The Journal of Clinical Psychopharmacology Podcast

In this podcast, Drs Balwinder Singh and Liliana Patarroyo-Rodriguez discuss their case report of lithium toxicity in a patient with bipolar I disorder who had obtained tirzepatide online without clinician supervision. Tirzepatide is a GLP-1 medication that the patient sought for weight management. Prescribing information for tirzepatide cautions against coadministering it with medications with a "narrow therapeutic index" such as lithium. For medications with a narrow therapeutic index, the difference between a therapeutically effective dose and a toxic dose may be minimal. This case underscores the importance of proactive lithium level and renal function monitoring after GLP-1 receptor agonist initiation or dose changes, as well as having a heightened clinical suspicion for emerging toxicity.

Drs. Patarroyo-Rodriguez and Singh, as well as their coauthors Jonathan Leung, Kemuel Philbrick, and Justin Choe, are from the Mayo Clinic, Rochester, Minnesota. The case report was published in the July-August 2026 issue of the journal.

Article doi: 10.1097/JCP.0000000000002207

in this podcast, Dr. Julia Ann Koretski, Digital Editor of the Journal of Clinical Psychopharmacology, leads a discussion of an editorial authored by Giovanni A. Fava, Steven L. Dubovsky, and Richard Balon. Drs Fava and Dubovsky, both form the University at Buffalo, and Dr. Balon, from Wayne State University and Associate Editor of the journal. The editorial, titled "Intermediate Steps in the Practice of Psychopharmacology: The Role of Clinical Judgment," is published in the September-October 2026 issue of the journal. The article and discussion highlight the importance of clinicians carefully analyzing the often-complex needs of the individual patients in front of them and applying their skills, training, and understanding of clinical guidelines and research to develop a therapeutic approach and changing the approach over time as needed.

Article doi: 10.1097/JCP.0000000000002206

Serotonin reuptake inhibitors (SRIs) are a common treatment for major depressive disorder, but they are inadequate for many patients. An article published in the July-August 2026 issue reviews decades of evidence suggesting that their effects may be improved by developing medications, based on candidate compounds, that are specifically designed to increase the brain's ability to make more serotonin.

In this podcast, Dr. Stephania Chaikali discusses the promise of a two-step strategy of both increasing brain supply of serotonin and blocking its reuptake. Dr. Chaikali is a research clinical fellow in psychiatry at Massachusetts General Hospital. Her coauthor is Jacob Jacobsen, PhD, of Evecxia Therapeutics, Inc. The article is titled "Serotonin Synthesis Amplification to Augment the Therapeutic Efficacy of Serotonin Reuptake Inhibitor Antidepressants: Five Decades of Clinical Evidence."

Article doi: 10.1097/JCP.0000000000002180

Bremelanotide (Vyleesi) was approved by the US Food and Drug Administration in 2019 as an on-demand subcutaneous injectable for the treatment of hypoactive sexual desire disorder (HSDD) in premenopausal women. An editorial in the May-June 2026 issue of the Journal of Clinical Psychopharmacology suggests that the drug may hold promise for HSDD in men without testosterone deficiency but who have other disorders resulting from organic or psychogenic causes. Placebo-controlled and peer-reviewed studies would first be needed to confirm safety and efficacy in men.

The authors of the editorial are Dr. James G. Pfaus, PhD, a researcher from Charles University in Prague who specializes in the neurobiology of sexual behavior, and Dr. Richard Balon, MD, Associate Editor of this journal. Dr. Balon is on the faculty of Wayne State University School of Medicine in Detroit.

In this podcast, the authors discuss their editorial with Dr. Julia Ann Koretski, MD, who is JCP's Digital Editor and a staff psychiatrist at Newton-Wellesley Hospital in Massachusetts.

Article doi: 10.1097/JCP.0000000000002179

Why can it be challenging to find a psychiatrist well-trained in psychopharmacology? An editorial in the March-April 2026 issue of the Journal of Clinical Psychopharmacology suggests that the problem is not just an overall shortage of psychiatrists but also deficiencies in the depth of training, supervision, and evaluations psychiatrists receive during their residencies. As a result, too few psychiatrists are truly prepared to offer integrated psychiatric treatment that melds psychotherapeutic and other treatments with modern psychopharmacology techniques. The editorial offers a variety of recommendations on how to improve the landscape.

In this podcast, Dr. Julia Ann Koretski, JCP's Digital Editor, leads a discussion on the topic with the authors of the editorial, Drs. Ira D. Glick, Carl Salzman, and Anthony J. Rothschild.

Article doi: 10.1097/JCP.0000000000002146

In this podcast, Orges Alabaku discusses his article, "The Use of VMAT2 Inhibitors for Tardive Dyskinesia," which is published in the March-April 2026 issue of the Journal of Clinical Psychopharmacology.

