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Dr. Enrique Madrigal-segura

Psychiatry
Washington , DC
55 years experience male

Locations

Office

Washington , DC

Address

1629 K Street NW Suite 300, Washington , DC
Directions

Fax

(240) 394-4167

About

Bio

Clinical Psychiatry Children and Adolescent and Adult practice with wide range of approaches for diagnosis and treatment. Updated clinical skills in psychotherapy as well as psychopharmacological approach.

Specialties
Doctors may have more than one area of specialty interest. Board certification in a specialty area means the doctor has completed formal training and has practice experience in that specialty, and has passed the certification examination from the corresponding accredited medical specialty board.

Psychiatry

Languages spoken

English

Doctor Q&A

182 Answers
98 Agrees
The number of answers this doctor has agreed with.
A female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Alcohol a culprit?: People should learn how to drink rationally, not to abuse alcohol. That is if they are not alcohol dependent. I don't believe an episode of too much d... Read More
A 22-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Panic attack: You don't mention what medication you were taking for that long. A panic attack relapse could happen regardless if you are or not on medication. If yo... Read More
A 19-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Side effects: Traetment on SSRI's such as Citalopram can cause from initial GI symptoms like nausea. Usually GI symptoms last for a few days, perhaps less than a we... Read More
A 18-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Med or psychological: I strongly advised to consult with your doctor to get an evaluation of your condition and rule out medical issues, such as anemia, thyroid condition o... Read More
A 28-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Eating Disorder: Eyelashes loss, other than blepharitis or other seborrhea related problems are uncommon. However an eating disorder can cause vitamin deficiencies tha... Read More
A 17-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Depersonalization: This is a symptom that is not specific for any neuropychiatric conditions. It might also be transient, and benign. However, you might need a consultat... Read More
A 39-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
It varies: By and large, dosages of major psychopharmacological agents have to be carefully and individually determined. In adults Risperidone dosages range from... Read More
A 75-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Holistic approach: I have no experienced in holistic approaches, usually not the first choice in peer reviewed standards of care. If the person has some genetic polymorp... Read More
A 43-year-old member asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
If drunk excessively: No usual harm if you drink rationally. In excess, you can gain weight, increase urination and electrolyte loss, and lost of all, your functioning can ... Read More
A 29-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Heart rate: If your baseline heart rate was much higher this drop might be related to switching to Trazodone, which might have more side effects in the cardiovasc... Read More
A 24-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Don't give up: There are multiple medication options like benzodiazepines and ssri's as well as duals like venlafaxine among others endorsed by controled studies. Yo... Read More
A 18-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Before diagnosis: I am sorry you are having such a hard time at an age where you should enjoying life. Before a clinical diagnosis you might try some counseling since a... Read More
A 50-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Lexapro (escitalopram): You are right about this particular property frequently reported about escitalopram. However, this has been mostly considered a positive effect. In so... Read More
A female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Skin and anxiety: It is well known that clinical problems affecting epidermal tissues are triggered or complications due to anxiety and/or depressive features. A reacti... Read More
A 19-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Side effects: Don't worry. Side effects usually appear during the first few days. Late onset side effects are uncommon. Ask your doctor about dose adjustment if it ... Read More
A 29-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Natural product: I assume you are doing well on Wellbutrin (bupropion) and Celexa, in appropriate therapeutic doses. Valerian is a natural product used for anxiety but... Read More
A 23-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Manageable ED: ED is a major public health concern, beyond mental health. In order to get help, people who suffer from it will have to be committed to a comprehensiv... Read More
A 27-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Vyvance and energy: Although your medication has stimulant properties, it has been approved for the treatment of ADHD. It could be used for Narcolepsy, although it would ... Read More
A 47-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Target symptoms: You mention no noticeable effects, and I assume you mean side effects, and not target symptoms for which WBT was prescribed. If there was no change af... Read More
A 50-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Ativan/headaches: Yes, it is one of the side effects described and reported off and on.
A 34-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Sex and SSRI's: Some people experience sexual problems on SSRI's. The duration is variable and could be long. If you need treatment for OCD, you might discuss with y... Read More
A 37-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Not recommended: The Concerta has been approved for the treatment of ADHD and a few of rather narrow list of conditions. Since it is a stimulant, (noradrenergic), it i... Read More
A 20-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
OCD & skin picking: It is likely that both compulsive skin picking vis a vis side effects from some stimulants might pose a challenge to adjust treatment. It appears that... Read More
A 22-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Side effects: Buspar (buspirone) has been recommended and approved to control anxiety. However, it also has a few noradrenergic (stimulating) properties, and some ... Read More
A 24-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Zoloft (sertraline) & Propanolol: Unless you are hypersensitive, or have any of those catechol amine (like Epinephrine) dysfunction from any medical condition, it does not seem, under ... Read More
A 37-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Not likely: Don't worry if you have to. Paroxetine and SSRI's in general can be difficult to tqper off after weeks or months of treatment. Of course, if Paroxetin... Read More
A 37-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Meds and weigh gain: If your doctor advised you to add Mirtazepine to Sertraline, it must be because your insomnia is a symptom of a depressive disorder. Of course, the Mi... Read More
A male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Great….congrats: Wonderful. You made a great decision, and I hope you keep up with more reading and peers support. Thelength of time you exposed yourself to tobacco co... Read More
A 28-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Useful combination: Ask your doctor if there is no medical or presence any other psychiatric disorder contraindicating starting a serotonergic medication (Sertraline, Flu... Read More
A 23-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Ritalin (methylphenidate) and sedation: You don't mention a diagnosis as of why you were started on Methylphenidate. If it was for Narcolepsy (not the first choice med) I would agree the dos... Read More
A 26-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Serotonine: Today is Monday and while you still might have some SSRI effect, you were taking a low dose of Sertraline and it is quite unlikely you could experienc... Read More
A 30-year-old member asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Insomnia: Insomnia is not a psychiatric disorder, but a symptoms from multiple conditions. It ranges from poor sleep hygiene to major psychiatry disorder. Commo... Read More
A 36-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Ignore: Most of my PTSD patients do much better joining a support group, being able to reach out and 0 drugs.
A 36-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Ignore: Be a 100% compliant with the medication and stay away from alcohol and drugs.
A 48-year-old member asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Exhaustion: Hi. You don't specify if this is a short or long term health issue. If it is ongoing for over, say 1-2 weeks, it would be good to rule out a depressiv... Read More
A 19-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Stimulant: Adderall (dextroamphetamine and racemic amphetamine) is a stimulant that might affect your pulse as it is feasible in might increase your heart rate. ... Read More
A 17-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
If you feel it's OK: Beyond the label of mental disorder, anhedonia and internal thoughts affecting your school performance, depressive disorders are very common and affec... Read More
A 30-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
It is unlikely: Petit mal or absence phenomena , with EEG changes of wave-spike 3 times per minute are usually a relatively non-progressive specific brain irregular a... Read More
A 25-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Seizure and cannabis: Some cannabis components have been useful in severe cases of seizures, previously resistant to other medications alone or in combination. Those have b... Read More
A 25-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Xanax (alprazolam) at bedtime: If your prescriber recommended Xanax (alprazolam) for panic attacks, you should do that as much as safely needed. You could also ask him to take anoth... Read More
A 24-year-old member asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
No problem, but….: The active chemical of Kava Kava is a minor tranquilizer. Sertraline can help people with anxiety related to phobias, panic disorder, OCD, depression ... Read More
A 37-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Ignore: Your problem is treatable. Full compliance with meds. Keep focused and busy. Correct.distortions.
A 37-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Ignore: Be kind but firm Watch for early signs or stress Always encourage med compliance.
A 21-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Health & pregnancy: Most health workers agree that it is most beneficial for mothers and their babies to have a stress free pregnancy. Otherwise, a few complications coul... Read More
A 19-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Maxolon/Zyprexa: I don't think there will be any incompatibility with this combination.
A 24-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Side effects: Never heard this complaint in my practice regarding treatment with Vyvance or Concerta. However, tinnitus is a relatively common symptom and it can be... Read More
A 25-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
No problem: By the time you take your Tylenol, (acetaminophen) your liver has metabolized your blood alcohol after 10 hours. However, you do not mention why long ... Read More
A 37-year-old female asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Switching SSRI's: By and large, switching from a relatively low dose to an equivalent SSRI should not be a factor to go through a withdrawal from Paroxetine, if are sta... Read More
A member asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
Diazepam: he short answer is yes, as there is no medical contraindication. On the other hand, Diazepam is usually recommended for a short time, if there is anxi... Read More
A 34-year-old male asked:
Dr. Enrique Madrigal-segura
Psychiatry 55 years experience
OCD hospitalization: Not withstanding any diagnosed conditions such as OCD, hospitalization has to be considered for life-endangering consequences of not eating or restric... Read More

