Washington, D.C. · Telepsychiatry
Board-Certified Psychiatrist Serving Patients in Washington, D.C.
Adults throughout the District of Columbia can access independent psychiatric consultation via secure telepsychiatry, including diagnostic clarification, medication optimization, physician-guided psychiatric medication tapering, and independent second opinions. Patients across Washington, D.C. — including Georgetown and Dupont Circle — are seen without the need for travel.
Care is provided personally by Christian S. Monsalve, M.D., a board-certified psychiatrist — selective, longitudinal, and grounded in diagnostic clarity, medication restraint, and clinical responsibility. Consultations are available in English and Spanish.
Scope of Consultation
Clinical Areas of Consultation
Psychiatric second opinion
Independent consultation when diagnostic formulation or treatment direction warrants careful review.
Complex case consultation
Comprehensive psychiatric evaluation integrating longitudinal history, prior treatment response, laboratory assessment, and coexisting medical conditions.
Medication review and deprescribing
Medication decisions are approached conservatively, with attention to indication, exposure history, and functional impact. Deprescribing, when appropriate, is individualized and gradual — there is no standardized taper protocol.
ADHD evaluation
Careful adult ADHD assessment, including diagnostic clarification and consideration of stimulant and non-stimulant treatment options.
Substance use and addiction medicine
Comprehensive evaluation of substance use patterns, psychiatric comorbidity, and treatment planning when clinically indicated.
Integrated medical evaluation
Assessment of relevant medical, inflammatory, metabolic, sleep, and nutritional contributors to psychiatric presentation.
Medication Stewardship
Psychiatric Medication Tapering in Washington, D.C.
Psychiatric medication tapering is considered when it is clinically appropriate — not assumed. Consultation begins with careful review of diagnosis, treatment response, medication history, previous withdrawal experiences, current evidence, and the patient’s goals before individualized recommendations are made. Representative medication classes reviewed during consultation include, but are not limited to:
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.
Individualized by Design
Consultation begins with the person — not a protocol. Recommendations are individualized based on diagnosis, treatment response, medication history, previous withdrawal experiences, medical history, current evidence, and the patient’s goals.
How Care Works
Telepsychiatry throughout Washington, D.C.
Independent psychiatric consultation is conducted through secure telepsychiatry for adults physically located in Washington, D.C., at the time of the visit — without the need for travel. Availability depends on the patient’s location and applicable licensure in the District of Columbia.
Practice Structure
Common Questions
Is this a private-pay psychiatric practice?
Yes. Verigrate Health is a private, out-of-network membership practice, structured for depth, discretion, and physician continuity rather than volume.
What does an initial psychiatric consultation involve?
An unhurried, comprehensive evaluation: longitudinal history, prior treatment response, medication and withdrawal history, relevant medical factors, and the patient’s own goals — followed by individualized recommendations.
Is telepsychiatry available throughout Washington, D.C.?
Yes. Care is available across the District of Columbia via secure telepsychiatry for patients physically located in Washington, D.C., at the time of their visit.
Are second opinions and medication tapering offered?
Yes. Psychiatric second opinions, diagnostic clarification, and physician-guided medication tapering and deprescribing are central areas of the practice.
Who may not be well served by this model of care?
Patients requiring urgent or emergency psychiatric care, frequent crisis support, or in-network insurance-based treatment. Individuals in crisis should contact emergency services or local crisis resources.