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FAQ

What medications are used to treat depression?

These days there are numerous medication options to chose from to treat depression. These medications have been engineered to maximize safety while providing substantial benefit at the same time. SSRI’s, such as Zoloft, Lexapro or Prozac, are typically used as the first line of treatment. Additionally, SNRI’s, such as Effexor, Pristiq, and Cymbalta, are also considered effective treatments. Other examples of common antidepressants include Wellbutrin, Trintellix and Viibryd.

What is an SSRI?

SSRI stands for “selective serotonin reuptake inhibitor”, and designates a class of medications that work to increase levels of serotonin in the brain by preventing the body from breaking it down. Low levels of serotonin are thought to play a role in depression.

What is an SNRI?

SNRI stands for “serotonin and norepinephrine reuptake inhibitor”, and designates a class of medications that work to increase levels of both serotonin and norepinephrine in the brain by preventing the body from breaking down these two molecules. In addition to serotonin, low levels of norepinephrine are also thought to contribute to symptoms of depression.

What medications are used to treat anxiety?

Depending on the type of anxiety you are experiencing, different medications are prescribed. For panic attacks, SSRI’s, SNRI’s and benzodiazepines are typically used. Benzodiazepines include commonly known medications such as Xanax, Klonopin and Valium. Often, an SSRI or SNRI can take several weeks before benefits are noticed, so a benzodiazepine can be used simultaneously until the SSRI or SNRI starts to work. For generalized anxiety, SSRI’s, SNRI’s and benzodiazepines are also used.

What medications are commonly used to treat bipolar disorder?

Bipolar disorder, formerly known as “manic-depression”, is a complex illness that requires the use of different medications during different phases or cycles of the disorder. In general, mood stabilizers, such as Lithium, Depakote and Lamictal are used throughout treatment, but an antidepressant can be added during depressive phases while an atypical antipsychotic or benzodiazepine may be added during manic phases. Examples of atypical antipsychotics include Seroquel, Risperdal and Abilify.

What medications are commonly used to treat sleep disorders?

Sleep disorders can cause significant distress and functional impairment to those who suffer from them. Medications are not recommended as the first-line of treatment for sleep disorders, but can be used after other forms of treatment such as Cognitive Behavioral Therapy and sleep hygiene have failed, or for short-term relief. Some medications used for insomnia include Melatonin, Ambien, Sonata, Trazodone, Doxepin, Temazepam, and Lorazepam.

What medications are typically used to treat ADHD?

ADHD can affect individuals at any age, both children and adults. The most commonly used medications are stimulants derived from Methylphenidate (Ritalin), or amphetamine (Adderall and Vyvanse). Alternative therapies include non-stimulant medications such as Strattera and Bupropion.

Dr Tosk

How many years have you been a practicing psychiatrist?
I completed my psychiatry residency training in 2012. I became a board certified psychiatrist the same year and I have been practicing psychiatry ever since.
Are you LGBTQ friendly?
Yes.
Which psychiatric disorders do you specialize in?
I specialize in depression, anxiety, bipolar disorder, addiction, ADHD, sleep disorders and PTSD.
What is the goal of treatment?
Every individual has different goals of treatment. I will work with you to establish what those goals are and how they can be achieved.
Do you treat behavioral disorders?
No.

Perceptual Medicine

Do you accept insurance?
I do not accept insurance, but I will provide you with an invoice that can be submitted to your insurance company for reimbursement.
How easy is it to get an appointment?
Getting an appointment is as easy as calling or e-mailing the office. I can typically see new patients within one week.
Do I need a referral to receive services?
No referrals are needed to become a new patient.
How much is a self-pay visit?
Evaluations for new patients are $350. Follow-up sessions range from $125 – $350 based on the amount of time required.
What are your hours?
My hours are Monday through Saturday, by appointment only.
What should I bring to my initial consultation?
Please bring a list of your current medications and any recent lab results and physical exams you may have had. If you don’t have any of these, do not worry. They are not required to start treatment.

