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
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
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
Hydroxyzine
Hydroxyzine has been sitting in the pharmacy for sixty years doing useful work, and most prescribers act like it doesn’t exist. It’s an antihistamine in the same H1…
Sep 1, 2025
What to Expect in Your First Appointment
Nobody walks into a first psychiatric appointment relaxed and anybody who claims they did is lying. The fears stack up the same way for almost everyone… that I’m…
Aug 27, 2025
Bipolar Treatment
Bipolar treatment goes wrong in the first appointment more often than in any later one. Get the diagnosis wrong and every prescription after it is wrong. And bipolar…
Aug 27, 2025
Wellbutrin (Bupropion)
Wellbutrin is the weird cousin in the antidepressant family. Most of what people think of as antidepressants are SSRIs (selective serotonin reuptake inhibitors, the Zoloft/Lexapro/Prozac class), and they…
Aug 27, 2025
Sobriety Isn’t the Hard Part (It’s Everything After)
People think getting sober is the hard part. Yeah, detox sucks, early sobriety is uncomfortable, breaking the actual habit is genuinely difficult… that’s not what pulls people back…
Aug 25, 2025
Why “Self-Care” Misses the Point (And What Actually Works)
I’m not against bubble baths. If a hot bath and some candles make you feel better, great, do that, nobody’s coming for your candles. That’s not what this…
Aug 18, 2025
Propranolol
Propranolol is a cardiology drug that wandered into psychiatry by accident and stayed because it does one specific thing well. It’s a non-selective beta blocker, developed for blood…
Aug 3, 2025