Moving to Non-prescribing Therapist ... How to Get Meds?
January 3, 2020 7:14 AM   Subscribe

I'm moving from a prescribing (Lamotrigine) MD therapist to a non-prescribing (non-MD) therapist.

I'm moving from a prescribing (Lamotrigine) MD therapist to a non-prescribing (non-MD) therapist.
I've been told I can continue getting meds via an APRN.
My GP's practice has an APRN, but I don't necessarily have to use him.
I live in Connecticut.
So ...
1) What are the mechanics of continuing meds in this scenario?
2) Does my non-prescribing therapist have to establish a relationship with my GP and/or APRN?
3) Would I likely be required to physically visit an APRN (big hassle) to get a script every time or might I be able to do this over the phone?
4) What criteria would a GP and/or APRN apply to deciding to write scripts based on a visit/phone call?
5) Anything else I need to know?
6) Thanks.
posted by ZenMasterThis to Health & Fitness (7 answers total)
My psychiatrist left the state (not my fault!) and his replacement was unacceptable. So I asked my GP to continue prescribing my anti-depressant. After a little hesitation, he said yes but added that if my mental needs changed, I'd have to see a psychiatrist. He couldn't help me. Reasonable response, I think.
posted by tmdonahue at 7:17 AM on January 3, 2020 [1 favorite]

My therapist works directly with my GP via written communication. The therapist provides the GP with the diagnosis, some narrative about my situation, and a recommendation of which meds. The GP then discusses it with me and refines the recommendation and dosage. It has been a great approach. Granted, I have a high level of trust in both my therapist and GP, and they had an established relationship prior.
posted by slogger at 7:38 AM on January 3, 2020

A lot of this depends on your GP and their practice. It might be as easy as asking them to prescribe the drug and they will write you a script with refills, and will reauthorize when your pharmacy calls them. They probably will require that you be seen at least annually, and maybe more often, depending on the details of the drug and your physical and mental health situation, or based on the specific policies of their practice. They may also suggest or require labwork on some sort of schedule. I would try a phone call to ask them about their procedures for this, but you may want (or need) to set up an office visit to discuss in more detail.
posted by Rock Steady at 8:07 AM on January 3, 2020 [1 favorite]

On your #3: lamotrigine is not a controlled medication, so as long as the dose isn't changing, you probably will be able to see the prescribing provider just once a year. I'm not familiar with Connecticut law on phone prescribing, but everywhere else I've worked across the East Coast requires an in-person visit at least yearly in order to document an ongoing, bona fide patient-doctor relationship.

Your PCP might be comfortable taking over this prescription herself as part of your annual visit, or she might say you have to see the psych NP; the only way to know is to call and ask.
posted by basalganglia at 9:22 AM on January 3, 2020 [1 favorite]

Most PCPs are happy to work in-cooperation with a therapist. My PCP handles my psych med needs, and will speak with my therapist if need be.
posted by Thorzdad at 10:39 AM on January 3, 2020

My GP prescribes my Pristiq, Xanax, and Lunesta. She does not communicate with my therapist.
posted by missrachael at 11:03 AM on January 3, 2020

I do not currently have a psychiatrist and my GP prescribes me Lamotrigine and Latuda. In the past they've been willing to experiment with the prescriptions to find a good fit. I find this invaluable since psychiatrists are so difficult to work with, but I sometimes wonder if they're acting outside of their area of expertise.
posted by zeusianfog at 11:58 AM on January 3, 2020

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