Psychiatry at Insight Northwest Recovery
A Letter From the Medical Director about Psychiatric Medication Management
IMPORTANT: PLEASE TAKE 5 MINUTES TO READ THIS!
My name is Kathleen Johnson, and I am a board-certified and Licensed in the State of Oregon Psychiatric Mental Health Nurse Practitioner who has been working in Eugene for 3 years with Insight Northwest Counseling.
Our philosophy of care is to meet the patients where they are and do my best to evaluate the patients as they present today. We will take into consideration all the parts of the picture including the patient's medical history, psychiatric history, family history, previous trauma, previous diagnoses, and current medications.
My goal is to do my best to determine what the underlying driver is that is causing the symptoms and treat them aggressively to achieve remission of symptoms. The quicker we get symptoms under control, the greater the benefit the patient will get from attending this program.
This sometimes means:
I will prescribe multiple medications at the first meeting to quickly stabilize the patient.
I will meet with patients weekly in the first 4-6 weeks to ensure this is the best course of treatment and will de-prescribe as the patient stabilizes when it makes sense.
My goal is to discharge the patient with a medication regimen that has the best chance of longterm stabilization.
I will discontinue current medications that do not align with how the patient is presenting at this time. (Please keep in mind that this often a higher level of care, therefore, the current meds are often ineffective or have been prescribed as stopgaps and need to be addressed)
All patients will be prescribed vitamin D3. This is a very important vitamin for bones, the immune system, and most importantly, mental wellness. Vitamin D is a necessary vitamin for the body to make more Serotonin. Low serotonin is responsible for anxiety, depression, suicidal ideation, PMS, PMDD, cravings for carbs and sweets, poor digestion, intrusive thoughts, compulsions, neck pain, and TMJ. (not an extensive list)
The medications I prescribe may be listed in a specific drug class and may cause concern and make you question what the diagnosis is.
Often in psychiatry, medications are used at different doses for different reasons. Example:
Risperidone is in the antipsychotic drug class, the dose is typically 6-8mg a day and not typically the first choice for schizophrenia anymore, however, it has been purposed for the sedating effect for sleep, anger, and aggression irritability behaviors.
Lamotrigine is an older anticonvulsant medication with a typical dose of up to 500mg a day. This medication has been repurposed in psychiatry for mood dysregulation when big emotions with daily mood swings depending on the situation are present or for self-harming. Starting doses are 25mg and most people will do great between 150-200mg a day.
Medications are used off-label for something else or are used synergistically with other medications for a new benefit altogether.
ADHD medications such as stimulants/or non-stimulants work with clonidine (which is a blood pressure medication) to help the patient focus during the day and get rest at bedtime to reduce hyperactive body and mind.
Diagnoses may be working diagnoses until we get to know the patient. During treatment there will be a therapy session to discuss official diagnoses and provide education on ongoing treatment after discharge, future support, and prognosis.
In most cases, the patient will be seen in the first weeks of starting treatment. After the first appointment please ensure new medications are picked up and started within 24 hours of the initial appointment. This will allow me to reassess the efficacy of the medication the following week. While medication can take weeks to reach full benefit, I know what progress I am looking for to ensure we are moving in the right direction. My priorities in treating patients are safety, sleep, mood stabilization, focus, PTSD, and trauma symptoms.
Each Friday you will receive an overall update from our team via email. It will come from the email address insightrecovery@proton.me. The email will be encrypted to ensure only you are able to access the email. The password will be your child’s birthdate in the following format: 01/01/2024. Please reach out to Kaitlin Richards, Director of Client & Peer Services if you have questions about our care.
For more information about the patient and family experience, please visit insightrecovery.com/patientguides and the password is inrpatient2024
Warm Regards,
