Psychopharmacology and Psychiatry Updates

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