Integrative Medication Management
At Integrative Psychiatry Austin, we offer a balanced approach to medication management. We want to help you go beyond symptom resolution to healing, which is why our team takes an integrative approach to managing medication. Our approach is designed to provide the most effective therapy for the whole person.
We offer a variety of therapy options at Integrative Psychiatry Austin to help you go beyond symptom resolution to healing, including:
Ketamine Assisted Psychotherapy
Whole Person Assessment
- Holistic Medicine
- Neuropsychological Testing
- Child and Adolescent Mental Health
- Traditional Chinese Medicine (TCM)
What is psychopharmacology?
Psychopharmacology is the study of biological materials that influence mental states. Such agents can help with changes in mood, sensation, thinking, or behavior. These medicines can be derived from plants or chemically synthesized in a laboratory. Psychopharmacology is used to treat conditions like depression, anxiety, psychosis, acute pain, chronic pain, insomnia and a number of other conditions.
We believe that there are some medicines that can provide symptom relief and cures. Like antibiotics cure infections, medicines that act on the brain can sometimes provide a cure. But more often than not, the “cure” remains while the medicine is being taken. Thus, some people refer to medicines as a bandage. We believe healing is a multifaceted process. And we have found that, when used correctly, medicines that affect the psyche foster that healing.
Medicines are constantly being made but in general psychopharmacological medicines are broadly divided into the following categories.
- Anxiolytics (Like Alprazolam, Clonazepam, Lorazepam)
- Antidepressants (Like Fluoxetine, Venlafaxine, Duloxetine)
- Antipsychotics (Like Riseperidone, Quetiapine, Ziprasidone)
- Mood stabilizers (Like Valproic acid, Lithium, Lamotrigine)
- Stimulants (Like Methylphenidate, Dextroamphetamine, Modafinil)
- Hypnotics (Like Zolpidem, Eszoplicone, Ramelteon)
- Autonomic nervous system medicines (Like Clonidine, Propranolol, Prazosin)
The research shows that the medicines and psychotherapy are equal in efficacy but in most conditions, medicine acts faster than psychotherapy but psychotherapy is more effective in the long run. A combination of Medicines and Psychotherapy yields the best results often.
Use of medicines becomes a problem when they are being used to balance side effects or consequences of other decisions. For example if someone drinks too much coffee and then has to take an anxiolytic then the use of the medicine could probably be avoided if there was focus on lifestyle. Medicines can also have side effects. And the use of medicines is always balanced by a risk benefit ratio.
Side effects from medicines depend on many factors. For example side effects depend upon:
- Use of multiple medications
- High dosage
- Genetically sensitive individuals.
- Long term use of a medicine
- Co-existing medical or psychological conditions
It depends on why the medication is being taken. Some conditions can be life long in nature and a person decides at some point whether use of a medicine improves their quality of life and productivity. There have been some research studies that have been coming out that show that discontinuing medications can be more difficult for some medications than others.
Yes we try to simplify treatment as much as possible and wean people off medicines, supplements or herbs that are not needed. Our philosophy is that if we work on other healing modalities, the use of medications can be minimized. There is usually a lesser reliance on medications if other interventions are used.
It depends on the unique circumstances of an individual. Because extensive research is lacking about drug-herb interactions, we try to use safe biological substances together. Because of lack of research, individualizing treatment to a person can help avoid side effects from drug interactions.
We have hypotheses about mechanisms of actions for medicines. The neurotransmitter hypothesis or the inflammation hypothesis are two such theories. The research into how these medicines act is an ongoing field of study.
Yes. Before a medicine is approved to be used on humans, it has to be researched extensively and has to meet certain safety guidelines. The research on some medicines that have been around for decades, is extensive. Oftentimes the way medicines are used in clinical medicine is a result of multiple randomized controlled trials and meta-analyses and expert treatment algorithms and recommendations. Of course, there are times that the medicine does not have as extensive a research behind it.
What about “big pharma?”
A general mistrust of anything that the pharmaceutical companies make, is a cultural phenomenon of our times. It has to deal with lack of trust and spread of false information. Pharmaceutical companies, it is true, make a lot of money on some of these medicines. They also have a financial interest in studying specific medicines. Sometimes the best interest of a patient and financial incentives are in line with each other and at other times they are not. The allegations against big pharma are many. And everybody has a different point of view. We believe that awareness about these different points of view are helpful in customizing treatment plans. We respect everyone’s beliefs and attempt to guide healing according to that.
Yes. Genetic testing represents a big step towards precision individualized medicine. We can do genetic testing that tells us how your body is metabolizing various medications. Knowing this can give extra information which can be used in making your individualized treatment plan.
First and foremost a good assessment can help inform about previous medication trials and responses. There are some tests that can increase the likelihood of reaching a good fit between a person and a helpful medicine. We work with qEEG, which measures brain waves and can predict a response that a person will have to a certain medicine based on their unique brain wave pattern. We also work with a person’s genetic data to determine the metabolism and effect of medicines on their mind and body.
Absolutely not. We hold the use of medicines as sacred just like the use of some of our herbs. There are situations in which medicines are indicated and there are situations in which other treatment modalities have a better risk/benefit ratio. We find people confused with the overwhelming information out there and how it applies to their own self. Since we work in a collaborative manner, the choice of medicine and whether we want to medicate is a collective decision between physician and patient.