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

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