Sneak Preview—The 2026 Psychiatry Update!
Drs. Christoph Correll, Leslie Citrome, Denise Vanacore Chase & Donald Black Give a Sneak Preview…
Introduction
Welcome back to the Psychiatry newsletter!
In this issue, Medscape’s Co-Chairs and Advisory Chairs Drs. Christoph Correll, Leslie Citrome, Denise Vanacore Chase and Donald Black, who dish on new critical treatment options and therapies they have adopted into practice and look forward to on the horizon—topics that will be fully covered at the 2026 Psychiatry Update. Read on to see what they’re finding success with for their patients!
Need CME? We’ve got you covered—Don’t Miss!
March 26-28, 2026; Ritz-Carlton, Chicago, Illinois
- Full 3-day meeting with interactive presentations, discussion and networking opportunities in addition to the scientific sessions.
- Stellar agenda! Explore the latest advances in the treatment and management of bipolar disorder, MDD, schizophrenia, PTSD, ADHD, neuropsychiatric disorders, movement disorders, as well as innovative practice approaches such as neuromodulation and digital technologies.
- Register by clicking here!
Keep up to date as well on current research with this month’s Psych Resource section, featuring articles from MDEdge Psychiatry, New England Journal of Medicine, and JAMA Psychiatry—check them out below!
Thank you to Dr. Christoph Correll, Dr. Leslie Citrome, Dr. Denise Vanacore Chase and Dr. Donald Black for this month’s interview! Please contact me at colleen@cmhadvisors.com with any comments. –Colleen Hutchinson
Sneak Preview—The 2026 Psychiatry Update!
Drs. Christoph Correll, Denise Vanacore Chase, Leslie Citrome, & Donald Black
Dr. Correll, last year, in co-presenting Psychiatric Treatment Innovations: New Therapeutics, Novel Mechanisms of Action, and Pipeline Developments, you shared that the latest new therapeutics that have been of great import to treatment options and algorithms for patients were the following: Lumateperone across unipolar and bipolar depressive disorders; xanomeline-trospium for the treatment of schizophrenia; olanzapine-samidorphan to reduce olanzapine's cardiometabolic burden; one-monthly and two-monthly immediate release subcutaneous long-acting risperidone for relapse prevention.
Asked the same question one year later, does your answer differ? Or are they still achieving significant success as anticipated?
Dr. Correll:
One Year Later: Reflections on New Therapeutics and Novel Mechanisms in Schizophrenia
My answer has evolved. Partly because some agents have fallen short of the expected success, needing additional data, different dose or study methodology approaches, and partly because agents are finding their place in clinical care and clinicians are learning where to position them.
- Lumateperone has increasingly proven its value, especially in areas beyond schizophrenia, i.e., bipolar depression and most recently major depressive disorder, with added benefits due to tolerability and long-term safety.
- Xanomeline–trospium represents a genuine paradigm shift, demonstrating that non-postsynaptic D2 mechanisms can produce robust antipsychotic efficacy, opening the door to mechanistically differentiated treatment pathways. However, we are still learning about the best dose paradigms, which symptom domains beyond positive symptoms can be addressed and whether and where combinations with dopamine receptor antagonists and partial agonists could improve outcomes. The next wave of muscarinic receptor modulators is in phase 2 and phase 3 development for schizophrenia, and new indications like psychosis or agitation associated with Alzheimer’s disease and bipolar mania as well as others will be of increasing interest.
- Olanzapine–samidorphan has meaningfully reduced, though not eliminated, the metabolic liability of a highly effective antipsychotic, allowing more individualized risk–benefit decisions, with real world data indicating greater persistence and less healthcare utilization compared to other oral antipsychotics, including olanzapine.
- Subcutaneous long-acting risperidone formulations have strengthened the case that formulation innovation can improve relapse prevention and real-world outcomes. The NDA submission of subcutaneous olanzapine-LAI without risk for the postinjection delirium sedation syndrome is an exciting prospect of being able to use a safe olanzapine-LAUI in the near future that will not have a REMS associated with its use.
- The pipeline continues to expand, and novel mechanism action agents are still sorely needed, especially agents that are safe and effective for cognition, negative symptoms, and treatment-resistance. The technically simple but clinically complex implementation of measurement-based care, judicious use of AI in mental health care and biomarker stratified or even individualized care remain important frontiers.
Dr. Correll, what will be some takeaways for these sessions you moderate—Treatment Resistant Depression, and How to Manage Substance Use Disorders in General Psychiatric Practice?
Dr. Correll:
Treatment-Resistant Depression (TRD)
- Define resistance rigorously: many patients labeled “treatment-resistant” have had inadequate dose, duration, adherence, or diagnostic reassessment.
- Sequence intelligently: optimization and augmentation strategies should be systematic, not trial-and-error—integrating pharmacologic, neuromodulatory, and psychotherapeutic approaches.
- Match mechanism to symptom profile: Anhedonia, cognitive dysfunction, anxiety, and suicidality may point toward different next-step strategies rather than a one-size-fits-all approach.
Managing Substance Use Disorders in General Psychiatric Practice
- You don’t need to be an addiction specialist to make a difference. Screening, brief interventions, and evidence-based pharmacotherapies can and should occur in routine psychiatric care.
- Treat SUDs as chronic, relapsing brain disorders, not moral failings. This framing improves outcomes and clinician engagement.
