Psychiatry in San Diego
What is Psychiatry?
Psychiatry is the medical specialty concerned with the prevention, diagnosis, and treatment of mental health conditions. Psychiatrists are physicians trained to evaluate the full biological and medical context of psychiatric illness, including how medical conditions, genetics, and medications interact with mood, cognition, and behavior.
Alexander Papp, MD
Psychiatry at Point Loma Clinic
Dr. Alexander Papp is a board-certified psychiatrist with decades of clinical experience and specialized training in psychopharmacology, consultation-liaison psychiatry, and interventional psychiatric treatments. His approach integrates traditional psychiatric medications, novel treatments including ketamine, and evidence-based guidance on nutraceuticals. Expert medication management requires that treatment recommendations be continuously updated to reflect current scientific literature and calibrated to each patient’s clinical profile, history, and preferences.
Conditions treated include anxiety disorders, depression (including treatment-resistant and bipolar depression), bipolar disorder, PTSD, OCD, and ADHD. Patients with complex or treatment-resistant presentations are particularly well-suited to this practice. Dr. Papp has a particular research interest in antidepressant discontinuation (a clinically underrecognized problem) and has published peer-reviewed work on the subject, specifically on the symptom commonly known as brain zaps.
From Initial Evaluation to Ongoing Appointments
The initial psychiatric consultation with Dr. Papp is scheduled for 90 minutes. It encompasses a systematic review of presenting complaints, their history, and relevant medical and personal history. Laboratory tests, including psychogenetic testing, are ordered when clinically indicated. At the conclusion of the visit, diagnostic impressions are discussed, therapeutic goals are established, and referrals to outside specialists are made when appropriate. Ongoing appointments are scheduled at the frequency that clinical progress requires.
Psychogenetic testing adds a meaningful layer of precision psychiatry. By identifying genetic variants that influence medication metabolism, or that indicate deficiencies in neurotransmitter synthesis pathways, this type of screening informs both the selection and dosing of psychiatric medications. This precision medicine approach reduces trial-and-error prescribing, minimizes adverse effects, and improves the probability of an effective response, particularly for patients with a history of medication failures or significant side effects.
Point Loma Clinic Room
For patients who see both Dr. Papp and one of our psychologists, providers communicate directly and regularly, coordinating pharmacological and psychotherapeutic approaches around shared clinical goals. Research consistently demonstrates that combined medication management and psychotherapy produces superior outcomes to either treatment alone for most major psychiatric conditions. This collaborative model has been a defining feature of the practice for over a decade. Coordination with outside providers and, with patient permission, family members is available when clinically useful.
Frequently asked questions
How is evidence-based treatment different from other care?
Evidence-based treatment means the interventions we use have been tested in controlled research and shown to work for specific conditions. Applying it well also requires matching the right approach to the right person — which is why we begin with a thorough evaluation rather than a default protocol.
What is pharmacogenetic testing, and do I need it?
Pharmacogenetic testing identifies genetic variants that influence how you metabolize psychiatric medications. It is not required for most patients, but for those with a history of medication failures or unusual side effects it can reduce trial-and-error prescribing by informing both medication selection and dosing. Dr. Papp orders it only when the results are likely to change clinical decisions.
What happens at the initial psychiatric evaluation?
The initial consultation with Dr. Papp is scheduled for 90 minutes. It includes a systematic review of your current concerns, their history, and your relevant medical and personal background. Laboratory tests, including pharmacogenetic testing, are ordered when clinically indicated. By the end of the visit you will have diagnostic impressions, agreed therapeutic goals, and a treatment plan.
What does treatment-resistant depression mean?
Treatment-resistant depression generally refers to depression that has not responded adequately to at least two appropriately dosed courses of antidepressant treatment. It is common and treatable: options include systematic medication review, pharmacogenetic testing, combined medication and psychotherapy, and interventional treatments such as ketamine. Evaluating why prior treatments failed is often as important as choosing the next one.