Psychopharmacology and Psychiatry Updates

Antipsychotics and Weight Gain

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

EPA vs. DHA: Fish Oil and Treatment-Resistant Depression

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

AUD Medications and Hepatic Safety

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

GLP-1 Agonists in Serious Mental Illness: Current Evidence

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 weig

Gabapentin, Topiramate & Baclofen in AUD

In this episode, we explore three off-label but evidence-supported medications — gabapentin, topiramate, and baclofen — for alcohol use disorder, examining their mechanis

Deprescribing Benzodiazepines: When Tapering Might Do More Harm Than Good

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 ps

Disulfiram Unpacked: Efficacy, Risks, and Liver Safety

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, effic

GLP-1s and Lithium: What Clinicians Need to Know

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 agon

Naltrexone for Alcohol Use Disorder: What You Should Know

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

The OPTIMUM Trial: A Roadmap for Treatment-Resistant Depression in Late Life

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. W

Difficult-to-Treat Depression: First, Second, and Third-Line Strategies

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

Is High-Dose Olanzapine A Clozapine Alternative?

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 schizoph

CANMAT Guidelines: Herbs, Supplements, and Depression

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 t

Xylazine in the ED: Managing Toxicity

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 nal

Choosing the First Step in Depression Treatment: A CANMAT Guide

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 treatme

After Delirium Clears: When to Deprescribe?

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 kee

The Clinician's Guide to Paliperidone & Risperidone LAIs

In this episode, we explore the practical dosing, initiation, and conversion strategies for paliperidone palmitate and risperidone long-acting injectables in schizophreni

Antipsychotic Switching: Six Clinical Tips

In this episode, we explore the surprisingly thin evidence base behind antipsychotic switching — one of psychiatry's most common clinical maneuvers. Dr. Oliver Freudenrei

Mastering Long-Acting Injectables: Aripiprazole & Olanzapine

In this episode, we explore the practical use of long-acting injectable antipsychotics in schizophrenia — specifically aripiprazole and olanzapine formulations. What's th

Preventing Relapse: The Role of LAIs in Schizophrenia

In this episode, we explore when and why long-acting injectable antipsychotics (LAIs) should be considered for patients with schizophrenia, covering approved indications,