Psychopharmacology and Psychiatry Updates

David A. Gorelick, M.D., Ph.D., addiction psychiatrist and clinical professor, discusses semaglutide as a potential treatment for alcohol use disorder. He explains why GLP-1 receptor agonists might help, how semaglutide works and was tested in a randomized trial, reports on drinking and craving outcomes, and reviews safety, tolerability, and candidate profiles for off‑label use.

David Osser, Associate Professor of Psychiatry at Harvard Medical School and psychopharmacology expert, breaks down lithium's renal risks with clear evidence. He discusses actual risk numbers and who is higher risk. He covers monitoring frequency, dosing strategies to prevent toxicity, key drug interactions, and practical approaches for managing polyuria and edema.

Kristin Raj, psychiatrist and psychopharmacology faculty contributor, reviews clinical evidence on cariprazine for bipolar disorder in older adults. She discusses why studying elders matters. Topics include pharmacology and approvals, pooled trial design, efficacy for depression and mania across ages, dosing recommendations, safety and tolerability, and monitoring for akathisia and motor side effects.

David Osser, Associate Professor of Psychiatry at Harvard Medical School and psychopharmacology expert, gives concise clinical guidance on lithium. He reviews essential baseline labs, formulation differences, and why once-daily immediate-release dosing may protect kidneys. He covers starting doses, monitoring timing, interacting drugs, target levels for acute and maintenance care, tapering risks, and special population considerations.

Oscar G. Bukstein, psychiatry professor and ADHD/substance-use expert, outlines clinical safeguards for stimulant prescribing. He explains why stimulants are Schedule II and how pharmacokinetics affect abuse risk. He reviews screening questions, red flags for misuse and diversion, and practical precautions like long-acting meds, monitoring, urine screens, and nonstimulant options.

David A. Gorelick, clinical professor and addiction psychiatrist, joins to break down research on treating cannabis-induced psychosis. He recounts a large Swedish database study and which antipsychotic formulations cut hospitalization risk. He highlights differences between oral and long-acting injectables, names the medications that performed best, and discusses implications for discharge planning and real-world care.

Oscar G. Bukstein, child and adult psychiatrist and Harvard academic, discusses stimulant treatment for adult ADHD. He covers why amphetamines now outpace methylphenidate. He explains choosing short versus long-acting formulations. He reviews cardiovascular screening, monitoring vital signs and common side effects. He outlines when to switch stimulant classes for inadequate response.

Oliver Freudenreich, psychiatrist and psychopharmacology expert, breaks down the COaST trial on semaglutide for clozapine-related weight gain. He walks through study design, striking weight-loss results, safety signals and practical barriers to prescribing. Short, clear takes on what the trial shows and what still needs more research.

Oscar G. Bukstein, a Harvard psychiatrist specializing in ADHD treatment, walks through a practical treatment algorithm. He discusses when to prefer nonstimulants for co-occurring substance use, strategies for ADHD with depression or anxiety, and when stimulants remain first-line. He also covers next steps after stimulant nonresponse and evidence on efficacy and tolerability.

Kristin Raj, M.D., psychiatrist and clinical faculty known for practical psychopharmacology guidance. She discusses why a dopamine agonist like pramipexole might help treatment‑resistant bipolar depression. The conversation covers the PAX‑BD trial design, 12‑ and 36‑week results, safety concerns like hypomania and impulse control, and practical monitoring and dosing considerations.