Ketamine Without Needles

We are the experts: We are the only group in Houston with experience in the development of TMS as a treatment. 

We offer the most scientifically advanced technology: we are the only group in the area using both neuronavigation (nTMS) and functional MRI to personalize treatment. 

We also offer accelerated TMS which shortens the total treatment time from 6 weeks to as short as one week. 

You will love our offices – everyone does. Many of our patients describe TMS with us as a relaxing break from their otherwise hectic day. 

The first thing to know is that depression is not the same thing as being sad. When something bad happens, it is normal to feel sad. Signs that you may need help are if the sadness is present almost all day, everyday for several weeks, or if you are unable to enjoy the things that used to be fun in your life. Often, changes in sleep and appetite are also signs that may be part of the illness we call depression. The Personal Health Questionnaire (PHQ) might help.

Our expertise is in understanding the complexity of depression and anxiety disorders and providing comprehensive patient focused diagnosis and treatment recommendations. We combine decades of experience with state of the art science to get you well. We spend a full hour of physician time on the first visit, which is not possible in primary care. This allows us to really understand what is happening with you and design a personalized plan that fits your life. Therapy is very helpful as a place to learn new coping skills and to discuss stressful life situations or long-standing problems with how you behave that are not working for you. However, therapists cannot prescribe medication or offer TMS or other biological treatments. If you might need a medical perspective, you should consider starting with us. Many of our patients are referred to us by their therapists for our medical perspective, and we likewise include therapy in many of our treatment suggestions.

Anxiety often goes hand in hand with depression, but for some people anxiety is the main problem. Mild anxiety can often be treated by therapy alone, especially therapies that are designed specifically to teach patients how to change their thoughts about anxiety provoking ideas or situations. One example is Cognitive Behavioral Therapy (CBT). If your anxiety is interfering with your life, you might want to make an appointment with one of our psychiatrists for a full evaluation so we can set you on the right path. We have expertise in generalized anxiety disorder, panic disorder and obsessive compulsive disorder (OCD).

We are trained and board-certified as adult psychiatrists so our typical age range is 18 years and up. However, since Covid, there has been an intense need for additional psychiatric care for children and adolescents. As such, on a case by case basis, we will see teenagers 16 and up if they’re in therapy and are still in need of evaluation and medical treatment for depression, anxiety, or ADHD and if they can safely be treated as an outpatient.

For new patients, we provide an initial phone conversation free of charge in order to assess if our services are right for you. We believe that we are very good at what we do, but we are not always able to provide the ideal care setting for all patients. We value your time and your money and do not want to set up an appointment if you might be better served elsewhere. Click here to contact us.

Click here to learn more about insurance and fees.

We made the choice to not be “in network” with any insurance company in order to provide the most tailored treatment possible without compromise. However, if you have “out of network” benefits, you may be eligible for reimbursement from your insurance company. Plans vary, so check with your carrier if this is something you are interested in. We will provide a receipt with the service and diagnosis codes that insurance companies use to reimburse you.

Payment is required by cash or credit card at, or before, the time of service.

Assistance is available to verify insurance coverage to obtain preauthorization for TMS, Esketamine, and Spravato medication.

You will be greeted by someone on our team, offered coffee, tea, soda or water and a comfortable chair and given a clip board with new patient forms. These take about 10 minutes and include your contact information, our office policies and questions about how you have been feeling. You are welcome to have the forms before your appointment. You will then be greeted by Dr. Marangell or Al Jurdi and escorted to their office. First appointments usually last an hour and most of the time you will leave with a treatment plan that you and your doctor have agreed is best for you.

Click here to learn more about insurance and fees.

Click Here to see where we are located.