Frequently asked questions

It’s best to avoid alcohol. It can worsen symptoms and cause dangerous interactions, especially with anxiety or pain medications.

Marijuana can increase anxiety, depression, and interfere with your treatment—especially with long-term or high-potency use.

Herbal products can cause serious interactions. Always check with your provider before starting any supplements.

Some medications must be taken with food or on an empty stomach. Others, like MAOIs or lithium, require dietary caution. We’ll guide you.

Yes. Always share any prescriptions, OTC meds, or supplements so we can prevent harmful interactions.

Yes. SSRIs are often the first-line treatment because they increase serotonin, which can improve mood, sleep, and overall well-being. We also consider diagnosis, past med history, and your treatment goals when choosing where to start.

If SSRIs aren’t effective or the presentation is more complex (like chronic pain or hot flashes), We may try an SNRI. SNRIs boost both serotonin and norepinephrine, which can improve focus and motivation in addition to mood

In those cases, we may add or switch to Bupropion (an NDRI). It works on dopamine and norepinephrine, and can help improve energy, motivation, and libido. It’s also a non-stimulant option sometimes used for ADHD.

Yes, especially with severe symptoms or when a single med isn’t enough. We may combine meds from different classes to target multiple neurotransmitters or symptom domains.

We always taper slowly or cross-taper when switching to avoid withdrawal effects or destabilizing symptoms.

Definitely. Like therapists use a toolbox, I like to give patients a many options—especially for anxiety flare-ups or panic. This might include non-addictive meds like hydroxyzine or propranolol, and occasionally controlled meds for very high anxiety or panic episodes.

Serotonin is often called the "feel-good" neurotransmitter. It helps to stabilize mood, reduce anxiety, and promote feelings of well-being.

Serotonin plays a role in the sleep-wake cycle. It helps to induce sleep and maintain healthy sleep patterns. 

Serotonin helps regulate appetite and digestion.

Serotonin is involved in cognitive functions, such as learning and memory.

Serotonin contributes to social interactions and feelings of bonding.

Serotonin can affect blood pressure and heart rate regulation.

Norepinephrine stimulates the sympathetic nervous system, leading to increased heart rate, blood vessel constriction, and higher blood pressure.

It enhances alertness, arousal, and cognitive function. 

Norepinephrine is involved in the experience of emotions such as anxiety, fear, and excitement.

It triggers the release of glucose from the liver, providing the body with energy during stressful situations. 

Alprazolam is a short-acting benzodiazepine used to treat acute anxiety and panic attacks.

It starts working in 15–20 minutes and lasts about 4–6 hours.

Most adults start with 0.25mg; higher doses may be needed for intense symptoms.

Due to its short action, it’s best for situational use. Long-term use can lead to dependency. Avoid alcohol while taking this medication—it can cause dangerous sedation.

Clonazepam is a long-acting benzodiazepine used for ongoing anxiety or insomnia.

It begins working within 45–60 minutes and lasts 6–8 hours.

0.5mg is a common starting dose for adults.

This medication can be habit-forming with regular use. We recommend short-term use only and avoiding alcohol due to risk of sedation.

Hydroxyzine is an antihistamine often used to treat anxiety, sleep issues, and nausea.

It can start relieving anxiety or help with sleep within hours of the first dose.

No. Hydroxyzine is not habit-forming and is a non-controlled alternative to benzodiazepines.

Drowsiness, dizziness, dry mouth, headache, or fatigue. These are usually mild.

It should be avoided during the first trimester and while breastfeeding. Talk to your provider to weigh risks and benefits.

Yes. Your provider may prescribe it for daily or “as-needed” use, depending on your symptoms.

Avoid alcohol and other sedating medications unless directed. These can increase side effects like drowsiness.

Lorazepam is an intermediate-acting benzodiazepine used to treat anxiety and insomnia.

It starts within 30–60 minutes and lasts 4–6 hours.

Most adults take 0.5–1mg.

This medication is best used short-term or as-needed. It can lead to dependency and should not be taken with alcohol.

Mirtazapine is an antidepressant used in low doses at night to aid sleep and boost mood.

It generally begins working within an hour.

7.5–15mg at bedtime.

It is not addictive and can be used long-term. It may increase the effect of another antidepressant when used together.

Prazosin is used off-label to treat PTSD-related nightmares.

It is taken at bedtime and works overnight.

Start with 1mg and increase by 1–2mg every few days up to 15mg.

It is not addictive. Blood pressure monitoring may be needed during titration.

Propranolol is a beta-blocker used for physical symptoms of anxiety like rapid heart rate or performance anxiety.

Starts in about 30 minutes and lasts several hours.

10–40mg as needed, up to twice daily.

It is not addictive. It should be used cautiously in people with low blood pressure.

Sertraline is an antidepressant used to treat depression, anxiety, PTSD, OCD, panic disorder, and PMDD.

You may notice improved sleep or appetite in 1–2 weeks. Full benefits may take 6–8 weeks.

Nausea, headache, diarrhea, dry mouth, insomnia, or sexual side effects. Most improve with time.

Yes, sertraline is safe for long-term use when taken as prescribed.

Discuss with your provider—there may be risks, but untreated depression also carries risks. Caution is advised during breastfeeding.

Avoid alcohol and certain other medications that may increase side effects or serotonin levels. Always check with your provider.

Take it as soon as you remember—unless it's close to your next dose. Don’t double up.

Don’t stop suddenly. Stopping can cause withdrawal symptoms or mood changes. Talk to your provider about any changes.

Temazepam is used to treat insomnia by calming the brain and reducing anxiety.

It works within 1 hour and lasts through the night.

15–30mg before bedtime.

Temazepam may cause dependency with long-term use. We use it only when truly needed and avoid alcohol.

Trazodone is an antidepressant commonly used in low doses to treat insomnia.

It works in about 30–60 minutes.

50–200mg at bedtime.

Trazodone is not habit-forming and can be safely used long-term. It may enhance the effect of other antidepressants.

Used for sleep onset and maintenance (to help fall and stay asleep).

Begins within 30 minutes and lasts 6–8 hours.

6.25mg for women, 12.5mg for men.

It can be habit-forming. Do not take with alcohol. Short-term use only is recommended.

Used for waking up in the middle of the night with at least 4 hours of sleep time remaining.

Starts within 30 minutes and lasts 4 hours.

1.75mg for women, 3.5mg for men.

It may be less habit-forming than standard zolpidem, but still should not be combined with alcohol.