Dr. Timothy G Lesaca MD
Adolescent Psychiatrist | Child & Adolescent Psychiatry
Rating
5/5
About
Dr. Timothy Lesaca practices Child & Adolescent Psychiatry.
Education and Training
WVU Hospitals General Psychiatry Residency 1987
Chestnut Ridge Hospital Child/Adolescent Fellowship 1989
Wv Univ Sch of Med, Morgantown Wv 1984
Board Certification
Child & Adolescent Psychiatry (Psychiatry and Neurology)
Psychiatry and NeurologyAmerican Board of Psychiatry and NeurologyABPN- Child and Adolescent Psychiatry
Provider Details
Dr. Timothy G Lesaca MD's Expert Contributions
Understanding and Managing Stress: A Guide to Better Well-being
Stress is an unavoidable part of life. Whether it's related to work, relationships, finances, or health concerns, stress affects everyone at some point. While a small amount of stress can be motivating, chronic or unmanaged stress can lead to emotional, mental, and physical health problems. The good...
Understanding the Link Between Stress and Heart Health
Heart disease and emotional health are closely connected. Many people don't realize that mental health conditions like anxiety and depression can increase the risk of heart problems. In fact, research shows that people suffering from depression are twice as likely to develop heart disease compared...
Understanding Obsessive-Compulsive Disorder: A Guide for Patients and Families
Obsessive-Compulsive Disorder (OCD) is a common yet often misunderstood mental health condition. It affects people of all ages and can significantly impact daily life. What Is OCD?OCD is a mental health condition characterized by obsessions and compulsions. Obsessions are intrusive and unwanted...
Understanding Ultraprocessed Foods: What You Need to Know
If you’ve been paying attention to nutrition trends over the past few years, you’ve probably heard a lot about ultraprocessed foods and their impact on our health. Experts are increasingly linking these foods to various health issues, but what exactly makes a food ultraprocessed, and why should...
Understanding Panic Disorder and Its Treatment Options
If you’ve ever felt sudden and overwhelming fear without warning, accompanied by physical symptoms like a racing heart or difficulty breathing, you may have experienced a panic attack. While occasional panic attacks can happen to anyone, repeated episodes combined with constant worry about future...
Post-Traumatic Stress Disorder (PTSD): Treatment Options and Hope for Healing
Post-traumatic stress disorder (PTSD) can profoundly affect individuals who experience traumatic events. Whether it stems from combat exposure, an assault, a natural disaster, or another distressing experience, PTSD often brings challenges that disrupt daily life. Common symptoms include flashbacks,...
Understanding Adult ADHD: Symptoms, Causes, and Treatment Options
Understanding Adult ADHD: Symptoms, Causes, and Treatment OptionsAttention Deficit Hyperactivity Disorder (ADHD) is often thought of as a childhood condition, but did you know that many adults also live with ADHD? Around 2-3% of adults have ADHD, and for them, it’s not just about having trouble...
Understanding Postpartum Depression: A Guide for New Mothers
Having a baby is a life-changing experience, often filled with joy and excitement. But it can also be overwhelming at times. For many new mothers, the challenges of parenthood come with unexpected emotions, including sadness or anxiety. If you or someone you love is struggling, it might be...
The Rise and Fall of Done Global Inc.: Lessons in Virtual ADHD Medication Management
The Rise and Fall of Done Global Inc.: Lessons in Virtual ADHD Medication ManagementThe recent charges against Done Global Inc.'s CEO and head doctor highlight critical issues within the burgeoning telehealth industry. Federal prosecutors allege a fraud scheme centered on providing "easy access" to...
Rise of the Corporate Sociopath
Is Martin Shkreli a name that will live in healthcare infamy? Fortunately for him, he is a young man and thus has many years to live before history proclaims a final verdict. On the other hand, if his ultimate aspiration was to be an example of corporate psychopathic behavior, then he might have...
Gaslighting and Healthcare
The 1944 classic psychological thriller film, "Gaslight," tells the story of the fictional character Paula and her new husband Gregory, who goes about the task of isolating her and leading her to believe that she is insane. He accomplishes this by dimming and brightening the gas lights in their...
Imposter Syndrome
Why do people sometimes feel like frauds despite the abundant evidence of their accomplishments? Rather than internalizing their capabilities and efforts, they attribute their successes to transient and external causes, such as good luck or random chance. Impostor syndrome is a psychological...
Telepsychiatry Appointment Adherence and Productivity During COVID-19
The United States healthcare system has been transformed by COVID-19, with telemedicine technology being one of the most significant drivers of thought and change. Prior to COVID-19, telepsychiatry had already experienced significant expansion. The great promise of telepsychiatry was to provide a...
Executive Functions in Parents With ADHD
Over the past two decades, there has been considerable progress in understanding the functions of the prefrontal cortex of the brain and its regulation of mental activities that allow for self-control and goal-directed behaviors. These mental activities are unified under the term executive...
On Healthcare and Human Rights
Human rights are generally understood to be universal and egalitarian. They are inalienable, indivisible, and derived from the ideology of natural law which seeks to uphold universally accepted moral principles. Providing comfort and assistance to the physically and emotionally ill is one of those...
Online Physician Reviews
Online physician reviews have generated impassioned critiques both pro and con. Although physician online rating sites have provided an impressive volume of potentially useful feedback information, physicians had not necessarily responded favorably to the abrupt exposure to occasional negative...
