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.

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Get more high-yield psychiatric education for primary care and outpatient clinicians at: collaborative-psychiatry.org

Audio Courses Available Now

• Managing Depression in Primary Care: 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.

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. 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. 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. 

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. 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.

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.

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. 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.

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.

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. 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.

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.

Buprenorphine is one of the most powerful tools we have to fight the opioid epidemic but many primary care providers still feel uncertain about how and when to use it. In this episode, we break down the key pharmacologic concepts behind buprenorphine’s safety, misuse potential, and clinical challenges. By the end, you’ll have a clearer understanding of partial agonism, receptor affinity, and the mechanism behind precipitated withdrawal—so you can prescribe with more confidence.

For access to the Show Notes as well as the downloadable clinical references and patients handouts associated with this episode, visit the Episode Page. There, QuickTake Members will find:

• A quick-reference review of how buprenorphine works
• A suboxone initiation guide
• A patient handout on precipitated withdrawal

For a deep dive on managing antidepressants and treating depression in primary care, check out our Audio Course Managing Depression in Primary Care.

Learning Objectives

By the end of this episode, you'll be able to:

1. Differentiate between partial and full agonism at the mu opioid receptor, and explain how partial agonism contributes to buprenorphine’s safety and reduced misuse potential.
2. Describe the clinical implications of buprenorphine’s high receptor affinity, including its blocking effect on full agonist opioids.
3. Analyze the receptor-level mechanism of precipitated withdrawal, and identify the conditions under which it may occur.

For access to the Show Notes as well as the downloadable clinical references and patients handouts associated with this episode, visit the Episode Page. There, QuickTake Members will find:

• A stimulant reference chart
• A stimulant prescribing flowchart
• Patient handouts on amphetamines and methylphenidates
• A stimulant medication and skill use tracker for patients

For a deep dive on managing antidepressants and treating depression in primary care, check out our Audio Course Managing Depression in Primary Care.

Learning Objectives

By the end of this episode, you'll be able to:

1. Identify the two main stimulant classes used to treat ADHD in adults and understand their core similarities and differences.
2. Apply a practical framework for choosing between amphetamine and methylphenidate classes based on symptom severity and patient characteristics.
3. Confidently select from a core group of stimulant medications and adjust dosing using long-acting and short-acting formulations for optimal symptom control throughout the day.

For access to the Show Notes as well as the downloadable clinical references and patients handouts associated with this episode, visit the Episode Page. There, if you sign up for a free membership, you'll find:

• Links to the ASRS and WURS screeners
• A quick-reference reviewing the key points on evaluating ADHD in aduls
• A table reviewing the differential for chief complaints of inattention
• A patient handout on "Why you might feel distracted" that helps patient understand other factors involved in their (in)attention
• A patient handout on "How to improve focus without medications" that works for those with and without ADHD

For a deep dive on managing antidepressants and treating depression in primary care, check out our Audio Course Managing Depression in Primary Care.

Learning Objectives

By the end of this episode, you'll be able to:

1. Recognize the sociocultural and environmental trends contributing to increased self-reported attentional difficulties in adults.
2. Describe key clinical considerations that may suggest a diagnosis of ADHD versus other contributing factors
3. Outline a basic approach for initiating an ADHD assessment in primary care, including the use of the ASRS and WURS screening tools

For access to the Show Notes as well as the downloadable clinical references and patients handouts associated with this episode, visit the Episode Page. There, if you sign up for a free membership, you'll find:

• A clinical reference sheet on managing SSRI-related side effects, for quick recall of the topics discussed in this episodes
• An SSRI comparison table comparing the various antidepressant and their clinical + side effects
• An SSRI counseling phrase sheet to help you discuss these issues with patients
• A patient handout on What to Expect When Starting an SSRI
• A patient handout on Sexual Side Effects from SSRIs

For more comprehensive guidance on managing antidepressants and treating depression in primary care, check out our Audio Course Managing Depression in Primary Care.

Learning Objectives

By the end of this episode, you'll be able to:

1. Recognize the most common early-onset side effects of SSRIs (e.g., GI upset and headaches) and apply evidence-based strategies to counsel patients and manage these symptoms.
2. Differentiate between more activating and more sedating SSRIs, and implement p ractical dosing schedule adjustments to mitigate energy-related side effects.
3. Identify pharmacologic interventions for SSRI-induced sexual dysfunction and weight gain, including when to switch medications versus when to consider adjunctive treatments (e.g., bupropion, buspirone, PDE-5 inhibitors).

Checkout the website for the episode pages and access to all of the clinical resources: QuickTakes Page.