Why I started Rizzuto Psychiatry and Wellness
Why I built a telehealth practice around listening first, deciding together, and treating you like the person you are.
Read the post →
Blog
Beyond the visit
Personal notes, reflections on mental health, and glimpses of my life outside the practice. Written to connect, not to lecture.
Why I joined the Army National Guard
Raised to care for my neighbor and protect those who cannot protect themselves. Why I became a 65D and what service taught me about helping people through difficult times.
Read the post →
Grief: understanding the loss of a pet best friend
I lost my Doberman Ace at age four to dilated cardiomyopathy. What research tells us about pet loss grief, guilt, and giving yourself the same kindness you gave them.
Read the post →
Mario and Autism
Growing up with my brother Mario, who has autism, taught me to mature fast and care deeply. He is the reason I chose psychiatry.
Read the post →
The sacred vow of marriage
My wife Elizabeth taught me about love language. What it takes to grow a relationship: learning your partner's language, returning to your foundation, and keeping your vows.
Read the post →
Why I aim for the lowest dose that works
Medication should help you feel like yourself. Here is how I think about dosing, side effects, and deciding together.
Read the post →
Eleven Seconds
Patients get about eleven seconds before being interrupted. Here is what the research shows, and why my visits start with your words.
Read the post →
Helper or Harm: What the Research Says About AI and Your Mental Health
Therapy chatbots ease depression in clinical trials while recommendation feeds harm teenagers at scale. Here is what the research actually shows, and why the human relationship still matters most.
Read the post →
The cost of waiting: what untreated mental illness does to the brain
Waiting years for help is common, and the brain keeps score. What research shows about untreated depression, psychosis, and anxiety, and why it is never too late to start.
Read the post →
When panic hits: tools that work in the moment
Panic feels like dying but it is your alarm system misfiring. Therapist taught tools for the moment it strikes: slow breathing, the 5 4 3 2 1 senses method, cold, and talking back to the thought.
Read the post →
CBT, DBT, somatic therapy, exposure therapy: which one fits you
CBT, DBT, somatic work and exposure therapy sound similar but they are not the same. Here is what each one does, who it fits best, and how to choose.
Read the post →
TMS vs ECT: what they are and when each makes sense
When depression has not lifted with medication, two brain stimulation treatments come up. What TMS and ECT are, how they differ, and when each is considered.
Read the post →
Nasal ketamine: what the new science actually says
Ketamine can lift severe depression within hours instead of weeks. How esketamine nasal spray is used in clinics, what the trials show, and who may be a candidate.
Read the post →
Did you know some medications can quiet cravings? The story of gabapentin and cannabis
Craving is brain chemistry, not weak character. How gabapentin reduced cannabis use and withdrawal in a clinical trial, and why medications deserve a place in recovery.
Read the post →
Naltrexone: for alcohol cravings today, and weight management too
Naltrexone quiets the reward buzz alcohol gives, so one drink is less likely to turn into ten. It is also half of a weight management medication. The science behind both uses.
Read the post →
Simtriyo: the new ADHD medication that works on three brain pathways
The FDA approved centanafadine in July 2026. What it is, why the mechanism is new, the side effects, the cost question, and when it can actually be prescribed.
Read the post →
The days are getting shorter, and your mood might be too
Why fall pulls some moods down with the light, what the research says about morning light therapy, and when a seasonal slide deserves real care.
Read the post →
Why your antidepressant takes weeks to work
The first pill changes your brain chemistry within hours, but mood takes weeks. What your brain is quietly building in the meantime, and when to expect results.
Read the post →
The 3am wakeup: why your mind races at night and how to quiet it
You fell asleep fine, then 3am arrives with a racing mind. Why sleep gets fragile in the early morning hours, and what the research says actually helps.
Read the post →
What years of untreated depression do to the brain, and why treatment can rebuild it
The hippocampus shrinks under long untreated depression, and each episode leaves a trace. Why starting treatment protects the brain, and how movement helps it rebuild.