Concern for the Emotional Health of COVID-19 Frontline Healthcare Providers
Concern for the emotional health of COVID-19 frontline healthcare providers has evolved beyond theoretical into empirical. The findings of a study done in April 2020 at the hospitals of The Istituto Auxologico Italiano in Lombardy and Piedmont, Italy, showed significant self-reported emotional...
Can copper deficiency cause short-term memory loss and paresthesia of the face?
Copper is an essential trace element vital for numerous physiological processes, including the functioning of the nervous system. Deficiency in copper can lead to various neurological manifestations, some of which may align with the symptoms you're experiencing. Copper deficiency can result in several neurological issues, primarily due to its role in maintaining the health of the nervous system. The most commonly reported neurological symptoms include: Myelopathy: This refers to a disorder of the spinal cord. Patients often present with difficulty walking, balance problems, numbness, and paresthesia (tingling sensations), usually in the legs. On physical examination, there may be reduced vibration and proprioception senses, spasticity, and hypoesthesia in the distal portions of the limbs. The onset is generally subacute, developing over weeks to months. Peripheral Neuropathy: This condition involves damage to the peripheral nerves, leading to symptoms such as numbness, tingling, and weakness, typically starting in the extremities and potentially progressing inward toward the torso. These symptoms can become disabling if not correctly diagnosed and treated. Optic Neuropathy: Some patients with copper deficiency have reported vision and color loss, usually in the peripheral fields of vision. This bilateral vision loss is typically gradual and may be associated with nerve fiber layer loss, suggesting optic neuropathy or neurodegeneration. Paresthesia and Copper Deficiency Paresthesia, characterized by tingling or prickling sensations, is a common symptom of peripheral neuropathy resulting from copper deficiency. While paresthesia often begins in the extremities, there have been reports of facial involvement. For instance, a case study described a patient with copper deficiency presenting with severe tetraparesis and painful paresthesias, including facial involvement. Cognitive Impairment and Copper Deficiency Cognitive issues, including memory loss, have been associated with copper deficiency. Copper is integral to brain health, and its deficiency can lead to neurological problems. Some studies have indicated that individuals with certain neurological diseases, such as Alzheimer's disease, have low brain levels of copper. However, the relationship between copper levels and cognitive function is complex and not fully understood. Diagnosis and Management Diagnosing copper deficiency involves a combination of clinical evaluation and laboratory tests. Key diagnostic steps include: Serum Copper and Ceruloplasmin Levels: Low levels of these proteins are indicative of copper deficiency. Complete Blood Count (CBC): Anemia and neutropenia are common hematological manifestations of copper deficiency. MRI Imaging: In cases of myelopathy, MRI may show increased T2 signal in the posterior columns of the spinal cord. Treatment typically involves copper supplementation, either orally or intravenously, depending on the severity of the deficiency. It's crucial to identify and address any underlying causes, such as malabsorption issues or excessive zinc intake, which can interfere with copper absorption. Hematological abnormalities often resolve within weeks of copper supplementation, while neurological symptoms may take longer to improve and, in some cases, may not fully resolve. READ MORE
Vivid daydreams
To control vivid daydreams, try mindfulness techniques like grounding exercises to stay present. Set specific times for daydreaming as a reward, practice redirecting your focus when distracted, and create structured routines. Reducing stress and getting enough rest can also help minimize their frequency and improve your concentration. READ MORE
anxiety and depression
When evaluating the effectiveness and adjustment of antidepressant medications like Cymbalta (duloxetine), it's important to consider several factors, including the duration of treatment, dosage, patient response, and potential side effects. Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) commonly prescribed for depression and anxiety due to its action on serotonin and norepinephrine in the brain, which can help improve mood and anxiety symptoms. Given your history of using Cymbalta successfully for 17 years at 60mg daily and the recent increase to 90mg without perceived benefit, the situation merits careful consideration. Here are several points to consider: Timeframe for Effectiveness: The adjustment period for an increased dose of an antidepressant like Cymbalta can vary. While some individuals may notice improvements within the first few weeks, it can take up to 4-6 weeks (or sometimes longer) for the full therapeutic effects to be realized, especially when adjusting dosages. Dose Adjustments: The increase to 90mg and the consideration to move to 120mg are within the range of what is sometimes necessary for managing symptoms of depression and anxiety. However, it's essential to monitor for both effectiveness and side effects closely. Duloxetine has a maximum recommended daily dose, and increasing the dosage should always be approached with caution and under close supervision by a healthcare provider. Side Effects and Tolerability: As with any medication, it's crucial to balance the potential benefits with any side effects. Higher doses of duloxetine can increase the risk of side effects, which might include nausea, dry mouth, sleep disturbances, or increased blood pressure, among others. Monitoring these and discussing them with your healthcare provider is essential. Evaluation of Other Factors: It's also important to consider any external factors that may be contributing to the current "rough patch," including stress, life events, or other health issues. Sometimes, adjunct therapies such as psychotherapy, lifestyle modifications (including exercise, diet, and mindfulness practices), or even considering adjunctive medications might be beneficial. Second Opinion and Consultation: Seeking a second opinion, as you are doing, is a prudent approach, especially when considering significant changes to a long-standing medication regimen. Consulting with a psychiatrist or a pharmacologist specialized in psychopharmacology can provide a comprehensive review of your treatment plan, evaluate the current dosage's effectiveness, and consider any alternative strategies that might be appropriate. READ MORE
Can you fix obesity with only diet changes?
