NEUROPSYCHIATRY and BEHAVIORAL NEUROLOGY | PSYCHOPHARMACOLOGY
FORENSICS | RESEARCH | CONSCIOUSNESS | PHILOSOPHY | BOOKS | LITERATURE
PERSPECTIVES | CLINICAL | DÉJÀ VU | INTERESTING AREAS | ETHICS | CONTACT

KEY ARTICLES (MEDICAL): HEAD INJURY | NARCOLEPSY | PAROXYSMAL DISORDERS | PRESCRIPTION PRINCIPLES | GENERIC SUBSTITUTION | TARDIVE DYSKINESIA | DOUBLE BLIND

ENDURING INTEREST: GROUNDBREAKING PARADIGM SHIFTS | PHILOSOPHY | MORAL PHILOSOPHY | CONSCIOUSNESS | DEJA VU | GENIUS | ZMAIL

New Patients

Old Patients

Details of PNI Evaluations

Brief Bio of Dr. Neppe

Psychiatric Diagnosis

Head Injury

Cry The Beloved Mind

Déjà Vu

About Dr. Neppe

PNI More Information

Instruments

Research

Forensics

PNI'S ADDRESS | WHAT PNI DOES | PATIENT PROFILE | REFERAL SOURCE | APPROACH | TESTS ON NEW PATIENTS | DR NEPPE'S BACKGROUND

PNI's Address

Pacific Neuropsychiatric Institute
4616 25th Ave NE, #236
Seattle, WA 98105

Tel: 206.527.6289 (or "lap navy")
URL: http://www.pni.org/
Email: questions@pni.org

What the Pacific Neuropsychiatric Institute Does

The focus of the Pacific Neuropsychiatric Institute is with neuropsychiatric and psychopharmacological difficulties. Vernon M Neppe MD, PhD, FRSSAf, DFAPA, MMed, is the Director of the Pacific Neuropsychiatric Institute (PNI).

We are continuing to consult on Forensic (Medicolegal) patients. This is restricted to only civil consults or evaluations of mental capacity. Please look at the following links for more on this: www.VernonNeppe.org/forensics and www.pni.org/forensics.

Please note these evaluations and consults are only performed through attorneys. Note that we are unfortunately no longer performing non-forensic clinical evaluations at this time.

This includes disease processes with behavioral or psychological difficulties associated with known or suspected neurological conditions such as epilepsy, head injury, attention deficit disorder, dementia, tardive dyskinesia, atypical spells, irritability and any organic mental disorder. We also evaluate difficult to treat psychological or psychiatric conditions, including problems relating to medication. We also are consulted on difficult to treat psychological or psychiatric conditions, including problems relating to medication.

The kinds of patient spectrum reflect behavioral or psychological, emotional or thinking difficulties associated with known or suspected neurological or medical conditions.

Conditions that Dr. Neppe consults on forensically include epilepsy, head trauma / brain injury / cerebral disturbances/ head injury, Seizures and atypical spells, attention deficit disorder, dementia, tardive dyskinesia or other possible tardive conditions or movement disorders including Parkinsonian syndromes and neuropharmacology of basal ganglia disorders, antipsychotics, neuroleptics, metoclopramide, , subjective paranormal / psychic experience, blackouts, unusual episodes or atypical spells, irritability or aggression, chronic traumatic encephalopathy (CTE), carbon monoxide and other anoxic conditions, narcolepsy , cataplexy, insomnia, day-time sleepiness, chronic fatigue and sleep problems, pain or headache, obesity, endocrine disorder and any organic mental disorder, neuroleptic malignant syndrome, dementia, delirium, wrongful death, suicide, headaches, temporal lobe conditions, dyscontrol, temporal lobe dysfunction, and frontal lobe conditions.

The PNI sometimes evaluates difficult to treat psychiatric conditions, such as non-responsive psychosis, depression and panic, including problems relating to medication such as side-effects and clinical impacts of brain medications and of nutritional and herbal supplements, and pharmaceutical patents. These evaluations also include vegetative states and minimally conscious states, organic and psychiatric aspects of brain and biological conditions. And day-to-day conditions like depression, anxiety, irritability, obsessionality, phobias and stress, medical malpractice, personal injury, competency issues, prolonged chemical sensitivities, toxicities, metabolic syndromes, mental status evaluations, creativity, exceptional intelligence.

Dr. Neppe also has expertise in the Philosophy of Science, in Research Methodology, development of Neuropsychiatric testing, in Internet Security and HIPAA.

Until late 2018, we were performing mostly face-to-face clinical consultations for patients. But the building we were located in was sold and we regret, Dr. Neppe is unfortunately no longer seeing new patients. Unfortunately, we are not at this point doing such clinical evaluations: The evaluation goal was to provide a blueprint not only for the present but directions for the patient's primary physician (generally necessary) to manage the patient in the future.

