Collaborative Psychiatry QuickTakes

How I Choose a First-Line Antidepressant (Course Excerpt)

Season 1 of Collaborative Psychiatry QuickTakes may be complete, but the learning continues. In this episode, I’m sharing a short excerpt from the full Audio Course Managing Depression in Primary Care. This clip walks through a practical framework for choosing a first-line antidepressant and setting expectations so patients stay on treatment long enough to see benefit. You’ll hear: * How I choose between bupropion, escitalopram, and sertraline * How side effect profiles guide initial selection * How to frame the “we don’t know which one will work yet” conversation * Why anticipatory guidance about placebo response and timing matters If you’ve been enjoying the QuickTakes, this excerpt gives you a feel for how the full Audio Courses go deeper with structured, practical, and high-yield learning designed for real-world outpatient care. EXPLORE MORE Get more high-yield psychiatric education for primary care and outpatient clinicians at: collaborative-psychiatry.org [http://collaborative-psychiatry.org] AUDIO COURSES AVAILABLE NOW * Managing Depression in Primary Care [http://collaborative-psychiatry.org/courses/managing-depression]: A comprehensive framework for diagnosis, screening, medication selection, switching and augmentation strategies, treatment-resistant depression, and the broader treatment landscape including psychotherapy, neuromodulation, and ketamine/esketamine. COMING SOON * ADHD Pharmacology: A Practical Prescribing Framework * Managing Alcohol Use Disorder KEEP THE LEARNING IN YOUR BACK POCKET If you’ve been listening to the QuickTakes, don’t forget to download the associated PDF clinic resources and patient handouts available on each episode page. These quick-reference tools are designed to support you in real time — in the exam room, not just in your earbuds. Check out all the available resources here [http://collaborative-psychiatry.org/resources/].

Naltrexone Demystified: From Craving to Control

Get more high-yield learning on psychiatric management in primary care and outpatient practice at collaborative-psychiatry.org [http://collaborative-psychiatry.org]. Naltrexone is a safe, effective, and often underutilized option for treating alcohol use disorder or even just problematic drinking in primary care. In this episode, we walk through how it works, how to prescribe it, and how to counsel patients on what to expect. You’ll learn practical strategies for dosing, managing side effects, navigating liver function, concurrent opioid use, and the use of approaches like the Sinclair Method when daily use isn’t the patient's goal. Whether you’re already prescribing naltrexone or just getting comfortable with it, this episode offers clear, actionable insights to support your patients and expand your toolkit. For access to the Show Notes as well as the downloadable clinical references and patients handouts associated with this episode, visit the Episode Page [https://collaborative-psychiatry.org/quicktakes/naltrexone-demystified/]. There, QuickTake Members will find: * A quick-reference sheet for naltrexone use in primary care and outpatient settings * A reference sheet with counseling tips and scripts for prescribing naltrexone for AUD * A handout comparing naltrexone with other AUD medications * A patient handout on naltrexone for AUD For a deep dive on managing antidepressants and treating depression in primary care, check out our Audio Course Managing Depression in Primary Care [http://collaborative-psychiatry.org/courses/managing-depression]. We have a full course on Managing Alcohol Use Disorder in primary care and outpatient settings coming soon. LEARNING OBJECTIVES By the end of this episode, you'll be able to: 1. Explain how naltrexone reduces alcohol use by modulating the brain’s reward pathway through opioid receptor blockade.  2. Describe how to initiate and dose naltrexone for alcohol use disorder in the primary care setting, including approaches to managing common side effects.  3. Identify key safety considerations when prescribing naltrexone for AUD, including hepatic function, opioid use, and perioperative planning.

Two New Antidepressants You're Probably Not Using But Should Consider

Get more high-yield learning on psychiatric management in primary care and outpatient practice at collaborative-psychiatry.org [http://collaborative-psychiatry.org]. In this episode, we explore two underused antidepressants—vilazodone (Viibryd) and vortioxetine (Trintellix)—that offer important advantages over traditional SSRIs, particularly when it comes to minimizing sexual side effects and weight gain. You'll learn how these medications work, how to dose them effectively, and where they fit into real-world treatment strategies. By the end, you’ll be able to identify how vilazodone and vortioxetine differ from traditional SSRIs, compare their side effect profiles, understand titration schedules, and determine when to consider them as part of your antidepressant selection framework. For access to the Show Notes as well as the downloadable clinical references and patients handouts associated with this episode, visit the Episode Page [https://collaborative-psychiatry.org/quicktakes/two-new-antidepressants/]. There, QuickTake Members will find: * A visual flowchart guiding clinical use of Vilazodone and Vortioxetine. * A quick-reference table comparing clinically relevant aspects of Vilazodone, Vortioxetine and traditional SSRIs. * An informational handout for patients considering or being prescribed Vilazodone. * An informational handout for patients considering or being prescribed Vortioxetine. For a deep dive on managing antidepressants and treating depression in primary care, check out our Audio Course Managing Depression in Primary Care [http://collaborative-psychiatry.org/courses/managing-depression]. LEARNING OBJECTIVES By the end of this episode, you'll be able to: 1. Identify the key differences between vilazodone, vortioxetine, and traditional SSRIs. 2. Compare side effect profiles, especially regarding weight gain and sexual dysfunction. 3. Apply practical dosing and titration strategies for these two medications. 4. Determine where these medications fit in your antidepressant treatment algorithm.

