Balancing Efficacy and Tolerability in MDD Augmentation

Psych Congress Network · Balancing Efficacy and Tolerability in MDD Augmentation

In Part 2 of this podcast, Psych Congress Steering Committee Member Saundra Jain, MA, PsyD, LPC, moderates a Q&A session on major depressive disorder treatment (MDD) during the July Psych Congress Regional Online Series.

Expert Psych Congress faculty examine how aripiprazole may be used as adjunctive treatment for MDD. The discussion addresses low-and-slow dosing, the gap between clinical trial protocols and real-world tolerability, and concerns about side effects, including weight gain. The panel considers why increasing medication is not always the best next step and emphasizes evaluating behavioral, psychosocial, and sleep-related factors that may directly affect a patient’s depression outside the clinical visit.

Missed Part 1 of this series? Listen here: Why Early Augmentation Conversations Matter in MDD.

• In MDD, the panel recommended initiating adjunctive aripiprazole at 1 mg daily and increasing slowly; one clinician reported not exceeding 10 mg for depression.
• A May 2026 JAMA Psychiatry meta-analysis and systematic review was cited as evaluating adjunctive atypical antipsychotic dose, efficacy, tolerability, and acceptability; aripiprazole ranked second for efficacy and first for tolerability, according to the discussion.
• Clinicians emphasized monitoring weight gain and other adverse effects while assessing psychosocial, behavioral, sleep, and bipolar disorder factors before automatically increasing medication

Transcript coming soon!

Saundra Jain, MA, PsyD, LPC, is an adjunct clinical affiliate in the School of Nursing at The University of Texas at Austin and a psychotherapist in private practice. Dr Jain is a co-creator of WILD 5 – A Proven Path to Wellness and co-author of The Science and Practice of Wellness: Interventions for Happiness, Enthusiasm, Resilience, and Optimism (HERO). She is the co-creator of the Psychedelics and Wellness Survey (PAWS), exploring the intersection between psychedelics and wellness. She is the co-host of the newly launched podcast Happy Human 3.0, which explores how modern humans can move beyond merely surviving 21st-century stressors and begin to flourish by integrating neuroscience, positive psychiatry, and compassionate, human-centered care.

In addition, Dr. Jain serves on the Psych Congress Steering Committee, helping guide educational priorities and identify emerging needs in mental health practice. She also teaches with Fluence Training, a leading provider of psychedelic education for mental health professionals, where she serves as faculty in their certification programs in Psychedelic Harm Reduction and Integration (PHRI) and Ketamine-Assisted Psychotherapy (KAP).

Julie Carbray, PhD, PMHNP-BC, PMHCNS-BC, FAAN, is a clinical professor of psychiatry and nursing at the University of Illinois Chicago. She has been practicing as a Psychiatric Nurse Practitioner over 35 years. As UIC faculty, Dr Carbray teaches course content in psychopharmacology, mood disorders, and development and therapeutic interventions with children and adolescents for students across various multidisciplinary programs. As the Director of the Pediatric Mood Disorder Clinic, Dr Carbray leads the clinical program and multidisciplinary training and is a nationally recognized clinical expert in children and adolescents with mood disorders.

Dr Carbray holds a national reputation of excellence in serving families of children with mood disorders, and was recognized with the UIC Preceptor of the year award, the Karen Gousman Excellence in Nursing Award, the American Psychiatric Nurses Association Best Practices in an Outpatient Program for Bipolar Disorder Award, the UIC Inspire Award, the APNA Distinguished Service Award and the Susan McCabe psychopharmacology lectureship from the International Society of Psychiatric Nurses. Dr Carbray has presented her work nationally and internationally and across communities and organizations including the American Girl Company. With a particular focus on helping families to help their children with mood disorders, Dr Carbray has engaged in programs of research that are investigating the psychopharmacology of mood disorders, neurobiology of mood disorders, and neurobiologically informed treatments and family response to childhood mood disorders.

Brittany Albright MD, MPH, is a Harvard-trained, triple board-certified psychiatrist with clinical expertise in interventional psychiatry, addiction psychiatry, and obesity medicine. She completed her adult psychiatry residency at the nation’s top ranked program, Massachusetts General Hospital and McLean Hospital and a fellowship in addiction psychiatry at the Medical University of South Carolina, where she serves as an Affiliate Assistant Professor in the Department of Psychiatry & Behavioral Sciences. Dr. Albright is the Founder and CEO of Sweetgrass Psychiatry, South Carolina’s largest physician-owned psychiatry practice with three locations.

Her research and academic work include numerous abstracts presented at national meetings and peer-reviewed manuscripts focused on innovative treatments and psychiatric education. A national speaker and consultant, she serves as President Elect of the South Carolina Psychiatric Association and holds multiple leadership roles with Psych Congress, including co-chair of Psych Congress Elevate and originator of the Private Practice Summit.

She firmly believes in collaborative, comprehensive treatment and the restoration of wellness in her patients and practices psychotherapy with expertise in mentalization-based therapy and psychodynamic therapy. She also holds certifications in psychedelic assisted psychotherapy and transcranial magnetic stimulation.

Kevin N. Williams MS, MPAS, PA-C, is the CEO and Lead Clinician at OnPoint Behavioral Health. He is a Physician Associate that specializes in psychiatry and has a mission to provide care that is experienced, holistic, and compassionate. He holds 2 master’s degrees in interdisciplinary medical sciences and physician assistant studies from the University of South Florida and South University respectively. He has gained experience treating children, adolescents, and adults for the past 11 years in the areas of inpatient, outpatient, and long-term care. Kevin has 10 years of experience teaching as an Adjunct Professor at several institutions around the country. Kevin also has over 10 years in executive leadership experience and maintains a passion of educating others to lead with effective influence.