Utah · Telemedicine
Specialized Psychiatric Care in Utah
Verigrate Health provides specialized psychiatric consultation by telemedicine to eligible patients throughout Utah. Christian S. Monsalve, M.D., a board-certified psychiatrist and Founder & Medical Director, focuses on diagnostic clarification, complex psychopharmacology, difficult medication histories, precision tapering and deprescribing, and benzodiazepine-related clinical complexity.
The practice is intentionally limited and physician led. Each consultation is grounded in a close reading of the treatment history, the evidence, the patient’s present circumstances, and the risks of both changing and continuing medication.
Scope of Consultation
Clinical Areas of Consultation
A second look at uncertain diagnoses, incomplete treatment response, competing explanations, or unusually complex care.
Careful planning when medication reduction must account for duration of use, pharmacology, withdrawal sensitivity, and other treatments.
Specialist assessment of benzodiazepine exposure, dependence, prior withdrawal, clinical risk, and tapering options.
A structured review of medication necessity, cumulative burden, adverse effects, interactions, and current patient goals.
Psychiatric decision-making informed by relevant metabolic, sleep, physical-health, and lifestyle considerations.
Physician consultation for alcohol-related psychiatric complexity, evidence-based treatment, and level-of-care questions.
Medication Stewardship
Psychiatric Medication Tapering in Utah
For patients in Utah, a medication taper may be one possible conclusion of a broader psychiatric review. The consultation considers the original indication, response over time, adverse effects, prior dose changes, withdrawal symptoms, current medical and psychiatric context, and the patient’s reasons for seeking change. If reduction is clinically appropriate, the plan is individualized rather than standardized.
Antidepressants
SSRIs, SNRIs, tricyclic antidepressants, MAOIs, serotonin modulators, NDRIs, and other atypical antidepressants — including escitalopram (Lexapro), sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), fluvoxamine (Luvox), vilazodone (Viibryd), venlafaxine (Effexor XR), desvenlafaxine (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), bupropion (Wellbutrin XL, SR), mirtazapine (Remeron), trazodone (Desyrel), vortioxetine (Trintellix), amitriptyline (Elavil), nortriptyline (Pamelor), clomipramine (Anafranil), doxepin (Silenor, Sinequan), phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline transdermal (Emsam).
Benzodiazepines
alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), diazepam (Valium), oxazepam (Serax), temazepam (Restoril), chlordiazepoxide (Librium), clorazepate (Tranxene), and triazolam (Halcion).
Hypnotic and sleep medications
Orexin receptor antagonists, non-benzodiazepine hypnotics, and other prescription sleep medications — including zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata).
Other psychiatric medication classes
ADHD medications, antipsychotic medications, mood stabilizers, anxiolytic and adjunctive psychiatric medications, medications for opioid use disorder, and medications for alcohol use disorder are also reviewed when relevant to the consultation.
Balance Change With Stability
Good tapering decisions weigh the reasons to reduce against the value of stability. Recommendations account for the medication, the clinical history, the patient’s tolerance for change, and available support.
How Care Works
Specialized Psychiatry Throughout Utah by Telemedicine
Specialized psychiatric consultation is available by secure telemedicine to eligible patients physically located in Utah at the time of the visit. Care may be focused on a diagnostic question, a difficult medication history, deprescribing, or a proposed taper. The practice does not provide emergency or walk-in treatment, and availability depends on clinical fit and capacity.
Practice Structure
Common Questions
What does physician-led consultation mean at Verigrate?
Christian S. Monsalve, M.D., personally conducts the evaluation and remains responsible for the clinical recommendations. The model is designed for depth and continuity rather than high-volume, delegated care.
Can a consultation focus only on medication tapering?
Sometimes. A focused tapering consultation may be appropriate when another clinician remains responsible for ongoing care. In other situations, diagnostic clarification or broader psychiatric treatment questions need to be addressed before a taper can be evaluated safely.
Is telepsychiatry available statewide in Utah?
Eligible patients may be seen by secure telemedicine while physically located anywhere in Utah at the time of the appointment. Service availability remains subject to clinical appropriateness and practice capacity.
How does Verigrate approach previous withdrawal problems?
Prior withdrawal is reviewed in detail, including timing, dose changes, symptom pattern, duration, and concurrent treatment changes. That history may affect whether a taper is recommended and how slowly or sequentially it should proceed.
Is this practice appropriate for an urgent crisis?
No. Verigrate is not an emergency service and is not structured for same-day crisis care, frequent crisis contact, or walk-in treatment. Individuals in immediate danger should use emergency services or an appropriate local crisis resource.