We comprehensively evaluated all new patient referrals necessarily over several consultations. (Generally 4 to 5 plus extensive testing; now with forensic evaluations 1-3 evaluations). The clinical consultations of new patients generally require several (usually three, four or five) complex / comprehensive consultations / evaluations which include physical and neurologic examinations). A very extensive report is frequently prepared at the completion of the evaluation.

Forensic Patient Profile

  • Dr. Neppe only works with attorneys or attorney firms. Generally he requires all pertinent information and is unavailable for "short-cuts" like "just writing a quick letter".
  • Dr. Neppe is involved in civil not criminal cases, and also evaluations of competency issues if they have civil pertinence.
  • He works with both plaintiff and defense attorneys and endeavors to give a balanced perspective of each case.
  • He does forensic consultations at any stage of this case (before even filing all the way through to rebuttal).
  • He accepts cases anywhere in the United States, Canada and outside North America.
  • Each case requires a preliminary screen as to appropriateness.
  • Please note that Dr. Neppe does not consult with individuals who may be in litigation. If the client contacts Dr. Neppe directly, it may lead to him not taking the case. (Dr Neppe gives objective opinions and contacting Dr Neppe directly as patients or family for medicolegal purposes, may be construed as a source of bias that might be unacceptable. )

These are all patients with both complex and simple problems who require or request detailed assessment for behavioral or psychological, emotional or thinking difficulties associated with known or suspected neurological or medical conditions who are referred by physicians and have a primary care follow-up physician may be suitable provided they pass the appropriate screens.

A major approach is also towards pharmacological evaluation and management of the pathophysiologic difficulties (not psychotherapy) although the PNI tries to be very aware of the relevance of the biopsychofamiliosociocultural perspective. Patients generally complete detailed questionnaires on computers or paper, plus tests given face to face and other tests like EEGs, ambulatory EEGs, MRIs or blood tests as deemed necessary with their assessment. The tests generally take pre or three half day sessions. They may involve psychosocial screening, personality, behavioral and psychodiagnostic evaluations, special evaluations of areas of the brain such as the temporal lobe or for specific neuropsychiatric abilities and deficits. The evaluation goal was previously to provide a blueprint not only for the present but directions for the patient?s primary physician (generally necessary) to manage the patient in the future with referrals to follow-up physicians may occur after weeks or longer depending on circumstances. However, if this is purely forensic, the patients are not seen clinically.

If forensic evaluations are performed patients are evaluated in detail by both clinical consultation and neuropsychiatric testing. When certain tests have been done recently elsewhere, they usually do not need to be repeated.

Referral Source

Patients are generally referred from attorneys and sometimes forensically from other physicians or other health care professionals for a neuropsychiatric and/or psychopharmacologic evaluation. In every instance, the patients must be treated by colleagues sometimes referred back to their original referring physicians when appropriate. Referrals to follow-up physicians may occur after weeks or months depending on circumstances. For example, the referring doctor may wish to separate pharmacologic from psychotherapy management, or just be requesting a second opinion, or may want a guide to the pharmacologic or neuropsychiatric elements, or sometimes the patient prefers not to consult with their previous physician. Optimally, we want to work with the referring doctor or therapist.

Approach

See pni.org/forensics and VernonNeppe.org/forensics.

Tests on New Patients

Please note that all new patients are evaluated in detail by both clinical consultation and neuropsychiatric testing. When certain tests have been done recently elsewhere, they usually do not need to be repeated.

The clinical consultations of new referrals generally require several (usually three, four or five) complex / comprehensive consultations / evaluations which include physical and neurologic examination. A very extensive report is frequently prepared at the completion of the evaluation.

Dr Neppe's Background

Vernon M. Neppe: MD, PhD(Med), FRSSAf, FAPA, FFPsych(SA), FCPsych, FRCPC, MMed (Psych), DABFM, DABFE, FACFE, MB, BCh, DPM, BA, is Director and President of the Pacific Neuropsychiatric Institute (PNI) in Seattle and practices medicine in Washington state. He is also (Adjunct Full) Professor of Psychiatry and Human Behavior, St. Louis University School of Medicine, St. Louis, MO and formerly Director, Division of Neuropsychiatry, University of Washington, Seattle, WA

Prof. Neppe is an internationally recognized psychopharmacologist, neuropsychiatrist and behavioral neurologist, psychiatrist, geriatric psychiatrist, epileptologist and forensic specialist. He is also an accomplished author and playwright. His books on brain medications include Cry the Beloved Mind: A Voyage of Hope and Innovative Psychopharmacotherapy and amongst his other books are The Psychology of D?j? Vu and three books from early 2006 How Attorneys Can Best Utilize Their Medical Expert Consultant: A Medical Expert?s Perspective; D?j? Vu Revisited; and D?j? Vu: A Second Look (as well D?j? Vu Glossary and Library) and his most important play is Quakes.