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Testimonials
Recommendations and Thank you notes are endorsements given from patients or other doctors.

3
Recommendations
140
Thank you notes
May 31, 2015
Dr. Enrique Madrigal-segura's posts are consistently, sound, well-expressed and thorough. His knowledge encompasses not only the expected wisdom of his specialty, but also interesting tidbits from m...Read More
Apr 25, 2015
Smart, common sense answers, and I have learned a great deal from his postings. He collaborates well with colleagues, and meets patients humanely, warmly, and where they are. Great cyber-bedside manne...Read More
HealthTap member
Mar 31, 2015
Dr. Madrigal-segura is an amazing doctor! #nationaldoctorsday2015 #virtualflower1
HealthTap member
This made me feel good. Thanks! I just feel handicapped knowing that I can perform but my anxiety is holding me back. Thanks for your reassuring words that I'm not the only one.
HealthTap member
This was very helpful, thanks! It turned out to be my OCD, though. It turns out I did this as a young child as well. Still, this is good to know!
HealthTap member
Thank you, your answer was very helpful! I take it for GAD. I'm scared about withdrawl too. Some stuff ppl said

Education & Training

Medical/Graduate school

University of Costa Rica Faculty of Medicine, Costa Rica
Graduated 1967MD

Residency

Saint Luke's-Roosevelt Hospital Center, Columbia University, New York City

Awards

Founding Rx Editor, First Place, National - Winter
2015
Thought Leader, First Place, District of Columbia - Spring
2015
Top Psychiatrist, First Place, District of Columbia - Spring
2015
90,000 U.S. doctors in 147 specialties are here to answer your questions, provide medical advice, write prescriptions, and more.
Answer emailed
in 24 hours or less