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, 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
Guanfacine (Intuniv)
Guanfacine is one of those drugs that quietly does a lot of work and almost nobody talks about, which is sort of par for the course in psychiatry……
Nov 14, 2025
Prozac (Fluoxetine)
Prozac came out in 1987. Almost forty years later it’s still on the short list of SSRIs I reach for, and not because of nostalgia. Fluoxetine has a…
Oct 20, 2025
Vyvanse
Vyvanse is Adderall with a seatbelt. The molecule you swallow, lisdexamfetamine, has an amino acid (lysine, one of the building-block amino acids your body uses for everything) stapled…
Oct 10, 2025
Fluvoxamine (Luvox)
Fluvoxamine is the SSRI (selective serotonin reuptake inhibitor, the Zoloft/Lexapro/Prozac class) nobody thinks of first, and that’s sort of a shame, because for one specific job it’s still…
Sep 9, 2025