What is Psychopharmacology?
It’s easy to prescribe an antidepressant, but many people have more complicated issues. They may not respond to first attempts, or to standard treatments. You need someone to is thorough, knowledgeable and thinks outside the box.
We see clients who have been stuck on useless or harmful medications for years, suffering side effects and under-treated symptoms.
A psychopharmacologist has had in-depth training in pharmacokinetics and pharmacokinetics, neuroscience, biochemistry and the therapeutic relationship. We take a detailed and nuanced history and all our recommendations are tailored for you – your personality, experience, values, and goals. We take into account drug and alcohol use, genetics (sometimes using genetic testing to assist), sleep, nutrition and exercise, cognitive and attentional issues and many more factors to individualize treatment. We won’t leave you languishing on useless interventions but will set clear outcome goals and monitor them, changing strategies until you are thriving. As prior treatments may have done more harm and good, we often take medications away rather than add.
- medication assisted treatments including suboxone, vivitrol, low dose naltrexone, antabuse, baclofen, topirimate and many others
- sophisticated antidepressants including tricyclics, MAOIs, and IN and IM ketamine for treatment resistant disorders
- genotyping to determine metabolic and response idiosyncrasies
- nutritional and other supplements as adjuncts to contemporary pharmacology
Effectiveness of Psychopharmacology Treatment
The pharmaceutical industry and the psychiatric profession has been rightly criticised for corrupt and misleading practices that inflated response rates and minimized the downsides. People are right to be wary. On the other hand, good medication management can make all the difference to a treatment. Medicines can enable someone anxious to take those first steps to meeting people; or someone exhausted by cycles of irritability and insomnia be calmer, more rested and address relationships differently.
50% of People
Only 50% of people with depression respond to the first antidepressant, while some 40% will get significant side effects.
Don’t leave it to chance.
5 to 8X more Effective
Opiate replacement therapies are 5-8 times more effective than medication-free approaches.
Use science, not hunch.
2X the Response Rate
Combining medications and therapy will double response rates for people with severe depression and anxiety.
There’s no simple fix for complex issues.
Our Approach to Psychopharmacology
Psychopharmacological Examples & Philosophies
We will start with your wants, consider interactions, individual variability and how to measure success. Sometimes the right thing is less, or no medications. Here are some aspects of how we work:
- People shouldn’t take medications that they don’t understand or which don’t seem to help. A good psychopharmacologist works with the client’s values, preferences and knowledge of what helps them to come up with a plan that does make sense and can be followed.
- Medications should target specific outcomes. If they are not working then we stop them.
- People do better on fewer medications taken less often.
- Medications may effects one or multiple systems. Good psychopharmacology involves understanding the balance.
- Some medications cause harm, or effects that look like symptoms of illness.
- All medications have side effects. Skillful psychopharmacology requires a deep understanding of the medications and how they interact so that side effects can be minimized or even work in our favor.
- While doses of medications may be typical, people are not. Some require very low, others very high, doses of meds. This is because of genetics and interactions as well as intensity of symptoms.
- Genetic testing can be helpful but a good diagnostic evaluation is unbeatable.
- Many people cycle through drugs without having a thorough trial or appreciating factors getting in the way of effectiveness, including diet, alcohol or sleep disorders.
- We’ve evolved over a long time but are stretching ourselves to fit a new world, violating honed biological processes and rhythms. We need to pay attention to our selves more carefully. Attending to sleep, diet, exercise, and connection effects our biology.
- Medication types and dosage will likely need to change over time and in different phases of recovery and may cease to be needed at all.
- Medications can sometimes be great, but are often disappointing without direction and therapy. People need goals that they believe in, have innate strengths that guide them, and need help navigating the challenges that impede them.
- Emotions trump cognition and people live more freely and fully when therapy helps us to tolerate, accept and use these instead of drowning in them or suppressing them.
- Profound transformation and recovery does occur.
- A lot is known about the effectiveness of many medications for both general and addictions psychiatry. The research is always increasing and it is essential to keep reading and staying up to date. There’s a lot of rubbish information out there. An MD is worth more than a google search.
- A lot is not known. A psychopharmacologist must be humble and listen to the client.
Types of Psychopharmacology Therapies and Interventions
Expect careful, collaborative, thoughtful approaches: sometimes conservative, sometimes out of the box, always making sense to you.
Psych Garden has specialized in many areas and is expert in:
• Anxiety including OCD, panic, social anxiety and PTSD
• Mood disorders including bipolar disorder and depression
• Psychotic Disorders including schizophrenia and schizoaffective disorders
• Cognitive Issues including ADHD
We will help you pick medicines that can reduce cravings, relapse, withdrawal, insomnia, anxiety and more without increasing your risks. While it’s possible to use abstinence-based treatment, that choice should flow from deep knowledge of risks and benefits rather than dogma.
Opiate replacement by buprenorphine (e.g. Suboxone) or methadone is far more successful than abstinence- or naltrexone-based approaches such as Vivitrol.
Therapy is crucial and without it you’ll relapse, so we insist on it – with us or with someone we trust. We offer individual and group therapy in 3 recovery phases and balance the need to get back to life with the need to learn how to live safely and without relapse.
Read about our perspective on Suboxone.
For Pain and Addiction
Pain leads to addiction, anxiety and depression and it has to be addressed. But it works the other way too. These are problems of the stress regulatory system.
People need a multifaceted approach to find relief, working with trainers, mindfulness experts, therapists to change coping strategies, a doctor to guide you to the right medication combination.
Dr. Green has developed and run comprehensive pain programs and lectured nationally on this topic.
Complementary Approaches to Psychopharmacology Therapy
We commonly use these, blending them with meds and therapies. Most we do with you ourselves, but for some we send you to trusted collage that does it better:
- Fatty acids including omega 3
- Vitamins including D, E, B6, folate supplements
- Light exposure and sleep deprivation protocols
- Fisher Wallace Device
- Mindfulness Based Stress Reduction