Pregabalin (Lyrica)
Pregabalin is gabapentin’s better-looking, more expensive cousin. Same mechanism family, more aggressive marketing, much higher price, and a controlled substance in the US for reasons that have to…
Jun 1, 2026
Seroquel (quetiapine)
Seroquel is the antipsychotic that gets prescribed for everything other than what it’s actually approved for, and the off-label sleep use is the biggest example. There are real…
Jun 1, 2026
Spravato (esketamine) protocol
Spravato is FDA-approved esketamine, given as a nasal spray under direct supervision in a certified clinic. It’s the only legal-and-insured version of ketamine for treatment-resistant depression (TRD, which…
Jun 1, 2026
Suboxone (buprenorphine/naloxone)
Suboxone is the closest thing we have to a miracle drug in psychiatry, and most of the people who need it spent years being talked out of taking…
Jun 1, 2026Three Months In on an SSRI: What’s Normal, What’s Not, and When to Tell Your Prescriber
If you’re reading this, you’re probably somewhere between week eight and week twelve on an SSRI, you’re trying to figure out whether it’s working, and you don’t entirely…
Jun 1, 2026
TMS (Transcranial Magnetic Stimulation)
TMS (transcranial magnetic stimulation, an in-office procedure where a magnetic coil sits against the side of your head and pulses a magnetic field into a specific spot on…
Jun 1, 2026
Trazodone vs Quviviq vs Belsomra
The sleep medication landscape in 2026 is in a weird place. Trazodone is still the default for most prescribers, mostly out of habit and price. The orexin antagonists…
Jun 1, 2026
Vivitrol (extended-release naltrexone)
Vivitrol is naltrexone in a syringe, given once a month in your butt. That’s the whole pitch. If you’ve read the naltrexone post, you already know what the…
Jun 1, 2026
Vraylar for depression augmentation
Vraylar (cariprazine) is an atypical antipsychotic that got an FDA add-on indication for major depression a few years back. It’s been on TV constantly, the ads with the…
Jun 1, 2026
Xanax (Alprazolam)
I prescribe Xanax rarely, and when I do I usually regret it within six months. That’s not a slogan, it’s a clinical observation from watching how this drug…
Jun 1, 2026