Many people considering whether medication would be a good addition to their mental health care ask this question.
It is a common question to bring to a psychiatric evaluation, but not everyone gets the same answer.
Medication management is not simply writing a prescription.
So, what is medication management, exactly? It is a structured process that is time sensitive.
It involves a psychiatric provider who tracks the impact the medication is having on someone’s symptoms.
They will increase/decrease the dose and check on the side effects throughout the time the medication is prescribed.
The role of medication in mental health treatment goes far beyond the initial prescription – it is an ongoing clinical relationship.
Some mental health challenges do extremely well with this type of medication management.
Conditions That Respond Well to Psychiatric Medication Management
1. Major Depressive Disorder
Major depressive disorder is very common and is one of the psychiatric conditions that is most common and the most responsive to medication management mental health care.
It is common for moderate to severe presentations for antidepressants, and for SSRIs and SNRIs, the first-line medications.
Medication management includes the following:
- Monitoring of therapeutic delay for onset (typically 4–6 weeks)
- Inadequate response and agent switches when necessary
- Paradoxical symptom worsening particularly in the first few weeks
- Dosage titration to stay within therapeutic range
Depression not responding to one medication may be classified as treatment resistant depression which involves augmentation strategies, something a trained psychiatric provider does meticulously.
2. Bipolar Disorder
Bipolar disorder, whether it be Bipolar I, Bipolar II, or cyclothymia, consists of episodes of unstable moods that may be harmful to the individual or those around them!
Medications in this scenario are not just helpful for the vast majority of people, they are critical to being stable.
Pharmacotherapy involves first line mood stabilizers such as lithium, valproate, and lamotrigine.
Depending on the type and severity of the episodes, atypical antipsychotic agents may be included as well.
Here, ongoing med management is particularly important due to:
- The need for regular serum level monitoring due to lithium’s narrow therapeutic index
- The need for mood stabilizers, as antidepressant monotherapy, may provoke a manic or hypomanic episode
- Symptom remission differs in depressive versus manic phases
3. Anxiety Disorders
There is a lot of potential from a multimodal treatment approach which is inclusive of both medication and psychotherapy for anxiety spectrum disorders like generalized anxiety disorder, panic disorder, social anxiety disorder and post-traumatic stress disorder.
SSRIs and SNRIs are clinically considered the first choice for first-line agents and the current standard of care.
A short course of a benzodiazepine may be helpful for the short-term management of panic attacks.
4. Attention-Deficit/Hyperactivity Disorder
ADHD is a neurodevelopmental disorder that presents with a combination of inattention, hyperactivity, and impulsivity.
The stimulant medications are the most studied and proven pharmacological interventions.
The principles of good medication management for ADHD include the following:
- Recognizing the difference between immediate-release and extended-release medications
- Assessing the individual’s cardiovascular health prior to starting stimulant therapy
- Monitoring for appetite suppression, disruption of sleep, and rebound effects
- Considering the possibility of initiating treatment with non-stimulant medications, such as atomoxetine or guanfacine
5. Other Related Disorders
When thinking about mental illnesses vs mental disorders – and what is the difference between mental illness and mental disorder – it is worth noting that both terms cover a wide range of conditions, including schizophrenia spectrum disorders, which require some of the most intensive medication oversight of all.
The management of schizophrenia requires antipsychotic medication.
The positive symptoms of schizophrenia, such as hallucinations and delusions, are difficult to control without medication, and the chances of relapse are high.
Compared to first-generation antipsychotics, second-generation (atypical) antipsychotics are usually preferred because of their relatively less troublesome side effects.
Therefore, managing medications in this group of patients requires monitoring of metabolic effects, side effects, and compliance.
The Initiating of the Prescription Vs. Managing the Prescription
The actual writing of the first prescription is only part of the entire process. The ongoing contact between the patient and prescriber is what really makes a difference.
Adjusting psychiatric medications is very common, and the response to medication can change for many reasons.
Life events (stress, illness, and hormonal changes) and the normal aging process can all influence the medication’s effects.
Medcanvas Psychiatry can help.
We are ready to connect with you to facilitate your access to your mental health via meds. We also provide a complimentary intro call.
Feel free to contact us – 701-963-6917.
FAQs
Will I have to remain on the medications supplied through mental health services?
Reduction options are available with medications for mental health. Your health/study diagnosis, history of symptoms, and your individual response to the medication are considered.
Is it possible to do medication management without therapy?
Yes – medication management exists as its own clinical service.
However, the combination of medication and therapy has been shown to have better results, especially for depression and anxiety.
Your provider will assist you in determining which combination will be most beneficial to you.
How long will it take to see results from psychiatric medication?
This will vary depending on the class of medication.
Stimulants for ADHD typically take effect within hours.
Antidepressants and mood stabilizers can take several weeks to see their full effect.
Your provider will be able to give you the most realistic expectations during the initial evaluation.