explore three often-overlooked side effects of lithium — sexual dysfunction, hair loss, and skin changes like acne and psoriasis — and discuss practical, evidence-based strategies for managing each one without abandoning a medication that works. Faculty: David Osser, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.5 CME: Lithium: How to Manage Dosage and Side Effects Approaching Sexual Dysfunction, Hair Loss, and Rashes With Lithium

In this episode, we explore KarXT, a newly FDA-approved antipsychotic with a groundbreaking cholinergic mechanism, through the lens of a single powerful metric: the Number Needed to Treat. Could an NNT of 5 change how you approach treatment-resistant schizophrenia? Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 80 How Effective Is KarXT (Xanomeline-Trospium) for Schizophrenia? NNT and NNH Explained

In this episode, we explore how to keep your patients on lithium by getting ahead of two of its most common challenges — weight gain and gastrointestinal side effects. Dr. David Osser from Harvard Medical School shares practical, proactive strategies to anticipate, prevent, and manage these issues before they drive your patients away from a medication that could truly change their lives. Faculty: David Osser, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.5 CME: Lithium: How to Manage Dosage and Side Effects How to Mitigate Weight Gain and Gastrointestinal Side Effects of Lithium

In this episode, we explore a surprising new contender in the fight against alcohol use disorder — semaglutide. Could the blockbuster weight-loss drug also curb heavy drinking? We examine the first randomized controlled trial testing this GLP-1 receptor agonist specifically for AUD. Faculty: David A. Gorelick, M.D., Ph.D., D.L.F.A.P.A., F.A.S.A.M. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 79 Semaglutide for Alcohol Use Disorder: New RCT Data

In this episode, we explore lithium's renal side effects with Dr. David Osser from Harvard Medical School. How can we keep patients safe while using this highly effective medication? Discover the real risk numbers, prevention strategies, and evidence-based monitoring approaches that protect kidney function long-term. Faculty: David Osser, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.5 CMEs: Lithium: How to Manage Dosage and Side Effects Managing Renal Side Effects of Lithium Therapy

In this episode, we explore cariprazine's efficacy and safety in older adults with bipolar I disorder. Does age change how we should dose this medication? Discover evidence-based insights on treating both depression and mania in elderly patients, plus critical pearls on monitoring for akathisia. Faculty: Kristin Raj, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 79 Cariprazine Dosing for Bipolar Disorder In Older Adults

In this episode, we explore essential baseline testing, monitoring protocols, and optimal dosing strategies for lithium with Dr. David Osser from Harvard Medical School. Why does giving lithium once daily at night actually protect the kidneys better than divided doses? Discover evidence-based approaches that could transform your lithium prescribing practice. Faculty: David Osser, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: An Update on Bipolar Mania Algorithm Diagnosing Bipolar Mania and Comorbid Disorders

In this episode, we explore the delicate balance of prescribing stimulants for adult ADHD when abuse potential is a concern. How do you distinguish between performance-driven misuse and recreational abuse? Dr. Bukstein shares essential red flags, safety precautions, and strategies to protect both patients and prescribers. Faculty: Oscar G. Bukstein, M.D., M.P.H. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: Mastering Adult ADHD: A Comprehensive Clinical Guide Stimulants: Clinical Considerations, Preventing Abuse, and Red Flags

In this episode, we explore groundbreaking research on treating cannabis-induced psychosis with antipsychotic medications. Which formulations cut hospitalization rates by 75%? And why do some commonly prescribed antipsychotics show no effectiveness at all in preventing future psychotic episodes? Faculty: David A. Gorelick, M.D., Ph.D., D.L.F.A.P.A., F.A.S.A.M. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CMEs: Quick Take Vol. 78 Cannabis-Induced Psychosis: Which Antipsychotics Best Prevent Hospitalization?

In this episode, we explore stimulant medications for adult ADHD with Dr. Oscar Bukstein. Why have amphetamines overtaken methylphenidate as the most prescribed option? Discover how to match formulation duration to patient needs, navigate cardiovascular risks, and monitor treatment effectively for optimal outcomes in adult ADHD management. Faculty: Oscar G. Bukstein, M.D., M.P.H. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: Mastering Adult ADHD: A Comprehensive Clinical Guide Pharmacologic Treatments for Adult ADHD: Focus on Stimulants

In this episode, we explore the groundbreaking COaST trial examining semaglutide for clozapine-induced weight gain in schizophrenia patients. Could GLP-1 agonists finally offer a real solution to one of psychiatry's most frustrating paradoxes—when the medication that saves lives simultaneously shortens them? Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CMEs: Quick Take Vol. 78 Does Semaglutide Reverse Clozapine-Induced Weight Gain in Schizophrenia? Results from the COaST Trial