- Integrated care really matters. Addressing substance use meaningfully improves outcomes for mood, psychotic, and anxiety disorders, and reduces relapse, hospitalization, and mortality (which is highest/most premature in patients with SUD).
Can you tell us about the Keynote (“The Mind & Music,” Richard Kogan, MD) this year?
Dr. Citrome: Dr. Kogan and I were in the same residency class together at NYU and I was fortunate to be on many in-patient rotations with him. We all knew he was special in that he was a talented concert pianist, and after residency it was lovely to hear him give his "musical lectures" at conferences. His descriptions of composers, and the impact of mental illness on their work, captivates his audience wherever he goes!
Dr. Citrome, last year you co-presented Psychiatric Treatment Innovations: New Therapeutics, Novel Mechanisms of Action, and Pipeline Developments. Have some of the new therapeutics you covered achieved meaningful success with patient outcomes over the past year?
Dr. Citrome: Having additional different choices is what matters here. When treating individual patients, we can't be doing the same thing over and over again and expect a different result. Success has been evident, particularly for major depressive disorder, schizophrenia, and insomnia disorder.
Dr. Vanacore Chase, your background as a psychiatric mental health nurse practitioner is critical to rounding out the scope and depth of content for this year’s Psychiatry Update. Can you speak to what your perspective has brought to the table for this meeting?
Dr. Vanacore Chase: As a psychiatric mental health nurse practitioner, my perspective brings a clinically grounded, patient-centered lens that complements traditional psychiatric frameworks—emphasizing integrated care, holistic symptom management.
The goal is to marry the high-level science of psychiatry with the granular reality of nursing care. We want to treat the disorder, but we must care for the whole person—translating current psychiatric science into practical strategies that clinicians can use across settings, including primary care, specialty psychiatry, and collaborative care models.
What is a major misconception you run across in treating patients and how do you address it?
Dr. Vanacore Chase: Stigma is perhaps the single greatest "side effect" of mental illness. Many patients arrive feeling that if they were just "stronger" or "more disciplined," they wouldn't need a prescription. This view treats a neurobiological condition as a character flaw.
Dr. Correll, can you give us a couple pearls you’ll be covering in your upcoming Psych Update presentation, Special Populations: Elderly, Children and Adolescents?
Dr. Correll:
Special Populations: Elderly, Children and Adolescents
- Dose, duration, and development matter. Age is not just a demographic variable, it fundamentally alters pharmacokinetics, pharmacodynamics, and vulnerability to adverse effects. In youth, we must respect neurodevelopmental sensitivity; in older adults, reduced clearance, polypharmacy, and medical comorbidity dominate risk.
- “Start low, go slow, but go”. Under-treatment is as problematic as over-treatment. The goal is thoughtful titration to evidence-based target doses, with systematic monitoring rather than reflexive conservatism.
- Adverse-effect vigilance differs by age. Metabolic, hormonal, and growth-related effects are central in children and adolescents, while falls, cognitive effects, anticholinergic burden, QT prolongation, and drug-drug interactions are critical in older adults.
- Use data, not fear, to guide decisions. There is more evidence in these populations than many clinicians realize, especially when we integrate RCTs, real-world evidence, and regulatory guidance thoughtfully.
How would you characterize the current treatment options for BPD?
Dr. Black: BPD experts generally feel that psychotherapeutic programs – and there are many that are evidence based – are the treatment of choice. But many BPD patients can benefit from medication targeted at their BPD or comorbid disorders, such as major depression, posttraumatic stress disorder, or an anxiety disorder.
What is the biggest, or a major, misconception patients have and how do you address it?
Dr. Black: With regard to borderline personality disorder, the greatest misconception is that, as patients, they are unpleasant and untreatable. Neither is true, and over the last 2 decades the field has developed an array of evidence-based treatments, both pharmacologic and psychotherapeutic. Combined treatment is desirable for most of these patients.
Dr. Citrome, can you give us a couple pearls from your upcoming Medscape Psychiatry Update presentation, Special Populations: Elderly, Children and Adolescents?
Dr. Citrome: This session will focus on what's special about Special Populations, from differences in disease state to pharmacotherapy. For example, in the elderly there is now an approved agent for agitation associated with Alzheimer's disease. In addition, for both young and old, pharmacokinetic considerations become paramount in terms of drug metabolism as well as drug-drug interactions.
Last year you shared that for the treatment of schizophrenia, we need to get up to speed on muscarinic receptor agonism, and for major depressive disorder, we need a better understanding of agents that work on glutamatergic receptors. One year later, have we made progress?
Dr. Citrome: Alas, there is still a need to better understand both muscarinic and glutamatergic signaling. We can expect more agents that focus on receptors that we have not discussed in detail before. Stay tuned!
Dr. Black, can you give us a couple pearls (or a short overview/bullet points) you’ll be covering in your upcoming Medscape Psychiatry Update presentation, Borderline Personality Disorder: Pharmacotherapy vs. Psychotherapy?
Dr. Black: There are no FDA approved medications for borderline personality disorder, but several medications show promise and are highlighted in the presentation.
Psychiatry Resource Section
Medscape Medical News Commentary: What Should Inpatient Psychiatry Prioritize in 2026?
New England Journal of Medicine Perspective: Untangling the Risks of Antidepressants in Pregnancy
Medscape Medical News Article: Pregnancy Hypertension Risk Higher With SNRI Than SSRI, Study Shows
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