Frequently asked questions.

IMPORTANT: You must be physically present in Washington state at the time of the visit. We can not visit or change your plan of care whenever you are outside of the state of Washington.

A high-speed internet. A stable high-speed WiFi internet may be better than unstable spotty cellular internet.
A computer or a smart phone with a microphone and a camera. While a cell phone may be adequate, for a better experience, we recommend using a laptop or desktop computer with a camera, microphone, and wired/wireless Bluetooth headphones.
A private quiet location.

First, please ask your pharmacy for a med refill. If they do not have a prescription on file, they would usually send a refill request. Please contact us if further action is needed.
Requests for medication refills outside of a scheduled appointment are subject to individual evaluation and complex decision making. A $25 fee will be charged if the refill is approved.

Individuals react differently to medications based on their genetics, coping skills, lifestyle, sleep, diet, exercise, social support, personal resources, and concurrent medical issues. Like most medications, psychiatric medications may or may not cause side effects at typical prescribed doses. Some individuals may experience side effects while others may have no side effects. It is important to ascertain that a medication's benefits outweigh its side effects. Please continue to collaborate with your provider to monitor side effects. Your provider may adjust medication doses, time of administration, or switch to a different medication as needed to mitigate side effects.

Individuals react differently to medications based on their genetics, coping skills, lifestyle, sleep, diet, exercise, social support, personal resources, and concurrent medical issues.

It is important to ascertain that a medication's benefits outweigh its side effects.
Medications are used with an aim to reduce disruptive symptoms and improve function and quality of life. The medications are not designed to cure symptoms. Stopping medication may lead to the return of disruptive symptoms.
Some medications produce symptomatic benefits with the first dose while other medications may take weeks to produce symptomatic improvements. Some medications take 4-8 weeks to produce their full benefit. Finding the right medication can take time but is often rewarding.
Please take medications as prescribed. Please do not change medication doses or administration frequency on your own.
A comprehensive treatment plan often includes mental health counseling, lifestyle improvements, and other services in addition to medications.
For additional information on medication, visit Mental Health America.

Combining alcohol with certain medications, particularly those with sedative effects, can increase the risk of adverse events, including falls, driving accidents, and fatal overdoses. Alcohol can alter the metabolism and pharmacological effects of many common medications, and conversely, many medications can alter the absorption and metabolism of alcohol. Always check with your healthcare provider about potential interactions. Avoid alcohol if unsure.

If you miss 2-3 doses, please contact your provider through the patient portal to make a decision about how to resume the medication.

Do NOT restart Lamotrigine (Lamictal) on your own if you miss it for 4-5 days. Restarting it at full dose may cause a rare but serious life threatening rash called Steven Johnson's syndrome.
- Stevens-Johnson Syndrome - Johns Hopkins Medicine.
- Stevens-Johnson Syndrome - Cleveland Clinic
- Stevens-Johnson Syndrome - National Library of Medicine, USA.
- Stevens-Johnson Syndrome - National Health Service