Dr. Zanda Kalnina

Dr. Zanda Kalnina is a consultant psychiatrist at Riga East University Hospital (REUH) — Latvia's largest university hospital and the leading psychiatric and general medical institution in the Baltics. With 18 years of specialist practice, Dr. Kalnina is one of Latvia's most experienced psychiatrists, with particular expertise in severe mental illness, mood disorders, and addiction psychiatry.

Riga East University Hospital is affiliated with Rīga Stradiņš University and serves as the national referral centre for psychiatry in Latvia, operating inpatient psychiatric wards, a day hospital programme, and outpatient psychiatric clinics. Latvia has experienced significant challenges with mental health burden — depression, alcohol dependence, and suicide rates have historically been among the highest in the European Union, creating substantial demand for high-quality psychiatric services.

Dr. Kalnina's clinical practice spans the management of major depressive disorder, bipolar disorder (types I and II), and the full spectrum of schizophrenia and psychotic disorders. She is highly experienced in psychopharmacology, including the management of treatment-resistant depression with augmentation strategies and the use of clozapine for treatment-resistant schizophrenia.

Addiction psychiatry represents a significant area of her practice, particularly alcohol use disorder — Latvia has one of Europe's highest rates of alcohol-related mortality. She manages alcohol detoxification, post-detox relapse prevention with naltrexone and acamprosate, and co-occurring psychiatric and substance use disorders.

Dr. Kalnina holds the European Certificate in Psychiatry and consults in Latvian, Russian, and English.

Dr. Kalnina completed her MD at the University of Latvia Faculty of Medicine in Riga and undertook her residency in Psychiatry at Riga East University Hospital, gaining comprehensive training in acute and chronic psychiatric conditions, psychopharmacology, and psychiatric emergencies. She holds the European Certificate in Psychiatry (EPA) — the European professional qualification for psychiatrists requiring compliance with agreed European competency standards. She completed additional training in addiction psychiatry through the International Society of Addiction Medicine and a clinical attachment at a psychiatric centre in Germany, gaining exposure to structured psychotherapy approaches including cognitive behavioural therapy (CBT) integration with pharmacological management.

Dr. Kalnina's psychiatric expertise spans both inpatient and outpatient care. For mood disorders, she manages acute depressive episodes with antidepressant therapy, psychoeducation, and coordination of structured psychological therapies, and manages bipolar disorder with mood stabilisers (lithium, valproate, lamotrigine) and second-generation antipsychotics. For treatment-resistant depression, she employs augmentation strategies (lithium augmentation, atypical antipsychotics, thyroid hormone) and coordinates electroconvulsive therapy (ECT).

For psychotic disorders, she initiates and monitors antipsychotic treatment including clozapine for treatment-resistant schizophrenia with mandatory haematological monitoring. For addiction psychiatry, she manages alcohol withdrawal with benzodiazepines and symptom-triggered protocols, and prescribes naltrexone, acamprosate, and disulfiram for relapse prevention. She conducts comprehensive psychiatric assessments, risk assessments for suicidality and self-harm, and capacity assessments.

Riga East University Hospital has an international patient department with Russian and English language support. Dr. Kalnina consults in Latvian, Russian, and English, serving Latvia's Russian-speaking minority as well as international patients. Riga is easily accessible from Scandinavia, the UK, and other European cities, and Latvia's EU membership and European psychiatric standards provide assurance to international patients. Video consultations are available for follow-up psychiatric care and medication management for patients who have completed initial assessment in Riga.

Dr. Kalnina has been recognised by the Latvian Psychiatric Association with its Special Contribution Award for her outstanding role in addiction psychiatry capacity building in Latvia and for her sustained advocacy for improved access to community-based psychiatric care services across Riga.

She received the European Psychiatric Association Certificate of Recognition for her active participation in EPA's competency-based psychiatric training programme. She has been acknowledged by Riga East University Hospital for her leadership in developing the outpatient addiction psychiatry clinic, which has significantly expanded access to opioid substitution therapy and alcohol dependence management in the Riga East catchment area. She serves on the Latvian Psychiatric Association's national guidelines committee for addiction disorders.