Hello and welcome!
If you are looking for a psychiatrist– or, perhaps, looking to switch from the psychiatrist you are currently seeing– the chances are good that you have been asking yourself some difficult questions. For example, you may be asking yourself:
* Do I really “need” to take psychiatric medications? Are there any other strategies available for managing my symptoms and reaching my goals?
* If I decide to take psychiatric medications, which ones should I take (and what should the dosage be)? How risky are these medications? For how long will I need to take them?
* Am I on too many medications? How many medications are “too many”?
* Should I be seeing a talk therapist? If so, what kind?
* Are there any lifestyle changes that might help me to feel better?
* What about all of these “alternative medicine” treatments that I’ve read about? Do they work? Are they safe?
* What should I know about newer FDA-approved treatments such as transcranial magnetic stimulation (TMS) and ketamine (Spravato)?
My goal as a psychiatrist is to help you find answers to these questions. I am not here to “dictate” a course of treatment, but instead to advise you of a range of possible treatment approaches, describing the benefits and risks of each one. I strive to do this in manner that is clear, detailed, easily understood, and– most important of all– unbiased. I do not accept “speaking fees”, free steak dinners, or other forms of payment from drug companies
BECOMING A PATIENT
I offer a [free 15-minute introductory phone consultation] to prospective patients. This will help us to get to know each other and to determine if I am the right “fit” for you. If you prefer, you may skip this step and proceed [directly to booking].
If you decide to proceed, we will schedule a 60-minute introductory visit (which may be conducted either virtually or in-person). Followups are typically 20 minutes each, but it is not uncommon for me to schedule 30-minute followups when needed. The extra time typically does not affect how the session is billed, and I find that having the extra time is often helpful for both myself and the patient.
The frequency of follow-up visits is determined by what makes sense clinically, and also by your personal preference. I have patients who only need to see me a few times a year. Other patients may wish to meet as often as every one or two weeks. If an unexpected issue should come up between appointments, I am generally able to get established patients an appointment with me within a few days.
A WORD ABOUT TALK THERAPY
Although my main focus is on medications, I also have extensive training and experience in the techniques of talk therapy. In addition to asking you about symptoms and side effects, I will also be asking you questions about your relationships, work, and life goals.
In some cases, it may be helpful to enlist the help of a dedicated therapist who can work with me collaboratively. I have a small group of trusted therapists who I have worked with in the past, and can provide you with a referral to one of them if needed.
If you already have an outside therapist, I will be happy to consult with that therapist as needed in order to develop a holistic and comprehensive treatment plan.
When needed, I will also consult with your primary care physician– or with other specialists– in order to better understand any physical issues that may be affecting your psychological well-being.
CLINIC POLICIES
Before deciding to book an appointment, you should be aware of my basic policies regarding controlled or addictive medications.
BENZODIAZEPINES
“Benzodiazepines” are a class of addictive medications often used for anxiety or sleep (e.g. Klonopin, Xanax, Ativan, Valium, and Restoril).
As a general rule, I do not prescribe these medications on a long-term basis. I do not feel that these medications are safe or effective as a long-term treatment. (I do sometimes prescribe these medications for occasional use, e.g., during plane flights).
If you are currently taking one or more of these medications, and are interested in stopping, I can help. Over the years, I have helped many people successfully taper off benzodiazepines, in a manner designed to minimize any withdrawal effects. In most cases I have noticed that the patient experiences improvement of symptoms and greater mood stability after these medications have been stopped.
ADHD MEDICATIONS (A.K.A. “STIMULANTS”)
Although I do sometimes prescribe stimulants, please be aware that I prescribe these medications very selectively. Like many of my colleagues, I believe that these medications are currently over-prescribed. In the past 25 years, the use of stimulant medication in the United States has increased by over 500%.
If you are a prospective patient who is concerned about issues with focus or attention, you should be aware of the following:
(1) The diagnostic criteria for ADHD are subjective. Psychiatrists often disagree with each other about whether a specific patient meets criteria for ADHD. Thus, the fact that you have been diagnosed with ADHD by another physician does not guarantee that I will arrive at the same diagnosis.
(2) Problems with attention/focus are sometimes caused, in whole or in part, by clinical issues other than ADHD (e.g. sleep issues, emotional issues, undiagnosed medical issues, etc). My goal as a physician is always to address these issues before considering treatment with stimulants.
In cases where I do prescribe stimulants, I make efforts to prescribe the lowest effective dose and encourage patients to take “breaks” from stimulant use when possible. (For example, many patients will elect to skip stimulant medications on weekends or vacations). I also encourage patients to periodically re-evaluate their attentional symptoms and to re-evaluate whether there is an ongoing need for stimulant medication.