Psychopharmacology and Psychiatry Updates

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

In this episode, we explore the treatment algorithm for adult ADHD with Dr. Oscar Bukstein from Harvard Medical School. Should you start with stimulants or non-stimulants when substance use disorder complicates the picture? Discover how comorbidities like depression and anxiety reshape your medication selection strategy for optimal patient outcomes. 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 Treatment Algorithm for Adult ADHD

In this episode, we explore pramipexole—a Parkinson's medication—as a promising add-on treatment for treatment-resistant bipolar depression. Could a dopamine agonist be the unexpected solution when standard mood stabilizers and antipsychotics fail? We examine the PAX-BD trial's findings, safety concerns, and practical clinical applications. Faculty: Kristin Raj, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CME: Quick Take Vol. 78 Treatment-Resistant Bipolar Depression: Is Adjunctive Pramipexole An Option?

In this episode, we explore the controversial role of SERT gene testing in predicting SSRI response with Dr. Chris Aiken. Can genetic testing really tell us which patients will respond to antidepressants, or are we putting too much faith in pharmacogenetic promises that lack solid evidence? Faculty: Chris Aiken, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: The Role of Genetic Testing in Psychiatry SERT Gene and SSRI Response: Is It Clinically Useful?

In this episode, we explore a critical drug interaction: SSRIs combined with anticoagulants increase major bleeding risk by 35-47%. Should age and sex change our prescribing decisions? We break down the evidence from nearly 100,000 patients and discuss safer antidepressant alternatives for high-risk individuals. Faculty: Paul Zarkowski, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CME: Quick Take Vol. 77 Do SSRIs Increase Major Bleeding Risk with Oral Anticoagulants?

In this episode, we explore the paradox of pharmacogenetic testing with Dr. Chris Aiken: why do these tests consistently fail in clinical trials despite showing promise in understanding drug metabolism? Could industry bias and statistical noise be masking the truth about personalized psychiatric medicine? Faculty: Chris Aiken, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: The Role of Genetic Testing in Psychiatry Pharmacogenetic Panels: Do They Really Work?

In this episode, we explore how Lurasidone at lower doses (20-60 mg/day) effectively treats both depression and anxiety in bipolar I disorder. Why does the lower dose range outperform higher doses for patients with severe anxiety? Discover the surprising dose-dependent effects and metabolic advantages that make this a game-changer. Faculty: Kristin Raj, M.D. Host: Richard Seeber, M.D. Learn more about our membership here. Earn 0.75 CMEs: Quick Take Vol. 77 Is Lurasidone Effective for Bipolar Depression with Comorbid Anxiety?

In this episode, we explore how GLP-1 agonists—the weight loss medications making headlines everywhere—could revolutionize management of antipsychotic-induced weight gain. Can these drugs help patients lose weight while maintaining psychiatric stability? We examine the latest evidence and discuss practical implementation strategies for your practice. Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 76 Antipsychotic-Induced Weight Gain: Are GLP-1 Agonists Effective?

In this episode, we explore pharmacogenetics-guided dosing strategies with Dr. Chris Aiken. What if your patient's treatment failure isn't about the wrong medication, but the wrong dose? Discover how genetic testing reveals whether patients are poor or rapid metabolizers and learn the specific dosing adjustments that can transform outcomes. Faculty: Chris Aiken, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: The Role of Genetic Testing in Psychiatry Pharmacogenetics-Guided Dosing: Strategies for Poor and Rapid Metabolizers

In this episode, we explore the newly published INTEGRATE guidelines—the first truly international algorithm for schizophrenia treatment. Should clozapine be started after just 12 weeks? When are long-acting injectables appropriate for first-episode patients? Discover how these guidelines aim to standardize quality care worldwide. Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CME: Quick Take Vol. 77 INTEGRATE: New Schizophrenia Treatment Guidelines

In this episode, we explore the practical role of genetic testing in psychiatry with Dr. Chris Aiken. Which genetic tests actually matter in clinical practice? We cut through the marketing hype to reveal the three essential pharmacokinetic tests and FDA requirements that can prevent serious adverse events in your patients. Faculty: Chris Aiken, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: The Role of Genetic Testing in Psychiatry Pharmacogenetic Tests That Matter in Psychiatric Practice

In this episode, we explore a head-to-head comparison of lithium versus quetiapine augmentation for treatment-resistant depression. When patients have failed multiple antidepressants, which augmentation strategy offers the best balance of efficacy and tolerability? We examine real-world data tracking symptom burden and side effects over an entire year. Faculty: Paul Zarkowski, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 76 Treatment-Resistant Depression: Lithium vs. Quetiapine for Augmentation?

