About

David W. Oslin, MD, is a Professor of Psychiatry and Staff Physician at the CPL. Michael J. Crescenz VA Medical Center in Philadelphia. He serves as the Director of the VISN 4 Mental Illness, Research, Education and Clinical Center (MIRECC) and is the Chief of Behavioral Health at the VA Medical Center. He is also the Vice Chair of Veterans Health in the Department of Psychiatry at the Perelman School of Medicine, University of Pennsylvania. His research expertise includes Geriatric and Addiction Psychiatry, with a focus on Veterans' behavioral health. Dr. Oslin's educational background includes a B.S. in Biology with a Mathematics minor from the University of Richmond, an M.D. from the University of Virginia, and he is affiliated with the Perelman School of Medicine at the University of Pennsylvania.

Research topics

• Psychiatry
• Medicine
• Biology
• Psychology
• Clinical psychology
• Medical emergency
• Pharmacology
• Internal medicine
• Genetics
• Physical therapy

Selected publications

• A pilot study of pharmacogenomic testing as a tool to enhance depression care in Veterans

  The Pharmacogenomics Journal · 2026-04-01

  articleSenior author
  PublisherDOI

• Persistent benefit of pharmacogenomic testing on initial remission and response rates in patients with major depressive disorder

  Frontiers in Pharmacology · 2025-10-30 · 4 citations

  articleOpen accessSenior author

  Background: In patients with major depressive disorder (MDD), achieving remission and/or response may take many months because of the lengthy trial-and-error process often needed to identify effective medication. Pharmacogenomic testing is a prescribing tool that has been shown to improve remission and response rates for MDD patients, but data describing its impact over time is limited. The objective of this study was to determine whether pharmacogenomic-guided treatment increases the rate of remission and response over time in patients with MDD, and if so, to assess the persistence of that effect. Methods: analysis of the PRIME Care (Precision Medicine in Mental Healthcare) randomized clinical trial, a pragmatic trial that compared pharmacogenomic-guided treatment with usual care among veterans with depression. Participants were recruited at 22 Department of Veterans Affairs medical centers by 676 clinicians and were randomized to the pharmacogenomic-guided arm or the usual care arm. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations between study arm (pharmacogenomic-guided treatment or usual care) and the first instance of response or remission as assessed by the Patient Health Questionnaire-9 (PHQ-9) scale. Results: 1,764 (90.7%) of the 1,944 veterans who participated in the PRIME Care trial had sufficient visit data to be included in this analysis. Patients who received pharmacogenomic-guided treatment had higher rates of remission (HR [95% CI] = 1.27 [1.05, 1.53]; p = 0.015) and response (HR [95% CI] = 1.21 [1.05, 1.40]; p = 0.010) at any time relative to patients receiving usual care. Schoenfeld residuals tests were not statistically significant for remission (p = 0.931) or response (p = 0.112), providing no evidence that the benefit due to pharmacogenomic-guided treatment changed over the 24-week period. Conclusion: Pharmacogenomic-guided treatment led to faster initial remission and response in patients with MDD, and this benefit persisted over 6 months with no evidence of changing over time.

  PublisherOA PDFDOI

• 0538 A Randomized Controlled Trial of CBT-I in Veterans in Early Recovery from Alcohol Use Disorder

  SLEEP · 2025-05-01

  articleOpen access

  Abstract Introduction Although insomnia increases relapse risk in early recovery from Alcohol Use Disorder (AUD), no adequately powered clinical trial has evaluated the efficacy of Cognitive Behavioral Therapy for Insomnia (CBT-I) on either insomnia or alcohol outcomes in a largely African-American sample. Objectives: 1) To determine the efficacy of CBT-I for improving insomnia, alcohol-related outcomes, and daytime functioning at post-treatment and at 3- and 6-month follow-up; 2) Evaluate whether improvement in insomnia is associated with a reduction in alcohol-related outcomes post-treatment. Methods Design: A randomized, controlled clinical trial of CBT-I compared to Quasi-Desensitization therapy (QDT), conducted between 2015 and 2020, with assessments at baseline, end of treatment (8 weeks), and 3- and 6-month post-treatment (Clinicaltrials.gov # NCT01987089). Setting: Outpatient addiction psychiatry clinic at an urban VA Medical Center. Participants: 63 veterans (51.6±9.6 years, 58 men (92.1%), 52 African-Americans (82.54%) with insomnia and past-year AUD. Intervention(s): Eight weekly in-person sessions of either CBT-I (n=31) or QDT (n=32). Main Outcome(s) and Measure(s): Primary outcomes were the Insomnia Severity Index score (ISI), and Percent Days Abstinent (PDA, from the Timeline Follow Back interview). Secondary outcomes were sleep diary variables, drinks per day, percent non-heavy drinking days, Penn Alcohol Craving Scale score, and scores from the 12-item Short Form scale (SF-12), Beck Depression Inventory and Trait subscale from the State-Trait Anxiety Inventory. Results Post-treatment data were obtained from 88.9% of participants. Although CBT-I was efficacious in improving insomnia with effect sizes (E.S.) larger than the meta-analytic estimates, QDT was equally efficacious in improving insomnia (E.S.=-1.63 vs. -1.50), improving abstinence (E.S.=1.54 vs. 1.91) and next-day functioning (E.S.=-0.26 vs. -0.17). Across treatment groups, remission from insomnia was associated with a lower post-treatment alcohol craving score at 8 weeks (2.8, 95% CI=1.1, 4.4 vs. 9.5, 95% CI=6.1, 13.0 in non-responders), an effect that persisted for 6 months after treatment. Conclusion CBT-I and QDT are equally effective for treating insomnia during early recovery from AUD. Reduced alcohol craving may be a mechanism by which a remission from insomnia improves drinking outcomes. Support (if any) VA grant IK2CX000855 and 5I01CX001957 (SC) and NIH grants R01 AG041783 and R56 AG050620 (M.L.P.); R01 AA023192 and R01 AA021164 (H.R.K.).

