evidence-based psychiatric treatment.

Psychiatric nurse practitioner in Fredericksburg, Virginia.

You’ve tried everything you can think of to feel better, but nothing’s better.

Maybe you’ve been tried antidepressants like fluoxetine or bupropion, but they did not help at all or caused bothersome side effects. Or made things worse! You may have tried a couple of medicines without improvement and been told you have ‘treatment resistant depression.’ Maybe it feels like people are just throwing medication at you and waiting to see what sticks!

Perhaps you are considering trying medication, but wondering about side effects. Perhaps you feel trapped by your current medication, unable to stop something you no longer need because of withdrawal symptoms.

But you’re still feeling…

Like people are throwing medicines at you to see what sticks

Discouraged about trying yet another SSRI

Confused about what’s your problem or diagnosis really is

A different approach to psychiatric medication can help.

Use medication for what it’s good for, not for what it’s not. Understand the problem we’re trying to solve. Use what works, not what’s new.

  • I find axioms from Dr. Nassir Ghaemi helpful in thinking about prescribing: “Your treatment is as good as your diagnosis,” “Treat diseases, not symptoms,” and “All drugs are guilty until proven innocent.”

    I use a hierachical diagnostic framework, focusing on mood disorder treatment (when relevant). I carefully review past treatment history to insure that I provide you with options that are rational and not duplicative of prior ineffective treatments.

  • We will take time to clarify your goals, explore whether your symptoms are more consistent with a disease or a reaction/problem in living, the risks, benefits, and alternatives to a particular medication plan, and then monitor the efficacy of our plan over time.

  • By getting clear about how medications are most likely to help we can decide if they make sense for you and create a plan that aligns with your goals and your unique situation.

Is medication right for you?

Medication may be a good fit for you if you…

  • Have experienced repeated depressive episodes that occur ‘out of the blue’

  • Are struggling with the impacts of nightmares that cause sleep disruption

  • Notice patterns of periods of heightened energy and decreased need for sleep/difficulty sleeping

  • Need help reducing symptoms to let you be more effective in therapy or life in general

Your story is welcome here.

Your story is welcome here.

Questions?

FAQs

  • Yes, I can work with people to discontinue some medications, such as antidepressants, when they are no longer necessary, but are causing withdrawal symptoms if stopped abruptly or rapidly tapered.

  • Skeptical and distant. I do not take any type of gratuities (meals, etc.) from drug companies. I do not participate in continuing education or ‘detailing’ directly from drug companies. I actively monitor the conflicts of interests of presenters at trainings I attend and prioritize those that do not have drug company support.