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Top 10 Drug Combinations in Major Depressive Disorder: Interview with Dr. Michael Thase PART 2

Transcript Hi! You’re listening to the Psychopharmacology Institute podcast. I’m your host, Dr. Wegdan Rashad and this is the show that aims to help you, the mental health clinician stay sharp on psychopharm! Today we are continuing our discussion from the last episode on the top 10 drug combinations in the management of major depressiveRead More

  • Top 10 Drug Combinations in Major Depressive Disorder: Interview with Dr. Michael Thase PART 2

  • Top 10 Drug Combinations in Major Depressive Disorder: Interview with Dr. Michael Thase PART 1

  • Reducing Suicidal Ideation Through Insomnia Treatment: A Randomized Clinical Trial

  • The Clinician’s Algorithm To Managing COVID-19 Related Delirium

  • Does Samidorphan Reduce Olanzapine-Induced Weight Gain?

  • Managing Depression, Anxiety, and Psychosis in Parkinson’s Disease

  • Management of Psychiatric Disturbances in Parkinson’s Disease and Other Hypokinetic Movement Disorders

  • Case Discussion: Managing Agitation in Autism Spectrum Disorder

  • Pharmacotherapy of Autism Spectrum Disorder: Randomized BAART Clinical Trial

  • Antidepressant Safety During Pregnancy: Autism, IQ and Teratogenicity

  • Does Prenatal Stress Predispose to Borderline Personality Disorder?

  • Clinical Pearls in Perinatal Psychiatry

  • What Do You Know About Cognitive Enhancers in Depression?

  • Can Lithium Prevent Dementia?

  • Psychopharm in 2019: Your Ultimate Guide

  • Clinical Storytime with Dr. Ken Gillman

  • Do Antidepressants Increase Risk of Dementia?

  • Behind the Scenes: Meet Our Team

  • “New” Antidepressants? A Quick Takes Episode

  • Why Don’t We Prescribe MAOIs?

  • Ketamine for Suicidal Ideation: A Quick Take Episode

  • The Basic Guide To Ketamine and Esketamine

  • Your Psych Guide to Pharmacogenetic Testing

  • Do You Order Pharmacogenetic Testing For Your Patients?

  • Transdermal Patches in Psychiatry: Interview with Dr. Leslie Citrome

  • MOC Self Assessment #9: Ketamine in Clinical Practice: State of The Art Update, Cardiac Side Effects of Psychotropic Drugs and Pharmacogenetic Testing in Psychiatry

  • Clinical Guide to Synthetic Opioids and Bath Salts

  • Designer Drugs: Can You Handle Spice?

  • What You Need To Know About Psychedelics

  • The Magic of the Serotonin Receptors

  • Generalized Anxiety Disorder: What if You Can’t Use An SSRI?

  • Approaching A Case of Generalized Anxiety Disorder: The Basics

  • How Helpful are Antipsychotic Plasma Levels?

  • How to Prescribe Natural Medications? Part 2

  • How to Prescribe Natural Medications? Part 1

  • How to Manage Adverse Effects of Clozapine – Part 2

  • How to Manage Adverse Effects of Clozapine – Part 1

  • Do SSRIs Increase Bleeding Risk?

  • Your Guide to Treating PTSD Comorbidities

  • How to Treat PTSD-Related Sleep Disturbances?

  • Prescribing Psychotropics in the Medically Ill

  • Psychotropics and Gastrointestinal Conditions: Prescribe with the Gut in Mind

  • Clinical Pearls in Geriatric Psychopharmacology

  • Treatment-Resistant Depression: Clinical Conundrum

  • How to Manage an Agitated Patient?

