Treatment Approach

I take a collaborative evidence-based approach to psychiatric medication management, meaning that I will apply the most up to date information based on research studies to develop a treatment plan that is right for you. Often there are multiple choices in medications that we can use and we will work collaboratively to identify which is best for you. We will consider your goals for treatment, overall health and use of other medications, your lifestyle and values in making treatment decisions.

About Medication-Based Treatments

Depending on the class of medications, there are different mechanisms by which they address your symptoms. In many cases, there is continued debate as to how exactly they achieve their outcomes. Our brains have billions of cells (neurons) that contain and communicate between each other with neurochemicals called neurotransmitters. The most commonly targeted neurotransmitters in psychiatry are serotonin, norephinephrine, and dopamine. Alterations in these neurotransmitters and how they are received by the neuron receptors can change our energy levels and focus, our sense of calm and contentment, memory and motivation, our cravings and impulses. What psychiatric medications do not do is change who you are. My goal in treatment is to help you be exactly who you are by addressing biological mechanisms that are associated with your distress, limit your functioning, or interfere with your values and goals.

Often medication(s) have FDA approval for the use in the presenting problem, however, there are situations where this is not the case. I will apply my clinical experience and knowledge from research evidence to develop a safe plan that is most likely to achieve the desired outcome.

Medications are not first line treatment for all mental health disorders. We will discuss alternative treatment approaches, make appropriate referrals, and provide you with the information you need to make the right decision for you.

  • Antidepressants

    This class of medications is used in the treatment of anxiety, OCD, and depression. There are different types of antidepressant formulations which operate in slightly different ways by acting on different combinations of neurotransmitters, cellular channels, enzymes, and receptors. While the desired outcome is the same for each, not all are tolerated or effective for everyone. We will discuss which may be most appropriate for you.

  • Mood Stabilizers

    This group of medications is most commonly used in the treatment of bipolar disorder including both manic and depressive episodes. There are other diagnoses which involve mood symptoms for which this class of medications may be appropriate. Many of these medications were originally developed to treat seizure disorders and were subsequently found to be effective for mood symptoms. Medications in this class include but are not limited to Depakote, Lithium, Lamotrigine, and Carbamazapine.

  • Antipsychotics

    While this class is primarily used in the treatment of schizophrenia spectrum disorders, there are indications for its use in bipolar disorder and with other mood symptoms as well. There are newer and older formulations of these medications - first generation and second generation antipsychotics. Both types remain widely used and operate in very similar ways. Each individual medication has its pros and cons and will require careful consideration of your unique needs when choosing your treatment.

  • Stimulants

    These medications are primarily used in the treatment of ADHD. I do not prescribe stimulant medications due to the often specialized nature of ADHD care via stimulants. I will be happy to discuss non-stimulant ADHD treatment options.

  • Benzodiazepines

    This specialized class of medications is used in the treatment of severe anxiety and panic. Some are used for sleep. They are designed to be used sparingly in specific situations as needed. Due to the habit forming nature of these medications and their potential for dependence and abuse, I strongly limit their use in my practice.

  • Other Treatments

    There are other types of medications that are commonly used in psychiatry. For example, there are other types of medication options for the treatment of anxiety and sleep. There are also a variety of medications that are used to manage side effects. Some of these medications are very specialized to psychiatry, while others come from the treatment of other medical issues like blood pressure, allergies, and migraines.

Self-referrals are welcome. An initial evaluation is the first step.