Osmind

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.

01/31/2026

The cost of treatment resistance: Each failed antidepressant trial actively worsens patient outcomes.

Join us February 19, 2026 for a deep dive into the clinical evidence behind VNS Therapy™—featuring findings from the RECOVER trial, the largest randomized controlled study of VNS Therapy for difficult-to-treat depression.

What you'll learn:
➡️ 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

Expert speakers: Hamish McAllister-Williams, MD | Northern Centre for Mood Disorders, Newcastle University & Dr. William Sauvé, MD | Chief Medical Officer, Osmind

Can't attend live? Register to receive the recording.
[REGISTRATION LINK] https://osmind-org.zoom.us/webinar/register/WN_INZArKsaR-yIeQfZMQLfhg

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-2500191

01/22/2026

Proud to sponsor American Society of Ketamine Physicians, Psychotherapists and Practitioners (ASKP3) every year since its inception.

Interventions like ketamine are changing lives, and this community is leading the charge.

This year, Osmind Scientific Advisor L. Alison McInnes MD, MS. takes the main stage to present real-world data on ketamine for PTSD from 1,340 patients across our network.

See you in Austin!

01/21/2026

Sleep is a single-player experience. You have no idea how the person next to you sleeps or whether your own fatigue is normal. So sleep disorders go unrecognized and get labeled TRD, anxiety, ADHD.

The stereotype of sleep apnea is an overweight 65-year-old man snoring on the couch. It's now showing up earlier, in different presentations.

Brittany Albright MD, MPH, DABOM refers almost every TRD patient for sleep testing. Most come back positive. Some longstanding ADHD cases—no childhood history, stimulants not quite working. "Lo and behold, they have sleep apnea. They get treated and I've been able to remove the ADHD diagnosis and deprescribe stimulants.”

The 2-3am wake-up you think is anxiety? It could be the airway collapsing during the third REM cycle where muscle tone is lowest. Women get missed constantly; their apnea often clusters in REM sleep, so overall scores look normal even when they're not.

Only 150 sleep fellows graduate annually. Wait times hit 9–12 months. Patients get tested, come back negative, return to psychiatry with a Seroquel recommendation. The symptom gets treated, but the cause doesn't.

So what’s a psychiatrist to do?

🎧 Listen/read as Drs. Avinesh Bhar, MD MBA, William Sauvé, MD, and Brittany Albright MD, MPH, DABOM discuss why sleep disorders hide behind psychiatric diagnoses, and how to catch what's being missed.

Sleep apnea and depression are more connected than most clinicians realize—and standard testing often misses it. Dr. Avinesh Bhar breaks down the link and what psychiatrists can do about it.

01/16/2026

Just back from ACNP 2025 in Paradise Island, Bahamas. A few research highlights that stood out:

Obesity-depression subtypes are gaining traction. Dr. Roger McIntyre presented his classification system showing that Class 3 patients—those with insulin resistance, inflammation, and visceral adiposity—may represent a distinct subtype requiring targeted treatment approaches.

His work continues to earn well-deserved recognition from the psychiatric research community.

We presented our own research on BMI and ketamine therapy outcomes. Analyzing data from over 16,000 patients on the Osmind platform, we found BMI relates differently to symptom trajectories depending on the condition:

Depression: U-shaped relationship—both low and high BMI linked to higher symptom severity, but higher BMI predicted slightly greater improvement across infusions.

Anxiety & PTSD: Higher BMI associated with lower baseline symptoms, though no effect on rate of improvement.

The takeaway: metabolic health indicators like BMI may help clinicians contextualize symptom burden and set expectations for ketamine therapy response.

Trauma + inflammation = ketamine responders? Emerging data suggests MDD patients with comorbid trauma history and elevated inflammation markers may respond particularly well to ketamine and esketamine. This could help clinicians identify who's most likely to benefit.

Microdosing update: still underwhelming. Sessions reinforced what prior research has shown: microdosing psychedelics hasn't demonstrated meaningful clinical efficacy. Therapeutic signal remains with full doses in supported settings.

Grateful to the American College of Neuropsychopharmacology , Dr. Roger McIntyre, Dr. Rob Berman, and the Osmind team inlcuding Jimmy Qian, Dr. Emily Shih, William Sauvé, MD, L. Alison McInnes MD, MS, Dr. Jamie L., PhD MPH

01/12/2026

VNS therapy exists because a scientist went to Lamaze class with his pregnant wife...

In the 1980s, neuroscientist Jake Zabara was studying the vagus nerve in dogs when he started attending childbirth preparation classes.

Sitting there learning breathing techniques, he asked a question most people wouldn't think to ask: How does controlled breathing actually reduce the pain of contractions?

His hypothesis: the vagus nerve, running from the diaphragm to the brain, was the pathway.

He went back to his lab, isolated the vagus nerve in dogs, and started stimulating it directly. The rest became the foundation for a treatment that now helps patients with severe, treatment-resistant depression.

Another example of serendipity in psychiatry. The biggest breakthroughs often come from paying attention to the small, strange observations.

Learn more about Vagus Nerve Stimulation and keep your finger on the pulse of the future of psychiatry. Listen to the full episode on Psychiatry Tomorrow.
This episode features William Sauvé, MD, Lucian Manu, M.D., Carlene MacMillan, MD, FCTMSS,DFAACAP

Search your podcast player or find the link below.