Lievy Psychiatry, LLC

10/29/2025

10/24/2025

Another amazing presentation on Caplyta. New indication coming soon for……can’t say it yet but it’s exciting. Delicious foods and good education!!

10/22/2025

Love it when pharm reps spoil the providers!! Fancy meal and great education.

10/10/2025

Vraylar (generic name: cariprazine) is an atypical antipsychotic medication used to treat several mental health conditions. It works by balancing dopamine and serotonin activity in the brain — chemicals involved in mood, thinking, and perception.

🔹 Approved Uses

Vraylar is FDA-approved for:
• Schizophrenia in adults
• Bipolar I disorder, including:
• Acute manic or mixed episodes
• Depressive episodes (bipolar depression)
• Major Depressive Disorder (MDD) — as an adjunct treatment (used with antidepressants)

🔹 How It Works

Cariprazine acts mainly as a dopamine D3 and D2 receptor partial agonist and a serotonin 5-HT1A receptor partial agonist, meaning it helps regulate neurotransmitter activity without fully blocking or stimulating receptors.

🔹 Common Side Effects
• Restlessness or feeling unable to sit still (akathisia)
• Insomnia
• Nausea
• Dizziness
• Tremor
• Constipation
• Weight gain (usually mild compared to some other antipsychotics)

🔹 Serious but Rare Side Effects
• Tardive dyskinesia (involuntary muscle movements)
• Neuroleptic malignant syndrome (NMS)
• Metabolic changes (blood sugar, cholesterol)
• Orthostatic hypotension (drop in blood pressure when standing)

🔹 Other Key Facts
• Taken once daily, with or without food
• Has a long half-life — stays in the body for a while, so dose changes take time to take full effect
• Not recommended for elderly patients with dementia-related psychosis (increased risk of death)

Would you like me to explain how it compares to other medications (like Abilify or Latuda), or go over what to expect when starting it?

10/03/2025

Trintellix (generic name: vortioxetine) is a prescription medication used to treat major depressive disorder (MDD) in adults. It is known for having a unique mechanism of action compared to other antidepressants.

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🔹 Key Information About Trintellix

✅ Uses:
• Treatment of Major Depressive Disorder (MDD) in adults.

🧠 How It Works:
• Trintellix is a serotonin modulator and stimulator.
• It affects serotonin receptors and inhibits the reuptake of serotonin (5-HT) in the brain.
• Its multimodal action helps regulate mood and emotional state.

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💊 Dosage:
• Typically starts at 10 mg once daily.
• May be adjusted to 5 mg to 20 mg daily, depending on individual response and tolerability.
• Can be taken with or without food.

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⚠️ Common Side Effects:
• Nausea
• Constipation
• Vomiting
• Dizziness
• Sexual dysfunction (less common than with SSRIs)
• Dry mouth

🔴 Serious Side Effects:
• Serotonin syndrome (especially if combined with other serotonergic drugs)
• Suicidal thoughts (particularly in young adults and adolescents)
• Abnormal bleeding
• Hyponatremia (low sodium)
• Mania/hypomania (in bipolar disorder patients)

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🚫 Drug Interactions:
• MAOIs – Do not use with or within 14 days of taking an MAOI.
• Other serotonergic drugs – Risk of serotonin syndrome.
• Blood thinners or NSAIDs – May increase risk of bleeding.
• CYP2D6 inhibitors – May increase levels of Trintellix.

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❗ Warnings & Precautions:
• Monitor for worsening depression or suicidal thoughts, especially during the first few weeks.
• Use caution in patients with a history of bipolar disorder, seizures, or bleeding disorders.
• Not approved for use in children.

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🤰 Pregnancy & Breastfeeding:
• Use only if the benefit outweighs the risk during pregnancy.
• It’s unknown if Trintellix is safe during breastfeeding – consult a healthcare provider.

