Psychiatric Medication Management For Mental Health

December 12, 2023

Written by Dr. Kevin Marra, MD

Mental Health Medication Management 

Like many aspects of mental health, the role of medication management in holistic treatment is often misunderstood. Preconceived notions are usually based on misinformation, so part of our job at HopeWay is to provide accurate information and education around all aspects of treatment, including medication.

What is Psychiatric Medication Management

Psychiatric medications target specific neurotransmitters implicated in mental illnesses. Examples may include, but are not limited to, serotonin, dopamine and norepinephrine. The benefit of these medications, which at times can be truly lifesaving, has been known for decades and repeatedly shown through rigorous studies. 

Determining Diagnosis and Medication

Furthermore, we know that mental illnesses have a strong biological component and they are brain diseases, so treating them with medications is typically recommended for the best results. While not every client at HopeWay uses medication, it remains a key component to many clients’ success. Research has concluded for several years that the combination of medication and therapy is most effective, and our ultimate goal is to help clients find lasting success when managing their diagnosis.

Probably the most important part of determining whether or not medication is recommended is having an accurate diagnosis identified through psychiatric and clinical evaluations and/or psychological testing. An accurate diagnosis will inform which medicines are most appropriate for relieving the client's symptoms and managing the diagnosis. For example, there are some diagnoses, like schizophrenia or bipolar disorder, where we would strongly recommend medication as part of treatment for the most effective outcomes.

Medication Treatment Plan at HopeWay

After a full assessment is completed and a diagnosis has been determined, it is time to formulate a treatment plan. At HopeWay, all of our recommendations stem from evidence-based practices. We strive to prescribe the least amount of medication at the lowest effective doses for our clients to avoid polypharmacy – a term that refers to being on many medications that may interact with each other or cause unforeseen side effects.

We certainly get pushback from some clients, or even their family members, about incorporating medication as part of their treatment plan. If this is the case, we try to explore their hesitation, provide education that may clear up any misconceptions and remind them that there is reliable scientific evidence suggesting proper medication works, especially when combined with other therapies.

Medication Timeline

I am frequently asked, “Will medicine be a permanent part of my life?” The length of time someone is on medication depends on multiple factors such as the diagnosis, how many episodes they have experienced in their lifetime and what psychosocial stressors they expect to encounter. For example, if someone has had more than two episodes of major depression in their life, the chances of having a third may be so high that we recommend antidepressant treatment indefinitely. Alternatively, if this is only their first episode, we typically recommend 9 to 12 months of stability while using a medication before there is consideration for coming off of it.

Monitoring the Effects of Medication 

After starting any medication, it is important to work with your provider to monitor the effectiveness and potential side effects. Think about it this way. If someone were having an issue with their blood pressure, their primary care doctor would pick a medication that best fits their medical needs and then continually observe whether it’s effective, making adjustments as needed. Monitoring the effectiveness of a medication truly depends on the illness and the medication. For example, antidepressants sometimes take weeks before someone notices a change, while some anxiety medications may start to take effect after only a couple of hours.

The Importance of Therapy & Medication Routine

Once someone starts taking psychiatric medicines, whether at HopeWay or elsewhere, I always recommend that they also participate in therapy. Medicine alone is not enough. Because there are many psychological components to one’s mental health, psychotherapies can improve the results and efficacy of medicines for optimal outcomes.

I think of a prescribed medication routine as similar to wearing a seatbelt while driving a car. When a person initially stops their medication, they may not immediately experience the symptoms. But if there is any kind of life stressor, the protective barrier of medication is not going to be there if they are not consistently taking the proper dose. Similar to being in a car wreck without a seatbelt, this places the client at risk of a relapse.

Ultimately, psychiatrists are here to help individuals find prolonged wellness through effective treatment plans, which can include medications. And for many, medicine in combination with therapy is life-changing.

 

 

Dr. Kevin Marra, MD

Dr. Kevin Marra is a board-certified psychiatrist and serves as HopeWay’s Director of Medical Services. In addition to his practice as an inpatient psychiatrist at Mindy Ellen Levine Behavioral Health Center, Dr. Marra has served on several committees including the Medical Records Committee and Trauma Focused Therapy Committee, and was involved in coordinating projects related to optimization of the Behavioral Health Electronic Medical Record. Dr. Marra received his Bachelor’s in Biology from West Virginia University and Medical Degree from the West Virginia University School of Medicine. He went on to complete a Forensic Psychiatry Fellowship at UNC. He is also a member of the American Psychiatric Association and the American Academy of Psychiatry and the Law where he was selected as a Rappeport Fellow in 2011.

 

Learn More About Our Outpatient Psychiatry