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23


Sep
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What Psychiatric Medications Are Available via Telemedicine?

What are psychotropic medications and how do they work?

Psychiatric medications—also called psychotropic medications—are medications which are psychoactive. A psychoactive drug is one that can affect a person’s mind, emotions, and behavior by changing the chemical makeup of the central nervous system, which includes the brain and spinal cord. Your mental health (including behavioral health) and physical health all depend heavily on the health of your central nervous system, as it controls most functions of both your mind and your body.

For example, serotonin is a key hormone in the brain which regulates mood and feelings of well-being and happiness; abnormally low levels of serotonin can lead to depression. Selective serotonin reuptake inhibitors (SSRIs) are a class of psychotropic medications which are used to treat depression because they block the reuptake process and allow more serotonin to build up in the brain. Another common example of a psychotropic medication is lithium, which is often used to decrease the intensity of manic episodes and to treat depression and bipolar disorder. Lithium is thought to stabilize a person’s mood by strengthening nerve cell connections in portions of the brain which are associated with regulating mood and behavior.

 

Can I ask my doctor to prescribe generic medications?

Individual psychiatric medications, as with other drugs, are often known by two or more names. At a minimum, most medications have a name for the generic chemical compound and at least one branded name for marketing purposes. For example, the SSRI fluoxetine is often marketed as Prozac or Sarafem.

A rather loosely kept secret is that generic medications are typically around 80% to 85% cheaper than their brand-name counterparts, according to GoodRx. Contrary to popular belief, generic versions of prescription drugs are not merely similar “knock-off” versions, as generic household products or generic packaged foods may be. By law, a generic equivalent of a brand-name drug is required to: contain the exact same active ingredients; be identical in strength, dosage form, and route of administration; function the same way in the body; and meet the same quality standards set by the FDA for the brand-name drug. This means that asking your doctor for prescriptions for generic medications may pay dividends, helping you to save up to hundreds or thousands of dollars per year on health care.

According to a study conducted by Dr. Eric Campbell, Ph.D., professor of medicine at Harvard, around 40% of doctors sometimes or often provide a generic prescription simply because their patients ask for it. In some states, you can also ask your pharmacist for a generic refill of your brand-name prescription, unless your doctor has written “do not substitute” on a prescription for a brand-name drug, in which case you must take only the brand-name version. If you are not sure whether your medication has an FDA-approved generic equivalent, you can ask your doctor or search using the Drugs@FDA tool on the FDA’s website. You should always follow the direction of your physician and never take any medication in a manner other than prescribed.

What kinds of psychiatric medications are not available through SAMI-Aid?

The psychoactive properties of certain psychotropic drugs make them especially dangerous when not used appropriately. Drugs which the U.S. Drug Enforcement Administration (DEA) considers dangerous— such as those which have no recognized medial use, are habit-forming, have a high potential for abuse, lead to severe psychological or physical dependence, or have a high safety or dependence liability even with medical supervision—are designated as DEA-controlled substances. Narcotics, depressants, stimulants, hallucinogens, and anabolic steroids are all DEA-controlled substances. While physicians are sometimes allowed to prescribe DEA-controlled substances, they can do so only according to strict regulations. In the U.S., a physician cannot legally prescribe any controlled substance via telemedicine without a prior in-person examination.

Although certain narcotics such as oxycodone and fentanyl are occasionally prescribed for chronic pain relief, these are Schedule II controlled substances and cannot be prescribed via telemedicine. Adderall is a powerful stimulant, sometimes prescribed as an anti-seizure or anti-anxiety medication; it is a Schedule II controlled substance which cannot be prescribed via telemedicine. Benzodiazepines such as Ativan, Valium, and Xanax, though often used to treat anxiety or insomnia, are Schedule IV controlled substances and cannot be prescribed via telemedicine.

SAMI-Aid’s doctors and psychiatrists, through a policy emphasizing caution, decline to prescribe certain other types of medications which they believe to carry a high liability risk for telemedicine. Some of these may not be DEA-controlled substances, but nevertheless SAMI-Aid’s primary care doctors and psychiatrists will not prescribe any:

  • Gabapentin (Neurontin)
  • Medicinal marijuana
  • Erectile dysfunction medications
  • Sleeping pills
  • Muscle relaxants
  • Hair loss medications
  • Weight loss medications
  • Injectable medications (other than diabetes medications)

 

What kinds of psychiatric medications are available through SAMI-Aid?

Antidepressant medications such as SSRIs are not controlled substances and can be prescribed via telemedicine. Antipsychotic medications such as Abilify and Seroquel, used to control psychotic symptoms of bipolar disorder, are not controlled substances and can be prescribed via telemedicine. Lithium carbonate is not a controlled substance and can be prescribe via telemedicine. Beta-blockers such as propranolol, used to treat high blood pressure, are not controlled substances and can be prescribed via telemedicine.

Specific medications which SAMI-Aid doctors or psychiatrists have been known to prescribe include:

  • Abilify (aripiprazole)
  • Effexor XR (venlafaxine)
  • Guanfacine
  • Hydroxyzine HCl
  • Lamictal (lamotrigine)
  • Lexapro (escitalopram)
  • Lithium carbonate
  • Neurontin (gabapentin)
  • Propranolol
  • Prozac (fluoxetine)
  • Risperdal (risperidone)
  • Seroquel (quetiapine)
  • Strattera (atomoxetine)
  • Trazodone
  • Zoloft (sertraline)

 

In addition to medication, SAMI-Aid also offers an abundance of resources such as compassionate talk therapy. SAMI-Aid’s behavioral health providers offer a variety of specialties including relationship counseling as well as treatment of anxiety, depression, bipolar disorder, and more. You can create a free SAMI-Aid account today and schedule an appointment with a SAMI-Aid therapist or psychiatrist anytime for just $59.99. Signing up takes just about 2 minutes and gives you instant access to our teletherapy and telepsychiatry services for just $59.99 per visit, or get 2 free visits per month with SAMI-Aid Premium for $79.99 per month. If you have questions, feel free to email us at info@samiaid.com, call us at 1-844-SAMI-AID, or visit our website for more information.


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