Conservative Medication management

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What is conservative medication management?

Conservative medication management is a treatment approach to the management of psychiatric conditions, that emphasizes the use of nonpharmacologic treatments in patients’ treatment regimens, and only uses medications when essential.

Why is conservative medication management important?

The idea behind conservative medication management arose from our career observation that that many patients tend to needlessly accumulated multiple psychiatric medications at high doses. Oftentimes these patients were not engaged in any non-pharmacologic treatment approaches.

Overprescribing is a consequence of our current healthcare system, which is highly efficient at dispensing and promoting medications use but not efficient at safely discontinuing medicaionts options for health conditions. Large investments in the promotion of medication treatments by highly resourced pharmaceutical companies, often means that family doctors and psychiatrists are much more familiar with medication therapies than alternative approaches. In addition, the time constraints and economics of managed care often means patients are typically seen for less than 25 minute intervals, and sometimes intervals as short as 15 minutes, which also lends itself to a more transactional model of health care where drug treatments are more easily deployed to treat symptoms than more time consuming and poorly reimbursed non-pharmacologic interventions. 

The problem that arrises from the over-reliance on medications is that it can frequently lead to polypharmacy and adverse health consequences. Most psychiatric medications can contribute to weight gain and cardiovascular problems. Some can even cause permanent neurological damage. Given these risks, we believe the use of medications must be minimized to the extent possible

Why might you reduce a psychiatric drug?

If you find that the medication you are currently taking is no longer providing the desired benefits or if you are uncertain about its effectiveness, we can assist you with medication tapers. There are various reasons why a medication taper may be necessary. For instance, you may be experiencing emergent adverse effects such as weight gain, emotional blunting, sexual dysfunction, dizziness, or inter-dose withdrawal symptoms. Alternatively, the stressors that initially led to your need for medication might have resolved, or you may have doubts about the accuracy of the initial diagnosis for which the medication was prescribed. Some individuals also wish to explore life off medications to discover their baseline well-being, while others are concerned about polypharmacy and whether they are taking too many drugs. Our expert team can guide you through a safe and personalized medication tapering process, addressing your specific concerns and helping you achieve the desired outcomes.

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How can we Help

At our practice we believe that psychiatric medications can be essential for the treatment of some individuals with psychiatric conditions.We treat these patients conservatively with medications, while ensuring that they are fully informed about all long term risks and alternatives treatment modalities. 

In order to minimize an over reliance on medications we recommend our patients consider engaging in the following:

  • Talk therapies: psychotherapy, life coaching, trauma-based therapies, dialectical and behavioral therapy (DBT), and cognitive behavioral therapy for insomnia.
  • General well-being practices: full nutritional review and counseling, exercise, yoga, and the reduction of substances that may have mood-destabilizing effects such as nicotine and caffeine
  • Nervous system regulation therapies: acupuncture, biofeedback, craniosacral therapy, EFT (tapping) massage, and reflexology.
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