  • When to Discontinue Antipsychotics? Reviewing the Evidence

  • Are Drug Interaction Warnings Influenced by Drug Company Promotion? An Interview with Dr. Jeffrey Mattes

  • Do Depression Efficacy Trials Apply to Your Clinical Practice? An Interview with Dr. Mark Zimmerman

  • Psilocybin for Treatment-Resistant Depression: An Interview with Dr. Robin Carhart-Harris

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Switching Antipsychotics: When, Why, and How

1.50 CMEs
An updated, practical review of antipsychotic switching: when a switch is warranted, when it is ill advised, and how to run abrupt, cross-taper, taper, and plateau strategies. Dr. Miller covers oral and long-acting injectable transitions, clozapine titration and plasma levels, switching to xanomeline-trospium, and receptor-based management of switch-emergent effects.
Brian Miller, M.D., Ph.D., M.P.H.
Medical College of Georgia Augusta University
97.37 minutes in 11 sections

Quick Take Vol. 93

0.75 CMEs
Should antipsychotics be stopped during pregnancy, and what is the relapse risk? Should psychiatrists prescribe statins for antipsychotic-related dyslipidemia? Is pramipexole worth its risks for anhedonic depression? Does lithium carry a lower dementia risk than valproate? Can coffee and brain training lower dementia risk?
Faculty: Oliver Freudenreich, M.D., F.A.C.L.P., Amanda Koire, M.D., Ph.D., James Phelps, M.D., Paul Zarkowski, M.D., Scott R. Beach, M.D.
39.43 minutes in 5 audio sections

Fluoxetine Practical Guide: Pharmacology, Indications, Dosing, Interactions, Switching and Adverse Effects – Update

1.0 CMEs
This guide covers fluoxetine, the SSRI with the longest half-life and the only antidepressant FDA-approved for bulimia nervosa. It is also FDA-approved for major depressive disorder, obsessive-compulsive disorder, panic disorder and premenstrual dysphoric disorder, and with olanzapine for bipolar I depression and treatment-resistant depression. In adults it is a first-line SSRI chosen for its half-life and tolerability rather than its efficacy, which sits at the lower end in head-to-head depression trials. Missed doses cause fewer discontinuation symptoms than with sertraline or paroxetine; the trade-offs are activation, appetite loss and more drug interactions than most SSRIs, through CYP2D6 and CYP2C19. The guide details its clinical positioning among the SSRIs, the 60 mg dose in bulimia, which co-prescribed drugs need a lower dose or another antidepressant, switching to and from it, tapering, and use in pregnancy, breastfeeding and older adults.
Sebastián Malleza, M.D.
Psychopharmacology Institute
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Cariprazine: Pharmacology, Indications, Dosing Guidelines and Adverse Effects

0.75 CMEs
This guide covers cariprazine, a dopamine partial agonist FDA-approved for schizophrenia, acute mania, adjunctive treatment of major depressive disorder and, unlike aripiprazole, bipolar I depression. It causes little short-term weight gain or prolactin change and is among the least sedating antipsychotics; the trade-offs are dose-related akathisia, efficacy at the lower end of the class in acute schizophrenia, and a metabolite with a half-life of one to three weeks. The guide covers its clinical positioning in each indication, the D3 hypothesis and the negative-symptom evidence, why each dose takes weeks to judge, akathisia management, CYP3A4 inhibitor dose cuts, and use in pregnancy, breastfeeding and older adults.
Sebastián Malleza, M.D.
Psychopharmacology Institute
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Quick Take Vol. 92

0.75 CMEs
Is haloperidol still a sound choice for emergency agitation? Do psychotropics beyond clozapine and lithium lower suicide risk? Can anti-inflammatory agents target anhedonia in depression? Can AI help choose an antidepressant? Should buprenorphine start at higher doses for patients using fentanyl?
Faculty: Scott R. Beach, M.D., Paul Zarkowski, M.D., James Phelps, M.D., David A. Gorelick, M.D., Ph.D., D.L.F.A.P.A., F.A.S.A.M.
38.28 minutes in 5 audio sections

Pharmacotherapy of Borderline Personality Disorder

1.0 CMEs
A review of medication use in borderline personality disorder, where psychotherapy remains first line. Dr. Links covers quetiapine, risperidone, and clozapine, the negative lamotrigine trial, antidepressants for comorbid depression, methylphenidate for comorbid ADHD, benzodiazepine risks, collaborative deprescribing, and a clinical case.
Paul S. Links, M.D., F.R.C.P.C.
McMaster University in Hamilton, Ontario, Canada
62.06 minutes in 12 sections

