To Sleep, Perchance to Dream- part I

Sleep remains one of medicine’s mysteries. Why do we even need to sleep? We don’t yet know the answer to this basic question. We do know that sleep is critically important to our health and happiness. Part I of this blog will cover sleep hygiene and what you can do yourself to improve your sleep-…

Electroconvulsive Therapy and Depression

Many people are surprised to hear that electroconvulsive therapy (ECT), popularly known as “shock treatments,” is still being performed. They think of it as a relic from the 1950’s, and popular opinion of it was shaped by the movie “One Flew Over the Cuckoo’s Nest” with Jack Nicholson. The reality is that ECT is still…

The Story on Spravato

(Note to casual browsers- I am NOT planning on becoming a Spravato provider in the near future. For the reasons why, read on. . .) This week the FDA approved the new antidepressant adjunct Spravato (esketamine) nasal spray for treatment-resistant depression, defined as patients who have failed 2 or more antidepressant drugs. There’s a lot…

“Why don’t doctors want to give me my Xanax any more?”

The benzodiazepines (or “benzos”, for short) are a class of medicines that have been quite popular and widely used to treat anxiety and sleep problems for many years. Examples include Librium (chlordiazepoxide), first marketed in the U.S. in 1960, Valium (diazepam) in 1963, Klonopin (clonazepam) in 1975, Ativan (lorazepam) in 1977, and Xanax (alprazolam) in…

“My meds are too expensive- what to do?”

The modern pharmaceutical industry has revolutionized treatment of psychiatric illness- but all that progress comes at a cost. Medication prices continue their march upwards, insurance gets less generous rather than more generous over time, and people often struggle to pay their bills, for meds and otherwise. What to do? Tell me about the problem. Don’t be embarrassed- as with…

Should you take CBD oil?

Since Indiana legalized CBD oil earlier this year many patients have asked me what I think about it and whether they should try it or not.  My answer is a qualified “yes,” with the caveats and cautions below. A few basics- the brain has its own “endogenous” cannabinoid receptors, just like we have serotonin, norepinephrine,…