Psychiatric Prescribing
The Process
We have a two part intake process.
During the first appointment, we go over your health history as it pertains to psychiatry. We then have time to consider options for you, and for you to do some reading or thinking if that’s relevant.
During the second appointment, we can go over options together, and send off prescriptions. We can also discuss non-medication options, and how to fit them into your life. This takes longer than you’d think, since there’s probably a good reason you haven’t been doing them.
Follow up timing depends on the individual plan. We may follow up as fast as one to two weeks, usually not more than four.
On average, it’s reasonable to expect appointments every 2-6 weeks for several months. Once we aren’t making changes as often, we may go out to every 2 months, then every 3.
Depending on your medication regimen and the comfort of your primary care provider, you may eventually transition back to their care. This also depends on if you feel safe and comfortable doing so.
Shared Informed Decision Making
This is a buzz phrase in medicine these days, but we take it very seriously. You deserve to know what medicine we’re suggesting you put in your body, and what the rationale is.
Many times there is more than one equally good option. When that happens, we are likely to run the pros and cons of each by you and let you choose.
Modern medicine doesn’t know exactly how all of the medications we prescribe work. We are committed to humility as individuals and as representatives of the health care establishment. What we don’t know, we will tell you. When it’s possible to find an answer, we will look for one and get back to you.
If you know something has worked for you in the past, or wonder if a specific new approach might work for you now, let us know! We don’t promise to prescribe that medication, but we promise to talk it through with you.
As anyone who has been through psychiatric prescribing knows, finding the right medicine(s) can take some trial and error. It probably didn’t take one or even six months to end up feeling poorly enough to seek help. It probably won’t be a quick fix to heal. We know this can be frustrating when you want to feel better. That’s part of why it’s so important to keep people informed about how we make decisions along the way.
It’s okay to ask lots of questions. Even if they seem silly to you. It’s a question that you have, so it’s important.
Individual Autonomy
We respect that you are your own person making decisions for reasons that make sense in your life. It is our job to meet you where you are.
Sometimes people feel guilty telling their provider when a given medicine doesn’t work, has uncomfortable side effects, or they forget to take it. All of that is both common and normal, and we won’t scold you for it. Nor will we have our feelings hurt when that happens. Your health isn’t about us, it’s about you.
It’s normal to be ambivalent about taking psychiatric medications. We aren’t going to reprimand you for not being sure.
You are entitled to choose what side effects feel worthwhile in your life, and which ones don’t. What is small to us may not be to you, and that’s okay.
You know how adulting is amazing when you eat ice cream for breakfast and real stinky when you pay the bills? Being an autonomous patient is like that. Our job is to figure out the right treatment plan. Your job is committing to the messy and nonlinear process of healing. It can really stink sometimes. We wish there was a magic wand, but there isn’t. (We’d be using it right and left.)
Considering medication for mental health for the first time? Read a bit more about what that might be like.
