Medication Evaluations

Welcome to the Pychopharmacology Service. Providers have a long tradition of providing quality care in a setting that ensures the clients are treated in the most respectful and courteous manner possible. This page will provide you with answers to some of the questions most commonly asked when clients are considering medication.

What is a Psychopharmacologist?

Medication

Psychiatrists and Psychiatric Nurse Clinical Specialists are practitioners who specialize in the pharmacologic treatment of problems that you may be experiencing with your mood (how you feel — for example, happy or sad), your behavior (how you act — for example, impulsive or angry) or your cognition (how you think — for example, memory loss or unusual thoughts like having to count things over and over again even if you really don't want to). Before prescribing medication, the proscriber will do a complete evaluation, during which time they will consider all forms of psychiatric treatment such as individual, couples, or family psychotherapy, group psychotherapy, or behavioral therapy. The evaluating psychiatrist or clinical nurse specialist may decide that you do not need medication treatment. Alternatively, it may be decided that all you need is medication treatment or medication treatment may be recommended only on the condition that you start or continue with another form of psychotherapy at the same time.

What is the initial evaluation?

In general, the initial evaluation is an interview that lasts approximately 50 minutes. You may be asked a number of questions about the symptoms that you have been experiencing and any precipitating factors to your current problem. In addition, you may be be asked about prior psychiatric or medical treatment, medications you are taking, your childhood development (for example — any history of early learning problems), your family history (for example, if there are any symptoms similar to yours experienced by any family members) and the use of any recreational drugs or alcohol. The prescriber understands that these questions may be very personal and difficult to answer, especially when they are asked by someone you are meeting for the first time. If you do not wish to answer a particular question, please feel free to say that you would rather not. The more information they have, the more accurate their diagnosis will be and the more likely they will be able to recommend an effective treatment.

The last 20 minutes of your interview will be spent discussing impressions and recommendations and any questions you may have. Subsequent visits will depend on the decisions made concerning your treatment. For medication treatment, follow up visits tend to be scheduled as needed (on average every one to three months) and last approximately twenty minutes each visit.

What if I am already in psychotherapy?

Many clients are referred for medication evaluation and management by their psychotherapists. Others are referred by their primary care physicians or by calling their managed care health insurance companies. Your prescriber will make every effort to include your current treatment providers in every aspect of your care. You may be asked to provide authorization to contact current and/or previous treatment providers.

Do you keep records and are they confidential?

Medication providers are very aware of the concerns individuals have about their medical records in general and psychopharmacology records in particular. Your prescriber may keep detailed records of your initial evaluation and subsequent treatment. Each visit, practitioners document the details of your response to various medication trials, the results of diagnostic tests that have been performed and the side effects you might have had in response to any medication. Every effort is made to include only those facts that they feel are essential to assure you the highest quality care. You have a right to see what information is contained in your medical record. If you do choose to review your medical record, it is suggested that you do it with your physician or practitioner present.

Will I need a physical exam or other tests?

The initial interview does not include a physical examination. Since psychiatric symptoms, like depression, can arise from medical and neurological conditions, you will be asked to be under the care of a primary care medical doctor. You may be asked to have a physical examination, if you have not already done so in within the last year. You also may be asked to get some routine blood tests, EKG, EEG, psychological testing, or neurosychological testing, if these tests will help us understand the cause of your symptoms.

How do I reach my practitioner in an emergency?

Your practitioner's phone message contains information on how to reach that person for urgent problems, (for example serious side effects to your medication). In an emergency, you are asked to go to your nearest hospital emergency room. An emergency is any situation that you feel may risk immediate harm to yourself or someone else. All other matters concerning your medications or health care and/or scheduling can be handled by leaving a message for your practitioner. Please be sure you leave a phone number where you can be reached.

What if I run out of medication?

Your practitioner will generally prescribe enough medication to last until your next visit. Therefore, there should be no need to call for medication if you come for your next scheduled appointment. If due to unavoidable circumstances you are about to run out of medication, please give your prescriber a few days advance notice to refill the prescription, as that prescriber may not be able to do it immediately. If you discuss a change in your medication with your doctor between appointments, then a new prescription will be phoned in at that time.

What is the payment and cancellation policy?

If using insurance, your insurance company will be billed directly. You will need to accept all responsibility for confirming benefits with your insurance company to make sure that our services are covered under their provider network and to obtain all of the necessary prior approvals. You are also responsible for all co-payments and deductible amounts. Medication prescribers require a 48-hour (two business days) cancellation notice for all initial evaluations and follow-up appointments. If you have a Monday appointment, you are responsible for canceling before 5:00 p.m. on Friday. Insurance companies cannot be billed for a missed appointment, so please give 48 hour notice to avoid being charged for the time reserved for you.

We hope you have found this information useful and look forward to meeting with you. If you have any further questions, please feel free to ask.