In this episode, we explore pharmacologic strategies for postpartum psychosis with insights from Dr. Lauren Osborne, focusing on a critical clinical question: Can we safely use mood stabilizers like lithium in breastfeeding mothers with bipolar disorder? Discover evidence-based guidance for navigating this high-stakes decision when maternal mental health hangs in the balance. Faculty: Lauren Osborne, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Understanding Postpartum Mood Disorders: A Comprehensive Guide Postpartum Psychosis: Pharmacologic Strategies

In this episode, we explore brexanolone and zuranolone—the first FDA-approved medications specifically for postpartum depression. How do these neurosteroid-based treatments work differently than traditional antidepressants, and could they offer relief in just days rather than weeks? Faculty: Lauren Osborne, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Understanding Postpartum Mood Disorders: A Comprehensive Guide The Role of Brexanolone and Zuranolone in Postpartum Depression

In this episode, we explore lumateperone for treating major depressive episodes with mixed features – that challenging presentation where patients experience depression alongside racing thoughts and restlessness. Can we effectively treat both the despair and the activation without triggering mania? Dr. Kristin Raj examines the evidence and clinical implications for this understudied population. Faculty: Kristin Raj, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CME: Quick Take Vol. 76 Lumateperone for Depression with Mixed Features: Is It Effective?

In this episode, we explore pharmacologic treatment for postpartum depression in breastfeeding mothers. Can psychiatric medications be safely used while nursing? Dr. Lauren Osborne explains how nearly all antidepressants are compatible with breastfeeding, why postpartum women may respond faster to treatment, and how to choose the right medication. Faculty: Lauren Osborne, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Understanding Postpartum Mood Disorders: A Comprehensive Guide Postpartum Depression: Pharmacologic Considerations for Breastfeeding Mothers

In this episode, we explore a new study examining whether antidepressants and antipsychotics truly increase the risk of torsades de pointes, a potentially fatal cardiac arrhythmia. What does the evidence say about using multiple psychiatric medications together, and when should we actually be concerned? Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 75 Torsades de Pointes: Impact of Antidepressants and Antipsychotics

In this episode, we explore the critical distinction between postpartum OCD and postpartum psychosis. Dr. Lauren Osborne reveals why accurate diagnosis matters for treatment and safety. Did you know intrusive thoughts about infant harm don't actually indicate elevated risk in OCD, but do in psychosis? Faculty: Lauren Osborne, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Understanding Postpartum Mood Disorders: A Comprehensive Guide Distinguishing Postpartum OCD from Postpartum Psychosis

In this episode, we examine groundbreaking research that challenges the widespread clinical belief that SSRI side effects improve with time. Using data from the landmark STAR*D trial, we explore which patients actually experience side effect resolution and which face worsening symptoms. Faculty: Paul Zarkowski, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CME: Quick Take Vol. 75 Do SSRI Side Effects Improve Over Time?

In this episode, we explore evidence-based strategies for augmenting lithium when monotherapy fails in acute mania. Why is quetiapine the preferred add-on to valproate, despite decades of clinical tradition favoring anticonvulsants? 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 Augmenting With SGAs After Unsatisfactory Response to Lithium in Bipolar Mania

In this episode, we explore a groundbreaking Mayo Clinic algorithm that revolutionizes antipsychotic selection for first-episode psychosis. Should the presence of violence completely change your medication choice strategy? Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CME: Quick Take Vol. 75 Schizophrenia Algorithm: Selecting an Antipsychotic for First Episodes

In this episode, we challenge conventional prescribing by exploring why lithium should be the first-line treatment for acute classic mania, despite widespread use of antipsychotics. Dr. David Osser presents evidence-based arguments for lithium's unique neuroprotective benefits and long-term efficacy. Faculty: David Osser, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.5 CME: An Update on Bipolar Mania Algorithm Lithium for Bipolar Mania Without Mixed Features

