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Flow Device: FDA Approval vs Real-World Effectivenes

February 9, 2026

In December 2025, Flow did in fact receive FDA Approval, based on data from the Empower trial. Before that, it had been marketed under FDA clearance—a lower evidentiary bar. That correction matters—and it sharpens the question many subscribers have been asking me: How much does FDA approval tell us about real‑world effectiveness?

Treating Anxiety and Sleep Issues in Children and Adolescents

February 2, 2026

Joshua Feder, MD and Mara Goverman

A parent sits across from you and asks, "Why can't my child just take the same anxiety medicine that helps me?” Sounds reasonable, but the evidence tells a very different story.

Psychodynamic Therapy

January 29, 2026

Daniel Carlat, MD

Psychodynamic therapy isn’t outdated.
It’s evolving. Grounded in evidence.

Clinical Update

Selective Mutism: Helping Kids Find Their Voice

April 1, 2025

Mariel Zeccola, APRN, PhD

Mariel Zeccola, APRN, PhD. Nurse practitioner in private practice, Westport, CT.

Dr. Zeccola has no financial relationships with companies related to this material.

Selective mutism (SM) in children can create tremendous frustration, often resulting in harsh reactions from parents or teachers. This clinical update from our own Dr. Mariel Zeccola will help you differentiate SM from co-occurring anxiety and other conditions and offer a path to treatment with therapy and, when needed, medication.

Note From the Editor-in-Chief

January 1, 2025

Joshua D. Feder, MD

In our note from the Editor in Chief, Dr. Feder underlines the hope for better outcomes for the ravages of substance use disorders and a timely message for those impacted wildfires and other disasters.

Expert Q&A

Vaping and Nicotine Addiction in Children and Adolescents

January 1, 2025

Jonathan P. Winickoff, MD, MPH

Jonathan P. Winickoff, MD, MPH

Pediatrician at Mass General for Children; Director of Pediatric Research, Tobacco Research and Treatment Center at Massachusetts General Hospital; Professor, Pediatrics, Harvard Medical School, Boston, MA.

Dr. Winickoff has no financial relationships with companies related to this material.

Nicotine is among the most addictive substances out in the community. Learn how to talk with patients and families and use the most effective strategies we know to intervene.

Expert Q&A

Addressing the Overdose Crisis: What You Can Do

January 1, 2025

Aaron Quiggle, MD, MS

Aaron Quiggle, MD, MS

Adult, child, and adolescent addiction psychiatrist; Medical Director, Addiction Recovery Management Service (ARMS), Massachusetts General Hospital, Boston, MA.

Dr. Quiggle is a co-investigator of an investigator-sponsored trial for Ironshore Pharmaceuticals. Relevant financial relationships have been mitigated.

There are multiple ways that we can help our patients reduce the risk of overdose. In our interview with Dr. Aaron Quiggle, we cover screening, fentanyl testing, the use of Narcan and the importance of learning to prescribe buprenorphine.