#36 Depression Subtypes: How to Pick the Best Antidepressant for Each

There are many subtypes of depression, and this can be important when selecting the best medication. Today I will be going over these subtypes and will be giving you the algorithm for each as to what I would pick first, second, third, and so forth. Knowing this may lead to going with an MAOi or TCA, for example, much sooner than you thought you would, which can lead to faster resolution of symptoms for the patient. I'll talk about Treatment-Resistant Depression, Atypical Depression, Melancholic Depression, Anxious Depression (Depression with anxiety distress), Depression with Mixed Features, Psychotic Depression, Seasonal Affective Disorder, and I'll briefly mention catatonia and peri-partum depression which I will go into more detail later. So, if you aren't familiar with all of these and you aren't aware of the differences in med choices for each, you'll definitely want to listen to this episode!

#35 Antidepressant Augmentation

So you've found an antidepressant that seems to be helping the patient, but not quite as much as you'd both like. It's maxed out or we've topped out on adverse effects and can't take it any higher. Should we change it? Maybe not. We can try adding something to it. But what should we add? That's what I'll be talking about today. I'll go over every augmentation strategy that I can think of, and there's a lot of them, and I bet you haven't heard of more than a few of them, so listen in and find out what I think about adding medications to a patient's antidepressant regimen.

#33 Antidepressant Efficacy Part 3: The Case for Antidepressants

So we had two episodes on the efficacy of antidepressants and I think I may have been a little hard on them, so I decided to make a part 3 where I instill some hope in these medications. They work great for so many people, yet so many people hate them as well. How can that be? And why do their effectiveness numbers look so abysmal? Find out on this episode!

#32 Medication Treatment Course

We've gone over all the antidepressants. We've talked about how to pick one. But what do you do when you find the right one? How long should the patient take it? Is it ok to come off? How do you take them off? How likely is it that they will get worse again and how do you respond to that? Well that's what I'll be discussing today, so tune in!

#31 Psychogenomic Testing

I bet a lot of you have heard of psychogenomic testing or at least seen one. Maybe you are a patient and you got one or are thinking about getting one. Are these things worse the time and money? Listen to this episode to learn about them and get my 2 cents on the topic!

#30 Improving Efficacy of Medications

On the last episode on antidepressant efficacy we discussed effect size and placebo. On today's episode I will cover a topic called psychodynamic prescribing. I'll be giving you tips on how to become a prescriber that gets max effect from medications. There's a lot of things that you can to maximize the effect, so tune in to find out what they are.

#29 Efficacy of Antidepressants

OK, so we've learned about the antidepressants, how to pick one, and how to dose. Well, how well do they work? I'll be discussing the efficacy of antidepressants on this episode, and I will be exploring the idea of placebo as it relates to these medications. It's more than what you would like, so tune in to find out all about it!

#28 Selecting an Antidepressant

So we've talked about all the FDA approved medications for depression. How to you choose which one to use? Have no fear, I have my break down where I go over all the factors that I take into consideration. Let's not be lazy and pick 5 SSRIs before moving on to other options. Learn about my algorithm that will help you pick the best 1st, 2nd, 3rd, 4th, and 5th choice. And also find out my tier list of these medications. What will be S and A tier? What will be F tier? Tune in to find out!

#27 Investigational Antidepressants

In this episode I will be discussing the different mechanisms of action that are being looked at as the next phase of antidepressant medications. I will also talk about drugs that are in Phase 1, 2, and 3 trials, and how those trials are going. These medications are the likely future of antidepressants. We haven't had many new medications until recently, and they may be followed by several more. Hopefully they will help patients that have yet to benefit from what is out there, but only time will tell. Listen to find out more!

#26 Antidepressant Dosing

On this episode I will be going over all the nuances of dosing the most common antidepressants. I'll talk about the optimal ranges for dosing for most patients, the max doses, and when we can go above the max dose and how high we can go. I will also talk about what doses I start with and how I titrate. I will also discuss a little about why some patients may need doses much lower and much higher than the average patient, and I will touch on hepatic and renal dosing as well. There's a lot more in here than you will find in the prescribing guidelines. I think you will find this detailed information on how to maximize effect and minimize adverse effects with dosing to be really helpful. Enjoy!

#25 5-HT1A Partial Agonist: Gepirone ER

Today I will be talking all about the most recently approved antidepressant, gepirone ER. I'm really not a fan of this one, and there are several reasons why. I honestly cannot think of a reason ever to use it. So tune in to find out all about it!

#24 NMDA Receptor Antagonists: Ketamine, Esketamine, and Dextromethorphan+Bupropion

Today we have an interesting episode. We are covering the first of a very new class of antidepressants, the NMDA receptor antagonists. These are the first antidepressants approved for use for depression which do not interact with the monoamine system, and many more may be coming out in the future. We will talk about ketamine, its sister, esketamine, and the only oral form, a combination of the cough suppressant dextromethorphan and bupropion. Find out how this new class of antidepressant works for depression and what my opinion is of these new medications!