Danielle Dyer, PMHNP

Ha I'm still mentally recovering from almost getting organ trafficked in El Paso...bear with me ***PLEASE BE OK WITH POSSIBLY WAITING A WEEK FOR YOUR PRESCRIPTION AS I FIGURE THIS OUT*** If you are still reading this - you are likely one of my first patients I am not yet familiar with the narcotic prescribing software as I have just started practicing I will get your script to your pharmacy within a week or I will refund you and yes - 11pm is when I do exams until 7 days a week unless it's blocked off for some reason BTW - as much as I despise anti-narcotic rhetoric used to intimidate prescribers and patients to get drug offenses for prison labor and overdoses from street drugs for organized procurement and placement for organ seekers in NM and AZ from other states... I am never - ever - looking to get anyone "hooked" on something but if you have never had one of these scripts before - really enter this with caution I'm not going to tell you what to do - if you think you need it for whatever you're going through right now - that is what matters any "medium to high" dosage of Xanax is going to be limited to 1 month, same with z-drugs only thing that is ever going to be issued by me "regularly" for a medium or "medium high" dosage is going to be the ADHD drugs, valium or klonopin I'll give you another script a long side of this "one time" medium-high dosage for a low dosage for the remaining 5 months I hate even saying that too - like I am restricting or being controlling about it - and I'm not like that at all it's just you won't "be better" next time you see me in 6 months I know there are a lot of people that are interested in Esketamine (Spravato) - this has to be administered by a "provider" and is usually done by the psychiatrist or psychiatric NP The conditions for prescribing it are 2 prior different classes of antidepressants that have failed - along with providers being encouraged to require still having one these "other" antidepressants prescribed alongside of it Do I think the addition of this "other" antidepressant cocurrently is going to help you? Yes and no, I think much of depression has to do with anxiety and traditional antidepressants are misnomers for actually being anxiolytics but regardless - I still have to prescribe this "other" antidepressant alongside of it because it is what manufacturer of this "not yet" generic drug - esketamine, wants and the pharmacist that is going to be actually "giving" you it (since I cannot) is going to want to see being filled, prescribed alongside of the esketamine I am not in any way against prescribing esketamine (Spravato) - but I am still even learning how to do the other narcotic prescribing - with esketamine having to be administered in person and I can't because I'm just in an apartment right now - not a commercial practice if you look up "spravato licensed" pharmacy and want me to send a script there for you to "see how it goes" - that is fine with me please don't see me for "just" this because you will have a lot of headache from me just being unfamiliar with prescribing it and will likely have to do a lot of the footwork yourself as finding the pharmacy / "present to me" whatever you want me to fill out for your insurance to provide coverage for it many people have co-occurring, comorbid conditions - anxiety, depression, sleep disorders, adhd so again - do not mind giving you the script to take to a spravato-licensed approved pharmacy but I cannot personally give you the nasal spray so this will likely be a frustrating endeavor for you when you are already not feeling great to begin with