  PublisherOA PDFDOI

• What if STAR*D Had Been Placebo-Controlled? A Critical Reexamination of a Foundational Study in Depression Treatment

  Journal of Clinical Psychopharmacology · 2025-06-13 · 1 citations

  articleOpen accessSenior author

  BACKGROUND: The STAR*D trial's sequence of dose escalation, switching, and augmentation strategies has served as a model for most depression treatment guidelines. However, STAR*D was an open-label pragmatic trial that did not use a placebo control, which complicates the assessment of its outcomes. Most STAR*D treatment steps have now been studied in blinded placebo-controlled randomized trials, which could validate STAR*D and support the growing use of pragmatic trials in depression. METHODS: This review evaluates outcomes from randomized controlled trials (RCTs) for the major STAR*D treatment steps: dose increase after inadequate response to an antidepressant (Level 1), switching the antidepressant after treatment nonresponse (Levels 2 and 3), augmenting an antidepressant with bupropion or buspirone (Level 2), augmenting an antidepressant with lithium or T3 thyroid hormone (Level 3), and using combination mirtazapine-venlafaxine (Level 4). FINDINGS: RCTs have generally not replicated the findings of STAR*D. Of the major treatment steps, there is only positive evidence for lithium augmentation and α2-antagonist-serotonin-reuptake inhibitor combination. Limitations of this review include variation in the quality and quantity of comparable RCTs for each treatment level and differences in the inclusion criteria of RCTs and STAR*D. CONCLUSIONS: These findings raise questions about the evidence supporting widely used treatment strategies following an inadequate response to an initial antidepressant. They suggest that pragmatic trials should be interpreted cautiously in the absence of blinded placebo-controlled studies and point to the need for high-quality blinded clinical trials of second-step and third-step depression treatments.

  PublisherOA PDFDOI

• What <i>Psychiatric Services</i> Stands For

  Psychiatric Services · 2025-04-30 · 1 citations

  editorial
  PublisherDOI

• Comparative Effectiveness of Trauma- and Non-Trauma–Focused Treatment Strategies for PTSD among Those with Co-Occurring SUD (COMPASS) Study

  2025-12-17

  report
  PublisherDOI

• Macrophage Migration Inhibitory Factor and Interleukin 1-β mRNA Levels as Predictors of Antidepressant Treatment Response in Major Depression

  Psychopharmacology Bulletin · 2025-08-12

  articleOpen accessSenior author

  Background: Immunologic measures have been studied as predictors of who will respond to standard antidepressants. Two previous, small studies of pretreatment leukocyte mRNA expression levels of the cytokines macrophage migration inhibitory factor (MIF) and interleukin 1-beta (IL1-β) identified antidepressant treatment responders. Methods: We tested these findings in 1,299 patients from the PRIME Care study, a multi-center pharmacogenetic depression treatment trial. Patients underwent 5 depression-symptom assessments over 24 weeks. mRNA was extracted from peripheral blood, purified, and assayed with TaqMan gene expression assays and a known copy number calibrator to yield relative quantification and copy numbers for each sample. In generalized estimating equations models, we regressed the repeated depression measures and a binary treatment response measure on the baseline MIF and IL-1β measures and relevant covariates. Results: Participants' depression scores decreased monotonically during treatment, with the treatment response percentage increasing concomitantly. We found no significant associations of the cytokine concentrations with either the change in depression scores or the likelihood of a treatment response. A secondary analysis limited to a subsample of 126 participants selected to remove the potential for confounding also showed no significant associations. Limitations: Despite efforts to control for sample and assay method differences, these could have contributed to the lack of replication of prior research. Conclusions: We did not replicate prior findings that pre-treatment expression levels for two cytokines predicted antidepressant treatment response. This raises questions about the clinical utility of using these biomarkers in treating depression.

