Osmind

03/20/2026

Treatment-resistant depression doesn't have a formal DSM definition. But most psychiatrists know it when they see it—and most of them are seeing it constantly.

Osmind CMO William Sauvé, MD and medical advisor Brittany Albright MD, MPH, DABOM Albright, MD joined a Psychiatric Times panel to unpack why depression persists after multiple medication trials, and what full remission actually requires.

A few things that stood out:
→ The majority of patients with MDD in psychiatric practice meet the threshold for TRD: two or more adequate trials at appropriate dose and duration

→ Many patients who say they've "tried everything" discontinued within days. Distinguishing that from true TRD matters before changing course.

→ Residual symptoms, even with partial response, significantly increase relapse risk

→ One panelist reframed TRD as "monoamine treatment-resistant depression"; the medications are failing patients, not the other way around

Full remission, not just response, is the goal.

Watch here →https://www.psychiatrictimes.com/view/treatment-resistant-depression-residual-symptoms-and-remission

03/18/2026

Eli Lilly just launched Phase 3 trials for a GLP-1 drug in alcohol use disorder. Not diabetes. Not weight loss. Addiction.

GLP-1 receptors sit in the VTA, nucleus accumbens, insula, and prefrontal cortex, the brain regions that run reward, craving, and compulsion. In a study of 142,000+ patients published this month in Frontiers in Psychiatry, GLP-1 RA users had 75% lower odds of any substance use disorder.

William Sauvé, MD, Annette Bosworth, MD, and Brittany Albright MD, MPH, DABOM break down what psychiatrists need to know:

→ Why the addiction trial data is stronger than most clinicians realize

→ How anhedonia on GLP-1s may be a dosing problem, not a drug problem (and a ziprasidone parallel that hits close to home)

→ What low-dose tirzepatide combined with a ketogenic diet looks like in real patients

One clinician on the call shared a case: a 42-year-old woman with alcohol use disorder whose PHQ-9 dropped from the twenties to 2 in seven weeks on tirzepatide.

If you treat reinforcement dysregulation, you can't afford to outsource this drug class to primary care.

Read the full breakdown here →

Are GLP-1 agonists psychiatric drugs? The neuroscience of reward, new addiction trial data, and a dosing hypothesis that reframes anhedonia.

03/09/2026

Your most treatment-resistant patients need more options. This webinar shows you how to deliver them.

Considering VNS Therapy™ for your patients with difficult-to-treat depression? This webinar covers what happens after you decide it's the right clinical option.

Dr. Karen Giles joins Dr. Will Sauve to discuss the practical side of VNS Therapy implementation. From identifying candidates to understanding the surgical procedure and dosing, they'll walk through the essential knowledge for both new and experienced prescribers.

March 12, 2026 | 11am PT / 2pm ET

Can't make it live? Register and we'll send you the recording.
https://osmind-org.zoom.us/webinar/register/1017721267187/WN_yFgJuxNXRseiQn8KeWnvmw

Webinar selected by Osmind | Sponsored by LivaNova, PLC
More information about VNS Therapy for Difficult-to-treat Depression (DTD) is available at https://www.livanova.com/depression/en-us

The VNS Therapy™ System is indicated for the adjunctive long-term treatment of chronic or recurrent depression for patients 18 years of age or older who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments.
Important safety information is available at https://www.livanova.com/depression/en-us/hcp-safety-information

DEP-2500192

03/04/2026

The average patient in the RECOVER trial had been living with their current depressive episode for 18 years. They'd failed 13 antidepressants. Half had tried ECT.

In our latest webinar, Dr. Hamish McAllister-Williams from Newcastle University breaks down the RECOVER trial results for VNS Therapy in difficult-to-treat depression. The findings challenge how we think about treatment success:

The primary symptom endpoint missed significance - but quality of life improved meaningfully:

•Patients who failed ECT or TMS showed the strongest differential benefit

•80% of responders maintained gains at 24 months

Dr. McAllister-Williams makes a compelling case: "Treatment goals are not defined solely by symptom remission." For patients with profound, chronic treatment resistance, improvements in day-to-day function and quality of life represent genuine progress.

Watch the full webinar to learn which patients benefit most and what the durability data tells us about long-term outcomes: https://www.osmind.org/blog/evidence-for-vns-therapy

Selected by Osmind | Sponsored by LivaNova, PLC
More information about VNS Therapy for Difficult-to-treat Depression (DTD) is available at https://www.livanova.com/depression/en-us

The VNS Therapy™ System is indicated for the adjunctive long-term treatment of chronic or recurrent depression for patients 18 years of age or older who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments.