Addressing obesity involves a comprehensive approach that often includes diet changes, physical activity, behavioral modifications, and sometimes medical interventions. Dietary changes can be a significant part of weight management and may lead to weight loss, especially if these changes lead to a reduction in calorie intake and an improvement in nutritional quality. However, the effectiveness of diet alone can vary greatly from person to person, depending on factors like age, metabolism, level of physical activity, and any underlying health conditions. For your daughter, a tailored approach that considers her unique needs, preferences, and health status would be most beneficial. Here are a few considerations: Dietary Changes: Focusing on whole foods, such as fruits, vegetables, lean proteins, and whole grains, can improve overall nutrition and help manage calorie intake. Reducing the intake of processed foods, sugary beverages, and high-calorie snacks is also beneficial. Physical Activity: Regular physical activity is crucial for overall health and can support weight management. It doesn't have to be intensive exercise; it can include walking, swimming, or any other activity she enjoys. Behavioral Changes: Developing healthy eating habits, such as mindful eating and portion control, can support weight loss and maintenance. Medical and Nutritional Counseling: Consulting with healthcare professionals, such as a dietitian, pediatrician, or a specialist in pediatric obesity, can provide personalized advice and support tailored to her specific needs. Emotional Support: Encouraging a supportive environment that focuses on health rather than weight, and addresses any emotional or psychological factors related to eating behaviors, is important. Long-term Commitment: Sustainable weight loss and management require long-term changes rather than quick fixes. It's about creating a healthier lifestyle that can be maintained over time. It's important to approach the topic sensitively and positively, emphasizing health and well-being over weight alone. Creating a supportive and encouraging environment will help your daughter make and sustain these lifestyle changes. READ MORE
Is gambling addiction serious?
Gambling addiction, also known as gambling disorder or compulsive gambling, is a serious condition that can have significant impacts on your life and well-being. It is recognized by mental health professionals as a pattern of gambling behavior that becomes disruptive to major areas of life: psychological, physical, social, or vocational. The seriousness of gambling addiction lies in its potential to lead to severe financial problems, relationship issues, employment difficulties, mental health disorders such as depression and anxiety, and even suicide. Treatment Options for Gambling Addiction Cognitive Behavioral Therapy (CBT): CBT is effective in changing the thoughts and behaviors that contribute to gambling addiction. It helps in developing coping strategies to deal with urges to gamble, improving problem-solving skills, and learning how to confront irrational beliefs. Medications: While there's no specific medication for treating gambling addiction, medications used for treating co-occurring disorders like depression or anxiety may help in reducing the urge to gamble. Self-help Groups: Groups like Gamblers Anonymous (GA) provide peer support to help control the urge to gamble. Sharing experiences with others facing similar challenges can be highly beneficial. Motivational Interviewing: This approach enhances your motivation to change and can be particularly effective in the early stages of treatment to help you engage in the treatment process. Family Therapy: Gambling addiction does not only affect the individual but also has a significant impact on family members. Family therapy can address these issues, improve communication, and help rebuild trust. Lifestyle Changes: Developing new hobbies, exercising, and practicing relaxation techniques can help manage the urge to gamble by providing healthy alternatives. Financial Counseling: Since gambling can lead to severe financial stress, seeking the advice of a financial counselor can help in managing debts and planning finances more effectively. READ MORE
Does exercise help with anxiety?
Yes, exercise can be quite beneficial in managing anxiety. Engaging in physical activity can help reduce anxiety symptoms for several reasons: Neurochemical Changes: Exercise can increase the production of endorphins, which are chemicals in the brain that act as natural painkillers and mood elevators. It also reduces the levels of the body's stress hormones, such as adrenaline and cortisol. Reduction of Inflammation: Regular exercise can reduce inflammation in the body, which has been linked to the development of anxiety and other mood disorders. Enhanced Brain Function: Physical activity improves cognitive function, increases neuron growth, and reduces neurological inflammation, which can help alleviate anxiety. Improved Sleep: Exercise can also help improve sleep patterns, which can be negatively affected by anxiety. Better sleep can reduce anxiety levels. Increased Confidence: Regular exercise can boost self-esteem and confidence, which can reduce feelings of anxiety. Distraction and Mindfulness: Engaging in physical activity provides a constructive distraction from anxious thoughts. It can also promote a state of mindfulness, which is being present in the moment, further reducing anxiety symptoms. Social Interaction: Group exercises or sports can provide social support and decrease feelings of isolation, which can contribute to anxiety. READ MORE
Can child anxiety be cured?
Child anxiety is a condition that can significantly impact a child's daily life, but with the right approach, it is manageable and can be effectively treated. While the term "cured" may not fully capture the complexity of anxiety disorders, many children can learn to manage their anxiety to a point where it no longer dominates their life. The goal of treatment is to reduce anxiety symptoms to a manageable level, improve functioning, and enhance the child's coping skills. For a child who appears angry all the time, it's important to understand that anger can sometimes be an expression of underlying anxiety. Children might not always have the words to express what they're feeling inside, and their anxiety can manifest as irritability or anger. Treatment for child anxiety often includes: Cognitive-Behavioral Therapy (CBT): This is a highly effective treatment for anxiety disorders in children. CBT helps children understand the connection between their thoughts, feelings, and behaviors. It teaches them coping skills for managing anxiety and helps them challenge and change unhelpful thought patterns. Family Therapy: Sometimes, involving the family in therapy can be beneficial. It can help family members understand the child's anxiety and learn ways to support them effectively. Medication: In some cases, especially when anxiety is severe and interferes with daily functioning, medication may be recommended in addition to therapy. Medications can help manage the symptoms of anxiety, but they are typically used in conjunction with therapy for the best outcome. Lifestyle and Environmental Changes: Making changes in the child's daily routine, diet, exercise, and sleep can also help manage symptoms of anxiety. A stable, supportive, and structured environment can contribute to a child's sense of security. Mindfulness and Stress Management Techniques: Teaching children mindfulness practices and relaxation techniques can be an effective way to help them manage moments of anxiety. READ MORE
Do antidepressants ruin your brain?
