Lance Steinberg

Extremely important question as well as a difficult question. It is always best to customize Medication’s to a specific individual including drug interaction, medical issues, potential side effect tolerability. Many people believe that Clozapine is the strongest medicine for schizophrenia but it comes with significant number of side effects. OCD is classically helped by SSRIs including Prozac, Zoloft, and Luvox. The negative symptoms in schizophrenia have a wide range of treatments that go in and out of vogue.
The most important thing is to work closely with your psychopharmacologist and be very honest with your prioritization of symptoms you desire to reduce.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

You seem to be describing a reflexive behavioral reaction that is opposite to your thought. Many people would consider this a form of obsessive compulsive disorder. Frequently obsessive compulsive disorder involves thoughts or actions and behaviors that are virtually the opposite of what one would ordinarily do. In Somewhat older Termanology, these actions are ego dystonic – that is not consistent with who you are as a person. OCD does not make a person crazy. It is just a pattern of thinking. The fantastic usage of talking therapy called cognitive behavioral therapy with exposure response prevention and mindfulness has proven very very successful. Medicines have also been very helpful. Would strongly encourage you to seek out a Psychiatrist familiar with obsessive compulsive disorder that can describe in depth both non-medication and medication options for you, while taking into account the medication‘s your on and your own personal preferences.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

There are many approaches in trying to understand the depth or intensity of depression. Often there are scales that certain people use. Since there are many different measurement tools, it’s hard to say what number or amount implies high depression. However, if an individual is feeling depressed, it is so very important to get help from a mental health professional someone can overcome depression and enjoy more of life as soon as possible.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

In general, panic disorder is not a serious issue if all the other medical problems that can actually cause panic symptoms are looked at and completely ruled out. Panic disorder is more of a problem with regards to how it affects a person on a day today basis. It can be very difficult to enjoy life, sometimes drive, sometimes travel or be in certain situations. Once all the medical issues that can cause panic have been diagnostically examined and found to not be an issue, treatment is highly highly highly successful! Lots and lots of help. Currently, cognitive behavioral therapy with exposure response prevention, and mindfulness, are unbelievably successful. These are approaches without any medication! Medication, is also very successful in treating panic episodes!! Many people choose to do both, depending on your medical situation and the acuity of panic. Always seek out psychiatric consultation. So much hope!

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

Excellent question! It really depends on many many things. It includes which medicine you were taking, the duration you were taking the medication, how quickly you lowered the medicine to zero, and your overall physiologic health. Generally, most people feel back to normal within a couple of months. Of course, that’s assuming that the medication was not taken for many many years, and was not abruptly stopped. If you were still experiencing discomfort emotionally or physically, would strongly encourage you to talk with your psychiatrist. Quality of life comes first. Lots of hope!

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

Panic attacks or symptoms of your nervous system. Firstly, it’s critical to understand what is the cause of the panic attack. There are many many medical causes, medication causes, emotional causes, etc. Would strongly encourage having a psychiatrist go through your complete medical and psychiatric history t to give an internist some leads as to what he or she might intricately examine to find out if the panic attacks are coming from specific organ systems. After one gets medically evaluated to rule out any specific causes that can be taken care of from an organic perspective, then one can use phenomenal treatment approaches like cognitive behavioral therapy with exposure response prevention and mindfulness. Sometimes, that’s all that’s necessary to treat the remaining panic symptoms. On the other hand, there are an enormous number of medications that can really really help you. Some people like to use a combination of talking therapy and medication. The most important thing is that there is lots of hope to get the panic episodes under control! First, start with getting an excellent psychiatrist and move on from there. Lots and lots and lots of hope!

Panic attacks are commonly seen with anxiety. There are medical causes for anxiety, and panic attacks, and it is important to make sure the underlying reason for these issues is taken care of. Definitely would be an advantage to see a psychiatrist. Anxiety and panic attacks can often be handled without medication u using various forms of cognitive-behavioral therapy, exposure-response prevention protocols, and mindfulness. There are other approaches as well. Medications can greatly help if desired. Most importantly, one should not allow anxiety and panic attacks to decrease their quality of life.

Really brilliant question! Not clear of any studies that document one approach or another. Many times, however, distraction techniques from intense anxiety episodes that help ground an individual can be very very helpful. Because anxiety can really affect an individual both neurologically as well as from an outright emotional perspective, would strongly encourage talking with a therapist to find specific techniques that would be helpful for you personally. That certainly would help your quality of life. Sometimes medication may be especially helpful and that would require a psychiatric consultation. Finally, sometimes anxiety episodes are secondary to medical issues and a psychiatric consultation would help elucidate the actual cause of the anxiety.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

Absolutely brilliant question! Currently, we have many medications that are called antidepressants but that actually help with both anxiety as well as depression. Some of them even help with obsessive-compulsive disorder. In very general terms, selective serotonin reuptake inhibitors are known as the excellent medication‘s that help with depression and anxiety. The brand names include Zoloft, Prozac, Paxil, Celexa, Lexapro, and Luvox. There are also medicines that are known as selective norepinephrine and serotonin reuptake inhibitors. These are known by their brand names Cymbalta, Effexor XR, Fetzima, and Pristiq. There are even others that have more technical mechanisms of action. People frequently place a medicine called Remeron into that group as well as quite a few others! The best bet would be to talk to a psychiatrist or psychopharmacologist about your own physiology, what side effects would be most upsetting to you, as well as what other medication you might be on at the time. Lots and lots of hope! In fact, sometimes we even combine medications or augment them! Lots of help! lots of hope!

