Psychopharmacology Updates for Prescribers

A review of nutraceuticals and phytoceuticals for anxiety disorders. Covers dosing, safety, and drug interactions for lavender, kava, ashwagandha, chamomile, omega-3s, CBD, passion flower, saffron, NAC, L-theanine, and inositol, plus supplement quality verification and a clinical case applying these strategies in practice.

This guide examines gepirone, the first FDA-approved selective 5-HT1A receptor agonist for major depressive disorder; its favorable sexual side-effect profile and weight neutrality, dose-dependent QTc prolongation requiring ECG monitoring, mandatory food administration, and contraindication with strong CYP3A4 inhibitors. It also traces gepirone's unusually contested path to approval — four FDA rejections and a 2015 advisory-committee vote against its efficacy before the FDA approved it in 2023 on a modest evidence base.

Must antipsychotics always be avoided in catatonia? Should you prescribe antidepressants in bipolar depression? Should clozapine start after just one failed antipsychotic trial? Is atypical depression a distinct subtype that resists standard antidepressants? Does soft drink intake worsen depression?

A discussion with Dr. John Kane on therapeutic drug monitoring of antipsychotics, covering proper sampling timing, distinguishing pseudo-resistance from true treatment resistance, the clozapine TDM algorithm and smoking effects, drug-specific monitoring of risperidone, aripiprazole, and haloperidol, long-acting injectables, and use in pregnancy.

This guide distills practical pearls from the 2026 ASCP Annual Meeting: deprescribing complex regimens by reconstructing each drug's purpose ("pharmacoarcheology"); interpreting what "FDA approval" does and does not mean; tailoring antipsychotic choice and dose to ancestry and metabolism (benign ethnic neutropenia and clozapine access, first-trimester safety); and montelukast's age-stratified neuropsychiatric effects.

A guide to safe prescribing in patients with cardiovascular disease, anticoagulation requirements, and renal failure. Dr. Gee reviews the cardiac risk profile of ADHD medications, antidepressant and antipsychotic interactions with anticoagulants, mood stabilizer management in patients on NOACs and warfarin, antidepressant and antipsychotic dosing in hemodialysis, and alternative administration routes for patients who cannot take oral medications.

Which antipsychotic should you choose for a woman with first-episode psychosis? When clozapine isn't an option for treatment-resistant schizophrenia, what actually works? Do real-world abuse data change how you select insomnia medications? Did serial ketamine outperform midazolam in a new inpatient trial? Can sustained anthocyanin intake improve cognition?

This guide provides a comprehensive overview of dextromethorphan/bupropion — the first oral NMDA receptor antagonist approved for major depressive disorder and, as of April 2026, the first non-antipsychotic medication FDA-approved for agitation associated with dementia due to Alzheimer's disease. It covers the unique mechanism and rapid antidepressant onset in MDD, the indication-specific titration schedules (including the slower titration with the new 30 mg/105 mg tablet for Alzheimer's agitation), the supporting evidence, drug interactions driven by CYP2D6 inhibition, the newly added hyponatremia warning, and special considerations for elderly patients, CYP2D6 poor metabolizers, and other populations.

A discussion with Dr. Sandra Kooij on how estrogen fluctuations shape ADHD severity across the menstrual cycle, postpartum, and perimenopause in women. Topics include premenstrual stimulant dose adjustment, PMDD treatment options, postpartum depression risk, cardiovascular comorbidity, earlier menopause onset, and hormonal history taking.

What are the teratogenic risks of zolpidem in pregnancy? Do SGLT2 inhibitors slow lithium-related kidney decline? Which antipsychotic works best for acute schizophrenia? Do herbals like Rhodiola or St. John's wort help in mild depression? When should antipsychotics be continued after substance-induced psychosis?

An updated algorithm for PTSD that prioritizes prazosin for sleep disturbances and nightmares before SSRIs. The presentation reviews evidence-based dosing for men and women, sleep initiation alternatives, second-line antidepressants, antipsychotics for PTSD-related psychosis, augmentation options, and considerations for comorbid substance use and bipolar disorder.

This guide addresses tricyclic antidepressant safety across the prescribing lifecycle: CYP2D6 inhibitor interactions (fluoxetine, paroxetine, bupropion), CPIC-guided dosing in poor and ultrarapid metabolizers, a structured monitoring framework, agent selection across pregnancy, breastfeeding, and older adults, and overdose recognition.