The concern that antidepressants might "ruin" or permanently damage the brain is a common one, but it's important to consider the evidence. Research and clinical experience have shown that when used appropriately, under the guidance of a healthcare provider, antidepressants are generally safe and can be highly effective in treating depression and other mental health conditions. They play a crucial role in improving the quality of life for many people. There are various classes of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs), each with their own mechanism of action and side effect profile. While side effects can occur, these are typically manageable and often improve over time as the body adjusts to the medication. Long-term studies on the use of antidepressants have not conclusively shown that these medications cause permanent damage to the brain. In fact, there is evidence to suggest that untreated depression can have negative effects on the brain, leading to changes in brain structure and function. In this context, the use of antidepressants may actually help protect the brain by treating the depression. It's essential to have an ongoing conversation with your psychiatrist or healthcare provider about your concerns and experiences with antidepressants. If you experience side effects or feel that the medication is not working as expected, your healthcare provider can adjust the treatment plan, which may include changing the medication, adjusting the dosage, or incorporating other forms of therapy. Remember, the goal of treatment is to find the most effective way to manage symptoms with the least side effects. If you're concerned about the effects of antidepressants on your brain, it's crucial to discuss these concerns with your psychiatrist, who can provide personalized information based on your health history, the specific medication you're taking, and the latest scientific research. READ MORE
What activities help with panic attacks?
I'm sorry to hear you're experiencing panic attacks. It's important to approach management with a combination of immediate coping strategies and long-term interventions to reduce their frequency and severity. Here are some activities and strategies that may help during and in between panic attacks: Immediate Coping Strategies Deep Breathing Exercises: Practice deep, slow breathing techniques such as diaphragmatic breathing. This can help calm your nervous system and reduce the intensity of a panic attack. Progressive Muscle Relaxation (PMR): Tense and then slowly relax each muscle group, starting from your toes and working your way up to your head. This helps reduce physical tension and can distract your mind from panic symptoms. Grounding Techniques: Use the 5-4-3-2-1 technique by identifying five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste. This can help bring your focus back to the present. Mindfulness Meditation: Focus on your breath or the sensations in your body without judgment. Acknowledge any thoughts that come up and gently bring your attention back to your breath or sensations. Long-Term Strategies Regular Exercise: Engage in regular physical activity, which can help reduce overall anxiety levels and improve your mood. Healthy Eating Habits: Maintain a balanced diet. Some foods and beverages, like caffeine and sugar, can exacerbate anxiety symptoms. Adequate Sleep: Ensure you're getting enough sleep, as lack of sleep can increase anxiety. Stress Management: Techniques such as yoga, meditation, and tai chi can help manage stress levels. Avoid Substance Abuse: Alcohol, drugs, and even excessive caffeine can increase panic attacks in frequency and severity. Therapy: Cognitive-behavioral therapy (CBT) is particularly effective for panic disorder. It helps identify and challenge the thoughts that contribute to panic attacks and teaches coping strategies. READ MORE
What causes anxiety in a child?
Anxiety in children can be caused by a combination of genetic, environmental, psychological, and developmental factors. Children, much like adults, may experience anxiety as a normal part of their development; however, for some, it can become more pronounced and interfere with their daily lives. Here are several factors that can contribute to anxiety in children: Genetic Predisposition: Anxiety can run in families, suggesting a genetic component where children inherit a tendency to be anxious from one or more parents. Environmental Stressors: Experiencing or witnessing stressful events, such as family conflict, bullying at school, or significant changes like moving to a new home or school, can trigger anxiety in children. Temperamental Traits: Children who are naturally timid, cautious, or shy may be more prone to developing anxiety, especially in unfamiliar or challenging situations. Parenting Styles: Overprotective or highly critical parenting can contribute to a child's anxiety, as it may prevent them from learning how to cope with challenges independently. Learning and Modeling: Children often learn behaviors by observing those around them. If a child frequently sees parents or significant adults in their life respond to situations with anxiety or fear, they may learn to react similarly. Regarding your daughter's experience of getting angry easily, it's important to recognize that anxiety in children can sometimes manifest as irritability or anger, rather than the classic symptoms of nervousness or fear. This can be due to their difficulty in understanding and expressing their feelings of anxiety. A supportive and understanding approach, along with professional guidance if necessary, can help in addressing the root causes of her anxiety and developing effective coping strategies. READ MORE
Should I go to a psychiatrist for depression?
Treating depression with medications, often antidepressants, varies significantly among individuals, depending on several factors such as the type of medication, the severity of symptoms, and individual response to treatment. Typically, it might take about 2 to 4 weeks to begin noticing improvements in symptoms, but it can take up to 6 to 8 weeks to experience the full effects of the medication. Some patients may need to try different medications or dosages to find what works best for them, which can extend the period before significant improvement is noticed. It's important to maintain regular follow-ups with your healthcare provider during this period to monitor your progress and make any necessary adjustments to your treatment plan. Remember, the duration of treatment itself varies; while some individuals might only need to take medication for a short term (6-12 months), others may require longer treatment durations to prevent the recurrence of depressive episodes. The decision to continue or stop medication should always be made in consultation with a healthcare provider, considering the patient's history, current state, and risk of relapse. READ MORE
Will psychotherapy help anxiety?
