About Us
Our Philosophy
Dr. Aleksandra Krunic provides expert individualized psychiatric patient care. Using a comprehensive treatment approach and preventive care, Dr. Krunic devotes her full attention and effort to address a broad range of clinical issues. In addition to medical and psychological interventions, Dr. Krunic
focuses on interventions that target lifestyle, nutritional habits, physical activity, stress management skills, sleep hygiene, and social supports because she believes that they are equally important in the outcome and prognosis of our mental health.
Meet the Staff
Aleksandra Krunic, M.D.
Dr. Krunic is currently in a full-time private practice specializing in Child, Adolescent and Adult Clinical Psychiatry.
Before transitioning to full-time private practice, Dr. Krunic had extensive experience in clinical and academic psychiatry and held positions in several major medical centers.
Dr. Krunic served as Director of the Division of Child and Adolescent Psychiatry at Lenox Hill Hospital.
She was a Director of Consultation Pediatric Psychiatry at St. Luke's Roosevelt Hospital, Columbia University College of Physician and Surgeons where she also served as a Training Director for their Child and Adolescent Psychiatry Fellowship.
In addition, Dr. Krunic directed the Consultation-Liaison Pediatric Psychiatry Service at Hasbro Children's Hospital, Brown Medical School.
Dr. Krunic held the academic position of Clinical Professor of Psychiatry at Columbia University College of Physicians and Surgeons and Professor of Psychiatry at Brown University.
Dr. Krunic continues to hold an academic teaching appointment at the Mount Sinai Hospital in NYC where she supervises and teaches child psychiatry fellows.
Dr. Krunic's research experiences have been in the area of brain imaging and anxiety/obsessive-compulsive disorders.
Dr. Krunic is a diplomat of the American Board of Psychiatry and Neurology, and she is board-certified in both child and adolescent and general psychiatry.
She completed Child and Adolescent Psychiatry training at New York Presbyterian – Columbia University Medical Center where she served as Chief Resident. Training in Psychiatry at St. Luke's Roosevelt Hospital Center - Columbia University College of Physician and Surgeons.
Dr. Krunic is a member of the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry as well as a member of Society of Professors of Child and Adolescent Psychiatry
Lisbeth Reilly, RN
Lisbeth is a Registered Nurse and certified TMS technician. She has a diverse background, which includes clinical nursing, research coordination, and many years of experience in the mental health field.
Lisbeth graduated Summa Cum Laude from the State University at Stony Brook with a Bachelor of Science degree in Nursing.
Lisbeth has been a Transcranial Magnetic Stimulation clinician since 2010. Her background provides a strong foundation for helping patients with depression understand their treatment and feel comfortable receiving TMS therapy. She strives to provide patients with a safe and welcoming experience while receiving TMS therapy.
Services Offered
Evaluation and Diagnostic Clarification
· Clinical interview with Dr. Krunic (2 hrs) · Use of Clinical Rating Scales · Obtain collateral information from clinicians enrolled in care · Review supportive documentation such as individual educational plan(s), psycho-educational testing, etc. · Medical work-up such as blood work or referral to other medical providers if it is clinically indicated
Computerized Brief-Core Neurocognitive Evaluation
· This brief neuro-cognitive assessment assesses the degree (if any) of neurocognitive impairment related to a range of conditions such as ADHD, Brain Trauma, MDD, etc. · Test can be re-administer after the establishment of baseline to assist with decision making, to monitor disease or recovery process, measure treatment results, compliance and outcome.
Expert Psychopharmacology
Offering an in depth understanding of the latest innovations in research, treatment advances, and current standard of care options · Dr. Krunic successfully integrates many complex issues during treatment including: routinely assessing and managing medication side effects, combining medications with holistic treatment modalities, monitoring for drug interactions, providing psychosocial interventions and/or neuromodulation (Deep TMS). · Additionally, blood work is routinely screened for metabolic issues related to the use of psychotropic medications.
The Genocept Assay
· Many patients fail to respond adequately to their first psychiatric medication. · “The Genocept Assay is a test that looks at genes that affect how a particular psychiatric medication affects your body (for example if you will be at risk of poor response to the medication or to develop side effects) or how your body affects the medication (for example if your liver eliminates particular medication quickly or slowly)”.
