Treating a mental health condition can sometimes feel more complicated than treating a physical illness. With some medical conditions, there may be a test that clearly identifies the problem and a medication that reliably treats it. Psychiatry is often different.
Two people with the same diagnosis can respond very differently to the same medication. One person may improve significantly, another may experience little benefit, and another may have side effects that make the medication a poor fit. The National Institute of Mental Health notes that people respond differently to psychiatric medications and that it may take several attempts to find the treatment that provides the most benefit with the fewest side effects.
That does not mean psychiatric treatment is simply guessing. It means mental health treatment often involves careful assessment, evidence-based prescribing, monitoring, and adjustment based on how each individual responds.
Finding the Right Medication Can Take Time
When people begin psychiatric medication management, they sometimes expect the first prescription to solve everything quickly. Unfortunately, that is not always how treatment works.
Some medications need several weeks before their full benefit can be evaluated. Antidepressants, for example, can take several weeks to begin producing their full effects.
Other medications may help certain symptoms while causing side effects that outweigh the benefit. A dose may need to be adjusted, a different medication may need to be considered, or the treatment plan may need to change altogether.
This is why staying engaged in treatment is so important.
A medication that does not work is not necessarily a failed treatment experience. It gives your psychiatric provider additional information about how your body and symptoms respond and can help guide the next decision.
Communication With Your Psychiatric Provider Is Essential
Your provider cannot respond to a problem they do not know is happening.
Be open about what you are experiencing, even if you worry that something sounds minor or you are unsure whether it is related to your medication.
Tell your provider if you notice:
- Increased anxiety, agitation, or irritability
- Changes in sleep
- Changes in appetite or weight
- Emotional numbness
- Increased depression
- New or worsening thoughts or behaviors
- Difficulty concentrating
- Sexual side effects
- Fatigue or excessive energy
- Physical symptoms that began after starting or changing medication
- A medication simply does not seem to be helping
And just as importantly, be honest with yourself.
If your symptoms are worsening, acknowledge it rather than trying to push through without telling anyone. NIMH specifically recommends contacting your healthcare provider when you are concerned that a medication may be causing problems or doing more harm than good.
Do not independently stop or change a psychiatric medication without discussing it with your prescriber, because some medications need to be adjusted gradually.
Track Your Symptoms and Side Effects
It can be surprisingly difficult to remember exactly how you felt three weeks ago.
Keeping a simple mental health and medication log can make appointments much more productive.
Consider tracking your:
- Mood
- Anxiety level
- Sleep
- Energy
- Concentration
- Appetite
- Panic symptoms
- Irritability
- Medication side effects
- Medication changes
- Menstrual or hormonal changes when relevant
- Major stressors
Even a brief daily note can help you and your provider identify patterns that might otherwise be missed.
Can Pharmacogenomic Testing Help?
Another option patients can discuss with their provider is pharmacogenomic testing, sometimes called psychiatric genetic testing.
These tests look at certain genetic differences that may influence how your body metabolizes or responds to particular medications. Pharmacogenomic information can sometimes provide useful additional information when choosing or dosing certain medications. The FDA recognizes pharmacogenomic biomarkers for a number of psychiatric medications.
However, genetic testing is not a crystal ball.
It cannot reliably tell someone, “This is the medication that will work for you.” The FDA has specifically cautioned against relying on genetic tests that make unsupported claims about predicting a person’s response to specific psychiatric medications.
Think of pharmacogenomic testing as one potential piece of information that may help your provider—not a replacement for clinical evaluation, medication history, symptoms, follow-up, and professional judgment.
If you have struggled with multiple medications or experienced significant side effects, it may be reasonable to ask your psychiatric provider whether pharmacogenomic testing could add useful information to your treatment planning.
Sometimes the Right Treatment Means a Higher Level of Care
There may also be times when outpatient medication management and therapy are no longer enough.
If symptoms are becoming more severe, your provider may recommend additional support or a higher level of care.
That could include more intensive outpatient services, partial hospitalization, residential treatment, or inpatient psychiatric care depending on the person’s needs and safety.
Needing more support is not failure.
In many cases, recognizing that the current level of treatment is not enough is progress. It means the treatment team is working to match the person with the level of care they actually need so they have a better opportunity to stabilize and improve.
The most dangerous approach is often staying silent while symptoms continue getting worse.
Our Approach to Medication Management at Integrative Health Services
At Integrative Health Services, our new Psychiatric Mental Health Nurse Practitioner, Emily Trentacoste-Martin, CRNP, PMHNP-BC, provides psychiatric evaluations and medication management for children, adolescents, and adults.
Emily’s role is not simply to prescribe medication or hand out controlled substances.
Our philosophy is to use medication thoughtfully and collaboratively. When clinically appropriate, the goal is to consider the lowest effective level of medication while minimizing unnecessary side effects, rather than assuming that more medication is always better.
Treatment decisions are based on the individual, their diagnosis, symptoms, medical history, previous medication experiences, risks, benefits, and treatment goals.
We also believe psychiatric medication management works best when patients feel comfortable saying:
“This isn’t helping.”
“I’m having side effects.”
“I’m feeling worse.”
“I’m scared about how I’m feeling.”
“I think I need more help.”
Those conversations are not inconveniences. They are an essential part of good psychiatric care.
Emily provides in-person medication management in Pelham and Gardendale for patients throughout Shelby County and Jefferson County, as well as telehealth psychiatric services for eligible patients throughout Alabama.
Finding the right mental health treatment may take patience, adjustments, and sometimes more than one attempt. What matters most is continuing the conversation, monitoring your response, and working with a provider who is willing to adjust the plan as your needs become clearer.
Find Psychiatric Medication Support That Fits Your Needs
Finding the right medication can take time, but you do not have to navigate each decision or side effect on your own. At Integrative Health Services, Emily Trentacoste-Martin, CRNP, PMHNP-BC, provides thoughtful, collaborative psychiatric medication management for children, adolescents, and adults throughout Alabama.
- Call 205-644-1166 or use our online booking form to request an appointment.
- Meet with Emily for a psychiatric evaluation to discuss your symptoms, health history, previous medication experiences, side effects, and treatment goals.
- Continue with ongoing follow-up appointments so your response can be monitored and your treatment plan adjusted when needed.
Additional Therapy Options Available in Pelham, Alabaster/Calera, Gardendale, and Surrounding Areas
Integrative Health Services offers comprehensive mental health counseling for children, teens, adults, and families throughout Alabaster, Pelham, Calera, and Gardendale. Our clinicians provide anxiety therapy, depression counseling, trauma therapy, EMDR therapy, and Brainspotting. Our team also offers play therapy, LGBTQIA+-affirming therapy, and marital and premarital counseling.
This article is educational and is not a substitute for individual medical advice. Contact your healthcare provider before making changes to prescribed medications. If you are experiencing a mental health emergency or are in immediate danger, call 911 or contact the 988 Suicide & Crisis Lifeline.