Yes, psychotherapy can be very effective in treating anxiety. It provides a safe space for you to explore your feelings, understand the roots of your anxiety, and learn coping strategies to manage it. Several types of psychotherapy have been found to be particularly beneficial for anxiety, including: Cognitive-Behavioral Therapy (CBT): This type of therapy is highly effective for anxiety disorders. It involves identifying and challenging negative thought patterns and behaviors that contribute to anxiety. CBT teaches practical skills to manage these thoughts and behaviors, reducing the symptoms of anxiety. Exposure Therapy: Often used for specific phobias and other anxiety disorders, exposure therapy involves gradual, controlled exposure to the sources of your anxiety. This can help reduce the fear and anxiety associated with these triggers over time. Acceptance and Commitment Therapy (ACT): ACT helps you accept your thoughts and feelings rather than fighting or feeling guilty for them. It encourages commitment to actions that align with personal values, which can improve psychological flexibility and reduce anxiety. Mindfulness-Based Stress Reduction (MBSR) and other mindfulness-based interventions: These approaches focus on present-moment awareness and acceptance of thoughts, feelings, and bodily sensations, which can help reduce anxiety by preventing over-engagement with negative thought patterns. Interpersonal Therapy (IPT): Although more commonly used for depression, IPT can also be helpful for anxiety. It focuses on improving interpersonal relationships and communication patterns, which can reduce social anxiety and stress-related anxiety. READ MORE
Does anxiety go away if you ignore it?
Ignoring anxiety might provide temporary relief from symptoms because it distracts you from the immediate feelings of anxiety. However, this approach is generally not effective for long-term management. Anxiety can stem from a variety of sources, including genetic predispositions, learned behaviors, and life stresses. When ignored, the underlying causes of anxiety remain unaddressed, which can lead to worsening symptoms over time. For many, addressing and managing anxiety involves a combination of strategies, including: Therapy: Cognitive-behavioral therapy (CBT) is particularly effective for anxiety disorders. It helps individuals identify and challenge negative thought patterns and behaviors that contribute to anxiety. Medication: In some cases, medication may be prescribed to help manage symptoms, especially if they're severe. Lifestyle Adjustments: Incorporating regular physical activity, maintaining a healthy diet, ensuring adequate sleep, and practicing relaxation techniques such as deep breathing or meditation can help reduce anxiety symptoms. Support Networks: Sharing your experiences with friends, family, or support groups can provide comfort and advice on coping with anxiety. It's important to confront anxiety rather than ignore it. Seeking help from a mental health professional can provide you with strategies tailored to your individual needs, helping you to manage your anxiety more effectively. If you're experiencing frequent anxiety attacks, consider reaching out. READ MORE
Antidepressant Withdrawal
When considering tapering off Mirtazapine, especially after a period of four weeks of use, the goal is to minimize withdrawal symptoms while ensuring the stability of your mental health. The process can vary significantly among individuals, depending on factors such as the dosage, the duration of use, individual sensitivity to medication changes, and any concurrent medical or psychiatric conditions. For Mirtazapine, a gradual taper is usually recommended to reduce the risk of withdrawal symptoms, which can include insomnia, nausea, agitation, and rebound anxiety or depression. Given that you have been on a relatively low dose (15 mg) for a short duration (four weeks), the tapering period might be shorter compared to someone who has been on a higher dose for a longer period. However, it is crucial to approach this process carefully and under the guidance of a healthcare professional. Suggested Tapering Strategy: Assessment: Initially, an assessment of your current mental health status, including the stability of depression and anxiety symptoms, as well as the presence of any IBS symptoms, which might be affected by changes in your medication. Tapering Plan: A typical strategy might involve reducing the dose gradually over a few weeks. For instance, you could reduce the dosage to 7.5 mg daily for one to two weeks and then reassess. If withdrawal symptoms are minimal and manageable, and if your depression and anxiety symptoms remain stable, you could then consider stopping altogether or reducing to an every-other-day dosing schedule for another week before stopping. Monitoring: Close monitoring of symptoms is essential during the tapering process. This includes both potential withdrawal symptoms and any signs of relapse or worsening of depression and anxiety. It’s also important to monitor any changes in IBS symptoms, as changes in medication can sometimes influence gastrointestinal symptoms. Supportive Measures: Implementing non-pharmacological strategies to manage depression and anxiety symptoms during this period can be beneficial. This might include psychotherapy, lifestyle modifications, and strategies to manage stress and sleep hygiene. Adjustments: The tapering plan should be flexible. If you experience significant withdrawal symptoms or if there’s a worsening of your depression and anxiety, the rate of tapering may need to be slowed down, or the current dose maintained for a longer period before attempting further reductions. READ MORE
Do antidepressants work for everyone?
Antidepressants can be effective for many people, but they don't work for everyone. Their effectiveness can depend on various factors, including the type of depression, individual biology, genetics, other health conditions, and the specific antidepressant used. Here's a breakdown of how antidepressants might work and the nuances involved: Type of Depression: Antidepressants are generally more effective for moderate to severe depression. In cases of mild depression, the benefits of antidepressants might not outweigh the risks and side effects. Individual Differences: People respond differently to medications due to individual differences in genetics, brain chemistry, and the body's metabolism. What works well for one person might not work for another, or might cause side effects. Finding the Right Medication: Often, finding the most effective medication or combination of medications requires a trial-and-error approach. It might take several weeks or even longer to notice the benefits of an antidepressant, and it may be necessary to try more than one medication to find the one that works best for you. Comorbid Conditions: The presence of other medical conditions can affect how well an antidepressant works. For example, anxiety, bipolar disorder, or substance use disorders can complicate treatment for depression. Psychotherapy and Lifestyle Changes: For some individuals, combining medication with psychotherapy (talk therapy) and lifestyle changes (such as regular exercise, a healthy diet, and stress management techniques) can be more effective than medication alone. Side Effects: Antidepressants can have side effects, which vary by medication and the individual. Some people may not tolerate certain medications well, which can influence their effectiveness. READ MORE
What medications are used to treat ADHD?