The Antidepressant Switch Guide: When to Switch and How to do it Right

Get more high-yield learning on psychiatric management in primary care and outpatient practice at collaborative-psychiatry.org [http://collaborative-psychiatry.org]. Switching antidepressants is one of the most common—and often most confusing—tasks in primary care and outpatient mental health management. In this episode, we’ll walk through a clear, practical framework for how to approach antidepressant switches with confidence. You’ll learn when to consider switching, how to choose a new medication, and how to carry out the transition using one of three main strategies: taper and switch, direct switch, or cross-taper. We’ll cover how to assess withdrawal risk, use loose dose equivalence ranges, and tailor your approach based on patient needs and medication classes. Whether you’re dealing with a lack of response, antidepressant burnout, or just want to make a strategic change, this guide will help you do it safely and effectively. For access to the Show Notes as well as the downloadable clinical references and patients handouts associated with this episode, visit the Episode Page [https://collaborative-psychiatry.org/quicktakes/antidepressant-switch-guide/]. There, QuickTake Members will find: * A quick-reference overview of how to switch antidepressants, and a rating of withdrawal risk by medication. * A flowchart detailing when to employ each of the three switching strategies. * A table with approximate dose-range equivalencies for the major antidepressants, to aid in planning switches. * Example cross-tapers, to help guide you when designing your own. * An informational handout for patients about switching antidepressants. Also includes a schedule on second page that can be filled in to provide instructions. For a deep dive on managing antidepressants and treating depression in primary care, check out our Audio Course Managing Depression in Primary Care [http://collaborative-psychiatry.org/courses/managing-depression]. LEARNING OBJECTIVES By the end of this episode, you'll be able to: 1. Identify common clinical scenarios that warrant switching antidepressant medications, including inadequate response and antidepressant tolerance (“burnout”). 2. Differentiate between the three primary strategies for switching antidepressants—taper and switch, direct switch, and cross-taper—and describe the risks and benefits of each. 3. Apply a dose-range framework to guide antidepressant transitions, using low, medium, and high dose equivalents across common medications. 4. Evaluate antidepressant withdrawal risk based on medication class and duration of treatment, and incorporate this risk into switch planning.

Psychiatric Screeners in Primary Care: Cutting Through the Noise

Get more high-yield learning on psychiatric management in primary care and outpatient practice at collaborative-psychiatry.org [http://collaborative-psychiatry.org]. In this high-yield episode, we break down five psychiatric screeners every primary care provider should have in their toolbox: the PHQ-9, GAD-7, C-SSRS, Rapid Mood Screener, and Maclean Screening Instrument for BPD. You'll learn when and how to use each screener to streamline your workflow, sharpen your diagnostic thinking, and navigate complex mental health presentations. Whether you're managing depression, anxiety, suicidality, bipolar disorder, or borderline traits, these tools can help you focus your assessment and guide smarter treatment decisions--without adding to your cognitive load or taxing your time. For access to the Show Notes as well as the downloadable clinical references and patients handouts associated with this episode, visit the Episode Page [https://collaborative-psychiatry.org/quicktakes/psychiatric-screeners]. There you will find: * Direct links to all screeners discussed in this episode * A quick-reference chart reviewing the most helpful psychiatric self-report screeners for general use in primary care * A flow chart describing how and when to use psychiatric screeners in your clinical workflow * A quick-reference chart describing a case-based approach to use of these screeners * A quick-reference tool to assist in differentiating Bipolar Disorder from Borderline Personality Disorder, including questions you can use to guide the process. For a deep dive on managing antidepressants and treating depression in primary care, check out our Audio Course on Managing Depression in Primary Care [http://collaborative-psychiatry.org/courses/managing-depression]. LEARNING OBJECTIVES By the end of this episode, you'll be able to: 1. Identify a go-to psychiatric screener for depression, anxiety, suicidality, bipolar disorder, and borderline personality disorder in primary care. 2. Determine when to use each screener—before, during, or between visits—to streamline your workflow. 3. Apply targeted screening to help distinguish between complex conditions such as bipolar disorder and borderline personality disorder.