As Dr. Albaku notes, tardive dyskinesia (TD) is a potentially severe and often persistent movement disorder associated with prolonged exposure to dopamine receptor-blocking agents, particularly antipsychotic medications. The only FDA-approved medications for TD are vesicular monoamine transporter 2 inhibitors (VMAT2-Is), valbenazine and deutetrabenazine, while another VMAT2-I medication, tetrabenazine, is used off-label. However, data about VMAT2-I use remain limited.

In their study, Dr. Alabaku and colleagues Mark Olfson, T. Scott Stroup, and Tobias Gerhard characterized trends in TD diagnosis and VMAT2-I use among adults with mental health diagnoses receiving antipsychotics by analyzing 2017-2022 MarketScan data. They report that TD remains underdiagnosed, with treatment rates low, highlighting the need for improved TD recognition and VMAT2-I access.

doi: 10.1097/JCP.0000000000002155

In youth, binge eating is often marked by loss of control eating (LOC-E), defined as difficulty stopping eating and persistent, compulsive food-seeking behaviors that occur even in the absence of physical hunger. In this podcast, Dr. Aaron Keshen discusses his article, titled, "Reduction of Loss of Control Eating in Youth With Attention-Deficit/Hyperactivity Disorder Following Initiation of Stimulant Medication: A Prospective Study." In their article, the authors describe a prospective observational study that aimed to examine changes in LOC-E over a 3-month period in youth with comorbid attention-deficit/hyperactivity disorder and LOC-E who initiated stimulant medication.

The other authors are Colby Price, Elena Koning, Anastasia L. Harris, Nami Trappenberg, Anja Hilbert, Sara Bartel, Jill Chorney, Laura Dixon, Joseph Sadek, Guido K.W. Frank, Victoria Taylor, Wanda Rasmussen, Hanif Chatur, Drew Yamada, and Stuart B. Murray. The article is published in the January-February 2026 issue of The Journal of Clinical Psychopharmacology.

doi: 10.1097/JCP.0000000000002106

Treatment-resistant depression (TRD) is a considerable clinical challenge. Esketamine, in conjunction with an oral antidepressant, is a potential treatment for TRD. In this podcast, Dr. Matteo Lupi discusses his article, "Esketamine and Quality of Life Improvement in Treatment-Resistant Depression Patients: A Real-World Clinical Study." The prospective study described in the report explores the long-term effects of esketamine therapy on subjective quality of life in adults with TRD.

The other contributing authors are Alessandro Carano, Tiziano Acciavatti, Stefano Marini, Marco Palmucci, Elicio Marinucci, Enrico Paolini, Alessandro Gentile, Angelomarco Barioglio, Marco Giri, Domenico De Berardis, and Giovanni Martinotti. The article is published in the January-February 2026 issue of The Journal of Clinical Psychopharmacology. doi: 10.1097/JCP.0000000000002042

Atomoxetine is a selective norepinephrine reuptake inhibitor prescribed for the management of attention-deficit hyperactivity disorder (ADHD). In this podcast, Emily Yamada discusses her article "Atomoxetine as a Viable ADHD Treatment in Breastfeeding Mothers: Evidence From Human Milk Pharmacokinetic Analysis."

In their article, Yamada and her colleagues present data showing that there is minimal transfer of atomoxetine in breast milk, suggesting that maternal atomoxetine use poses a very low risk to breastfed infants, making it a suitable choice for medication management of ADHD in lactating women.

The other contributing authors are Shraddha Trehan, Amy Stark, Kaytlin Krutsch, and Palika Datta. The article is published in the January-February 2026 issue of The Journal of Clinical Psychopharmacology. doi: 10.1097/JCP.0000000000002109

As interest grows in the therapeutic potential of ketogenic diets for bipolar disorder, careful attention must be given to drug-diet interactions. Overlapping mechanisms between therapeutic ketosis and mood-stabilizing agents may offer opportunities for synergistic effects, but may also introduce risks related to altered pharmacokinetics, pharmacodynamics, and additive toxicities. In this podcast, Dina N. Ali, MD, and Jonathan Leung, PharmD, discuss the complex picture of trying to optimize treatment outcomes while many research questions are yet to be answered. Ali and Leung are authors of the commentary, "Diet Drug Interactions: Achieving and Maintaining Ketosis As Adjunct to Psychotropic Polypharmacotherapy," which is published in the November-December 2025 issue of the Journal of Clinical Psychopharmacology.

The other contributing authors are Mark A. Frye, MD; Iain H. Campbell, PhD; Matej Markota, MD; Mikaela M. Hofer, PharmD, and Heather Standorf, PharmD. doi: 10.1097/JCP.0000000000002074