  PublisherOA PDFDOI

• Comparative Effectiveness of Trauma- and Non-Trauma–Focused Treatment Strategies for PTSD among Those with Co-Occurring SUD (COMPASS) Study

  2025-12-17

  report
  PublisherDOI

• A Randomized Controlled Trial of Cognitive Behavioral Therapy for Insomnia During Early Recovery from Alcohol Use Disorder Among Veterans

  medRxiv · 2025-01-05 · 2 citations

  preprintOpen access

  Study Objectives: 1) To determine the efficacy of Cognitive Behavioral Therapy for Insomnia (CBT-I) for improving insomnia, alcohol-related outcomes, and daytime functioning at post-treatment and at 3- and 6-month follow-up, in a largely African American Veteran sample; 2) Evaluate whether improvement in insomnia is associated with a reduction in alcohol-related outcomes post-treatment. Methods: An RCT of CBT-I (n = 31) compared to Quasi-Desensitization therapy (QDT, n = 32), eight weekly in-person sessions, with assessments at baseline, end of treatment (8 weeks), and 3- and 6-months post-treatment. Primary outcomes were the Insomnia Severity Index (ISI) total score, and Percent Days Abstinent (PDA). Secondary outcomes were sleep diary variables, drinks per day, percentage non-heavy drinking days, Penn Alcohol Craving Scale, PCS and MCS scale (from the SF-12), BDI and STAI-Trait subscale total scores. Results: Post-treatment data were obtained from 88.9% of participants. Although CBT-I improved insomnia with effect sizes (E.S.) larger than the meta-analytic estimates, QDT was equally efficacious in improving insomnia (E.S. = -1.63 vs. -1.50), improving abstinence (E.S. = 1.54 vs. 1.91) and next-day functioning (E.S. = 0.26 vs. -0.17). Across treatment groups, remission from insomnia was associated with a lower post-treatment alcohol craving score (2.79, 95% CI 1.14, 4.44 vs. 9.51, 95% CI 6.06, 12.95 in non-responders), an effect that persisted for 6 months after treatment. Conclusions: CBT-I and QDT are equally effective for treating insomnia during early recovery from AUD. Reduced alcohol craving may be a mechanism by which a remission from insomnia improves drinking outcomes.

  PublisherOA PDFDOI

• The Perceived Value of Pharmacogenetic Testing in Depression Treatment: Mixed-Methods Results From the PRIME Care Study

  Psychiatric Services · 2025-04-16 · 2 citations

  articleSenior author

  OBJECTIVE: This mixed-methods study explored providers' perceptions of the value of using pharmacogenetic (PGx) testing in depression treatment after they had used the test during a pragmatic clinical trial. METHODS: Data were drawn from baseline and follow-up surveys (mental health and primary care providers; N=217) of and qualitative interviews (N=61) with trial participants. Pre-post changes in agreement with statements about PGx testing's value in depression care were examined with a generalized estimating equations cumulative logit ordinal regression model with two time points and robust standard errors. Interviews were analyzed via rapid qualitative analysis. RESULTS: Analyses showed greater agreement at follow-up with statements about comfort with PGx testing, feeling well informed about PGx testing, and the strength of the evidence base. Mental health providers had stronger levels of agreement compared with primary care providers. Interview data indicated that although providers found value in PGx testing, they also thought that the test was useful only for some patients. Several providers felt that the main value may be in facilitating patient buy-in to trying medication. CONCLUSIONS: Overall, this mixed-methods study demonstrated that, after using PGx testing during a clinical trial, primary care and mental health providers have overall positive perceptions of its potential value and utility in depression treatment.

  PublisherDOI

Recent grants

• NIH Grant R01AA017164

  NIH · $3.0M · 2014

• NIH Grant K08MH001599

  NIH · $897k · 2005

• NIH Grant R01AA014851

  NIH · $3.3M · 2008

• NIH Grant P30MH066270

  NIH · $7.3M · 2008

• Linking VA and non-VA data to study the risk of suicide in chronic pain patients.

  NIH · $3.6M · 2020–2025

Frequent coauthors

• Shahrzad Mavandadi

  240 shared

• Joel E. Streim

  215 shared

• Lucinda B. Leung

  Center for the Study of Healthcare Provider Behavior

  184 shared

• Wilfred R. Pigeon

  United States Department of Veterans Affairs

  182 shared

• Ronald C. Kessler

  174 shared

• Edward P. Post

  170 shared

• Robert M. Bossarte

  University of South Florida

  170 shared

• Nathan A. Kimbrel

  Duke University

  165 shared