Read the post →
Luvox vs Prozac for OCD: why one SSRI is not the same as another
Fluvoxamine, fluoxetine, sertraline, and paroxetine all treat OCD, but they differ in important ways. Why OCD needs higher doses and longer trials, what makes Luvox unique, and how prescribers choose.
Read the post →
The mood shift nobody warned you about: depression in perimenopause
Women entering perimenopause face two to four times the risk of depressive symptoms. Why hormone fluctuation matters more than hormone levels, and what good evaluation and treatment look like.
Read the post →
How therapists actually treat panic: training the brain to stop fearing the feeling
What happens in therapy once panic attacks have started: cognitive restructuring, interoceptive exposure, expectancy violation, and why the goal is no longer to feel calm during exposure.
Read the post →
Methylphenidate vs amphetamine: two stimulants, two different pharmacologies
Methylphenidate blocks reuptake while amphetamines also drive release. How two stimulant classes differ in mechanism, timing, and clinical use.
Read the post →
Why your drug screen shows amphetamines when you take ADHD medication
A positive amphetamine result is expected when you take prescribed stimulants. Why it happens, how clinicians read it, and what to tell the lab.
Read the post →
Can cold medicine make a drug screen positive for methamphetamine
Cold medicines with pseudoephedrine can trigger a preliminary positive for methamphetamine. The cross reactivity research and why confirmatory testing settles it.
Read the post →
ADHD stimulants are not just milder meth: the chemistry says otherwise
ADHD medications are not milder meth. What the chemistry and the neurotoxicity literature actually show about therapeutic stimulants versus methamphetamine.
Read the post →
What patients ask about long term side effects of psychiatric medications
Weight, sleep, heart, and hormones: an honest tour of what long term studies show about SSRIs, SNRIs, stimulants, non stimulants, trazodone, and zolpidem.
Read the post →
Hydroxyzine and dementia risk: what the long term evidence shows
Anticholinergic drugs have been linked to dementia risk in large cohort studies. Where hydroxyzine sits on that spectrum and what the evidence does and does not prove.
Read the post →
High blood pressure and ADHD stimulants: why monitoring matters
Stimulants raise blood pressure and heart rate modestly on average. Why monitoring matters, what the cardiovascular trials found, and when prescribers reconsider treatment.
Read the post →
Lonely in a crowded world: what isolation does to your mind and how to reconnect
Loneliness is not about how many people you know. What research says about connection, depression, and the threat scanning brain, and the small repeated steps that rebuild it.
Read the post →
Kindling: why each untreated bipolar episode may make the next one more likely
The first bipolar episode usually has a clear trigger. Later ones can arrive on their own. What the kindling hypothesis says about untreated episodes, why earlier treatment works better, and why it is never too late to start.
Read the post →
Why your mind gets loudest at night: bedtime anxiety, the tired brain, and how to quiet it
Why worries grow louder after dark, what sleep science says about the tired brain, and the practical steps that break the bedtime worry loop.
Read the post →
The trauma brain: what untreated PTSD does to the mind, and why treatment can rebuild it
Untreated PTSD can shrink the brain's memory center and raise long term risks. What imaging research shows about the trauma brain, and the evidence that treatment can rebuild it.
Read the post →
The window of tolerance: why you snap at small things and go numb at big ones
Why the same nervous system snaps at small annoyances and goes numb at big ones, what the window of tolerance says about stress, and the simple practices that widen it.
Read the post →
The alarm in your head: what brain scans reveal about anxiety, and how treatment quiets it
Brain imaging shows anxiety as an overactive amygdala alarm with a quiet prefrontal brake, and shows both medication and therapy retraining the circuit. Why reassurance never works, and why the anxious brain can learn calm.
Read the post →Have a topic you want me to cover?
I would love to hear it at your next visit. This space will keep growing with the questions patients actually ask.