Medication management · Solutions Psychiatry
Medication management inside a full psychiatry practice
Here, medication is one half of a complete course of care. The clinician adjusting your prescription is the clinician who hears your whole story in therapy, so every change is made with full context.
Solutions Psychiatry is the full practice: therapy and medication care from one clinician. If you want medication management only, that care has its own home at PsychMed Care.
One chair, both halves of care
The usual arrangement asks you to maintain two relationships: a prescriber who sees you briefly and adjusts doses, and a therapist who knows your life but cannot touch the prescription. Each holds a fragment. Decisions get made on partial information, and you become the courier between them.
At Solutions Psychiatry the two halves sit in one chair. Your prescriber is your therapist. A dose change is weighed against what therapy has surfaced: your sleep, your stress load, your relationships, the side effects you mentioned in passing three weeks ago. Nothing about you gets lost in a handoff, because there is no handoff.
This page describes medication care as part of that combined model. If you want medication management on its own, in greater depth and without therapy, that is a different door into the same practice, and it is described further below.
A note on how prescribing decisions sound here: plain. You will hear what a drug is for, what it cannot do, what the alternatives are, and what would make us stop it. If a medication is not clearly earning its place, that gets said too, in the room, not discovered on a portal summary months later.
Combined care in practice
What medication management looks like here
Thoughtful starts, careful changes
Precise psychopharmacology: the right medication, started deliberately, changed one variable at a time, and deprescribed when it no longer serves you.
No five minute refills
Follow-up Appointments are real conversations. There is time to actually think, together, before anything changes.
Decisions informed by therapy
Your prescriber hears the whole story in session, so adjustments rest on your lived week, not a symptom score read cold.
A whole body lens
Labs, sleep, nutrition, movement, and physical health are considered alongside the prescription, because mood does not live in a vacuum.
Precision when it matters
GeneSight pharmacogenomic testing and targeted labs, so decisions rest on your biology, not averages.
Honest expectations
What a medication can do, what it can't, and how the two of you will know it is working, stated plainly at the start.
Precision tools, inside the relationship
Testing earns its place when it changes a decision. GeneSight pharmacogenomic testing can show how your genes may affect the way you process common psychiatric medications, which is most useful after a trial has disappointed or side effects keep repeating. If you want the medication-only practice's full breakdown, including GeneSight cost and coverage, PsychMed Care publishes it.
Targeted labs cover the physical contributors that mimic or amplify psychiatric symptoms: thyroid function, B12, folate, vitamin D, iron, and metabolic and inflammatory markers. Where the picture calls for it, targeted supplementation, including magnesium glycinate, L-theanine, N-acetylcysteine, and omega-3s, can support the plan. These are adjuncts chosen for a reason, never a substitute for a medication that is clearly indicated.
The practical shape of it
Care starts with a 60 minute Comprehensive Initial Appointment ($350) and continues in 30 minute Follow-up Appointments ($250). The practice is in network with Aetna, Cigna and Evernorth, UnitedHealthcare and Optum, the Blue Cross Blue Shield family, Oscar, Oxford, Carelon, Providence, and more, plus Medicare in five states and Medicaid in two. Every plan is verified before your first visit, and copays for most plans land between $0 and $40, known exactly up front. Medicare coverage has its own page.
Controlled substances follow the rules of the state you are in. This practice is telehealth by design, and in most states a controlled-substance prescription requires one in-person visit a year. Those visits happen by arrangement, in the state where you are, to meet federal and DEA requirements, and they are planned together well in advance. They are never walk-in office visits.
Between visits, existing patients reach the practice through the patient portal and Spruce for prescription questions and brief check-ins. Medication questions do not have to wait for the next appointment to be asked; they just get answered in the order they deserve, with the chart open.
The arc of care
From first prescription to steady state
1. Evaluate before prescribing
The 60 minute Comprehensive Initial Appointment covers your history, every prior medication trial and how it actually went, your medical picture, and labs or genetic testing where they would change the decision.
2. Decide together
Options are laid out with their trade-offs: likely benefits, common side effects, what success looks like, and how the two of you will know. The choice is shared, never announced.
3. Start carefully, watch closely
Early Follow-up Appointments focus on effect and tolerability. Because your prescriber is also your therapist, the judgment call rests on your lived week, not a two-minute symptom report.
4. Simplify over time
Regimens get reviewed, not just renewed. When a medication has done its job or stopped earning its place, deprescribing is part of the plan, handled gradually and together.
When less medication is the right medication
Many patients arrive on regimens assembled over years by different prescribers, each adding and none subtracting. Part of combined care is a periodic, honest audit: what is each medication doing, what is it costing in side effects and interactions, and what happens if one is carefully tapered? Simplification is done one change at a time, with therapy watching the same picture, so a wobble is caught early and understood in context. The goal is never the fewest pills as a trophy. It is the smallest regimen that genuinely works, which for some people is none, for some is one, and for some is several, each earning its place.
Two doors, one practice
Stay on this site if you want medication woven into ongoing therapy with one clinician: the therapy half of care explains how that work runs. Choose the other door if medication is the whole job. For medication management only, visit PsychMed Care, the dedicated medication practice run by the same clinician, where every page goes deeper on prescribing, testing, and follow-up care.
Neither door locks. Patients move between combined care and medication-only care as their needs change, and because both doors belong to one practice and one clinician, the move costs nothing in continuity.
One clinician for the whole conversation.
Start with a 60 minute Comprehensive Initial Appointment. Your insurance is verified before the visit, and you leave with a plan, not vague reassurance.