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Reflections on Psychiatry & Psychology


Artificial Intelligence in Mental Health: Benefits, Risks, and What It Means for Your Care
AI is reshaping mental health care by expanding access, improving diagnosis, and enabling personalized treatment. While early results are promising, concerns remain about safety, bias, privacy, and loss of human connection. Experts emphasize AI should augment—not replace—clinicians.
Alexander Papp, MD
Oct 5, 20254 min read


Navigating Complex Ketamine Treatment: A Case Study on Ketamine Therapy and Bipolar Diagnosis in Psychiatric Practice
A clinical case study on how integrated ketamine therapy and psychiatric care at Point Loma Clinic enabled early detection of a shift from depression to bipolar disorder. Patient Background: Treatment-Resistant Depression and a History of Mood Instability Joe is in his mid-fifties, an accomplished attorney who has been suffering from recurrent depression since his early adulthood. The depression was difficult to treat; many different medications have been tried, including mo
Alexander Papp, MD
Jul 6, 20253 min read


The "Benzodiazepine Wars": Risks, Benefits, and the Future of Anxiety Treatment
Debate over benzodiazepines persists because better treatments for severe anxiety are lacking. Recent media portrayals highlight both benefit and risk. Used carefully, they remain essential for some patients—illustrating medicine’s constant balance between helping and harming.
Alexander Papp, MD
May 4, 20252 min read


Even More on Brain Zaps and Antidepressant Withdrawal
Brain zaps during SSRI/SNRI withdrawal remain poorly studied and often overlooked by psychiatry. Patients frequently learn about them online rather than from physicians. Researchers and clinicians call for better awareness, informed consent, and more research on antidepressant discontinuation effects.
Alexander Papp, MD
Mar 2, 20252 min read


AI Therapy Chatbots and Teen Mental Health: Why AI Cannot Replace a Real Therapist
A psychiatrist posed as a troubled teen to test AI therapy chatbots — and the results were alarming. Point Loma Clinic in San Diego explains why AI cannot safely replace licensed therapists, especially for vulnerable teens.
Alexander Papp, MD
Jan 6, 20253 min read


Another Independent Pharmacy Closes in San Diego
After 30+ years serving San Diego, Point Loma Shelter Island Drug and Point Loma Cabrillo Drug closed. Crime and PBM “clawbacks” strained the small, personal pharmacies. Owner Michael Saad sold to a chain after years of 12-hour days. Loyal patrons will miss the care.
Alexander Papp, MD
Jul 30, 20232 min read


Pharma Company Evergreening
Pharma has saved millions but is driven by profit. New drugs are priced high to recoup R&D costs; when patents expire, generics get cheaper. Companies often use tactics to extend profits beyond patent life.
Alexander Papp, MD
Apr 25, 20213 min read


Self-pay versus Insurance-based Practice
A JAMA Psychiatry study found U.S. psychiatrists increasingly go cash-only (19% to 27%). Self-pay visits are longer and more frequent, suggesting higher value than brief insurance “med checks.”
Alexander Papp, MD
Oct 25, 20202 min read


Ketamine is Not a Sedative: the Risks of Misuse
In 2019, Elijah McClain died after EMTs injected him with 500 mg ketamine during a police arrest. The text argues ketamine is not a sedative but a dissociative anesthetic that inhibits GABA indirectly and can raise heart rate and blood pressure. In a stressful arrest, this may worsen agitation and cardiac strain. It concludes ketamine should not be used to “sedate” detainees.
Alexander Papp, MD
Jul 1, 20202 min read
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