Psychiatric Pharmacology

Dr. Dmitry Malkin, NYC Psychiatrist


Dr. Dmitry Malkin is New York City-based psychiatrist and psychopharmacologist who is well versed in the treatment of psychiatric disorders with psychiatric medications. He designs treatment programs that may incorporate the use of medication to assist in the management of various psychiatric conditions. While medications can be helpful, it is important to note that a medicine is not a cure in and of itself, and not all conditions require medication.

The patient is typically expected to take the medication in a consistent fashion and over a length of time for it to be effective. Whether or not the patient responds to the medication depends on some variables, including the particular disorder and the patient’s unique circumstances.

In conjunction with regular therapy sessions, medication forms a highly effective element of the management of ADHD, anxiety, and depression.

What are psychiatric medications?


  1. Antidepressants

All antidepressants work by boosting or prolonging the activity of particular brain chemicals called neurotransmitters (such as norepinephrine, dopamine, and serotonin) which are both thought to be involved in regulating mood.

Norepinephrine and serotonin are neurotransmitters. This means that they pass messages between nerve cells in your brain and also between nerves and other target organs in the rest of your body. Although an antidepressant is prescribed to treat depression, some may also be used to treat conditions such as anxiety, phobias or panic attacks.

  1. Antipsychotics

Patients are most likely to be prescribed antipsychotic drugs if they are experiencing psychosis, either as a one-off episode or as part of an ongoing illness. Psychotic illnesses include schizophrenia and bipolar disorder, but one may also experience brief episodes during severe depression, a physical illness or due to effects of street drugs such as amphetamines, cocaine or cannabis. Sometimes antipsychotics are occasionally prescribed as add-ons to help treat other mental health problems which did not respond as well to other medications.

Antipsychotics are not a cure for psychosis, but are often effective in controlling its symptoms, and may help you to return to normal life. You may find that rather than stopping your psychotic experiences, e.g. hearing voices, the drugs just stop you feeling so bothered by them.

  1. Mood Stabilisers

Some of the individual drugs we call mood stabilisers are very different chemical substances from each other. But health care professionals often group them together, because they can all help to stabilise your mood if you experience problems with extreme highs, extreme lows, or mood swings between extreme highs and lows.

Depending on your diagnosis and the problems you experience, Dr. Malkin might suggest that a combination of a mood stabiliser and another drug might be the best way to manage your symptoms.

  1. Sleeping Pills and Tranquilizers

Sleeping pills and minor tranquillizers are prescribed for severe anxiety and sleeping problems. They include:

  • benzodiazepines for both anxiety and sleeping problems
  • medications for anxiety only
  • medications for sleeping problems only.

Sleeping pills and minor tranquillisers are sedatives. This means that they slow down your body and brain’s functions, such as your breathing, heartbeat and thought processes. They cannot cure the underlying reasons anxiety or sleeping problems, but they can help to control the symptoms while you work with Dr. Malkin to address the underlying problems you face.

  1. Stimulants

Stimulants are prescribed primarily for the treatment of ADHD in conjunction with psychotherapy. When we speak of stimulants in the context of psychopharmacology, we are specifically referring to medications which increase the release or block the reabsorption of dopamine and norepinephrine, two brain neurotransmitters. These medications are widely known today by brand names such as Ritalin (methylphenidate), Dexedrine and Adderall (both amphetamines).

Generally speaking, stimulants effectively decrease inattention, distractibility, overactivity and impulsivity in three-quarters of individuals with ADHD. By stimulating the brain, the patient becomes more able to bring their focus to their lives in areas which had been disrupted by attention deficit symptoms.

A word on herbal supplements.

Dr. Malkin has occasionally found success in the use of herbal supplements. Primarily these have been SAM-e, St John's Wort, Rhodiola Rosea, and Omega-3 oil capsules, for the treatment of Anxiety, Depression, ADHD, OCD, and sleeping difficulties. Dr. Malkin stresses the importance of understanding that even though these herbs may be bought without a prescription, there are still side effects that may be unpleasant or interactions with other medications that could have serious consequences.

When taking any supplement such as these, it is important to consult a doctor first. After all, many of the chemically derived medicines we use today are the offspring of older herbal medicines, and should be handled with great care. One does not self-medicate with opium because the medical profession uses morphine for pain treatment, and similar one should never use herbal remedies without consultation.

It's important to remember that all medications can affect different people differently.

Although many people find that the benefits of taking a mood stabiliser outweigh any negatives, not everybody does – and your experience will be personal to you.

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