The glucagon-like peptide 1 (GLP-1)–based diabetes and obesity drug semaglutide, with trade names Ozempic and Wegovy, will become the second best-selling drug in 2024, with estimated worldwide Ozempic sales of US ~$16 billion. Finally, the pharmacological treatment of obesity seems to have a breakthrough after decades of setbacks, with previous weight-loss medications withdrawn from the market because of serious side effects. In this podcast, the co-author of a guest editorial, “Glucagon-Like Peptide 1 Receptor Agonists in Psychiatry,” Hubertus Himmerich, MD, reviews the implications ..read more

Among most prescribers, bupropion is considered a substance of low misuse potential, with some studies showing lesser misuse potential than caffeine. However, several case reports exist of recreational bupropion misuse and diversion. This podcast, a discussion by authors of their bupropion systematic review, reports that snorting and intravenous injection of bupropion occur almost exclusively in patients with a substance use disorder history, with a preponderance of patients with stimulant use disorder or multiple substance use disorders. Users who divert bupropion from prescribed use describe ..read more

In a guest editorial in the Journal of Clinical Psychopharmacology, authors Eric G. Smith and Kushani M. Patel discuss how case series and case reports can contribute to psychiatric treatment decisions. Their article in the March-Apil 2024 issue is titled “The Role of Case Series and Case Reports in Evidence-Based Medicine.” Dr. Smith is from the VA Bedford Healthcare System and the UMass Chan Medical School. Dr. Patel is from the Boston University Chobanian & Avedisian School of Medicine.   Case reports and case series are justifiably far down in the hierarchy of evidence-b ..read more

“Rapid cycling” in bipolar disorder is defined by the occurrence of at least 4 episodes of mania, hypomania, depression, or mixed states during the preceding 12 months. Episodes are demarcated by partial or full remission for at least 2 months or a switch to an episode of opposite polarity. In this podcast, Dr. Ross J. Baldessarini of McLean Hospital and Harvard Medical School discusses the prevalence of rapid cycling and the challenges in its treatment. Rapid cycling is more common in women and is associated with an elevated risk of suicide. Dr. Baldessarini's comments are informed by recent ..read more

Two articles in the March-April 2024 issue of the Journal of Clinical Psychopharmacology present research on glucagon-like peptide-1 receptor agonists (GLP-1 RAs),  a class of medications that has drawn considerable media attention in recent months for their ability to promote significant weight loss. The articles in JCP consider their use in specific populations of patients: individuals with bipolar disorder or eating disorders (in this case, atypical anorexia nervosa). This podcast features a discussion of the articles by authors Susan L. McElroy, MD; Anna Ward, ARPN; and Dr ..read more

In 1954, Dr Heinz Lehmann published the first clinical article on the use of chlorpromazine. Chlorpromazine was the first synthetic drug used to control states of mania and psychomotor excitement, marking the birth of modern psychopharmacology. Seventy years later, the Journal of Clinical Psychopharmacology is highlighting the anniversary of Dr Lehmann’s publication. The January-February 2024 issue of the journal includes a guest editorial that offers a brief history lesson on Dr Lehmann’s contributions. The authors of the editorial are Drs. Pablo Dutra, Richard Balon, and Antonio E. Nardi. In ..read more

Replacement therapy is a key tool in the treatment of individuals who abuse opioids. The idea is to replace heroin or morphine with less euphoric and longer-acting substances, such as methadone, under a medication management protocol. The goals of medical-assisted replacement treatment include reducing an individual's craving for abused opioids, preventing medical complications, decreasing criminal behavior and its consequences, and utimately, hopefully, helping the individual become opioid-free. In this podcast, Dr. Richard Balon discusses the potential for replacement therapy for abuse of ot ..read more

Clozapine is an important drug in the treatment of schizophrenia, and adherence is generally thought to be as good as, if not better than, other antipsychotics. Nonadherence, however, is difficult to detect and potentially dangerous. Tolerance to the cardiovascular effects of the drug is easily lost; restarting at a “normal” dose can prove fatal after a period of abstinence. Nonadherence also increases the risk of self-harm. In this podcast, Dr. Robert Flanagan, a now-retired clinical scientist at Kings College Hospital in London, discusses his study of nonadherence, as measured by plasma leve ..read more

Much has been written in recent months regarding the growing use of artificial intelligence (AI) in medicine and the potential benefits and risks of its use. In this podcast, Anthony J. Rothschild, MD, Editor-in-Chief of the Journal of Clinical Psychopharmacology, highlights a paper in the journal by Drs. Jose de Leon and Carlos De Las Cuevas that reports their experiment to see how ChatGPT3 would respond to various questions about clozapine metabolism. The generated text proved to be profoundly unreliable. Dr. Rothschild also discusses his editorial about the journal’s policies regarding ..read more

The COVID-19 pandemic and associated public health measures shifted the way people access health care. In this podcast, Dr. Christine Leong, Associate Professor at the University of Manitoba College of Pharmacy, discusses the research she and her colleagues conducted to study the effects of the pandemic on psychotropic medication adherence. The data were drawn from a claims repository that contains information on health service and medication use for almost all Manitoba residents. The study showed improved adherence to most psychotropic medications in the 9 months after public health restricti ..read more