Clinical Management Between Sessions
· The continuity of care is provided by our Registered Nurse Lisbeth Reilly under the direct supervision of Dr. Krunic. · Although treatment should always be reserved for the sessions with Dr. Krunic, many patients require even more personalized and tailored care in between of their sessions. · New symptoms, concerns or side effects can appear in between appointments and can be stressful for the patients and their family. Lisbeth Reilly RN will promptly contact each patient to assess the nature and urgency of their call, and will provide assistance. · When necessary, she will schedule an urgent phone session with Dr. Krunic.
Life Style & Weight Management Assessment and Interventions
Dr. Krunic firmly believes that empowering your body through a positive lifestyle, proper nutrition, and stress management can prevent brain disorders (such as depression) and can speed recovery. The essential first step is an assessment of general medical and nutritional status along with an examination of maladaptive behavioral patterns. Once the assessment is complete, Dr. Krunic will help develop a comprehensive treatment plan that may include a referral to an appropriate nutritionist, functional medicine physician, personal trainer, and/or behavioral coach.
Psychotherapy and Psychiatric Illness Therapy
In addition to being medically trained, she has extensive training in many forms of evidence based psychotherapeutic techniques. · Dr. Krunic believes that psychiatry practice today must transcend the "prescriber model" in which a physician is seen as a mere "prescriber" - someone that just writes medication prescriptions. The training in medicine, brain science, psychopathology, psychology, and interventions places a psychiatrist in a unique but advantageous position where she or he can have a fundamental, all-encompassing understanding of a patient's problems. Psychotherapy, if delivered appropriately, can be life changing.
Evaluation and Treatment of Disorders Between Medical and Psychiatric Illnesses
· Dr. Krunic is a Consultation Liaison (CL) Psychiatrist, which is a medical subspecialty that focuses on systemic medical conditions that have acute or chronic impact on brain condition and vice-versa. Conditions such as Irritable Bowel Syndrome, Eating Disorders, or Fibromyalgia are frequently associated with brain syndromes such as depression and anxiety. This can lead to cognitive and behavioral changes that significantly impact the patient’s quality of life. · Dr. Krunic will recommend specific behavioral techniques, pharmacological management, and/or neuromodulation to support medical interventions already in place.
Neuromodulation: Deep Transcranial Magnetic Stimulation (Deep TMS)
· Deep Brain Stimulation is a non-invasive non-medication treatment for Major Depressive Disorder. This safe and effective treatment is FDA approved for use as a single treatment option, or in combination with medication to treat depression in those older than 17 years of age. The treatment is provided using the Brainsway H-Coil and is a non-invasive neurostimulatory technique based on the principle of electromagnetic induction of an electric field in the brain. · The treatment has no general side effects and is very convenient, requiring only a 20-minute daily (5 days per week) session over a period of 4-6 weeks. · Your doctor and the TMS clinician provide the treatment in a pleasant, private treatment office.
For more information on this treatment please visit: www.brainsway.com
Preparing for your First Visit With Dr. Krunic:
F.A.Q's
Q: Do you accept health insurance?
A: Dr. Krunic believes in comprehensive clinical care for her patients. Because of that, at this time, she is unable to accept the reduced fees that the insurance carriers offer for targeted brief psychiatric services. However, we do provide itemized receipts for each appointment (after processing payments) which can be submitted to insurance companies for reimbursement depending on your personal insurance plan.
B. Many insurance plans do now have coverage policies for TMS in place and we are happy to investigate patient benefits and assist in obtaining authorization for coverage of TMS when possible.
Q: Who do I contact to make an initial appointment?
A: Shelli Trager, the office manager, will provide the fee schedule and other details regarding our practice at the time of your initial contact. If you decide to schedule an evaluation, she will help guide you through the process by scheduling the initial appointment and providing you access to our electronic medical record.
Q: How long does it take to schedule your first appointment?
A: Before calling, please be aware that in order to best address your needs, this initial phone call can last about 20 minutes. To reserve an initial 2 hour evaluation time slot with Dr. Krunic, we will ask for a non-refundable fee that will go towards the balance of your evaluation at the time of the first visit.
Q: What is the payment schedule like?
A: The office accepts credit cards (except Amex), checks, or cash. The payment is due at the time of each visit.
Q: What should I bring to my evaluation with Dr. Krunic?
