What this episode covers An antidepressant has helped, but the patient is still struggling. This episode looks at when it makes sense to preserve that benefit and add another treatment, how to choose an add-on for a specific remaining problem, and how to decide whether it helped enough to keep. Clinical question When one antidepressant …
Read more “Antidepressant Augmentation: What to Add and Why”
What this episode covers A patient can still feel depressed even when an antidepressant has changed something meaningful. This episode looks at how to recognize a partial response, ask what is different in daily life, and use that information to decide whether to give the medication more time, optimize the dose, switch, or consider augmentation. …
What this episode covers A patient has taken the same clonazepam dose responsibly for more than a decade, and the medication has probably helped him. But sleep apnea, fatigue, memory concerns, a fall, alcohol exposure, and better treatment of his underlying anxiety have changed the clinical picture. This case excerpt follows how I decide that …
What this episode covers Billing for mental health visits can feel murky because the work is often cognitive, conversational, and risk-based rather than procedure- or lab-driven. This episode walks through how to think about billing mental health-related visits using medical decision making, time-based E/M billing, and a few key add-on codes. Quick Practical Takeaways Listen …
Read more “Billing Mental Health Visits Without Losing Your Mind”
What this episode covers Naltrexone is one of the most practical and underused tools for alcohol use disorder. This episode focuses on when to use it, how to start it without overcomplicating things, and how to address the common concerns that tend to get in the way. Quick Clinical Takeaways Listen Now Prefer to listen …
What this episode covers Switching antidepressants is one of the most common and often most confusing medication decisions in outpatient mental health care. This episode focuses on when a switch actually makes sense, how to choose a new antidepressant strategically, and how to carry out the transition in a way that minimizes withdrawal, side effects, …
Read more “The Antidepressant Switch Guide: When to Switch and How to do it Right”
What this episode covers Psychiatric screeners are everywhere in outpatient care, but most clinicians aren’t using them in a structured way. This episode focuses on how to use a small set of high-yield screeners to improve diagnostic clarity, reduce cognitive load, and guide treatment decisions without slowing down your workflow. Quick clinical takeaways Listen now …
Read more “Psychiatric Screeners in Primary Care: Cutting Through the Noise”
What this episode covers Buprenorphine is one of the most effective treatments we have for opioid use disorder, but many clinicians hesitate to use it because the pharmacology feels confusing. This episode breaks down the core concepts you actually need to understand to prescribe it safely and confidently. Quick clinical takeaways What this changes in …
Read more “Buprenorphine from the Ground Up: Understanding Mechanism, Safety and Clinical Use”
What this episode covers Stimulant prescribing for ADHD can feel complicated because of the number of medications and formulations available. In reality, most decisions come down to a small set of patterns you can apply consistently. This episode breaks stimulant prescribing into a simple, practical framework you can use in everyday outpatient care. Quick clinical …
Read more “Stimulants, Simplified: A Primary Care Framework for Choosing and Using ADHD Meds”
What this episode covers Evaluating ADHD in adults can feel unclear, especially when patients present with new concerns about focus and attention. This episode provides a practical starting point for assessing adult ADHD in outpatient care, including how to differentiate it from other causes of inattention and how to begin a structured evaluation. Learning Objectives …
Read more “Not All Inattention Is ADHD: A Practical Framework for PCPs”