Cymbalta (Duloxetine)
Cymbalta is the drug I reach for when the depression has a physical component...
Social Anxiety Disorder
Social anxiety isn't shyness, it's an anxiety disorder run by avoidance. Here's how dodging makes it worse and how exposure, CBT, and meds fix it.
Lexapro (Escitalopram)
Lexapro is the SSRI I start with most of the time, and the reason is boring...
When to switch antidepressants, and when to stay
Half the antidepressant switches that happen shouldn't have happened, and the other half should have happened six months earlier.
Choosing between SSRIs, SNRIs, and what comes next
The decision tree for picking an antidepressant in 2026 isn't really a tree, it's more like a workflow, and the workflow is a lot simpler than the size of…
Adderall vs Vyvanse: side by side
Both are amphetamines, both work, the differences are real but not enormous, and the right answer for any given patient depends on factors that the rep…
Belsomra (Suvorexant)
Belsomra (suvorexant) blocks the brain's wake signal instead of forcing sedation. Best for staying asleep, and the dependence math beats the benzos.
ADHD meds for adults: the questions I get most
Adult ADHD is everywhere now, which means I get the same set of questions from people considering a stimulant, in slightly different fonts, over and over.
How long does an antidepressant actually take to work?
Eight to twelve weeks at a real dose.
Does Wellbutrin actually not cause sexual side effects?
The short version: mostly true, the marketing is shading it slightly cleaner than it actually is, and the most useful clinical move with Wellbutrin in…
Finasteride (Propecia, Proscar)
Finasteride (Propecia, Proscar): how it holds onto your hair, the sexual side effects, the contested post-finasteride question, and the PSA catch.
What the men’s mental health movement gets wrong
There are basically two wings of the men's mental health conversation in 2026 and both of them are selling stuff, which is most of the problem.