Service
Medication Management
- Telehealth by Zoom
- Ages 5 and up
- Licensed in OR, WA, ME, FL
In short
Justin Bethoney, PMHNP prescribes psychiatric medication when symptoms are too distressing or are impairing work, home life, relationships or self-esteem. He starts low and goes slow, aims for the lowest effective dose, and after two to three months of stability typically discusses a slow, stepwise taper of one medication over three to six months.
- 01
Start low, go slow
The lowest effective dose and the fewest medications, adjusted step by step.
- 02
Taper when you're ready
After two to three months of stability, a slow stepwise taper over three to six months is often discussed.
- 03
Medication is optional
Decide against it and continue with therapy and integrative care, without changing providers.
Principles
- Start low and go slow
- Aim for the lowest effective dose and the fewest medications
- Medication can't overcome a stressful or unhealthy environment on its own, so that gets attention too
- Once you're well, it is usually worth trying to taper slowly in the long run
When to start, and when to taper
Medication is usually started when symptoms are too distressing or are getting in the way of functioning at work, at home, in relationships or in how you feel about yourself.
After two to three months of few or no symptoms, stable mood and functioning, and improved confidence, Justin typically raises the idea of a slow taper of one medication over three to six months, in steps that reduce the total dose by 20% or less each time.
What Justin prescribes
- Antidepressants
- ADHD medications, including stimulants
- Mood stabilizers
- Antipsychotics
- Sleep medications, mostly mild options (Ambien-type drugs only rarely)
- Benzodiazepines only for panic attacks, as needed rather than as a daily dose
What Justin does not prescribe
Justin does not prescribe opioids or substance-use treatment medications such as methadone, Suboxone or naltrexone. People who need those are best served in a setting with more staff and monitoring. If you already take a standing dose of a benzodiazepine or opioid from another prescriber, he will refer you elsewhere.
Often part of care for
From Justin's book, free to read
Go deeper in The Mental Wellness Diet
Common questions
Can Justin prescribe medication over telehealth?
How do refills work?
Do I have to take medication?
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