The treatment for ADHD (Attention-Deficit/Hyperactivity Disorder) includes various medications that can help manage symptoms. These medications are broadly categorized into stimulants and non-stimulants. It's important to work closely with your healthcare provider to determine the most appropriate medication and dosage for your daughter, as the effectiveness and side effects can vary from person to person. Here's an overview of the types of medications commonly used to treat ADHD: Stimulant Medications Stimulants are the most widely used medications for ADHD and are often considered the first-line treatment. They work by increasing levels of certain neurotransmitters in the brain, such as dopamine and norepinephrine, which help improve concentration and reduce impulsivity and hyperactivity. Examples include: Methylphenidate-based medications: Ritalin Concerta Daytrana (patch) Quillivant XR Metadate Focalin and Focalin XR Amphetamine-based medications: Adderall and Adderall XR Vyvanse (lisdexamfetamine dimesylate) Evekeo Dexedrine Mydayis Non-Stimulant Medications Non-stimulant medications may be considered when stimulants are not effective or cause unacceptable side effects. They can also be used in combination with stimulants to enhance efficacy or to treat coexisting conditions. Examples include: Atomoxetine (Strattera): Unlike stimulants, atomoxetine is not a controlled substance, so it doesn't have the same potential for misuse. It can take several weeks to notice the full benefits. Guanfacine (Intuniv) and Clonidine (Kapvay): These are alpha-2 adrenergic agonists. They are also used to treat high blood pressure but can help manage ADHD symptoms when used as part of a treatment plan. Bupropion (Wellbutrin): Though primarily an antidepressant, it's sometimes used off-label for ADHD treatment, especially if the patient has co-occurring depression or anxiety. Important Considerations Side Effects: Both stimulant and non-stimulant medications can have side effects. Common side effects for stimulants include decreased appetite, weight loss, sleep problems, and increased heart rate. Non-stimulants may cause side effects like fatigue, stomach upset, and drowsiness. Monitoring: Regular follow-ups with the healthcare provider are crucial to monitor the effectiveness of the medication and any side effects. Adjustments to the dosage or type of medication may be necessary. Holistic Approach: Medication is often more effective when combined with behavioral therapy, lifestyle changes, and educational interventions. READ MORE
What happens if a panic attack goes untreated?
When panic attacks go untreated, they can lead to a variety of complications and effects on your life and well-being. It's important to consider these potential outcomes to understand the importance of seeking treatment and support: Increased Frequency and Severity of Panic Attacks: Without treatment, panic attacks may become more frequent and severe over time. This can lead to an escalation in the intensity of symptoms experienced during an attack. Development of Panic Disorder: Repeated panic attacks can lead to the development of panic disorder, a condition characterized by frequent panic attacks and constant fear of having another attack. This fear itself can become debilitating. Avoidance Behaviors: Individuals may start to avoid places, situations, or activities that they associate with panic attacks. This avoidance behavior can lead to agoraphobia, a condition in which people fear and avoid places that might cause them to panic or feel trapped, embarrassed, or helpless. Impact on Quality of Life: Untreated panic attacks can significantly impact your quality of life. They can disrupt your daily activities, work, relationships, and social life. The constant fear of having a panic attack can lead to stress, anxiety, and depression. Physical Health Risks: Although panic attacks themselves are not life-threatening, the stress and anxiety associated with them can contribute to physical health problems such as heart disease, high blood pressure, and other stress-related conditions. Depression and Other Mental Health Issues: The stress and isolation that can result from untreated panic attacks may lead to depression, anxiety disorders, and other mental health issues. Substance Use: Some people may turn to alcohol or drugs as a way to self-medicate and alleviate the symptoms of panic attacks. This can lead to substance abuse and dependence. READ MORE
How long is it safe to stay on antidepressants?
The duration of antidepressant treatment varies greatly among individuals and depends on several factors, including the severity of the condition, the patient's response to the medication, and the history of depression relapses. Generally, it's essential to follow a treatment plan tailored to your specific needs and to have ongoing discussions with your healthcare provider regarding the duration of treatment. For a first episode of major depression, many guidelines suggest continuing antidepressant medication for at least 6 to 12 months after symptoms have improved. This duration helps to reduce the risk of relapse. If someone has experienced multiple episodes of depression, a longer duration of treatment, potentially years or even lifelong therapy, may be recommended to prevent recurrence. The decision to continue or stop antidepressant medication should always be made in consultation with your healthcare provider, considering the benefits of the medication against any side effects or risks. It is crucial not to stop taking antidepressants suddenly or without medical advice, as this can lead to withdrawal symptoms and a possible relapse of depression. Adjustments to the treatment plan, including the duration of medication use, should be based on a continuous assessment of the individual's response to treatment, side effects, and personal preferences, always aiming for the highest quality of life and functional ability. READ MORE
Can a pilot take antidepressants?
