Beyond Monotherapy: Mixed Episode Management
Psychopharmacology and Psychiatry Updates
Release Date: 11/02/2025
Psychopharmacology and Psychiatry Updates
In this episode, we explore a head-to-head comparison of lithium versus quetiapine augmentation for treatment-resistant depression. When patients have failed multiple antidepressants, which augmentation strategy offers the best balance of efficacy and tolerability? We examine real-world data tracking symptom burden and side effects over an entire year. Faculty: Paul Zarkowski, M.D. Host: Richard Seeber, M.D.
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In this episode, we explore pharmacologic strategies for postpartum psychosis with insights from Dr. Lauren Osborne, focusing on a critical clinical question: Can we safely use mood stabilizers like lithium in breastfeeding mothers with bipolar disorder? Discover evidence-based guidance for navigating this high-stakes decision when maternal mental health hangs in the balance. Faculty: Lauren Osborne, M.D. Host: Richard Seeber, M.D.
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In this episode, we explore brexanolone and zuranolone—the first FDA-approved medications specifically for postpartum depression. How do these neurosteroid-based treatments work differently than traditional antidepressants, and could they offer relief in just days rather than weeks? Faculty: Lauren Osborne, M.D. Host: Richard Seeber, M.D.
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In this episode, we explore lumateperone for treating major depressive episodes with mixed features – that challenging presentation where patients experience depression alongside racing thoughts and restlessness. Can we effectively treat both the despair and the activation without triggering mania? Dr. Kristin Raj examines the evidence and clinical implications for this understudied population. Faculty: Kristin Raj, M.D. Host: Richard Seeber, M.D.
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In this episode, we explore pharmacologic treatment for postpartum depression in breastfeeding mothers. Can psychiatric medications be safely used while nursing? Dr. Lauren Osborne explains how nearly all antidepressants are compatible with breastfeeding, why postpartum women may respond faster to treatment, and how to choose the right medication. Faculty: Lauren Osborne, M.D. Host: Richard Seeber, M.D.
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In this episode, we explore a new study examining whether antidepressants and antipsychotics truly increase the risk of torsades de pointes, a potentially fatal cardiac arrhythmia. What does the evidence say about using multiple psychiatric medications together, and when should we actually be concerned? Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D.
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In this episode, we explore the critical distinction between postpartum OCD and postpartum psychosis. Dr. Lauren Osborne reveals why accurate diagnosis matters for treatment and safety. Did you know intrusive thoughts about infant harm don't actually indicate elevated risk in OCD, but do in psychosis? Faculty: Lauren Osborne, M.D. Host: Richard Seeber, M.D.
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In this episode, we examine groundbreaking research that challenges the widespread clinical belief that SSRI side effects improve with time. Using data from the landmark STAR*D trial, we explore which patients actually experience side effect resolution and which face worsening symptoms. Faculty: Paul Zarkowski, M.D. Host: Richard Seeber, M.D.
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In this episode, we explore evidence-based strategies for augmenting lithium when monotherapy fails in acute mania. Why is quetiapine the preferred add-on to valproate, despite decades of clinical tradition favoring anticonvulsants? Faculty: David Osser, M.D. Host: Richard Seeber, M.D.
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In this episode, we explore a groundbreaking Mayo Clinic algorithm that revolutionizes antipsychotic selection for first-episode psychosis. Should the presence of violence completely change your medication choice strategy? Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D.
info_outlineIn this episode, we explore the critical decision of when to add lithium or valproate to second-generation antipsychotics in mixed manic episodes. Should you rush to combination therapy under managed care pressure, or does patience with strategic benzodiazepine bridging lead to better outcomes?
Faculty: David Osser, M.D.
Host: Richard Seeber, M.D.