Important safety information is available at
https://www.livanova.com/depression/en-us/hcp-safety-information

DEP-2600003

03/03/2026

Your most treatment-resistant patients need more options. This webinar shows you how to deliver them.

Considering VNS Therapy™ for your patients with difficult-to-treat depression? This webinar covers what happens after you decide it's the right clinical option.

Dr. Karen Giles joins Dr. Will Sauve to discuss the practical side of VNS Therapy implementation. From identifying candidates to understanding the surgical procedure and dosing, they'll walk through the essential knowledge for both new and experienced prescribers.

March 12, 2026 | 11am PT / 2pm ET

Can't make it live? Register and we'll send you the recording.
https://osmind-org.zoom.us/webinar/register/5517664319437/WN_yFgJuxNXRseiQn8KeWnvmw #/

Webinar selected by Osmind | Sponsored by LivaNova, PLC
More information about VNS Therapy for Difficult-to-treat Depression (DTD) is available at https://www.livanova.com/depression/en-us

The VNS Therapy™ System is indicated for the adjunctive long-term treatment of chronic or recurrent depression for patients 18 years of age or older who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments.

Important safety information is available at https://www.livanova.com/depression/en-us/hcp-safety-information

DEP-2500192

02/26/2026

Five years ago, Benjamin Leopold was curled on his apartment floor with a bottle of scotch. Today he runs marathons, writes horror novels, and surfs whenever he can get to the coast.

He cycled through 10 antidepressants in 18 months. The side effects were brutal. Emotional blunting erased his personality and got mistaken for progress.

It wasn't until a psychiatrist stopped prescribing and started asking what was underneath the depression that things changed. SPRAVATO® (esketamine) gave a bird’s eye view to years of trauma.

During dissociation, Ben could finally step outside his anxiety and see himself clearly for the first time:

"That's who Ben is? Dude, you're okay, man. Look at all the stuff you've done and all the things you've been through and all the amazing people in your life."

In this episode of Psychiatry Tomorrow, Ben sits down with and to walk through the full journey—from childhood trauma, to the antidepressant carousel, to the moment he finally saw what everyone around him had seen all along.

Worth a listen/read if you've ever wondered what treatment-resistant depression actually looks like from the patient's seat.

🎧

Hear how one Spravato patient went from cycling through 10 antidepressants to building a life he loves — running marathons, writing novels, and surfing. Ben Leopold shares how the combination of deep therapeutic work and Spravato treatment finally broke through his treatment-resistant depression.

02/19/2026

For psychiatrists looking to help treatment-resistant patients while adding a profitable service line, TMS is worth a serious look.

TMS response rates run 50-60% for standard protocols. Accelerated protocols are pushing 80%+. Covered by insurance. And new devices have dropped the barrier to entry to $3,000/month with no upfront capital.

Our Chief Medical Officer, William Sauvé, MD, and Ben Spielberg wrote a guide to adding TMS to your practice. It covers:

•Patient eligibility: 4 FDA-cleared indications, common off-label uses, and CE-marked indications in Europe

• Setting realistic expectations with patients

• 8 TMS devices compared with latest available pricing, from Ampa's $3K/month portable subscription to BrainsWay's deep TMS with the broadest FDA clearances, and Nexstim's MRI-guided neuronavigation

• Deep coils vs. figure-8: efficacy data, clearances, and real trade-offs

• Financing: lease vs. purchase, third-party lenders, and Section 179 tax implications

• Billing codes, prior auth strategy, and reimbursement ranges

• Building your referral pipeline before the device even arrives

This is the guide we wish existed when practices started asking us about TMS.

Read it here →

Ready to add TMS to your practice? This guide covers patient eligibility, 2026 device pricing for 8 systems, financing, billing codes, and how to build your referral pipeline from day one.

02/12/2026

"What's the next step for my patient who hasn't responded to multiple antidepressants?"

If you're asking this question, you're not alone—and the answer matters more than you might think. Research shows that treatment outcomes decline with each failed trial, making your next clinical decision critical.

On February 19, 2026, join Dr. Will Sauve and Hamish McAllister-Williams, MD to discover how VNS Therapy™ offers a clinically validated path forward for patients with difficult-to-treat depression.

