Psychiatric Medication Management

Medication management is the ongoing clinical work of finding the right medication and dose for you, checking in on whether it’s doing what it’s supposed to do, adjusting when it isn’t, and staying on top of side effects. It is not a one-visit transaction, and when it’s done well it is quietly one of the highest-leverage things we offer.

Our psychiatric nurse practitioners are board-certified PMHNPs. They prescribe, monitor, and (when clinically appropriate) taper the medications used to treat depression, anxiety, ADHD, bipolar disorder, PTSD, OCD, sleep disorders, and related conditions in adolescents and adults.

Conditions we treat

• Depression, including postpartum, seasonal, and chronic forms
• Anxiety disorders (generalized anxiety, social anxiety, panic disorder)
• ADHD in adolescents and adults, including careful stimulant and non-stimulant prescribing
• Bipolar disorder — mood stabilization and long-term maintenance
• PTSD and trauma-related symptoms
• OCD, often at higher SSRI doses than we use for depression or anxiety
• Insomnia and sleep disorders
• Mood disorders, substance use disorders, and a range of related conditions

For anything complex, we’d rather see you for an evaluation than give a definitive yes-or-no in advance. If you’ve been told something is “treatment-resistant” or you’ve already tried several medications, say so when you schedule — we can match you with the right clinician from the start.

The first visit

About 60 minutes. Your clinician will review your psychiatric history, medical history, current medications, prior trials (what worked, what didn’t, what the side effects were), family history, substance use, and current symptoms. Labs are ordered only when they’d change the plan.

By the end of the visit you should have a diagnosis, a plan — usually a specific medication with a defined starting dose and titration — and a clear timeline for the next visit. Plans are written down and sent to you, not just discussed.

Ongoing visits

Typically every 1–3 months once you’re stable, more often during the first months or during a medication change. Follow-ups are shorter than the initial — usually 20–30 minutes. The work is reviewing symptoms, side effects, sleep, any stressors worth knowing about, and adjusting as needed.

How we prescribe

We start with the lowest reasonable dose, titrate slowly, and change one variable at a time. We ask what you want out of treatment and what side effects you’d rather not have, and we use that to choose between medications that are comparably effective. If a medication isn’t working after an adequate trial, we talk about what’s actually happening before reaching for something new.

Controlled substances

We prescribe controlled substances — stimulants for ADHD, sometimes benzodiazepines for specific situations — when they’re the right answer. We also take seriously the risks of over-prescribing either class, and we hold ourselves to careful practices: a real diagnostic workup first, a single pharmacy, regular check-ins, and honest conversations if concerns come up. See the ADHD page for more on how we think about stimulants specifically.

Therapy alongside medication

For many diagnoses, the combination of medication and therapy produces better outcomes than either alone. Our therapists and psychiatric NPs are in the same practice and coordinate directly. If you’re only seeing us for medication and it becomes clear therapy would help, we’ll tell you — and we can refer you to an in-house therapist or to outside providers, depending on your insurance.

Telehealth, in Colorado

All medication management visits are over secure HIPAA-compliant video. Same-day and next-day availability is common for established patients; new-patient wait times are typically a week or less.

Frequently asked questions

How long does it take for medication to work?

Depends on the medication and what we’re treating. Benzodiazepines and stimulants tend to work the same day. SSRIs and related antidepressants usually take 2–4 weeks to start working and up to 6–8 weeks for full effect. Mood stabilizers can take weeks to months. Your clinician will give you a specific timeline when they prescribe.

Will I have side effects?

Most people have some, especially in the first week or two. Most are mild and fade; some don’t. We titrate slowly partly to minimize this, and we’re comfortable switching medications if side effects aren’t tolerable. You should not white-knuckle side effects — tell us and we’ll adjust.

How long will I need to take medication?

It depends on the condition and your course of treatment. Some people take an SSRI for 9–12 months after an episode of depression and then taper off. Others have conditions (bipolar disorder, chronic recurrent depression, ADHD) where long-term medication is the standard of care. We talk about this openly and reassess together.

Can I stop my medication if I feel better?

Talk to us first. Many psychiatric medications need to be tapered rather than stopped — antidepressants in particular can produce discontinuation symptoms if stopped abruptly. Feeling better is usually evidence the medication is working, not evidence you no longer need it.

Do you prescribe controlled substances?

Yes, when clinically appropriate, in line with state and DEA regulations. We do a thorough evaluation before prescribing, ask you to use a single pharmacy, and check in regularly. See the ADHD page for more on our approach to stimulants.

Can you take over refills from another provider?

Usually, yes — but we need to see you for a visit first so we know what we’re prescribing and why. Don’t count on a handoff happening without an appointment; plan ahead so you don’t run out.

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Medication management is provided by board-certified Psychiatric Mental Health Nurse Practitioners (PMHNPs) licensed in Colorado.