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Psychotherapy Coordinated with Ketamine Treatment

How Ketamine Opens the Door to Therapeutic Breakthroughs One of the most compelling and underutilized applications of ketamine treatment is its capacity to augment psychotherapy — not just as a stand-alone antidepressant, but as a tool…

I Feel Better, Now What?

All Posts, Diagnoses & Conditions, Side Effects

Jack (a fictionalized name; real patient) was a married man in his mid fifties. He came to see me due to chronic depression, feeling down and lacking motivation, unable to enjoy pleasurable things, for some 20 years. His last therapist had…

Pharma Company Evergreening

All Posts, Medications, Practice

Millions of lives have been saved by the products of pharmaceutical companies, but let’s face it, they are not primarily in the business of saving lives. They are in the business of making money. As long as we remain able to live our lives…

When Ketamine Is No Longer Indicated, or a Disappointed Patient

All Posts, Diagnoses & Conditions, Ketamine, Medications

A Case Study in Depression, Hypomania, and Bipolar Diagnosis Joe (a fictionalized name; real patient, case shared with permission) was in his mid-fifties, an accomplished attorney who had suffered from recurrent depression since his early…

When the Ketamine Trip is a Dud

All Posts, Ketamine

Ketamine Works Even When You Feel Nothing Patients who receive ketamine for depression, PTSD or other indications, experience distortions of time and space, and a loss of sense of self, during the peak blood levels of ketamine. These…

New Ways of Thinking about Suicide

All Posts, Diagnoses & Conditions, Medications, Science

Suicidal Disorder, Antisuicidal Medications, and the Limits of Prediction Suicide is the tenth most common cause of death in the US. It is a terrible loss for the survivors and a great burden to society in general. Providers…

I Quit Using. So Why Don’t I Feel Happy?

All Posts, Diagnoses & Conditions, Psychotherapy, Science

The Role of Dopamine in Pleasure and the Brain’s Reward System People who quit using drugs often report that they are bored, uninspired, and have a hard time enjoying everyday living. Why does this happen? It has to do with the…

What’s in a Name, or the Curious Drug called Topiramate

All Posts, Diagnoses & Conditions, Medications

Topiramate (Topamax): More Than What It's Called! Patients frequently ask their psychiatrist: “Why are you prescribing me an antidepressant for anxiety when I’m not depressed?” or “Why are you prescribing me an antipsychotic for…

Self-pay versus Insurance-based Practice

All Posts, Practice

A respected psychiatric journal, JAMA Psychiatry, recently published a study, in which they showed that an increasing number of psychiatrists in the US have been opting out of accepting payment for services by insurance and will only see…

Lavender Oil for Anxiety and Sleep: The Science Behind Linalool, Silexan, and CalmAid

All Posts, Herbs and Vitamins

Lavender: The Plant with Surprising Effects Lavender was first used in ancient Egypt and Greece as a fragrance, and it has been used for its healing properties since the days of the Roman Empire. This knowledge was furthered by the Arabs and…