top of page
Reflections on Psychiatry & Psychology


Brain, Behavior, and Drugs*
Drugs disrupt brain homeostasis by hijacking the dopamine reward system, producing intense pleasure that outweighs natural rewards. Repeated use rewires brain circuits, weakens self-control, and creates cravings, withdrawal, and relapse. Though genetics and environment influence risk, top-down control allows change and recovery.
Julie Myers, PsyD, MSCP
Nov 2, 202513 min read


Can a Pill Slow Aging? Geroscience, Health Span, and the Future of Anti-Aging Medicine
Geroscience studies aging itself as a root cause of disease. It distinguishes life span (years lived) from health span (years lived in good health). Research explores lifestyle changes, drugs like metformin, and senolytics to slow biological aging and extend healthy, active years.
Alexander Papp, MD
Jun 1, 20252 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


Lithium and Alzheimer’s Disease: New Research Links Low Brain Lithium to Memory Loss
Researchers found that amyloid plaques in Alzheimer’s brains trap lithium, creating early lithium deficiency that may contribute to disease onset. In mice, low lithium worsened plaques and memory loss, while low-dose lithium orotate improved them. Human studies are still needed.
Alexander Papp, MD
Feb 2, 20252 min read


Does Naltrexone Block Ketamine’s Antidepressant Effect? The Opioid Receptor Problem in Ketamine Therapy
Does naltrexone block ketamine’s antidepressant effects? Stanford research shows opioid receptor blockade dampens ketamine’s mood and antisuicidal benefits. Point Loma Clinic in San Diego explains what this means for your treatment plan.
Alexander Papp, MD
Nov 3, 20243 min read


The Resurgence of Psychedelic Psychiatry: An Exciting Yet Cautious Advance
Psychedelic psychiatry is moving from fringe research to mainstream clinical practice. An overview of psilocybin, MDMA, and ketamine — including benefits, risks, and what the evidence supports.
A. Papp MD & Julie Myers, PsyD, MSCP
Jul 7, 20243 min read


Advancing Treatment Approaches for Treatment-Resistant Depression
If multiple antidepressants haven't worked for you, you're not alone and you're not out of options. Why Antidepressants Fail: Lessons from the STAR*D Study Treatment-resistant depression (TRD) is a complex challenge in mental health, characterized by patients' inadequate response to standard antidepressant therapies. The landmark STAR*D study, which extensively evaluated treatment strategies for depression, revealed that a significant percentage of individuals do not respond
A. Papp MD & Julie Myers, PsyD, MSCP
Jun 2, 20242 min read


How Stress and Bipolar Disorder Interact: Causes, Course, and Treatment
Stress and bipolar disorder (BD) interact bidirectionally. Stress, particularly in early life, appears to have lasting effects and marks for early onset of BD, although the exact mechanism is poorly understood. The relationship of stress to the onset of the disorder and its course has implications for treatment and management — and perhaps even prevention.
Julie Myers, PsyD, MSCP
Feb 24, 202419 min read


A New Oral Medication for Postpartum Depression
Zurzuvae, the first FDA-approved oral pill for postpartum depression, is taken for 14 days and can reduce symptoms within days. Costing about $15,900, access may be limited despite its rapid action compared with traditional antidepressants.
Alexander Papp, MD
Nov 26, 20232 min read


Understanding Methylfolate: Genetic Connection and Clinical Insights
Methylfolate, the active form of folate (B9), supports serotonin and dopamine production and may help depression, especially in people with MTHFR variants or treatment-resistant cases. It can cause GI upset or insomnia and should be used cautiously, especially with SSRIs, under medical supervision.
Alexander Papp, MD
Sep 24, 20232 min read


The "Pipeline"
There are several exciting developments in the field of antidepressants, with various drugs currently in the pipeline. still in various stages of development. Clinical trials are ongoing to evaluate their safety, effectiveness, and potential side effects.
Alexander Papp, MD
Apr 3, 20232 min read


More on Brain Zaps
A 2022 study confirmed brain zaps as real antidepressant-withdrawal symptoms. Restarting or slowly tapering meds may help. Most improve over time, but some suffer for years. Despite this, psychiatry has shown little response.
Alexander Papp, MD
Mar 26, 20234 min read


Cough Medicine for Depression?
Dextromethorphan (DXM), found in cough meds, acts like mild ketamine. Combined with bupropion to slow its breakdown, it works quickly for depression. This combo was FDA-approved in 2022 as Auvelity.
Alexander Papp, MD
Jan 23, 20232 min read


What's in your Genes?
Years of trial-and-error approach can be averted by this relatively new tool in mental health assessment. The psychiatrist will be able to devise an effective treatment, without side effects.
Alexander Papp, MD
Nov 28, 20212 min read


Taking Control of Your Cravings
If you can identify your triggers, you have taken the first step toward genuine control of your cravings.
Julie Myers, PsyD, MSCP
Jul 25, 20212 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


When Ketamine Is No Longer Indicated, or a Disappointed Patient
One of the advantages of Ketamine being administered in a general psychiatric practice is that it is easy to catch changes in the clinical presentation, changes that may necessitate reevaluating the feasibility of the Ketamine treatment on the spot.
Alexander Papp, MD
Mar 28, 20213 min read


New Ways of Thinking about Suicide
Suicide is the 10th leading US death. Predicting it is hard; only clozapine, lithium, and ketamine reduce risk. Genetics, stress, and access to means all contribute.
Alexander Papp, MD
Jan 31, 20213 min read


What's in a Name, or the Curious Drug called Topiramate
Drug labels can mislead: meds are named for first uses, but act by mechanism. Topiramate (Topamax) began as seizure and migraine treatment, yet is also used off-label for mood stabilization or weight loss, among others.
Alexander Papp, MD
Nov 29, 20203 min read


When the Brain Buzzes: Understanding Zaps After SSRI Discontinuation
“Brain zaps” are shock-like sensations during antidepressant withdrawal, especially with short–half-life SSRIs like Effexor or Paxil. Poorly studied, often abrupt-stop related; tapering helps only somewhat.
Alexander Papp, MD
Jul 31, 20202 min read
bottom of page