Psychiatry

What is psychiatry?
Psychiatry is a medical specialty that focuses on treating mental health disorders.
What is the difference between a psychologist and a psychiatrist?
Psychologists are not physicians and cannot prescribe medications. Psychiatrists go to medical school and have expertise in medication management in addition to psychotherapy.
How do I know if I need to see a psychiatrist?
There are many different reasons that people see a psychiatrist. I would recommend seeing a psychiatrist if you are suffering from a mental health issue that is interfering with your life and/or ability to function.
Can a psychiatrist treat depression and anxiety?
Yes. Anxiety and depression are some of the most common conditions that psychiatrists treat.
Does a psychiatrist treat bipolar disorder?
Yes. Bipolar disorder is one of the most common conditions that psychiatrists treat.
Can a psychiatrist prescribe medication?
Yes. Psychiatrists are licensed physicians who can prescribe medication.

Medication Management

What does medication management entail?
Medication management first requires an understanding of your current problems and symptoms. Thereafter, we will discuss the different options and medications available to treat those symptoms. Together we will determine the best course of action for your personal needs and what medications may or may not be useful before prescriptions are provided.
What should I bring to a medication management appointment?
Please bring a list of any current and past medications that you have been prescribed.
What conditions can you manage medication for?
As a psychiatrist, I can prescribe medications for any and all mental health disorders.
What types of medication do you prescribe?
I prescribe most psychiatric medications, which includes anti-depressants, anti-anxiety medications, mood stabilizers, ADHD medications, addiction medications, Ketamine, and sleep aids.
How much does medication management cost without insurance?
After the initial evaluation, medication management appointments start at $125.

Ketamine Therapy

What is ketamine therapy?
Ketamine therapy involves the use of a medication, ketamine, to treat a number of mental health conditions.
Which psychiatric disorders can ketamine therapy treat?
At this time, ketamine is FDA approved to treat depression, but is also used “off-label” to treat anxiety, OCD and PTSD.
What is the success rate for ketamine therapy?
About 70% of patients with treatment-resistant depression respond favorably after a single treatment; and 30-60% of treatment-resistant depression patients can achieve considerable degrees of remission of their depressive symptoms for variable lengths of time.
What does a ketamine session include?
After it is determined that ketamine therapy is appropriate for you, you can then plan your first two-hour in-office session. During the session, you will be accompanied by a therapist, phsychiatrist, or both. After taking the ketamine lozenge, you will be asked to lie down while the effects of ketamine are experienced. Relaxing music will play in the background while you safely rest with eyes closed or wearing eyeshades. You are welcome to have a friend or family member accompany you throughout the sessions.
Do I need to be a therapy client in order to receive ketamine treatment?
You do not need to be a therapy client to receive ketamine depending on your goals of treatment.
Is ketamine therapy usually covered by insurance?
At this time, ketamine therapy is not covered by most insurance providers.
What is the price of one ketamine therapy session without insurance?
$500

Psychotherapy

What is psychotherapy?
Psychotherapy is one of the cornerstones of mental health treatment. Its origins date back to the late 1800’s when Sigmund Freud developed the practice of psychoanalysis. There are many different forms of psychotherapy, but the goal of each is to improve your mental health by expanding awareness and acceptance.
What types of psychotherapy exist?
At the Center for Perceptual Medicine, we draw from numerous forms of therapy to address your individual needs. A few notable types of therapy include Jungian, transpersonal, cognitive, interpersonal and supportive psychotherapy.
Which psychiatric disorders can be treated most effectively with psychotherapy?
Psychotherapy is effective in treating most all mental health conditions, including depression, anxiety, OCD, PTSD, sleep disorders and addiction.
Will psychotherapy typically be covered by insurance?
Psychotherapy is often covered by insurance and we will provide you with an invoice that you can submit for reimbursement with your insurance company.
How much does a single psychotherapy appointment cost without insurance?
The cost of psychotherapy varies depending on the type of clinician you are seeing. Dr. Tosk charges $350/hour, but psychologists and therapists often charge less.

Telemedicine

What is telemedicine?
Telemedicine involves the use of secure HIPAA compliant video-conferencing software to conduct a session.
What are the benefits of telemedicine appointments?
Telemedicine allows you to participate in treatment from the comfort of your own home or while at work. This may be useful if you are unable to drive, if you have severe anxiety, or if you live far away from the office.
How much does one telemedicine follow-up session cost?
Telemedicine appointments cost the same as a face-to-face appointment.