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🔄 Discontinuation:
• Tapering off is not usually required, but consult your doctor before stopping.
• Some patients may still experience withdrawal symptoms if stopped abruptly.

10/01/2025

Sleep is essential for emotional regulation, cognitive function, and overall psychological well-being. Lack of sleep can lead to increased irritability, mood swings, and stress, and is linked to various mental health conditions, including depression, anxiety, and bipolar disorder. To improve sleep for better mental health, maintain a consistent sleep schedule, limit caffeine and screen time before bed, and create a calm sleep environment. Exercise regularly and consider relaxation techniques like meditation or deep breathing before sleep.

09/24/2025

Social support plays a crucial role in maintaining and improving mental health. It refers to the emotional, informational, and practical help received from family, friends, peers, or support networks. Here are the key benefits of social support for mental health:

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✅ 1. Reduces Stress
• Talking to someone you trust can help reduce the emotional burden of stress.
• Support systems can offer perspective, comfort, and even practical help with problems.

✅ 2. Protects Against Depression and Anxiety
• Strong social connections are linked to lower levels of depression and anxiety.
• Feeling connected reduces feelings of isolation and loneliness, which are major risk factors for poor mental health.

✅ 3. Boosts Self-Esteem and Confidence
• Supportive relationships provide encouragement and affirmation, helping you feel valued and capable.
• Positive feedback from others can enhance self-worth and resilience.

✅ 4. Improves Coping Skills
• Social support provides guidance during difficult times, helping you cope with adversity more effectively.
• People with strong support systems are more likely to adopt healthy coping strategies, like problem-solving rather than avoidance.

✅ 5. Encourages Healthy Behaviors
• Friends and family can motivate you to maintain healthy habits, such as exercising, eating well, and attending therapy or medical appointments.
• Being part of a supportive community can lead to better lifestyle choices.

✅ 6. Buffers the Effects of Trauma and Grief
• Social support can ease the psychological impact of traumatic experiences, loss, or major life changes.
• Having someone to talk to can provide emotional stability and reduce the risk of PTSD.

✅ 7. Enhances Emotional Regulation
• Sharing emotions with others can help you process feelings more effectively and gain insight into your reactions.
• This can lead to improved emotional resilience over time.

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In Summary:

“People need people.” Social support isn’t just nice to have—it’s essential for mental well-being. It helps individuals feel connected, grounded, and better equipped to handle life’s challenges.

09/19/2025

Drinking electrolytes can benefit mental health in both direct and indirect ways. Here’s a breakdown of how maintaining electrolyte balance supports your brain and mood:

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🧠 1. Supports Brain Function

Electrolytes like sodium, potassium, calcium, and magnesium are essential for:
• Nerve signal transmission
• Brain cell hydration
• Neurotransmitter function

Without balanced electrolytes, brain fog, fatigue, irritability, or confusion can occur.

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😌 2. Helps Stabilize Mood
• Magnesium, in particular, plays a role in regulating the nervous system and reducing anxiety.
• Calcium and potassium also influence neurotransmitters like serotonin, a key chemical in mood regulation.

An imbalance can contribute to symptoms of depression, anxiety, and mood swings.

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💧 3. Prevents Dehydration-Related Mental Fatigue

When you’re dehydrated, cognitive function drops. Electrolytes:
• Help the body retain fluid
• Prevent the sluggishness and mental drain that comes with dehydration
• Improve mental clarity and energy

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💤 4. Improves Sleep Quality
• Magnesium and calcium are known to help with sleep initiation and quality.
• Electrolyte drinks before bed (especially with magnesium) can support relaxation and reduce nighttime cramping that disrupts sleep.

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⚡ 5. Reduces Stress Effects on the Body

Chronic stress depletes magnesium and other minerals. Replenishing electrolytes can:
• Lower cortisol levels
• Support adrenal health
• Improve resilience to stress

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⚠️ Caution:

Too much of certain electrolytes (like sodium) can be harmful. Balance is key — not over-supplementation.