In this episode, we explore a head-to-head comparison of trazodone, doxepin, and melatonin for treating insomnia when benzodiazepines are off the table. Which non-benzodiazepine sleep aid offers the best balance of effectiveness and tolerability in real-world psychiatric patients? Faculty: Paul Zarkowski, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 74 Melatonin, Trazodone, or Doxepin for Sleep Disorders

In this episode, we explore the critical decision of when to add lithium or valproate to second-generation antipsychotics in mixed manic episodes. Should you rush to combination therapy under managed care pressure, or does patience with strategic benzodiazepine bridging lead to better outcomes? Faculty: David Osser, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CMEs: An Update on Bipolar Mania Algorithm Choosing Between Valproate or Lithium Augmentation for Bipolar Mania With Mixed Features

In this episode, we explore a provocative argument for reconsidering disulfiram as a first-line treatment for alcohol use disorder. Could this decades-old medication, often dismissed as outdated and dangerous, actually be more effective than newer alternatives when used in appropriately selected patients? Faculty: David Gorelick, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 74 Alcohol Use Disorder: Should Disulfiram Be First-Line?

In this episode, we explore the complex pharmacological management of mixed mania, a challenging bipolar presentation affecting up to 40% of manic episodes. Why do traditional mood stabilizers like lithium fall short, and which second-generation antipsychotics emerge as first-line treatments for this dual-symptom condition? 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 Managing Renal Side Effects of Lithium Therapy

In this episode, we explore psychedelic-assisted therapy in clinical practice, examining how these treatments differ fundamentally from traditional pharmacotherapy. Can psychiatrists reconcile mystical experiences with evidence-based medicine while navigating the complex therapeutic paradigm of preparation, 8-hour sessions, and integration work? Faculty: Franklin King, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CMEs: Use of Psychedelic Drugs in Psychiatry Psychedelic-Assisted Therapy in Clinical Practice

In this episode, we explore groundbreaking research revealing that lower doses of lurasidone (40-60mg) may be more effective for bipolar depression than higher doses. Could we be over-medicating our patients when the sweet spot for both efficacy and tolerability lies in this unexpected lower range? Faculty: Kristin Raj, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 74 Lurasidone for Bipolar Depression: What Is the Optimal Dose?

In this episode, we explore a compelling comparison between olanzapine and risperidone for managing behavioral symptoms in dementia patients. Are the delusions we see in Alzheimer's disease actually true delusions, or something entirely different that requires a new treatment approach? Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CME: Quick Take Vol. 73 Alzheimer's Disease: Olanzapine vs. Risperidone for BPSD

In this episode, we explore the complex drug-drug interactions between psychedelics and psychiatric medications. Do SSRIs really blunt psychedelic effects, or is this just clinical folklore? We'll examine surprising new research and discuss potentially dangerous combinations every psychiatrist should know. Faculty: Franklin King, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Use of Psychedelic Drugs in Psychiatry Examining the Combined Use of Psychedelics and Psychiatric Drugs

In this episode, we challenge the conventional wisdom of "what gets them well keeps them well" by exploring groundbreaking Finnish research on bipolar disorder medication dosing. Does maintaining patients on high doses actually improve long-term outcomes, or could standard doses be the optimal strategy for relapse prevention? Faculty: Kristin Raj, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: Quick Take Vol. 73 Bipolar Disorder Maintenance: What's the Optimal Dose Range?

In this episode, we explore how psychedelics like psilocybin disrupt the brain's default mode network, creating windows of neuroplasticity that correlate with mystical experiences and therapeutic breakthroughs in treatment-resistant depression, anxiety, and addiction. Faculty: Franklin King, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 1.25 CMEs: Use of Psychedelic Drugs in Psychiatry How Psychedelics Influence Brain Networks

In this episode, we explore groundbreaking research showing how long-acting injectable antipsychotics can literally save lives in schizophrenia treatment. Could choosing the right medication delivery method be the difference between a patient thriving or facing premature death by 15-20 years? Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: Quick Take Vol. 73 Long-Acting Injectables: Superior for Reducing Mortality in Schizophrenia?

In this episode, we explore the fascinating mechanisms behind psychedelic drugs in psychiatry, examining how substances like psilocybin and LSD work through 5-HT2A receptors to promote neuroplasticity. What if these compounds are hijacking an ancient stress response system designed to help us rapidly adapt to survive? Faculty: Franklin King, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Use of Psychedelic Drugs in Psychiatry The Mechanisms and Effects of Psychedelics