May 19, 2026

Top News
Low-Dose Buprenorphine Sustains Ketamine’s Antisuicidal Effects in Major Depression
Diagnosis & Treatment
New research finds low-dose buprenorphine may help sustain ketamine's benefits for suicidal ideation

Low-dose buprenorphine administered after a single ketamine infusion significantly sustains reductions in suicidal ideation in adults with major depressive disorder.

Diagnosis & Treatment
Using Electroconvulsive Therapy to Treat Psychosis Associated With Huntington Disease-Like 2

This case report demonstrates that electroconvulsive therapy (ECT) can effectively treat refractory psychosis in a patient with Huntington disease-like 2, offering a viable option when pharmacotherapy fails.

Podcast Summary
Rethinking Postpartum Depression: Biology, Biomarkers, and New Treatments with Jennifer L. Payne, MD

This podcast episode discusses the biological mechanisms of postpartum depression, highlighting the role of neuroactive steroids and GABA-A receptors, and reviews the clinical impact of FDA-approved GABAergic treatments like brexanolone and zuranolone alongside emerging epigenetic biomarkers for risk prediction.

Diagnosis & Treatment
Determinants of antipsychotic prescription in women detainees admitted to an acute forensic psychiatric unit

This retrospective study reveals high rates of off-label second-generation antipsychotic prescribing in women detainees, with dosage determined by clinical history rather than demographic factors.

Drug Development
Opioid Use Disorder Treatment Gaps and Emerging Therapeutics to Address Them

This review outlines current treatment gaps in opioid use disorder and categorizes emerging therapeutic targets, including MOR-targeted agents, pharmacokinetic modifiers, and post-MOR signaling modulators like GLP-1 agonists.

Clinical Pearls

Bite-sized clinical takeaways from today's literature (sources from May 14 – May 19)

  • Consider low-dose buprenorphine as an adjunct to sustain the anti-suicidal effects of a single ketamine infusion in patients with major depressive disorder.
  • Counsel patients at clinical high risk for psychosis that co-using cannabis and tobacco triples their risk of developing a psychotic disorder.
  • Prioritize lithium over antidepressants for adolescent nonsuicidal self-injury, given evidence of its potential benefit and the inconsistent efficacy of SSRIs in this population.
  • Utilize clozapine as a first-line consideration for treatment-resistant schizophrenia when comorbid with conduct disorder or aggressive behavioral symptoms.
  • Reassure pregnant patients that current data shows no increased risk of autism or ADHD in offspring associated with antidepressant use during pregnancy.
  • Evaluate GLP-1 receptor agonists as a potential strategy to mitigate metabolic side effects in patients requiring long-term clozapine or olanzapine therapy.
  • Exercise caution with off-label leucovorin for autism spectrum disorder, as its rapid rise in prescriptions is driven by media hype rather than established clinical efficacy.
  • Prescribe SSRIs or NDRIs with specific consideration for post-stroke depression, as comparative efficacy data can guide antidepressant selection in this population.
  • Monitor for cardiac safety concerns in ADHD treatment, noting that large-scale studies indicate no higher cardiac risk with stimulant or non-stimulant medications.
  • Recognize that investigational MOR-targeted agents and pharmacokinetic modifiers are emerging therapeutic targets for opioid use disorder beyond standard maintenance therapies.

Diagnosis & Treatment 2

Leucovorin Autism Prescriptions Surge 2,000% via Media Hype

Off-label leucovorin prescriptions for autism spectrum disorder surged 2,000% due to media hype, highlighting a significant prescribing pattern shift without established clinical efficacy.

SSRI vs NDRI: Which Is Better for Post-Stroke Depression? - Medscape

This article compares the efficacy of SSRIs and NDRIs for treating post-stroke depression, offering clinical guidance for antidepressant selection in this specific patient population.

Drug Development 4

Novel Drug Target to Reverse Fragile X Syndrome Found

A study identifies EPAC2 as a novel drug target for reversing behavioral and neurological deficits in Fragile X syndrome, the most common genetic cause of autism.

Study finds psilocybin shows promise for treating depression - cbs19.tv

A study indicates psilocybin shows promise for treating depression, aligning with ongoing research into novel psychotropic treatments for mood disorders.

NST-SPARK Open-Label Phase 1 STTR (IGNITE)

A phase 1 open-label trial is recruiting to evaluate the safety and feasibility of the NST-SPARK device for the treatment of schizophrenia and schizoaffective disorder.

Phase 2 trial of XPro1595, a selective soluble TNF inhibitor, failed to meet its primary endpoint in early Alzheimer disease overall but showed directional cognitive and biomarker benefits in a prespecified inflammation-enriched subgroup, supporting a phase 3 strategy focused on inflammatory phenotypes.

Mechanism of Action 1

Can psilocybin alleviate phantom limb pain? 5 questions with neuroscientist Fadel Zeidan - The Microdose | Substack

Interview with neuroscientist Fadel Zeidan exploring the potential of psilocybin to alleviate phantom limb pain, highlighting its mechanism of action in pain modulation.

Substance Use 3

Magic mushrooms could be effective treatment for cocaine addiction, study shows - The Guardian

Preclinical or early clinical evidence suggests psilocybin may be effective for treating cocaine use disorder, highlighting the expanding scope of psychedelic research beyond approved psychiatric indications.

Combining Cannabis and Tobacco Triples Psychosis Risk

Co-use of cannabis and tobacco triples the risk of developing psychotic disorders in individuals at clinical high risk, highlighting a critical substance use interaction for psychiatrists managing psychosis prevention.

This review explores the emerging evidence and future directions for using GLP-1 receptor agonists as a pharmacological treatment for Alcohol Use Disorder.

Clinical Pearl 3

Single Psilocybin Dose Provides Rapid Relief From Depression, Small Clinical Trial Finds - U.S. News & World Report

A small clinical trial indicates that a single dose of psilocybin provides rapid relief from depression, highlighting its potential as a fast-acting treatment for depressive disorders.

Potential of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Mitigating Metabolic Side Effects Associated With Clozapine or Olanzapine Therapy: A Literature Review - Cureus

This literature review evaluates the potential of GLP-1 receptor agonists to mitigate metabolic side effects associated with clozapine or olanzapine therapy.

Single Psilocybin Dose Provides Rapid Relief From Depression, Small Clinical Trial Finds - HealthDay

A small clinical trial indicates that a single dose of psilocybin provides rapid relief from depression, highlighting its potential as a fast-acting psychotropic intervention.

Journal Article 1

Systematic Review and Meta-Analysis of Mood Stabilizers in the Treatment of Adolescent Patients With Nonsuicidal Self-Injury in China

This meta-analysis evaluates the efficacy of mood stabilizers for adolescent nonsuicidal self-injury, highlighting lithium's potential benefit and challenging the consistent therapeutic effects of antidepressants in this population.

Digital Health 1

Confirmatory Trial of Gamma Neurofeedback to Improve Working Memory in Schizophrenia

A clinical trial is recruiting to evaluate the efficacy of EEG neurofeedback for improving working memory in patients with schizophrenia and schizoaffective disorder.