Charles Debattista, MD

An oral glutamatergic option without the logistics of ketamine. Dr. Shirikjian walks through the trial program, the week-one separation, and the mechanism she had to unlearn to understand.

Older antidepressants did not get less effective, only less convenient. Dr. Clayton explains where tricyclics and MAOIs still belong, and when combining psychotherapy with medication outperforms either alone.

Most depression in this country is never treated by a psychiatrist. The panel maps which parts of the journey primary care can own, where handoffs break down, and what safety demands first.

The imaging evidence is associational, not causal. The panel weighs whether that is reason enough for a skeptical colleague to treat depression earlier, and how anxiety complicates the picture.

Fatigue and poor sleep send patients to primary care, but a CBC and a thyroid panel will not find depression. The panel examines what actually separates major depression from its mimics.

Depression rarely arrives named. The panel opens on the presentations that mask it, the risk factors worth flagging in primary care, and the lag between first symptom and adequate treatment.

Explore rapid TRD breakthroughs: accelerated TMS like SAINT, emerging neuromodulation tools, near-term psychedelic therapies, and why sharper diagnosis improves outcomes.

Venlafaxine (Effexor) is a novel antidepressant recently released to the American market. Its entry into the antidepressant market has been much heralded. The lay press has described the drug as "Prozac with a punch," and many patients were asking for it long before it was available. As the hoopla settles down, we are learning that venlafaxine is a potentially important drug with both advantages and disadvantages over other available antidepressants, including the selective serotonin reuptake inhibitors (SSRIs).