About the Author

 

Iván López-Ibor, MD

Medical Doctor · Madrid & Florida · 4+ Years Full Clinical Experience

Dr. Iván López-Ibor is a medical doctor with over four years of full clinical experience working as a treating physician in major psychiatric hospitals in Spain and the United States. His clinical work has spanned emergency psychiatry, acute inpatient care, and outpatient psychiatric services, with direct involvement in the management of mood disorders, schizophrenia spectrum disorders, substance use disorders, ADHD, and OCD.

His approach is grounded in evidence-based psychopharmacology and structured clinical decision-making, developed through years of hands-on work in high-acuity psychiatric settings — managing acute psychiatric presentations, severe mental illness, treatment-resistant cases, and complex dual diagnosis situations.

Dr. López-Ibor is currently pursuing USMLE certification as part of his pathway toward formal psychiatric training in the United States.

Clinical experience

  • Clínica López-Ibor (Madrid) — private psychiatric hospital established 1967; reference center for mood disorders, psychosis, and psychopharmacology in Spain
  • Sanatorio Dr. Esquerdo (Madrid) — 130-bed public psychiatric hospital within the Spanish National Health System; acute psychosis, bipolar stabilization, forensic psychiatry, and dual diagnosis programs
  • Clínica del Dr. León (Madrid) — 96-bed acute psychiatric unit; emergency psychiatry, inpatient mood and psychotic disorders, and detoxification programs for alcohol, benzodiazepines, and stimulants
  • Hospital Internacional HM Marbella — inpatient psychiatric care in a private hospital setting
  • South Florida Integrative Medical (Florida, USA) — clinical exposure to advanced psychopharmacology, TMS, and integrative psychiatric treatment approaches

Academic legacy

Dr. Iván López-Ibor continues a multi-generational tradition in academic psychiatry. His grandfather, Prof. Juan José López-Ibor, was one of the most influential figures in 20th-century European psychiatry — serving as President of the World Psychiatric Association (WPA), contributing to international diagnostic classification systems, and shaping psychiatric education across Spain and Europe through his scientific work and leadership in major professional societies.

Clinical interests

Treatment-resistant depression Schizophrenia & relapse prevention Psychopharmacology optimization ADHD & OCD spectrum TMS & neuromodulation Metabolic psychiatry Dual diagnosis

About this blog

This platform publishes clinical commentary, psychopharmacology reviews, and psychiatric case discussions drawing on years of direct patient care experience. Content is aimed at medical professionals and informed general audiences, and reflects current evidence-based practice in psychiatry.

All posts are authored and signed by I. López-Ibor, MD

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SSRI Treatment Failure: Contemporary Mechanisms, Diagnostic Pitfalls, and Evidence-Based Next Steps (2021–2025 Update)

I. López-Ibor, MD ABSTRACT Selective serotonin reuptake inhibitors (SSRIs) remain first-line pharmacological treatment for major depressive disorder (MDD). However, real-world remission rates remain modest, and “treatment failure” is frequently misclassified (1). Contemporary evidence highlights that non-response is often driven by diagnostic error, inadequate dosing/duration, pharmacokinetic variability, or comorbid psychiatric conditions rather than true pharmacological resistance. This article provides an updated, evidence-based framework (2021–2025 literature) for systematically evaluating SSRI non-response and guiding next-step interventions, integrating modern guideline recommendations and real-world effectiveness data. CLINICAL BACKGROUND  Major depressive disorder is increasingly conceptualized as a heterogeneous syndrome rather than a single biological entity. This heterogeneity explains variability in antidepressant response. Current guideline frameworks (APA, CANMAT, WFS...
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Pharmacological and Neuromodulatory Strategies Following SSRI Non-Response in Major Depressive Disorder: Divergent U.S. and European Treatment Pathways and the Emerging Role of Novel FDA-Approved Interventions

  I. López-Ibor, MD Clínica López-Ibor, Madrid, Spain. Sanatorio del Dr Esquerdo, Madrid, Spain. Clinica del Dr Leon, Madrid, Spain. South Florida Integrative Medicine, Miami, Florida.  Correspondence: drivanlopezibor@gmail.com Abstract Selective serotonin reuptake inhibitors (SSRIs) remain the cornerstone of first-line pharmacotherapy for major depressive disorder (MDD); however, remission following an initial adequate SSRI trial remains limited in routine clinical practice. When SSRI response is insufficient, treatment pathways diverge substantially between the United States and Europe, reflecting not only regulatory differences but fundamentally distinct conceptual frameworks for understanding antidepressant non-response. Over the past five years, U.S. clinical practice has progressively shifted toward earlier augmentation, broad mechanism diversification, and integration of novel FDA-approved pharmacological agents targeting glutamatergic, sigma-1, and dopaminergic systems...
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Recurrent First-Episode Schizophrenia-Spectrum Disorder with Messianic Delusions in an Adolescent Male: Seven-Year Longitudinal Follow-Up and Long-Acting Injectable Aripiprazole Stabilization

  Ivan Lopez-Ibor, MD (1,2,3,4) 1 Clínica López-ibor, Madrid, Spain. 2 Sanatorio del Dr Esquerdo, Madrid, Spain. 3 Clínica del Dr León, Madrid, Spain. South Florida Integrative Medicine, Miami, Florida. Department of Psychiatry, Madrid, Spain Corresponding author: drivanlopezibor@gmail.com   Abstract Background: First-episode psychosis (FEP) in adolescence is associated with high relapse rates, increased suicide risk, and long-term functional impairment. Antipsychotic discontinuation remains one of the strongest predictors of recurrence. Long-acting injectable (LAI) antipsychotics may reduce relapse by improving treatment adherence. Case Presentation: A 17-year-old male presented with acute schizophrenia-spectrum psychosis characterized by grandiose messianic delusions, auditory hallucinations, formal thought disorder, and suicidal ideation expressed in religious terms. Organic and toxic etiologies were systematically excluded. Initial treatment with olanzapine 15 mg/day resul...
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