Psychotic depression is a severely disabling illness and is more common than is generally realized. Unfortunately, there is no FDA-approved medication for its treatment. In this podcast, the Editor-in-Chief of the Journal of Clinical Psychopharmacology, Anthony J. Rothschild, discusses his opinions as to how this came about and encourages further research and development of a suitable medication with an eye toward FDA approval.

Authors Nicholas A. Mischel and Richard Balon discuss their commentary, “Esketamine: A Drug to Treat Resistant Depression That Brings More Questions Than Answers.” Their commentary asks: How does this treatment fit into the broader repertoire in treating resistant depression and suicidal ideation or behavior, with both concepts ill-defined?

Editor-in-Chief Anthony Rothschild discusses his editorial, “The Pitfalls of Psychotropic Polypharmacy.” For psychiatric disorders, it is common for patients to be prescribed more than one medication. While there may be benefits, it is essential that clinicians also be mindful of potential problems, such as pharmacokinetic interactions (affecting drug absorption, distribution, metabolism, and elimination), pharmacodynamic interactions (for example, serotonin syndrome, QT-interval prolongation, and lowering of seizure threshold), drug-induced liver injury, and falls in older patients. There are times when “treatment-resistant symptoms” are actually adverse effects of the many medications being taken.