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Medication Evaluation and Maintenance

Often people who come to see us or call us want to know what our approach is with medication. Our overall philosophy is holistic— meaning we need to understand not just the biology but other areas that may be contributing to the problem. These are areas such as environment, support, family of origin, patterns of coping and spiritual philosophy. We also want to use the least amount of medication possible in order to achieve emotional health. Each person and situation is different and calls for a thorough evaluation.

When a new client comes in we sit down with them and discuss several aspects of their lives in order to build a picture of what is happening. We discuss what they view to be their problems. We talk about their situation, emotional response, history of the problem, family history and any past treatment. We talk about how the client would like to be different. We talk about their general health, any allergies. We talk about their expectations and fears concerning medication. We talk about their support system, environment and any issues that may be contributing to the situation. This usually takes about an hour. In some cases it may take longer and if needed more time will be arranged.

At the end of this interview we can make recommendations if we believe medication could be helpful for the client's specific needs. If medication is appropriate we can make a recommendation as to which medication would be most helpful based on the symptoms and situation. We then would write a prescription for that particular medication and begin treatment.

In most cases we plan a follow up session in about 2 weeks to evaluate any side effects and how the person is responding to treatment. Based on this follow up we make plans for further treatment. If all is going well and the client is in counseling we usually follow up in about a month. By that time we should be seeing improvement in the client’s emotional response for their situation.

In most cases we advise that clients also see a counselor. The reason for this is that medications can help reduce and control certain symptoms but they cannot teach people new ways of coping with life’s ups and downs. We also believe that during these times having a counselor can help give the client support that is very important in addressing challenging life situations. In many cases people who come to see us already have this valuable support in place. In that situation we like to work closely with the counselor to let them know how we plan to help them and the client. If a person does not have a counselor we can make recommendations and often we can provide both of these services.

Medication Maintenance comes in to play once the clients has reached stabilization of their symptoms. It is a general rule that once this phase of treatment is reached the person continues on medication for 6 months to a year. If they have no prior history of symptoms, we wean them off of their medication. In many cases this period of treatment is enough to help the brain and body become balanced again and they can function without help. In some cases the symptoms may be chronic and a longer period of treatment is necessary. Medication Maintenance refers to “Maintaining” symptom remission using medications for an extended period of time. Adjusting medications as needed to achieve this goal.