Examining a patient's family history of medication response is a commonly used method to guide physicians in treatment selection. Though it is widely recommended, there are no published reviews that assess the validity of this approach when treating patients with affective disorders. In this podcast, authors Jeffrey J. Rakofsky, Michael J. Lucido, and Boadie W. Dunlop of the Department of Psychiatry and Behavioral Sciences at Emory University discuss their article, “A Systematic Review to Determine if Family History of Response to Medication Predicts Outcome in Mood Disorders,” which is published in the July-August 2025 issue of the Journal of Clinical Psychopharmacology. In their analysis, the evidence supporting using family history is weak and should be considered as just one piece of the puzzle that should not override other considerations. doi: 10.1097/JCP.0000000000002011

There is considerable evidence that marketing affects physician prescribing practices, even though physicians themselves may not feel that they are influenced. In a thought-provoking editorial, Dr. Jeffrey A. Mattes explores how e-prescribing systems may be one pathway through which pharmaceutical messaging may shape prescribing behavior. In this podcast, Dr. Mattes discusses his editorial, “How Does Drug Company Marketing Affect Physician Prescribing?” which is published in the July-August 2025 issue of the Journal of Clinical Psychopharmacology. doi: 10.1097/JCP.0000000000002030

It has been more than 35 years since clozapine was approved by the FDA for use in the United States. Since then, there have been major advances in pharmacokinetics as well as a substantial accumulation of real-world evidence about its use. In two articles in the May-June 2025 issue of the Journal of Clinical Psychopharmacology, Dr. Jose de Leon and dozens of colleagues call on the FDA to make important changes to the drug’s product label to reflect current knowledge about the drug’s pharmacology, safety profile, and proper titration. The stakes are high: The medication can be used effectively for treatment-resistant schizophrenia, but there has been concern that it has been underused, resulting in poorer outcomes for patients, including a high rate of suicides. Updating the package insert would help to educate clinicians on its proper use and monitoring for adverse effects.

In this podcast, Dr. Julia Ann Koretski, JCP’s digital editor, leads a panel discussion on the articles by Dr. de Leon and colleagues. In addition to Dr. de Leon, the other panelists include Dr. Larry Alphs, author of an editorial about the topic, Dr. Richard Balon, a coauthor and JCP Associate Editor, and Dr. Anthony Rothschild, a coauthor and Editor-in-Chief of the journal.

Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts Worldwide. Part I

Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts.  Part II

Incorporating Real -World Treatment Data Into Clozapine's Product Label

Dr. Jose de Leon speaks with Dr. Julia Ann Koretski, the Journal of Clinical Psychopharmacology’s Digital Editor, about practical strategies for clinicians prescribing clozapine. This discussion builds on another podcast episode in which Dr. de Leon and a panel of authors and editors discuss recommendations to the FDA to make important changes to the drug’s product label to reflect current knowledge about the drug’s pharmacology, safety profile, and proper titration. Dr. de Leon, Professor of Psychiatry at the University of Kentucky College of Medicine, is the lead author of two articles on the topic in the May-June 2025 issue of JCP. In this podcast, Dr. de Leon elaborates on some of the complexities involved in managing clozapine use, given individual differences in clozapine metabolism as well as genetic and ethnic variabilities among groups. He stresses, however, that clozapine is a life-saving tool that can reduce the risk of suicide in people with schizophrenia.

Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts Worldwide. Part I

Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts.  Part II

Valproic acid is one of the most frequently prescribed mood-stabilizing agents for bipolar disorder, and in some regions of the world, it now competes with lithium as the preferred treatment of choice for bipolar maintenance. There may soon be restrictions on the use of valproic acid, however, because of the risk in neural tube defects and major congenital malformations in children born to mothers and fathers who take it.

In this podcast, Dr. Samuel Dotson, from the Northeast Georgia Health System in Gainesville, Georgia, and Emory University in Atlanta, and Dr. Andrew Nierenberg, from the Dauten Family Center for Bipolar Treatment Innovation at Massachusetts General Hospital and Harvard Medical School, discuss the current state of research regarding the benefits and risks of valproic acid in comparison to lithium use. They also discuss the importance of informing patients about their options, noting that lithium use has sometimes been perceived as riskier than it is. Dr. Dotson and Dr. Nierenberg are the authors of a Guest Editorial titled “Growing Concerns Over Valproate Teratogenicity Present an Opportunity for Lithium” in the March-April 2025 issue of The Journal of Clinical Psychopharmacology.

"Designer benzodiazepines" are lab-created chemical derivatives of prescription benzodiazepines. They have not been approved for medical use and there is limited information on their safety and toxicity. More potent than their prescription counterparts, this subset of novel psychoactive substances have been growing in popularity in recent years and pose the potential for dangerous levels of intoxication.