Prior to surgery, it is very important to talk with the anesthesiologist. Many times the anesthesiologist can have you absolutely continue your antidepressants without any problem whatsoever. It could anesthesiologist well look up if there are any interactions with the medications it could be used for anesthesia and your antidepressants. The complications with anesthesia and anti-depressants maker, but with advanced notice, there should be nothing to worry about. Don’t hesitate to have a discussion with the anesthesiologist ahead of time. Good luck with the surgery! And may you have a very speedy recovery!

Psychosis is a symptom found in many psychiatric and non-psychiatric diagnoses. There are also many many forms of psychosis. To understand how a psychotic experience happens, there needs to be a very thorough neurological and medical intake history and physical exam, often in addition to many laboratory exams. Establishing the cars or probable cause of the psychosis is critical in both acute and long-term treatment. My advice would be to have a very thorough work up by a neurologist in addition to a psychiatrist. This is an absolutely critical part of treatment. Best of luck! Lots of hope and help!

Extremely complicated question. There are many different kinds of depressive periods as well as depths to the depression itself. For some people, they can function in a robotic automaton type fashion. The quality of functioning is greatly in question. On the other hand, day-to-day basic tasks can be truly impaired. When in doubt, definitely get help from a psychiatrist who can determine more exactly the best interventions to help an individual.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

The interplay or non-interplay of these two very specific diagnoses can be extraordinarily complicated and requires intricately detailed assessment by a geriatric neurologist. It would be suggested that you go to an Academic medical center and look for this kind of specialist. You are probably aware that there are complex drug interactions, that some medications can lower the seizure threshold, and that treating of TIAs can further complicate things. If there truly is a lot of hope, you absolutely require a very compulsive neurologist that can tease apart many many variables and confounding factors. I would not be comfortable giving you a premature conclusion. Seek out a consultation with an expert that you trust near you. In fact, it might even be worth getting an additional second or third opinion because of how critical the diagnoses are in addition to the treatment. Best wishes!

That’s a very very interesting question. Intermittent mild sadness can be part of every day life, but ideally not too often. I would suggest consulting a local psychiatrist with academic affiliations to discuss current mood, and whether it is appropriate to circumstance. There may be both medical and non-medical approaches that could be very very helpful!

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

This is a very interesting question. As a psychiatrist, I would suggest using trauma treatment psychotherapy often used in cognitive behavioral therapy. It would need to encompass all the different aspects of the emotional pain and all the subsequent reverberations of that pain. Would anticipate this would decrease the amount and intensity of the emotional pain, but not necessarily erase it. I think it might be more accurate to expect a decrease in the intensity and the frequency of the emotional pain waves or thoughts. Would not hesitate to go to an excellent top-notch psychiatrist in addition to a top-notch psychotherapist, ideally at an academic medical center, to get every different option that might be available to you. I hope you feel better.

Great question! It all depends on what the medication was being used for, the severity of the problem, whether there has been additional talking therapy approaches to help overcome the issue, and the amount and duration of the medication, as well as how you have decreased off of the medication. If you have been under the careful direction of a psychopharmacologist in addition to a therapist, tightly following your course of the treated issue along with the medication, generally things should go back to a physiologic state before the medication and therapy was started. Always do this under the guise of a psychopharmacologist and therapist.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

What you are describing could be as common as an individual being preoccupied or distracted by other thoughts, yet could be as complicated as a seizure like state. It would be best to have her talk with a psychiatrist and or neurologist about the experience in order to safely rule out more dangerous possibilities, as well as to prevent a future recurrence.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

There are many many reasons for anxiety. Sometimes it can be from one’s physiology or medical status. Sometimes it can be from substances like over-the-counter medication, prescribe medication, and several other things. The most important thing is to consider if this is a new experience, the intensity of it, and whether it’s interfering with your day-to-day life. When in doubt, always consult a psychiatrist. Assuming that there are no substances causing the issue, and it is not your physiology, and it is not imperative that you have immediate cessation, therapy is an outstanding approach. Most suggest cognitive behavioral therapy with an emphasis on anxiety reduction. Sometimes this may include breathing techniques, muscle relaxation techniques, and focusing on objects to help one be more grounded. Hope this helps.

It is always important to keep in mind the actual cause of the anxiety or the anger. In very rare cases, one might find neurologic or medical issues that may be the source. For that reason, it is safest to always consult a psychiatrist. However, most commonly, children can be helped with cognitive behavioral therapy approaches for anger episodes. In fact, there are connections with some individuals, between anxiety and ultimately an anger outburst. Cognitive-behavioral therapy approaches are highly effective means to helping a child while keeping parental frustration to a minimum. The specific direction will involve what the immediate environmental issues are that seem to trigger the child. This is a very long and involved answer but hopefully will direct you to get the best help because these techniques can be used throughout an individual‘s life. In fact, helping the child move regulate will be an extraordinarily important aspect of becoming a healthy well-balanced adult. It’s worth a consultation with the psychiatrist.

Most information indicates that these are very very well tolerated without much of a problem to one’s body. There have been some recent issues concerning bone density. My approach to advising the use of his medication is to use them as an appropriate length of time, and ultimately minimize the amount that keeps you happy and healthy. I have many people that have been on these medication‘s for many many many many years and are very content with out having any mood issues because of how the medication has been so helpful over the years. Would always try to be in cognitive behavioral therapy in order to potentially decrease the over all amount of the medication being taken to the minimum amount that is necessary. Hope this helps!!

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540