NEI Podcast

In this episode, Dr. Andy Cutler speaks with Dr. Thomas Schwartz about insomnia related to antidepressant discontinuation, including how rebound and withdrawal symptoms can emerge when tapering or stopping treatment. They review the underlying mechanisms, clinical risk factors, and how to distinguish discontinuation-related insomnia from relapse of depression or primary sleep disorders. The discussion emphasizes practical, evidence-informed strategies for safely tapering antidepressants and managing sleep disturbance in psychiatric practice.  

Thomas L. Schwartz, MD, is a Distinguished Teaching Professor at Norton College of Medicine, SUNY Upstate Medical University in Syracuse, New York. He is an award-winning educator deeply involved in medical student and resident training, as well as the development of continuing medical education in psychiatry. 

Andrew J. Cutler, MD, is a distinguished psychiatrist and researcher with extensive experience in clinical trials and psychopharmacology. He currently serves as the Chief Medical Officer of Neuroscience Education Institute and EMA Wellness. He is a Clinical Associate Professor of Psychiatry at SUNY Upstate Medical University in Syracuse, New York. 
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In this episode, Dr. Andy Cutler speaks with Dr. Holly Swartz about the critical role of sleep and circadian rhythms in bipolar disorder, including how sleep disturbance can function as both a symptom and trigger of mood episodes. They discuss how clinicians can better assess sleep to identify early warning signs of relapse, along with practical strategies for intervention, including applying principles of Interpersonal and Social Rhythm Therapy (IPSRT), choosing between behavioral and pharmacologic treatments for insomnia, and avoiding sleep medications that may destabilize mood. The episode offers a clinically focused approach to improving relapse prevention through better sleep management.  

Holly A. Swartz, MD, is Professor of Psychiatry at the University of Pittsburgh, Director of the Center for Advanced Psychotherapy, and Medical Director of the Depression and Manic Depression Prevention Program. An internationally recognized expert in bipolar disorder treatment, she is President of the International Society for Bipolar Disorders and known for advancing Interpersonal and Social Rhythm Therapy (IPSRT), an evidence-based approach targeting sleep, circadian rhythms, and mood stabilization to prevent relapse. 

Andrew J. Cutler, MD, is a distinguished psychiatrist and researcher with extensive experience in clinical trials and psychopharmacology. He currently serves as the Chief Medical Officer of Neuroscience Education Institute and EMA Wellness. He is a Clinical Associate Professor of Psychiatry at SUNY Upstate Medical University in Syracuse, New York. 
Resources 

The Social Rhythm Therapy Workbook for Bipolar Disorder 

Bipolar II Disorder 

Interpersonal and Social Rhythm Therapy – ipsrt.org 

Depression and Bipolar Support Alliance – dbsalliance.org 

 

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In this revisited episode, Dr. Robyn Thom discusses autism spectrum disorder (ASD) and the psychiatric comorbidities that frequently accompany it. She reviews how ASD is diagnosed, the core domains of social communication differences and restricted or repetitive behaviors, and why treatment often focuses on co-occurring conditions such as anxiety, ADHD, sleep disorders, and agitation. Dr. Thom also shares practical strategies for evaluating agitation, distinguishing overlapping symptoms, and selecting behavioral and pharmacologic interventions to support patients with ASD across the lifespan. 

Robyn Thom, MD, is an Assistant Professor of Psychiatry at Harvard Medical School and a staff psychiatrist at the Massachusetts General Hospital Lurie Center for Autism. She specializes in treating children and adults with autism spectrum disorder and other neurodevelopmental conditions, with clinical and research interests in psychiatric comorbidities, anxiety, and mood disorders.
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In this episode, Dr. Andy Cutler talks with Dr. Robert Cotes about optimizing outcomes in early psychosis and why the first episode is a critical window for intervention. They discuss the impact of duration of untreated psychosis, recovery trajectories after a first episode, and what to measure beyond symptom reduction—including functional outcomes, cognition, and relapse risk. The conversation also highlights strategies for engaging young adults and families in coordinated specialty care, early identification of clinical high risk for psychosis, and innovations aimed at improving long-term recovery. 

Robert O. Cotes, MD, is Professor of Psychiatry and Behavioral Sciences at Emory University School of Medicine and Chief of Psychiatry at Grady Health System in Atlanta. He directs the Clinical and Research Program for Psychosis at Grady, which includes Project ARROW, a coordinated specialty care program for young people with early psychosis, and a specialized clozapine clinic for treatment-resistant schizophrenia.   

Andrew J. Cutler, MD, is a distinguished psychiatrist and researcher with extensive experience in clinical trials and psychopharmacology. He currently serves as the Chief Medical Officer of Neuroscience Education Institute and EMA Wellness. He is a Clinical Associate Professor of Psychiatry at SUNY Upstate Medical University in Syracuse, New York. 
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PsychopharmaPearls is NEI's focused podcast series highlighting the clinical insights that can sharpen your prescribing decisions. In this episode, Dr. Andy Cutler talks with Dr. Lisa Harding about how to choose between IV ketamine and intranasal esketamine for patients with difficult-to-treat depression. They unpack the differences that truly matter in practice—from patient selection and monitoring to access, cost, and common missteps. Tune in for practical pearls you can immediately apply to select the right treatment for the right patient. 

Lisa Harding, MD is a board-certified psychiatrist and nationally recognized depression specialist with deep expertise in interventional psychiatry. She has performed more than 4,000 procedures, including electroconvulsive therapy (ECT), intravenous ketamine, intranasal esketamine, and transcranial magnetic stimulation (TMS). Dr. Harding is known for her thoughtful approach to complex, treatment-resistant depression, integrating advanced somatic therapies, psychopharmacology, and psychotherapy. She serves as an Assistant Clinical Professor of Psychiatry at Yale University in New Haven, Connecticut. 

Andrew J. Cutler, MD is a leading psychiatrist, psychopharmacology expert, and clinical researcher with decades of experience in CNS drug development. As Chief Medical Officer of Neuroscience Education Institute and EMA Wellness, he brings frontline clinical insight together with deep knowledge of the evidence base. Dr. Cutler is widely recognized for translating research into practical guidance for everyday practice and serves as a Clinical Associate Professor of Psychiatry at SUNY Upstate Medical University in Syracuse, New York. 

Resources 

Sanacora G et al. A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders. JAMA Psychiatry 2017;74(4):399-405. doi:10.1001/jamapsychiatry.2017.0080 

McIntyre RS et al. Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation. Am J Psychiatry 2021;178(5):383-399. doi:10.1176/appi.ajp.2020.20081251 

 

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