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✅ Best Sources:
• Natural electrolyte drinks: Coconut water, mineral water
• Supplements with balanced ratios: Especially if sweating a lot or under stress
• Whole foods: Bananas (potassium), leafy greens (magnesium), dairy (calcium)

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09/12/2025

Meditation offers a range of benefits, including reduced stress, improved focus, enhanced emotional well-being, and better sleep. By promoting mindfulness, it helps individuals respond to life’s challenges with greater clarity and calm.

08/26/2025

Maintaining a healthy Body Mass Index (BMI) is not only important for physical health but also closely linked to mental well-being. A balanced BMI, achieved through proper nutrition and regular physical activity, can help reduce the risk of conditions like anxiety and depression. Conversely, both underweight and overweight BMI levels have been associated with higher rates of psychological distress. This highlights the interconnected nature of physical and mental health, where taking care of the body can positively influence the mind.

08/25/2025

Now accepting clients for Grow. I’m enrolled with Headway and Rula as well. Connect with me for more information about my services.

Evelyn Hamman, PMHNP is a credentialed psychiatric np in Florida and District of Columbia and accepts Blue Cross Blue Shield, Cigna, United Medical Resources and more. Book a session online!

08/20/2025

Here are natural ways to decrease anxiety and stress, many of which are supported by science and widely recommended:

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🧘‍♂️ Mind-Body Practices
1. Deep Breathing / Box Breathing
• Try the 4-4-4-4 method: Inhale 4 sec → Hold 4 sec → Exhale 4 sec → Hold 4 sec.
• Activates the parasympathetic nervous system.
2. Meditation / Mindfulness
• Reduces cortisol levels and improves emotional regulation.
• Apps like Headspace, Calm, or Insight Timer can help.
3. Yoga or Tai Chi
• Combines movement, breath, and mindfulness.
• Improves flexibility and reduces anxiety symptoms.
4. Progressive Muscle Relaxation
• Tense and release different muscle groups to calm the body.

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🌿 Natural Supplements & Herbs
1. Ashwagandha
• Adaptogen that may reduce cortisol and anxiety.
2. Magnesium
• Deficiency can worsen anxiety; supplementing may help.
3. L-Theanine
• Found in green tea; promotes relaxation without sedation.
4. Chamomile
• Often consumed as tea; has mild sedative effects.
5. Lavender
• Aromatherapy or oral supplements (like Silexan) shown to ease anxiety.

⚠️ Always consult a healthcare provider before starting supplements, especially if you’re on medications.

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🍎 Lifestyle Habits
1. Regular Exercise
• Aerobic activity (even a brisk walk) boosts endorphins and lowers stress hormones.
2. Reduce Caffeine & Sugar
• Both can worsen anxiety symptoms if consumed excessively.
3. Sleep Hygiene
• Aim for 7–9 hours of quality sleep per night.
• Use a wind-down routine, limit screens before bed.
4. Balanced Diet
• Eat whole foods, omega-3-rich fats (e.g., fish, flaxseed), and fermented foods for gut health.

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💬 Emotional and Social Practices
1. Journaling
• Write down worries or practice gratitude journaling.
2. Talk to Someone
• Whether it’s a friend, support group, or therapist, verbalizing stress can help.
3. Limit Social Media
• Excessive use is linked to higher anxiety. Try a digital detox.
4. Laughter
• Watch or listen to something funny—laughter reduces stress hormones.

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🌞 Environmental & Behavioral
1. Spend Time in Nature
• “Forest bathing” or simply walking outside can reduce anxiety.
2. Light Exposure
• Morning sunlight regulates circadian rhythm and mood.
3. Create a Calm Environment
• Declutter, use calming scents (like lavender), and minimize noise.

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If your anxiety is interfering significantly with daily life, consider seeing a licensed mental health professional. Natural strategies work best when part of a comprehensive approach.