Most patients that seek care at the M Physicians St. Louis Park Clinic’s Interventional Psychiatry Program, unless they have urgent needs, start by receiving a thorough diagnostic assessment. Next, pharmacists assess every single past treatment and share the potential options with the team’s psychiatrist.
Ziad Nahas, MD, M Physicians psychiatrist and Dr. Saydra Wilson, a neuromodulation fellow, both integral members of the Interventional Psychiatry Program, detail why their program is one-of-a-kind and comprehensive.
The level by which we do our homework to then decide on a treatment plan is very unique. It’s almost like a research-level gathering of information. When patients come in they see a psychiatrist who already has all of their information. So, the time spent with them is to really think hard about their treatment plan. No one else regionally is doing this level of in-depth evaluation.
Dr. Nahas
Dr. Wilson reiterated a similar sentiment. “Our clinic’s intake process is pretty intense. By the time they see a psychiatrist they’ve already had two separate visits and a medical records review. Then they come and see us to talk through procedural and medication options. When I’m talking to someone about a wide array of options, I try not to overwhelm them and I explain which options might be reasonable for them personally,” Dr. Wilson said.
The program incorporates a multi-disciplinary team that benefits from an impactful partnership with the University of Minnesota Medical School, giving physicians continual access to academic medicine and groundbreaking research. The multi-disciplinary team, which also includes psychologists, nurse care coordinator and social worker, also reviews their cases during weekly meetings to ensure that disparate perspectives are taken into account.
Some of the treatment options include electroconvulsive therapy (ECT), a classic treatment for interventional psychiatry, as well as advanced pharmacology and transcranial magnetic stimulation (TMS), a noninvasive method of stimulating the brain to restore mood or function.
“Once we’ve exhausted all treatment options, then we may resort to ECT or Vagus Nerve Stimulation (VNS). There are some known side effects with ECT, so it’s pertinent that we perform evidence-based ECT and stay on top of the latest research, that way we can minimize side effects and maximize benefits,” Dr. Nahas said.
The St. Louis Park Clinic also has a unique intranasal/intramuscular ketamine infusion space overseen by psychiatrists, whereas most delivery clinics are typically run by anesthesiologists and nurses. If needed, psychiatrists can also refer patients to the M Health Fairview Clinics and Surgery Center - Minneapolis or other M Health Fairview locations for ketamine infusions.
“We are one of the few clinics that have multiple treatment options. In addition, we are one of the only clinics that has internationally known neuromodulation faculty on board. Because of this, we are always at the forefront of new information and research findings. Our approach to delivering TMS is not a cookie-cutter approach,” Dr. Nahas said.
Dr. Wilson spent several years in clinical practice before returning for a fellowship to gain a better understanding of TMS and to use its different capabilities each day.
I wanted to build my skill set here because it opens up treatment options for patients who are reluctant to take medications or for those that medications don’t work, which can be up to 30 percent. I think TMS is exciting because it’s part of where we’re pushing the boundaries of science and hopefully we can gather more patients into the group that is seeing improvement.
Dr. Wilson
Being intertwined with academic medicine allows the team to provide care that’s informed by the latest research and clinical trials. This keeps additional options open for those who may have not have had success with treatments like ECT, VNS or TMS. If traditional methods aren’t effective, then psychiatrists can look in other directions toward deep brain stimulation, cortical stimulation or alternative investigational treatments.