In the context of aviation, the use of antidepressants by pilots is subject to strict regulations and oversight by aviation authorities, such as the Federal Aviation Administration (FAA) in the United States. The primary concern is ensuring that the medication does not impair a pilot's ability to safely operate an aircraft. As of my last update, the FAA has specific guidelines regarding the use of certain antidepressants for pilots. Under these guidelines, pilots may be allowed to take certain approved antidepressants under the FAA's Special Issuance medical certification process. This process involves a thorough evaluation to determine if the individual can safely perform pilot duties while taking the medication. The approved antidepressants usually include a limited list of SSRIs (Selective Serotonin Reuptake Inhibitors). However, being permitted to use antidepressants while flying involves several steps: Medical Evaluation: The pilot must undergo a comprehensive psychiatric evaluation by a mental health professional to confirm the diagnosis and need for medication. Stable Condition: The pilot needs to be on a stable dose of the medication for a certain period (typically several months) without adverse side effects that could impair flying abilities. Continuous Monitoring: Regular follow-ups with a healthcare provider are necessary to monitor the effectiveness of the medication and any side effects. FAA Review: Detailed medical documentation must be submitted to the FAA for review. The FAA will consider the pilot's medical history, the specifics of the depression diagnosis, the treatment plan, and the response to the medication. It's crucial for you to consult with an aviation medical examiner (AME) or a psychiatrist familiar with aviation medical certification standards to discuss your specific situation. They can provide guidance on the process, the documentation required, and the likelihood of obtaining a Special Issuance medical certificate. Remember, the regulations and policies can vary by country, and they may have changed since my last update. Therefore, it's essential to check the latest guidelines from your country's aviation authority. READ MORE
Expert Publications
Data provided by the National Library of MedicineAreas of research
Publications
Lesaca,T, “The Rise and Fall of Done Global” The Bulletin of the Allegheny County Medical Society Vol 114 (7) July 2024 , pp 8-9.
Lesaca,T, “Imposter Syndrome” The Bulletin of the Allegheny County Medical Society Vol 113 (9) September 2023 , pp 12-13.
Lesaca,T, “Gaslighting and Health Care” The Bulletin of the Allegheny County Medical Society Vol 113 (1) January 2023 , pp 16-17.
Lesaca,T, “Online Physician Reviews” The Bulletin of the Allegheny County Medical Society Vol 111 (2) February 2022 , pp 11-13.
Lesaca,T, “The Few” The Bulletin of the Allegheny County Medical Society Vol 111 (1) January 2021, pp 12-13.
Lesaca,T, Pyle,P. “Telepsychiatry appointment adherence and productivity during COVID-19” The Bulletin of the Allegheny County Medical Society Vol 110 (8) August 2020, pp 246-248.
Lesaca,T. “Medical certifications and unpunished good deeds”
The Bulletin of the Allegheny County Medical Society
Vol 108 (6) June 2018, pp 216-217
Lesaca,T. (2017) "The impact of queue-controlled modified open access
scheduling on no-show rate in a community mental health child psychiatry med check
clinic: A pilot study," Patient Experience Journal: Vol. 4: Issue 1, Article 14.
Available at: http://pxjournal.org/journal/vol4/iss1/14
Lesaca,T. “Our Greatest Freedom” The Bulletin of the Allegheny County
Medical Society Vol 107 (7) July 2016, p 256-257
Lesaca,T. “A man, by his deeds” The Bulletin of the Allegheny County
Medical Society Vol 106 (1) January 2016, pp 10-11
Lesaca,T. “Running Into The Storm” The Bulletin of the Allegheny County
Medical Society Vol 105 (9) September 2015, pp 364-365
Lesaca,T. “Legal Considerations of Telemedicine” The Bulletin of the Allegheny County
Medical Society Vol 105 (3) March 2015, pp 98-99
Lesaca,T. “Something Rotten in Denmark?” The Bulletin of the Allegheny County
Medical Society Vol 104(10) October 2014, pp 384-385
Lesaca,T. “On Healthcare and Human Rights” The Bulletin of the Allegheny County
Medical Society Vol 104(2) February 2014, pp 46-48
Lesaca, T. “The Illness of Cyberbullying” The Bulletin of the Allegheny County Medical
Society Vol 103(7) July 2013, pp 286-287
Lesaca, T. “Medical Subspecialties: Child and Adolescent Psychiatry” The Bulletin of the
Allegheny County Medical Society Vol 102(11) November 2012, pp 474-475
Lesaca, T. “The Status Quo of Prior Authorization” The Bulletin of the Allegheny County Medical Society Vol 102(11) November 2012, pp 460-461
Lesaca, T. “Sorry Seems To Be The Hardest Word” The Bulletin of the Allegheny
County Medical Society Vol 102(4) April 2012, pp 142-143
Lesaca, T. “A Necessary Societal Artifact” The Bulletin of the Allegheny County Medical
Society Vol 101(9) September 2011, pp 354-355
Lesaca, T. “Physician Reentry” The Bulletin of the Allegheny County Medical Society
