Best psychiatrist in scottsdale winner Michael Yasinski MD has added several new treatment programs and types of therapy to his home-call pratice

1. Intensive agorophobia exposure treatment program

1-4 week program which treats people country wide with the most severe panic and agoraphobia conditions. Read more about it http://www.yasinskipsychiatry.com/services/. If you are unable to leave the house but want to get help anywhere in the country, I will fly to you and assist you in coming to Arizona for treatment in the intensive program.  The program consists of intensive exposure therapy with an expert in anxiety disorders psychiatrist for 3 hours a day.  Also integrated is cognitive-behavioral therapy principles specific to your fears, mindfulness techniques and ASMR (Autonomous sensory meridian response) techniques which is an extension of mindfulness. This is the only program in the country where you work closely every day with an M.D psychiatrist trained anxiety disorder specific cognitive-therapy and exposure therapy plus utilization of necessary medications to add synergy to the response to treatment.

2. In-home alcohol and drug detox

As this service has become extremely popular I have further expanded the program to include more intensive after-care therapy, new medications to prevent relapse or treat lingering post-acute withdrawal symptoms of opioids or alcohol and more intensive integration of support group resources and people who will be an integral part of long-term treatment. From the acute detox stage through follow-up stage I now offer the most effective and novel approach to beating addiction.

3. Naltrexone low-dose therapy for depression, anxiety, PTSD, anorexia and alcohol or drug cravings/Post-acute withdrawal symptoms of alcohol or opioids annd chronic-pain/fibromyalgia

A novel approach to pharmacotherapy without the side-effects of typical medication is utilization of low-dose naltrexone. Naltrexone traditionally is used at 50mg doses to prevent the binding of opioids to opioid receptors in the brain, thus blocking the ability to get high. It was also used to help alcohol cravings with minimal success however. The downfall of this treatment is blocking opioid receptors leads to apathy and depression in many people which is inconsistent with being able to get over an addiction.

Low-dose naltrexone uses doses of 0.25-2mg each night at 9-10pm. The pharmacological basis for treatment is as follows: The brain naturally produces the majority of endorphins from 11-3 AM (endorphins are natural opioids that bind to opioid receptors and are responsible for mood, calmness, focus and preventing pain). By transiently blocking these receptors using such a low dose, the receptors are only blocked for 1-2 hours. Since your brain views these receptors as not present and blocked, it increases production of endorphins to try to compensate for the lack of receptors by creating more endorphins to bind to the existing receptors the brain can see.  Since the blockade is transient, within hours the naltrexone de-couples from the receptors and now all receptors are available to bind to the increased production of the endorphins your brain produced.

This leads to a long-term increased level of endorphins stimulating the pleasure center of our brain and naturally combatting depression, anxiety, pain, anorexia and alcohol/drug cravings and withdrawal. There is no evidence in the form of formal studies however so the response is quite variable but I have had very successful results in most patients and is utilized as another tool in addition to traditional treatments.

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