1. Authorization for Release of Information
2. Credit Card Authorization Form
3. Psychiatrist Patient Services Agreement
4. Copies of relevant reports including, but not limited to: report cards, medical /neurological reports, language evaluations, prior psychological testing, and Committee on Special Education testing.
Q: On the day of my appointment, how early should I come?
A: You should come at least 15 minutes before your scheduled appointment to check with our office assistant in the administrative office, Suite 113.
Deep TMS
Deep Transcranial Magnetic Stimulation (TMS) Depression Treatment
Depression
Depression is a serious and chronic medical condition with remitting and relapsing clinical course through the life-cycle.
Symptoms of depression can wary from mild to severe and can cause mild or substantial impairments in functioning. Depression affects mood, cognition, and physical functioning. It can lead to loss of ability to experience pleasure (anhedonia) and our sense of hope and personal effectiveness. In severe cases it can lead to cessation of desire to live and suicide.
Depression is a treatable medical condition but it requires a comprehensive medical and rehabilitation approach such as improvement in the physical health, and use of psychopharnacology and psychotherapy.
However, the wast number of patients either do not respond to this approach, respond partially or have significant side effects to medications. Among others, frequently reported side effects to antidepressant medications are weight gain, metabolic complications, sweating, sexual side effects, drowsiness or dry mouth.
Neuromodulation technique such as Deep brain TMS is an effective depression non-drug treatment which does not entail side effects. It does not require hospitalization or anesthesia.
Brainsway Deep TMS - Depression Treatment
To learn about the Brainsway's revolutionary Deep TMS depression treatment, please click here
Why Should You Consider Deep TMS:
- No systemic side effects
- No interaction with other medical tretaments
- Augmentation of existing depression treatment
- No need for daily medication administration
- If you are a college student or a parent of a young adult studying away from home who suffers from depression, deep TMS may be better suited. Young depressed patient may not be willing or able to comply with the need for daily medication administration while away from home causing relapse in depression or distress from ongoing residual symptoms.
Deep TMS Advantages Over Other TMS Techniques:
Brainsway Deep TMS stimulates deeper brain structures. It's unique magnetic coil embedded in a comfortable helmet allows for an easier placement with less room for a technician to actually miss the stimulation target. With the Brainsway helmet we are absolutely sure that our patients receive the adequate stimulation each time they receive the treatment.
What To Expect When You Call Us:
Our RN on staff, Lisbeth Reilly will return your initial call.
She will explain the financial and scheduling aspect of the treatment.
She will set up a 1-hr targeted evaluation with Dr. Krunic to determine if the treatment is right for you.
Dr. Krunic will assess your mental and medical state and propose the right course of Deep TMS treatment.
Conditions like seizure disorders, mechanical implant(s) in the head or neck or a recent stroke episode are criteria that would lead Dr. Krunic to recommend other treatment possibilities for you.
If you are ready to move forward at this point, you can either proceed immediately with the treatment (self pay) or after taking a copy of your insurance card, we will contact your insurance company to determine what your individual health plan coverage is regarding TMS. In this case, as soon as we hear back from the insurance company, and provided that you insurance offers adequate coverage, you are ready to move forward with the initial Deep TMS session.
The first treatment is the only 1-hr session, as the others typically take about 20 mins. “TMS Mapping” is the reason for this longer initial session, during which the doctor obtains skull measurements in order to determine the optimal treatment location. This helmet contains a coil that induces a brief MRI-level electric field to stimulate the area in your brain responsible for depression.
During the treatment, you will hear a tapping sound as the pulses are delivered but we provide ear plugs to dull this. Being awake during TMS allows patients to voice any thoughts, feelings or concerns you may experience during the treatment like mild discomfort or slight headaches, but these side effects usually resolve themselves after the first few sessions. There are no systemic side effects like insomnia, weight gain, or sexual dysfunction that can often occur when taking medications. Following each treatment, you are able to immediately drive yourself home and go about your normal daily activities.
The Deep TMS course of treatment for major depressive disorder (MDD) lasts 4-6 weeks, during which your MDD symptoms will gradually improve until the full effects of the TMS Treatment are felt. Once you achieve remission, we will gradually taper off the treatment over a period of few weeks as determined on individual basis.
We hope that Deep TMS will help you find your path back to a joyful life.