Medication to Treat
Psychiatrists and psychologists both are trained to conduct psychotherapy. What distinguishes psychiatrists is that they are physicians and specialists. That means psychiatrists are medical doctors just like surgeons, internists, and obstetricians.
Following at least four years of college, they attend medical school for four years followed by four years of residency training during which psychiatrists specialize in treating patients with such illnesses as depression, bipolar disorder, anxiety disorders, addictions and adult ADHD. Because of this training, psychiatrists are highly skilled in the science and art of prescribing medications to the patients they treat.
Medications used by psychiatrist are typically very effective at treating the illnesses for which they are indicated. When you see Dr. Kline, he will always discuss with you what medication he believes you need, what symptoms it specifically treats, its side-effects, and how long it will take for the medication to be effective.
Many patients often report that they have tried multiple medications for their disorder, and they are confused by why the doctor wants to try it again. Non-psychiatrists often try a patient on a medication but discontinue it because of the medication's lack of effect. The question is did the physician take the medication to its highest dose. A medication cannot be considered a failure until the patient has tried the highest doses. That is just plain science. So, just because your primary care doctor tried a medication, doesn't necessarily mean that you shouldn't try it again. Also, some medications that have truly failed may work when combined with another medication. This is often the case with antidepressants.
Some medications used by psychiatrists are potentially addicting. These medications are controlled substances and they are highly regulated by the DEA. The DEA and local drug enforcement agencies enforce these regulations. With drug abuse so prevalent today, these medications are not prescribed without very good reason, and Dr. Kline checks on the use of these medications by his patients in several ways to insure that these medications are used appropriately. For prospective patients seeking such medications, you should understand that Xanax is never prescribed at your first visit and seldom in subsequent visits. Other drugs of this class are prescribed only after serious consideration and usually require that the patient also enter psychotherapy. You should also understand that we have ZERO TOLERANCE for medication misuse or sale, doctor shopping, or other illegal activities regarding these medications.
Dr. Kline prescribes no pain medication whatsoever.
All medications have side-effects. Patients often become reluctant to take medications because they get a book or go online and read all of the side-effects that a medication has. This may be a good example of when knowledge can be a dangerous thing. Of course all medications have side-effects. The important fact to remember is that serious side-effects are quite rare. What you read in a book or online are the side-effects and adverse reactions that have EVER been reported. You have in all likelihood already taken a medication that can cause death... like aspirin! Yes, people have died from aspirin -- and from practically every medication at some point in time. Common side-effects are usually mild and often just temporary while your system adjusts to the medication. When Dr. Kline prescribes a medication, he always discusses the common and the rare but serious side-effects. He and you will decide on a medication based on the risks, benefits, and side-effect profile of the medication.
Side effects generally occur because the medication molecule resembles another molecule normally found in the body. In fact, the medication molecule is so much like the normal body molecule that if fits in the receptor for that molecule and causes the same effect. Since these unintended effects are aside from the intended effects of the medication, they are called "side-effects."
Most medications are transformed in the liver which may activate the drug, inactivate the drug, or change the drug into another active form. This is called drug metabolism. These changes performed by the liver (which usually make the drug available for elimination from the body) are caused by protein molecules called enzymes. Sometimes the liver adds another molecule to the drug so that the body can eliminate the drug. How fast a drug is metabolized by the liver determines how often you must take the medication. Medications that are rapidly metabolized must be taken more often in order to maintain a therapeutic drug level.
Drug metabolism and drug elimination are the reasons that you have to take multiple doses of a medication over time. Think about it. If drugs were never metabolized and eliminated from the body, you would take just one dose of a medication.
Some drugs may interact with other drugs. The majority of drug interactions have no significant clinical effect, but some have pronounced effects and may be dangerous. Drug interactions may occur in a variety of ways. Some drugs inhibit an enzyme. If another drug is metabolized by the enzyme the first drug inhibits, them that second drug will not be metabolized as quickly and dose adjustments may be necessary to avoid the second drug's blood concentration from rising and becoming toxic. In similar fashion, enzymes may be induced by some drugs. This means that drugs that go through that enzyme will be metabolized more quickly and must be given in higher doses to compensate.
Drug interactions may also occur because one drug has more affinity for a carrier protein in the blood than a second drug. Medications generally exert their effects in the body when they are free in the blood, but a significant portion of a drug in the blood is actually bound to or "carried" on a plasma protein. You have probably heard of one of the most abundant plasma proteins, albumin. Anyway, the bound drug acts as a reservoir. As the free drug is gradually used up, the bound drug falls off the carrier protein and becomes free drug. Now if another drug has greater affinity for the carrier protein, it becomes bound and throws off the original drug. This causes the blood concentration of the original drug to rise.
Drug interactions are rather complicated (just one of the many reasons that medical training is so essential if you are to prescribe medications) but can be very significant. Dr. Kline is aware of these known interactions and often adjusts medication doses in anticipation of them.
* * * Please Note: We are no longer accepting patients with
Medicaid, Medicare, Aetna, UHC/UMR, or Suboxone patients. * * *