Psychiatry Education Forum – March 2026 Highlights
March 2026: What Busy Clinicians Shouldn’t Miss
March 2026 brought several important updates in psychopharmacology, along with a new book & course release and a meaningful discussions within our clinical community. Here’s a quick summary of key highlights.
If you’re a busy psychiatrist, resident, nurse practitioner, physician assistant, or pharmacist — here’s your concise, clinically focused recap.
🔬 Esmethadone (REL-1017): A New Option for Antidepressant Tachyphylaxis?
Antidepressant tachyphylaxis—often referred to as “poop-out”—remains a frustrating clinical challenge.
This month, we reviewed emerging data on esmethadone (REL-1017), an NMDA receptor modulator being studied for major depressive disorder. Unlike traditional monoaminergic antidepressants, esmethadone targets glutamatergic pathways, offering a novel mechanism for patients who lose response over time.
Key Takeaways:
- NMDA modulation may help restore antidepressant response
- Potential role in patients with treatment resistance or tachyphylaxis
- Represents a shift beyond serotonin/dopamine-based strategies
Esmethadone (REL-1017) for Antidepressant Tachyphylaxis
Psychedelics Didn’t Beat Antidepressants—Here’s Why That Matters
A recent meta-analysis compared psychedelic-assisted therapy with antidepressants under conditions designed to reduce bias (including equalized expectancy/unblinding).
Contrary to popular narratives, psychedelics did not clearly outperform antidepressants when these factors were controlled.
Clinical Insights:
- Expectancy effects play a significant role in psychedelic trials
- Antidepressants remain highly competitive in controlled comparisons
- Study design nuances are critical when interpreting psychedelic research
Psychedelics Didn’t Beat Antidepressants
📘 New Book Release: Light After Loss
This month also marks the release of my first book:
Light After Loss: A Guide to Navigating Grief & Finding Your Way Back to Life
This book is a compassionate, practical, and medically informed guide written by a board-certified psychiatrist to help you understand grief and learn how to live again after the death of a loved one.
This is not a book about “getting over” loss.
It is a book about learning how to carry it.
🎓 New Course Released: A Systematic Approach to Antidepressant Failure
We launched a new course this month:
Antidepressant Tachyphylaxis: Systematic Approach to Antidepressant Failure
This course is designed to provide a step-by-step clinical framework to evaluate and manage loss of antidepressant response.
What You’ll Learn:
- Differentiating true vs pseudo-tachyphylaxis
- Neurobiological mechanisms (including receptor fatigue)
- Evidence-based pharmacologic rescue strategies
- NMDA-based treatment approaches (2026 updates)
- Neuromodulation and device-based options
- Practical tools for real-world implementation
💬 Academy Case Discussion: Real-World Complexity
We posted our 7th Clinical Case for Academy members:
🧩 “The Weight of Delusional Guilt”
This month’s Academy forum featured a clinically rich case:
Complex Polypharmacy, Benzodiazepine Dependence, and Driving
The discussion focused on:
- Managing long-term benzodiazepine use
- Navigating polypharmacy in complex patients
- Assessing functional risk (including driving safety)
These types of discussions highlight the importance of collective clinical reasoning in areas where guidelines are often limited.
Case Consultation – Complex Polypharmacy, Benzodiazepine Dependence, and Driving
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