Psychopharmacology and Psychiatry Updates

In this episode, we explore prazosin for PTSD-related nightmares with Dr. David Osser. He explains why prazosin stands out among alpha-1 blockers, which patients are most likely to respond, and why so many trials failed from underdosing, including how titration differs for men and women.

Faculty: David Osser, M.D. Host: Flavio Guzmán, M.D.

• Learn more about our memberships here
• Earn 1.5 CME: PTSD Psychopharmacology Algorithm
• Prazosin for PTSD Nightmares: Dosing Protocols for Men and Women

Faculty: Amanda Koire, M.D., Ph.D. Host: Flavio Guzmán, M.D.

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• Earn 0.5 CMEs: Quick Take Vol. 87
• First-Episode Psychosis in Women: Which Antipsychotic Is the Preferred Choice?

Faculty: Robert Hudak, M.D. Host: Flavio Guzmán, M.D.

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• Earn 1.25 CME: Treatment-Resistant OCD: From SSRIs to Augmentation
• Second-Generation Antipsychotics for OCD Augmentation: Third-Line Agents

In this episode, we review a JAMA Psychiatry study of over 4 million pregnancies examining first-trimester Z-drug exposure and congenital malformations. Dr. Amanda Koire explains why overall risk wasn't increased, what the neural tube defect signal means, and how to evaluate insomnia before prescribing.

Faculty: Amanda Koire, M.D., Ph.D. Host: Flavio Guzmán, M.D.

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• Earn 0.75 CMEs: Quick Take Vol. 86
• Are Z-Drugs Safe in the First Trimester of Pregnancy?

Faculty: Robert Hudak, M.D. Host: Flavio Guzmán, M.D.

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• Earn 1.25 CME: Treatment-Resistant OCD: From SSRIs to Augmentation
• Glutamatergic Augmentation in OCD: Memantine, Riluzole, Lamotrigine and Other Agents

Faculty: Oliver Freudenreich, M.D. Host: Flavio Guzmán, M.D.

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• Earn 0.75 CMEs: Quick Take Vol. 85
• Schizophrenia: Which of Seven Antipsychotics Wins on Acute Efficacy and Safety?

Faculty: Robert Hudak, M.D. Host: Flavio Guzmán, M.D.

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• Earn 1.25 CME: SSRI Dosing for OCD: Beyond FDA Guidelines
• Treatment-Resistant OCD: From SSRIs to Augmentation

In this episode, we explore a new meta-analysis reconciling trazodone's real-world reputation with cautious sleep medicine guidelines, examining its effects on sleep architecture and depressive symptoms in patients with comorbid insomnia and depression, alongside its notable side effect profile. Can a decades-old antidepressant be the missing link for restorative sleep?

Faculty: Paul Zarkowski, M.D. Host: Flavio Guzmán, M.D.

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• Earn 0.5 CMEs: Quick Take Vol. 85
• Trazodone for Insomnia and Comorbid Depression: Are the AASM Guidelines Relevant?

In this episode, we explore why antipsychotics cause hyperprolactinemia and sexual side effects, a leading reason patients quietly stop treatment. Dr. Oliver Freudenreich breaks down which medications carry the highest risk, the long-term health implications, and practical strategies for monitoring, switching, or augmenting therapy.

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
• Managing Hyperprolactinemia and Sexual Side Effects from Antipsychotic Use

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.

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• 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.

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• 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.

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• 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.

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• 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.

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• 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