ECT (Electroconvulsive Therapy)
ECT (electroconvulsive therapy, the one with the bad PR from the Jack Nicholson movie) works better than any antidepressant we have, and almost nobody who needs it gets…
Jun 1, 2026
Involuntary holds: OR/WA specifics
Oregon and Washington don’t use the California 5150/5250 numbering, which confuses people who moved up here from the Bay Area expecting that vocabulary. The thing being described is…
Jun 1, 2026
Klonopin (Clonazepam)
The pitch for Klonopin, the one I hear from prescribers and from the guys who’ve been on it for years, is that it’s the cleaner benzo. Longer half-life,…
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
You Already Know You Have a Problem
If you’re reading this and wondering whether your drinking is a problem… it is. You wouldn’t be reading this otherwise. People without a problem don’t sit on the…
Sep 15, 2025
Lorazepam (Ativan)
Ativan has a reputation, and half my new patients walk in with strong feelings about lorazepam before I’ve said anything. The feelings split along a sharp line. The…
Aug 24, 2025
PTSD Treatment
PTSD is what happens when your brain encodes a memory wrong. Most memories get filed away, lose their sharp edges, and when you pull them back out a…
Jul 19, 2025
Anxiety Treatment
The public conversation about anxiety treatment and the clinical reality have drifted about as far apart as it’s possible for two conversations on the same topic to drift.…
Jul 7, 2025
Why “Rock Bottom” Is Bullshit
Rock bottom is bullshit. The idea that addicts and depressed people have to lose the marriage, lose the job, lose the house, get the DUI, wake up in…
May 6, 2025