Psychiatric medication management services in New Jersey, Pennsylvania, and Washington

At this time, see adults ages 18 and older, as well as teens ages 13 to 17.

I really love to support people who want or need:

• explanations you can understand about how and why things work (as far as we understand them, anyway... the brain is still kind of a mystery sometimes)
• support managing the impact of poor communication or therapeutic ruptures with previous providers, medical trauma, involuntary hospitalization or forced medication experiences
• understanding without judgment for less-healthy coping strategies like self harm or substance use
• worrying about being dismissed because of your weight or body size
• to be believed about your experiences
• companionship with existential angst or lack of meaning/purpose

Quirky, nerdy, fringe, geeky, weird, square pegs trying to fit into round hole type people are my people!

Coming from years of community health/community mental health, I'm strongly versed in depression and anxiety, bipolar disorder, psychosis, drug and alcohol use or misuse (I use harm reduction approaches to support your goals), PTSD, BPD, intentional self-injury, and crisis management.

I'm also good at supporting ADHD, Autism, obsessive compulsive disorder, functional neurologic disorder, and mental health needs in the context of acute or chronic medical conditions and disability.

Problems I am NOT the best at and will likely refer you to someone who can help you better:

• disordered eating with active restricting, purging, or compulsive exercising; or that needs support/supervision for meals... in other words, active disordered eating that puts you at acute, elevated risk of medical harm
• evaluations for criminal or civil legal proceedings (court-mandated treatment, divorce and child custody issues, parental fitness assessments, etc.)
• active problematic sexual behavior that violates other people's boundaries
• creation and/or distribution of sexual images of children, non-consenting adults, or animals
• repetitive violence toward humans or non-human animals, including intimate partner violence and child maltreatment

If you're wondering if your experience is something I can help with, please schedule a Meet and Greet Vibe Check so we can make a decision together.

This answer varies depending on your situation.

If you are starting new medication or changing medications, we will probably meet at least once every week or two weeks until we know how those changes are impacting you.

If you have been stable on your medication(s) for a while and things seem to be going well, we will probably meet every three to six months. These appointments can be a shorter amount of time, provided everything is working how you want it to.

If you have a prescription for a controlled substance (stimulants, benzodiazepines, buprenorphine, etc.) we will need to meet at least every three months.

Most psych meds can be managed via telehealth. This can be a game-changer for people with busy schedules, lower immune system functioning, living in rural areas, or transportation challenges.

In some cases it can be better to meet in person. If you have a hard time processing information over video call, expressing yourself verbally, or have a hard time feeling connected or trusting people over a screen, an in person appointment might be best for you.

If you have a prescription for controlled substances--like stimulants for ADHD or benzodiazepines for anxiety or sleep--we need to meet a minimum of every three months. 

New Jersey requires an in person appointment before a first prescription for stimulants and every three months thereafter, typically used for treatment in ADHD. 

Med management appointments can be rather intense. There's a lot of information I need to collect in order to help make safe, informed recommendations about medication. Some of these areas include:

• physical health and health history
• family history of physical and mental health concerns
• your mental health and substance use history and treatments you've tried in the past (both therapy and medications)
• safety including thoughts/actions of harming yourself or others, and being safe from harm from other people
• your quality of life and ability to take care of yourself or do things that are important to you

Near the end of this appointment, I'll summarize what I've heard to make sure I've got it right and didn't miss anything important.

I am most interested in helping you be safe, feel safe, and get the care that will help you feel and function better. As someone with many years of mental health crisis experience, I'm really good at helping come up with creative plans to help people feel safe and stable at home if possible. If things feel out of control, unmanageable, or dangerous it doesn't necessarily mean you need to be in the hospital. It means we need to carefully consider what resources will help you stay alive long enough to get meaningful help.

Many prescriptions can be written with refills once we know they are the right medications and the right doses for you.

New Jersey, Pennsylvania, and Washington allow prescriptions for non-controlled prescriptions of up to 12 months.

New Jersey law will only allow a 30 day supply of controlled substances on one prescription, no refills. The law in NJ does not allow me to write "pre-dated" prescriptions to be filled in the future (i.e., I cannot write you a prescription to fill in February if we meet in January).

Yes. I have a DEA (Drug Enforcement Agency) registration that allows me to prescribe controlled substances. This includes stimulant medications for ADHD, benzodiazepines (lorazepam/Ativan, clonazepam/Klonipin, alprazolam/Xanax, etc.) for use with some anxiety or panic disorders, buprenorphine (Subutex or Suboxone) for opioid use disorder, etc.

These medications have more requirements because they have been identified to have a greater risk of misuse, abuse, or addiction. There are times where these medications can be truly life-saving and life-changing. I think it's important to offer appropriate access where indicated.

Depending on the medications we decide are appropriate for you, I may ask you to go to a lab to give blood or urine samples for testing. This is a standard of care for some medications that treat bipolar disorder, schizophrenia, ADHD, or substance use disorders. Some of these types of medications include (but are not limited to):

• atypical antipsychotics agents like quetiapine/Seroquel or cariprazine/Vraylar
• first generation antipsychotic clozapine/Clozaril
• mood stabilizers like lithium/Eskalith or valproate/Depakote
• stimulants like methylphenidate/Ritalin or amphetamine salts/Adderall
• buprenorphine/Subutex or buprenorphine-naloxone/Suboxone

Some of these medications can cause changes in metabolism, cholesterol, liver function, or kidney function while others have the potential for abuse/misuse. Because we want to help you feel better overall, we also want to minimize the risk of medications causing other problems.

For other medications, I may ask you to get an electrocardiogram (ECG/EKG) to measure the electrical patterns in your heart. This can help us identify pre-existing conditions that could be made worse by certain classes of medication.