In this webinar, you'll discover:
➡️ Why treatment outcomes worsen with each failed trial (STAR*D insights)
➡️ What is VNS Therapy and how does it work?
➡️ Key findings from the RECOVER trial: the largest randomized controlled study of VNS Therapy
➡️ Which patients may benefit most from VNS Therapy based on treatment history

Register now—recording available if you can't make it live.
[REGISTRATION LINK] https://osmind-org.zoom.us/webinar/register/WN_INZArKsaR-yIeQfZMQLfhg

Webinar selected by Osmind | Sponsored by LivaNova, PLC
More information about VNS Therapy for Difficult-to-treat Depression (DTD) is available at
https://www.livanova.com/depression/en-us

The VNS Therapy™ System is indicated for the adjunctive long-term treatment of chronic or recurrent depression for patients 18 years of age or older who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments.

Important safety information is available at https://www.livanova.com/depression/en-us/hcp-safety-information

DEP-2500192

02/10/2026

Your patients started a GLP-1 for weight loss. Then they stopped drinking. Then they quit smoking. Then the compulsive shopping slowed down.

Sound familiar? You're not alone. This is just one of the conversations happening right now inside the Psychiatry Collective.

RSVP for two upcoming events in the community

🔬 GLP-1s in Psychiatry
Thu, Feb 12 | 11:00 AM – 12:00 PM PSTGLP-1s in Psychiatry with Annette Bosworth, hosted by Dr. Will Sauvé

Eli Lilly's CEO recently shared that GLP-1s are showing dramatic effects on addiction, compulsive behaviors, and mental health symptoms. Studies are underway for bipolar disorder and MDD, with a psychiatry-focused GLP-1 potentially 3-4 years out. We're discussing dopamine reward pathways, applications for addiction and OCD, the unknowns, and whether psychiatry should be prescribing these now. Bring your anecdotes.

⚡ TMS Best Practices & Training
Wed, Feb 18 | 9:00 – 9:30 AM PST with Ben Spielberg, PhD (Solstice Training Institute), hosted by Dr. Will Sauvé

An open conversation on TMS best practices, documentation, and training standards—plus advanced topics like TMS/ketamine combination therapy and fMRI-guided protocols. Bring your questions or just listen in.

Both sessions will be recorded for members who can't attend live.

RSVP for upcoming events: https://community.osmind.org/c/events/ Not a member yet? Join free: www.osmind.org/join-community?utm_medium=social

02/09/2026

Osmind is excited to partner with LivaNova to support education and awareness for clinicians caring for people living with difficult-to-treat depression (DTD).

This represents our shared mission of advancing mental healthcare and the emerging field of Interventional Psychiatry.

Stay tuned for more from this collaboration and join us on February 19 for a deep dive into published clinical research behind VNS Therapy™, featuring findings from the RECOVER trial.

Link to register in the comments.

See Indications and Important Safety:https://www.livanova.com/depression/en-us/healthcare-provider-resources

02/05/2026

One clinician saw their Spravato reimbursement drop $90 overnight in January. The culprit? A billing code change nobody warned them about.

CMS replaced S0013 with J0013 in 2026. Same drug. Same unit. New code. But the rollout has been messy:

→ Payer systems weren't updated in time
→ Prior authorizations are being handled inconsistently
→ Some practices are already seeing claim rejections

The scariest part for buy-and-bill practices? If a PA isn't valid, you could be out over $1,000 for medication you've already purchased and administered.

We pulled together what clinicians in the Osmind community are seeing: payer-specific guidance, PA reauthorization tips, and a documentation checklist so you're not caught off guard.

Consider it a living document. We're learning alongside you.

CMS replaced S0013 with the new Spravato J code (J0013) in 2026, but payer rollouts have been inconsistent. Learn which prior authorizations need to be redone and how to protect your practice from claim denials.

02/03/2026

Just wrapped ASKP3 and feeling energized. Some highlights from the conference:

• The conversation has shifted. Clinicians aren't just talking about ketamine anymore—they're asking how to add TMS, Spravato, and accept insurance to build sustainable, long-term practices. The next evolution of interventional psychiatry is here.

• Compliance questions are changing. Less "can I do this?" and more "how do I do this right?" Clinicians want to offer innovative treatments confidently—and they're looking for partners who understand the regulatory landscape.

•Osmind Scientific Advisor L. Alison McInnes MD, MS. presented real-world data on ketamine for PTSD from 1,340 patients across our network.

Thank you to everyone who stopped by, shared your stories, and reminded us why we do this work. The future of interventional treatment is bright, and it's being built by clinicians like you.