Dr. Enrique Madrigal-segura
Psychiatry
Washington , DC
56 years experience male
Locations
Office
Washington , DC
Phone
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.
SpecialtiesDoctors 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.
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 member asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Get back on it: Usually SSRI's don't give any trouble by missing one dose. Might be some exception in your case. Get back on it for few days.
Created for people with ongoing healthcare needs but benefits everyone.
158 viewsReviewed >2 years ago
A 22-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Yes, it is usual: Just take your daily dose and continue a regular scheduled plan as usual.
Created for people with ongoing healthcare needs but benefits everyone.
163 viewsAnswered >2 years ago
A 38-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Unusual med combo: First of all, the question of adding Gabapentin to any medication to any med combination is that this antiseizure medication is eliminated from your b... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsAnswered >2 years ago
A 27-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Natural jitters: If you ask your relatives and friends (me too!) it is frequent and natural to feel a bit anxious when you are starting a new job, such as the first da... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 48-year-old member asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Your own cells: There are some precursors like L Tryptophane but your own neurons will synthesize it in very selective areas where this neurotransmission takes place.... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.8k viewsReviewed >2 years ago
A 19-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Side effects: It is unusual to experience these side effects. In fact, 2.5 ia a low, usually a start up dosage. I suggest to consult your prescriber to switch you t... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsAnswered >2 years ago
A 45-year-old member asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
If prescribed OK: Piracetam is a pharmacological substance that has improves the neuron metabolismo, allowing better oxygen intake. It has been prescribed for some form... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.8k viewsReviewed >2 years ago
A 28-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Serotonine: I am sorry you have to worry about side effects of several medications. It appears that the only medication that could cause a serotonergic syndrome i... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 53-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Clonazepam taper: It appears you have reached an acceptable dose of Clonazepam to end a taper. On the other hand, some people have more difficulties to stop this medica... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 20-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Alternative for ADHD: If you are bothered by stimulant side effects, and need medication for ADHD, ask your prescribing doctor for alternative treatment with Atomoxetine or... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsAnswered >2 years ago
A 37-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Your are right t ask: ADHD has to be diagnosed before age 10 y/o to meet adult ADHD criteria. If so, Adderall (dextroamphetamine and racemic amphetamine) gen is a good opt... Read More
Created for people with ongoing healthcare needs but benefits everyone.
3k viewsReviewed >2 years ago
A 37-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Ignore: Ensure treatment compliance and follow up as well as self care and diet. Keep busy and sociable.
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsAnswered >2 years ago
A 37-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Ignore: Full awareness and acceptance, correct negative distortions about self, psychotherapy and good meds.
Created for people with ongoing healthcare needs but benefits everyone.
3k viewsAnswered >2 years ago
A 37-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Ignore: Keep in mind depression is treatable
Don't let despair take ober
Live a healthy life and proactive.
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 46-year-old member asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Stimulants: They belong to precursors and drugs used for weight loss, asthma and congestion. Phenylalanine is an essential amino acid. Ephedrine (ephedrine (ephed... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.8k viewsReviewed >2 years ago
A 20-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Helping OCD: It sounds like your friend is in need to consult in a mental health clinic or ask his doctor's advise in order to get treatment. OCD is usually a pers... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 20-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Healthy lifestyle: Of course, nature would be rooting for everybody to have a great chance to get a healthy baby. You could also help with a healthy diet, normal weight... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
No research yet: The plant Bacopa monnieri is widely use in India for the treatment of asthma, and anxiety. There is no research or evidence of its efficacy.
You are ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.8k viewsAnswered >2 years ago
A 29-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Long/short term: Depending on the route of use, mouth, snorting or IV, you can obtain a rush in 5 minutes and sustained euphoric states up to 12 hrs. This substance is... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.9k viewsAnswered >2 years ago
A 24-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Yes, careful: There are some reported drug interactions as fluoxetine oral will increase the level or effect of loratadine oral by altering drug metabolism.
Created for people with ongoing healthcare needs but benefits everyone.
2.9k viewsReviewed >2 years ago
A 41-year-old member asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Own self-regulation: Aside from our own self regulation tranquilizers, there are
GABA(A) agonists, they are mostly available in a group of anxiolytic meds called positive... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.8k viewsAnswered >2 years ago
A 23-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Strepsils and Prozac (fluoxetine): I don't believe that temporary relief use of strepsils can be contraindicated for a necessary treatment with Fluoxetine.