Vol 101(4) April 2011, pp 146-147 [Reprinted in Western Pennsylvania Healthcare
News May 9, 2012, Online Edition]
Lesaca, T. “Caleb Died” The Bulletin of the Allegheny County Medical Society Vol 101
(2) February 2011, pp 56-57
Lesaca, T. “Hyponatremia and Mental Status Changes Associated with Diuretic Therapy and Trazodone in a Geriatric Patient” The Bulletin of the Allegheny County Medical Society Vol 100 (12) December 2010, pp 468-469
Lesaca, T. “Eurydice” The Bulletin of the Allegheny County Medical Society Vol 100 (3) August 2010, pp. 304-305
Lesaca, T. “Electronic Prescribing of Schedule II Controlled Substances” The Bulletin of the Allegheny County Medical Society June 2010, pp. 242-243
Lesaca, T. “To Flush or Not To Flush” The Bulletin of the Allegheny County Medical
Society April 2009 , pp 186-187
Lesaca, T. “Am I My Brother’s Keeper?” The Bulletin of the Allegheny County Medical
Society Vol 96 (3) 2007, pp. 108-109
Lesaca T. “Litigation, the Physician, and Achille’s Rage” The Bulletin of the Allegheny
County Medical Society Vol 95 (7) 2006, pp. 342-344
Lesaca.T. “Life As We Know It” [Editorial] The Bulletin of the Allegheny County
Medical Society Vol 95 (1) 2006, pp. 8-11
Lesaca, T. “Who Am I? (and Why Am I Here?)” [Perspective] The Bulletin of the
Allegheny County Medical Society Vol 94 (8) 2005, pp. 396-397
Lesaca, T. “Doctor, Is There a Draft in the House?” [Editorial] The Bulletin of the Allegheny County Medical Society Vol 94 (2) 2005, pp. 60-61
Lesaca, T. “The Dirty Little Dance of the Pharmaceuticals” [Perspective] The Bulletin of the Allegheny County Medical Society Vol 93 (9) 2004, pp. 456-459
Lesaca, T. “The Winter of Our Discontent” [Editorial] The Bulletin of the
Allegheny County Medical Society Vol 93 (3) 2004, pp. 108-109
Lesaca, T. “To Tell The Truth” [Perspective] The Bulletin of the Allegheny County Medical Society Vol 92 (11) 2003, pp. 552-553
Lesaca, T. “Discontent Among Nurses’ Ranks” [Perspective] The Bulletin of the Allegheny County Medical Society Vol 91 (10) 2002, pp. 317-318
Lesaca, T. “Executive Functions in Parents with ADHD” Psychiatric Times Vol 18 (11) November 2001, pp. 17-18
Lesaca, T. “The Battle” [Perspective] The Bulletin of the Allegheny County Medical Society Vol 89 (11) 2000, pp. 344-345
Lesaca, T. “Understanding Landau-Kleffner Syndrome” Psychiatric Times Vol. 17 (1)
January 2000, pp. 31-32
Lesaca, T. “A Managed Care Education” [Perspective] The Bulletin of the Allegheny County Medical Society Vol 88 (20) 1999, pp. 526-527
Lesaca, T. “On Leadership and Holding the Lantern” Psychiatric Times Vol. 16(6)
June 1999, pp.26-28
Lesaca, T. “Adoption: From chaos to normalcy” The West Virginia Medical Journal, Vol. 94 March/April 1998, pp. 93-94
[reprinted in Psychiatric Times Vol 15(3) March, 1998, pp. 58-62]
Lesaca, T. “Thresholds” [Perspective] The Bulletin of the Allegheny County Medical Society Vol 86 (20) 1997, pp. 684-685
Lesaca, T. “Asperger’s Disorder: Intrigue and Dispute” Psychiatric Times Vol. 14 (9)
September 1997, pp. 64-65
Lesaca, T. “If You Were Arrested for Being a Physician..” [Perspective] Bulletin of the Allegheny County Medical Society, Vol. 86(7) 1997, pp.217-218
[reprinted in Psychiatric Times Vol 14(6) June, 1997, p.45]
Lesaca, T. "Ten Rules of Civility for the Medical Warrior" The West Virginia Medical Journal, Vol. 92 November/December 1996, pp. 310-311
Lesaca, T. "Eratosthenes' Dilemma" [Perspective] Bulletin of the Allegheny County Medical Society, Vol. 85(15) 1996, pp.626-627
Lesaca, T. "Sertraline and Galactorrhea" Journal of Clinical Psychopharmacology, Vol. 16 August 1996, pp. 333-334
Lesaca, T. "Symptoms of Stress Disorder and Depression Among Trauma Counselors After an Airline Disaster" Psychiatric Services, Vol. 47 April 1996, pp.424-426
[abstract reprinted in Focus on Depression and Anxiety, Vol. 8, April 1997, p.17]
Lesaca, T. "At mother's mercy: The nightmare of Munchausen syndrome by proxy" TheWest Virginia Medical Journal, Vol. 91 November/December 1995, pp.318-31
Lesaca, T. "Assessing the Influence of a No-Show Fee on Patient Compliance at a CMHC" Administration and Policy in Mental Health, Vol.22 July 1995, pp. 629-631
Lesaca, T. "An Overview of Adulthood Attention Deficit Hyperactivity Disorder" The West Virginia Medical Journal, Vol. 90 November 1994, pp. 472-47
Lesaca, T. "Adolescent Substance Abuse: Etiology, Treatment, and Prevention” (Book Review) Hospital and Community Psychiatry, February 1994, pp. 181-182
Lesaca, T. "Factors Influencing Length of Inpatient Stay for Depressed Adolescents in a Psychiatric Hospital" The Psychiatric Hospital, Vol .23 Summer/Fall 1992, pp.95-97
Lesaca, T. "Effects of Childhood Sexual Abuse" Pennsylvania Protective Services Quarterly, Vol. 7 Winter 1992, pp. 1-15
Lesaca, T. "Tic Disorders: An Overview" The West Virginia Medical Journal, Vol. 85
January 1989 pp. 12-14
Lesaca, T. "Amoxapine and Neuroleptic Malignant Syndrome" The American Journal of Psychiatry, Vol. 144 November 1987 pp. 1514
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