Treating Comorbid ADHD and Substance Use Disorder: From Screening to Pharmacotherapy

0.50 CMEs
A discussion with Dr. Crunelle on identifying and treating ADHD in patients with substance use disorders. Topics include ASRS screening at intake, assessing without waiting for abstinence, starting treatment early, choosing long-acting stimulants or non-stimulants, titrating above standard dose ranges, interpreting requests for a higher dose, and why relapse is not a reason to stop.
Cleo L. Crunelle, M.D., Ph.D.
Cleo L. Crunelle, M.D., Ph.D.
Brussels University Hospital (UZ Brussel), Free University of Brussels (VUB), International Collaboration on ADHD and Substance Abuse (ICASA)
23.27 minutes of audio interview

Lumateperone: Pharmacology, Indications, Dosing Guidelines and Adverse Effects

0.50 CMEs
This guide covers lumateperone, a second-generation antipsychotic approved for schizophrenia, bipolar I or II depression, and adjunctive treatment of major depressive disorder. It carries a low risk of extrapyramidal symptoms, prolactin elevation, and weight gain; the trade-offs are somnolence and the smallest effect size of 24 antipsychotics in acute schizophrenia. The guide details its clinical positioning in each indication and how it compares with other antipsychotics; the receptor profile behind its tolerability; the fixed 42 mg dose, when to lower it, and the CYP3A4 inducers to avoid; and use in pregnancy, breastfeeding, and older adults.
Sebastián Malleza, M.D.
Psychopharmacology Institute
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Quick Take Vol. 91

0.75 CMEs
How do estrogen and hormonal status shape psychosis treatment in women? Which GLP-1 agonist works best for antipsychotic weight gain? Do newer antipsychotics beat aripiprazole for bipolar maintenance? Does low-dose lithium slow decline in mild cognitive impairment? When is ketogenic therapy reasonable in serious mental illness?
Faculty: Amanda Koire, M.D., Ph.D., Oliver Freudenreich, M.D., F.A.C.L.P., James Phelps, M.D., Scott R. Beach, M.D., Derick E. Vergne, M.D.
41.37 minutes in 5 audio sections

Cardiac Side Effects of Psychiatric Medications

1.25 CMEs
A practical review of cardiac side effects across psychiatric medications: heart rate and blood pressure changes, QT prolongation with antipsychotics and antidepressants, IV haloperidol recommendations, clozapine myocarditis and cardiomyopathy monitoring, ADHD medication safety, and a risk-benefit framework for EKG monitoring beyond rigid QTc cutoffs.
Scott R. Beach, M.D.
Harvard Medical School
75.59 minutes in 11 sections

Thyroid in Psychiatry: TSH Testing, T3 Augmentation, and Lithium-Induced Hypothyroidism

0.50 CMEs
A discussion with Dr. Rustad on recognizing and managing thyroid dysfunction in psychiatric practice, covering a TSH-first testing protocol, interpretation of free T4 and anti-thyroid antibodies, euthyroid sick syndrome, when to treat subclinical hypothyroidism, T3 and T4 augmentation dosing in treatment-resistant depression, and monitoring for lithium-induced hypothyroidism.
James K. Rustad, M.D.
Geisel School of Medicine at Dartmouth
29.46 minutes of audio interview

2026 August Update: Centanafadine, Oveporexton, and New Guidance on OCD, Lithium, and Insomnia

0.75 CMEs
This guide covers the two first-in-class approvals of mid-2026, centanafadine for ADHD and oveporexton for narcolepsy type 1, alongside new guidance on OCD dosing thresholds, the serum lithium levels that drive renal risk, and the AASM’s ranking of CBT-I against combination treatment for chronic insomnia.
Sebastián Malleza, M.D.
Psychopharmacology Institute
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