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 17-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Possible withdrawal: It is very likely that your symptoms correspond to a withdrawal from Benzodiazepines. Ativan (lorazepam) can be easily tapered down by 0.25 mg daily. ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.9k viewsReviewed >2 years ago
A 27-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Lamotrigene: Very few reported gaining weight, which could be related to being started on this medication. The Mayo Clinic notes used to treat bipolar disorder inc... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 21-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
5-HT receptors: SSRI's like Paroxetine both activate or inhibit multiple serotinergic (5-HT), receptors. At least 4 of them regulate appetite and some anxiety and agi... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 25-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Unusual symptoms: By and large, phantom smells are not a frequent sign or diagnostic featue for an anxiety disorder. One would need to have a better history and tohroug... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 24-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Benzodiazepines: It sounds that you are experiencing residual or at times concurrent symptoms of laberynthitis, I would advise you to ask your doctor the possibility t... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 39-year-old member asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Not advisable: I would prefer not to, except in very exceptional cases. Lithium might be contraindicated in kidney failure and people needing a transfusion might be ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.8k viewsReviewed >2 years ago
A 21-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Initial reaction: It appears that you are experiencing an initial reaction to the norepinephrine and dopamine action, which is the basic pharmacologic effect of Wellbut... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.9k viewsAnswered >2 years ago
A 26-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Tramadol & Prozac (fluoxetine): I don't see any problem with this.
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsAnswered >2 years ago
A 28-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Complete taper: It appears that however you tapered your medication, it might be completed. You probably would not feel symptom-free every other day. If there are som... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 34-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Digestive med: Celevac is neutral and this might make this substance tolerable to treatment with Zoloft (sertraline). However, it is unpredictable how this will affe... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsAnswered >2 years ago
A 20-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Side effect: One of the frequent side effects from antidepressants such as Prozac and Paxil, (paroxetine) is that they migh decrease sexual desire, erctile dysfunc... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.8k viewsReviewed >2 years ago
A 19-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Anaphylaxia: In my experience, I have never encountered an anaphylactic reaction to Citalopram. Also, usually such a reaction, to any agent or medication, entails ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsAnswered >2 years ago
A 23-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Slow clearence: Although there might not be no definitive answer, the half life of buprenorphine is definitely long. Therefore it may be reasonable to assume that it ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.9k viewsAnswered >2 years ago
A 36-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Metabolic syndrome: One of the side effects of the first and second generation antipsychotics is the metabolic syndrome. One of the initial signs is weight gain and elev... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 69-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Med combo: If your doctor considered tramadol and diclofenac might be combined with sertraline, there is no contraindication, as they follow a different path in ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 20-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Lots of stress?: It sounds that might be under some stress and experiencing somatic equivalents from this or anxiety. Somatized, body equivalents or symptoms of this n... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 27-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
I suggest to stop it: Bloody and cloudy urine are documented side effects from Clonazepam (Klonopin). I would recommend to stop taking this medication, and ask your doctor ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
3k viewsAnswered >2 years ago
A 41-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Anxiety: Anxiety is a symptom that might correspond to different diagnostic conditions. Therefore, your question about Xanax (alprazolam) is very difficult to ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 20-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Drug screening: Yes, it will be cleared.
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 26-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Tremors & med mixing: I can identify two problems. The less important is age, as dosification might need to be carefully establish. However, the situation is complicated wi... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 29-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Treatment options: Depending on the severity of ADHD with or without learning problems, there are many successful approaches. School can provide some accommodations, and... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.9k viewsReviewed >2 years ago
A 58-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Side effects: You are right. Unfortunately both medications, most of all the Remeron (mirtazapine) (Mirtazepine) are known for undesirable tendency to gain weight a... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.8k viewsAnswered >2 years ago
A 44-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Same med: Levothyroxine is the generic of brand name product Synthroid.
Created for people with ongoing healthcare needs but benefits everyone.
2.9k viewsAnswered >2 years ago
A 22-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Hydroxicine: It is quite OK, and it will also help you to sleep better.
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 19-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Anxiety & obsessions: It seems you are quite worried about sex, although your thoughts appear to be related to anxiety and obsessional thinking. Depending on the intensity ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.9k viewsReviewed >2 years ago
A 43-year-old member asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
It does not: Amlodipine is a calcium channel blocker. Basically, it relaxes (widens) blood vessels and improves blood flow.
It will not make you fail a drug test i... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.8k viewsReviewed >2 years ago
A 38-year-old female asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
Expired meds: The expiration date 2008 makes it possible that the Zyprexa (olanzapine) will not work in controlling the panic attacks. However, I do not believe it ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
A 29-year-old male asked:
Dr. Enrique Madrigal-seguraanswered
Psychiatry 56 years experience
GABA and benzos: You are responding better to your sleep problem because while diazepam is a GABA agonist like Zolpidem, the latter is a Z pill with more sedative effe... Read More
Created for people with ongoing healthcare needs but benefits everyone.
2.7k viewsReviewed >2 years ago
TestimonialsRecommendations and Thank you notes are endorsements given from patients or other doctors.
Recommendations and Thank you notes are endorsements given from patients or other doctors.
3
Recommendations
141
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