Dr Neppe has numerous American Board Certifications as well as non-American specialist qualifications. He is Board Certified by the ABPN in psychiatry and has had further sub-certifications in geriatric psychiatry (91-01-11) and forensic psychiatry (94-04) . He is also boarded by the ABFE as a Forensic Examiner and in Forensic Medicine. He also has overseas specialist qualifications with majors in Psychiatry and Neurology.

In 1986, Professor Neppe established (and became Director of) the first Division of Neuropsychiatry in a Department of Psychiatry in the United States (at the University of Washington) His major current academic university affiliation is as (adjunct full) Professor of Psychiatry and Human Behavior at St Louis University, St Louis, MO. He is also an attending physician at Northwest Hospital, Seattle and Overlake Hospital.

Dr Vernon Neppe founded the PNI in Seattle, WA in late 1992. Prior to that, he had trained and worked at the University of Witwatersrand, Johannesburg, South Africa (medical degree, internship, specialist post-graduate training and as a consultant attending then senior consultant). He was also honored as the Witwatersrand University Overseas Traveling Fellow for 1982-3 and worked at Cornell University Medical College, New York where he consolidated his psychopharmacology, chronobiology and sleep-wake disorders, epileptology, geriatric and neuropsychological experience. Dr Neppe was formerly Director of the first Division of Neuropsychiatry in a Department of Psychiatry in the United States: This was at the University of Washington--- he was recruited there from South Africa after an international search

He is a fellow of seven and member of twelve professional associations (including the American or International Psychiatric, Medical, Neuropsychiatric, Epilepsy, Psychogeriatric and Clinical Psychopharmacology Associations and Societies) and his Consultancies have included the Epilepsy Institute and the American Psychiatric Assn Diagnostic and Statistical Manual.

Dr Neppe is listed in the peer-reviewed Americas Top Doctors (all five editions)?most recently listed under the disciplines of Forensic Neuropsychiatry, Neuropsychiatry/ Behavioral Neurology and Psychopharmacology. Prior to that, he was again via peer review listed in The Best Doctors in America (apparently all editions of this discontinued Woodward White book). He is also listed in the current Marquis Who'sWho in the World (first listed 1993-4). Amongst his numerous other special honors has been book listings in, Men of Achievement, Five Thousand Personalities of the World, Two Thousand Notable American Men, Five Hundred Leaders of Influence, Great Minds of the 21 st Century and Americas Top Psychiatrists. Dr Neppe was an International Man of the Year 1992-3 from the International Biographical Center in Cambridge, England "in recognition of his services to Neuropsychiatry, Psychopharmacology and Anomalistic Psychology." He was one of 3 winners worldwide of the Rupert Sheldrake New Scientist Research Hypothesis Competition (1983, London) and received the Marius Valkhoff Medal in 1982. In 2002, he was honored for his scientific contributions as apparently the first USA based physician to be elected a Fellow of the Royal Society of South Africa. In 2004, he was elected a Fellow of the American Psychiatric Association.

Professor Neppe has extensive scientific publications (more than 300 listed in his CV) in all six habitable continents. He has lectured in a dozen countries and at about 90% of the medical schools in the USA. He has chaired international conference symposia, and has had radio and television appearances round the world. He is founding editor of a journal, has been guest editor of another and on the editorial boards of numerous others and has authored numerous chapters in key text books. His play Quakes became public with a staged play reading in Hawaii in 2004. He has also proposed a major philosophical theory, Vortex Pluralism.

Dr Neppe has recently been chosen to be the sole leader of the United States (plus international delegation) in Psychopharmacology and Neuropsychiatry to China in June 2006 through the Ambassador People-to-People Program initially established by President Eisenhower.

Professor Neppe's major research areas include pharmacologic, neuropsychiatric and phenomenologic elements. He developed several measuring neuropsychiatric instruments and inventories including the BROCAS SCAN (Screening Cerebral Assessment of Neppe), The INSET (Inventory of Neppe of Symptoms of Epilepsy and the Temporal Lobe), the STRAW (the first time / severity measure for tardive dyskinesia), a geriatric inpatient instrument namely the PBRS (with JP Loebel) (The Problem Behaviors Rating Scale) as well as research Subjective Paranormal Questionnaires and Narcolepsy Questionnaires. Additionally, he first demonstrated the links of anomalistic psychological experiences (subjective paranormal experience) with the temporal lobe of the brain. His pharmacologic areas include the only double blind study demonstrating the value of carbamazepine in dyscontrol and psychosis thereby being a major pioneer of the whole area of anticonvulsant drugs in psychiatry and benefiting millions of patients, the use of high dose buspirone as a successful treatment for tardive dyskinesia, and the extended use of azapirones in aggression and attention deficit disorder. He has also developed concepts in medical areas such as deinduction, non-vertiginous dizziness, dysproccia, chindling and possible temporal lobe symptoms. He has also developed concepts in pharmacological areas such as deinduction, non-vertiginous dizziness, and chindling.

 


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