In this podcast, Dr. Sahil Munjal, program director of the Atrium Health Wake Forest Baptist psychiatry residency program, leads a discussion of the article “Clinical Management of Designer Benzodiazepine Intoxication: A Systematic Review," with his coauthors Dr. Gregory Noe, Katelyn Li, and Nicholas McDuffee. They provide an overview of designer benzodiazepines in comparison to prescription benzodiazepines and describe the findings from their review of 35 case reports. They discuss clinical presentations of designer benzodiazepine intoxication, common approaches to clinical management, and key takeaways from their review of the literature. Their article appears in the March-April 2025 issue of The Journal of Clinical Psychopharmacology.

Dr. Donald C. Goff, Marvin Stern professor of psychiatry at NYU Grossman School of Medicine, gives an overview of a new combination drug recently approved by the U.S. Food and Drug Administration for the treatment of schizophrenia. It will be marketed as Cobenfy, and its component active ingredients are xanomeline and trospium chloride, representing the first non-dopaminergic antipsychotic approved by the FDA. Dr. Goff briefly explores the decades of pharmaceutical treatment of schizophrenia and lays out the steps toward developing the new combination drug. He offers details on next steps, treatment, more extensive trials of the new drug, related approaches, and refers listeners to his editorial for prescribing information.

His guest editorial, “At Last, a Nondopaminergic Agent for the Treatment of Schizophrenia: The Combination of Xanomeline and Trospium (Cobenfy),” is published in the March-April 2025 issue of The Journal of Clinical Psychopharmacology.

Dr. Julia Ann Koretski, a psychiatrist and Digital Editor of the Journal of Clinical Psychopharmacology (JCP), leads a conversation about the guest editorial “Ethics in Psychedelic Science: Promises and Responsibilities” with its author, Dominic Sisti, PhD, a medical ethicist from the Perelman School of Medicine at the University of Pennsylvania, and a JCP podcast panel of Editor-in-Chief Dr. Anthony Rothschild and Associate Editor Dr. Richard Balon. Dr. Sisti provides an overview of recent regulatory actions in this area and summarizes the history of “utopian hype” in the field. The editorial and the podcast discussion detail what elements are required to build a solid ethics infrastructure for psychedelics research and clinical delivery that is free of hype and bias. Sisti advises moving ahead with caution, while noting that “the range of potentially treatable conditions is wide—including PTSD, major depression, anxiety disorder, obsessive compulsive disorder, anorexia nervosa, and substance use disorders.”

The guest editorial is published in the January-February 2025 issue of JCP.

About 20% of women experience depression while they are pregnant, and untreated depression has been associated with increased rates of adverse birth outcomes and complications. In this podcast, Julia J. Rucklidge, PhD, of the University of Canterbury in Christchurch, New Zealand, discusses nutrition, pregnancy, and mental health in detail with psychiatrist and Journal of Clinical Psychopharmacology (JCP) Digital Editor Dr. Julia Ann Koretski. Dr. Rucklidge is the senior author of the article “Broad-Spectrum Micronutrients or Antidepressants for Antenatal Depression: Effect on Maternal and Infant Birth Outcomes in an Observational Secondary Analysis of NUTRIMUM,” which is published in the January-February 2025 issue of JCP. The article reports the outcomes of a randomized clinical trial in which women with depressive symptoms were randomized to receive daily micronutrients or a placebo for 12 weeks during their pregnancy. As reported by Dr. Rucklidge and her colleagues, the micronutrients used to alleviate depression in pregnancy may mitigate negative effects of depression on birth outcomes and have more favorable birth outcomes compared with antidepressants.

About 20% of women experience depression while they are pregnant, and untreated depression has been associated with increased rates of adverse birth outcomes and complications. In this podcast, Julia J. Rucklidge, PhD, of the University of Canterbury in Christchurch, New Zealand, discusses nutrition, pregnancy, and mental health in detail with psychiatrist and Journal of Clinical Psychopharmacology (JCP) Digital Editor Dr. Julia Ann Koretski. Dr. Rucklidge is the senior author of the article “Broad-Spectrum Micronutrients or Antidepressants for Antenatal Depression: Effect on Maternal and Infant Birth Outcomes in an Observational Secondary Analysis of NUTRIMUM,” which is published in the January-February 2025 issue of JCP. The article reports the outcomes of a randomized clinical trial in which women with depressive symptoms were randomized to receive daily micronutrients or a placebo for 12 weeks during their pregnancy. As reported by Dr. Rucklidge and her colleagues, the micronutrients used to alleviate depression in pregnancy may mitigate negative effects of depression on birth outcomes and have more favorable birth outcomes compared with antidepressants.