Psychopharmacology

Numerous medicines exist for depression, bipolar disorder, anxiety disorders (generalized anxiety, social anxiety, panic, obsessive compulsive, post-traumatic stress), attention deficit disorder and other disorders, including addictions. It is important to search for the best possible outcome,  working with patients to achieve  robust efficacy, full remission when possible, and excellent tolerability.  A variety of medications can also be used off label for non-opiate pain management and mood disorder including low dose naltrexone (LDN)and MNDA receptor antagonists such as ketamine and Namenda (memantine). LDN is also sometimes useful off label for autoimmune disorders.

Second Opinion Consultation

When people fail to respond well to medications, it's crucial to search for a solution. Sometimes, people fail to get well because there are additional conditions such as attention deficit disorder or an anxiety disorder complicating depression or bipolar disorder. Refractory mood disorders (poorly responsive to medications) sometimes respond to medication combinations or to off label medications. Psychological issues can and do affect mood disorders as does marital stress. Dietary factors, immune dysfunction, genetic polymorphisms (see below), infectious agents and other medical illnesses and medications can make the treatment of mood disorder more challenging.

Psychotherapy

Whether combined with medication or not,  individuals  or couples can explore how past experiences and myths affect present relationships and self esteem. Learn how empathy, respect and healthy boundaries aid in compassionate, assertive communication.

Equine-Assisted Psychotherapy and Learning

EAGALA certified psychotherapy and workshops for individuals, families and groups offer a well established alternative to office based therapy. Non-mounted interactions and exercises with horses allow clients to explore emotions, problem solving skills, self esteem, roles, boundaries and many other challenges.

Genetic Testing

Identifying genetic variants in certain receptors, enzymes, proteins and calcium channels is sometimes useful in understanding and treating psychiatric disorders. For example, people with the C677T genotype for the MTHFR enzyme ,involved in folate metabolism, are at increased risk of depression, bipolar disorder and schizophrenia. In such cases, l-methyl folate is prescribed. Testing can also identify individuals with slower or faster metabolic pathways in the liver which can require very low doses of a medicine to avoid side effects (slow metabolizers) or high doses to avoid medicines failing (fast metabolizers).