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Getting Acquainted With Your Psychiatrist
Gillian (Jill) Karatinos, M.D. is Board Certified in General Psychiatry and in the subspecialty of Neuropsychiatry. She has special interests in manic depression, couples therapy, women’s issues, psychopharmacology, head injury, and syndromes where medical and psychiatric problems overlap. A special area of focus is in managing medications for both general medical and for psychiatric problems. She currently does only outpatient treatment. Dr. Karatinos passed the ten year recertification exam given in February 2014 by the American Board of Psychiatry and Neurology with an excellent score. Fifteen major subdivisions of psychiatry were tested. In August of 2018 Dr. Karatinos achieved a Masters in Psychopharmacology from the Neuroscience Institute, signed by Dr. Stephen Stahl and was awarded a Florida's Top Docs award in Neuropsychiatry.
NEUROPSYCHIATRIST
The role of the neuropsychiatrist in Traumatic Brain Injury (TBI) is to use medications to compensate the brain for deficits caused by the injury. Without medications, TBI patients cannot make optimal use of other therapies, such as behavioral modifications, and psychotherapy. Without medications, TBI patients will never reach Maximum Medical Improvement. These are the core conclusions of the last 10 years of brain research on TBI. There is no patient with TBI who will not benefit from medications. However, the difficulty that many TBI patients have is poor insight, poor judgment, and denial regarding their limitations, resulting in the refusal to take medications, which will then retard progress and waste time.
The most common kinds of medication used in TBI are:
1. Memory enhancing medications.
2. Medications to reduce aggression and irritability.
3. Medications to stabilize mood swings/depression.
Specialized training in psychopharmacology and in management of Traumatic Brain Injury as uniquely possessed by a neuropsychiatrist is required. There are only 388 Board Certified Neuropsychiatrists in the US currently and only 13 Board Certified Neuropsychiatrists in the state of Florida1. The neuropsychiatrist evaluates patients every 2-3 weeks. This involves reviewing the chart and medications, interviewing the patient and getting feedback from the care taking staff and/or case managers, and often, family members. The family is encouraged to attend sessions every 2 weeks to 3 months in person or by phone.
The neuropsychiatrist assesses the need for the patient to be evaluated by other doctors such as neurologists, neurosurgeons, orthopedists, etc. Referrals are made to these doctors by
the neuropsychiatrist. Blood tests and neuroimaging tests are ordered on a regular basis. A neuropsychological testing battery may be ordered to assess cognitive abilities and strength and weaknesses.