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

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