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
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
What “Trauma-Informed Care” Actually Means
Trauma informed care is the most successful piece of mental health branding of the last decade, and it’s quietly making people worse. The phrase used to mean something…
Nov 12, 2025
Prescription Education
Starting a psychiatric medication is mostly an exercise in being patient through a stretch of weeks that feel worse than baseline before they feel better. Nobody really tells…
Nov 5, 2025
What Medication Can and Can’t Do
People come in wanting a pill that fixes their life. They don’t say it that way. They say “I just want to feel like myself again,” or “I…
Nov 1, 2025
Consequences Aren’t Punishment
Consequences are just what happens next. You don’t sleep, you feel like shit, that’s biology. You drink most of a bottle of wine on a Tuesday and wake…
Oct 27, 2025