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It is a common complaint from women going through menopause that they find themselves facing a wide range of emotional and physiological symptoms. Menopausal symptoms typically reported include irritability, moodiness, and overwhelming sadness, not to mention feeling over-fatigued, experiencing memory lapses and poor ability to think clearly. For women already diagnosed with ADHD, they become acutely aware that ADHD symptoms become more pronounced over a period of 10 years, starting in peri-menopause and continuing non-stop into menopause. Hormonal fluctuations do result in intensified ADHD symptoms. For women with undiagnosed ADHD who enter menopause they may find the intensity of the symptoms so great that they seek mental health intervention.

Hormonal Effects of Menopause on ADHD

By the time of menopause, a woman’s estrogen level has dropped by 65% over the course of the prior 10 years. Psych Central reports that decreasing estrogen leads to decreased levels of the “feel good” serotonin and dopamine levels found in the brain chemistry. The drop in estrogen levels can exacerbate ADHD symptoms which can appear suddenly in women in their 30s and 40s as well as in women who have reached menopause. Decreased serotonin levels can lead to a depressed mood, while decreased availability of dopamine directly affects the appearance of increased ADHD symptoms.

Common Challenges of ADHD during Menopause

An insufficient amount of dopamine is a classic sign of ADHD. Additional declines of dopamine levels during the peri-menopause and menopause phases may result in more severe difficulties with concentration, attention and focus. In addition, women may discover that they are having trouble staying organized, managing their time, making thought-out decisions or finding that they become forgetful of even common routine activities and appointments. With peri-menopause starting about 10 years before menopause, it is important for women to know that there is help for their symptoms. Being diagnosed with ADHD opens the door to forming a complete mental health treatment plan that can provide relief.

Treatment Options for ADHD and Menopause

Attitude magazine reports it is important to find an ADHD menopause experienced psychiatrist who is able to set up a successful treatment strategy and make medication adjustments as needed to meet your changing needs through the decades long peri-menopause phase to the menopause stage. Women who experience intense PMS (pre-menstrual syndrome) may have undiagnosed ADHD. Receiving a correct comprehensive diagnosis can lighten the monthly depression, anxiety, irritability and “fuzzy headed” feelings that PMS and the pre-menstrual to menstrual phase bring.

Atlanta ADHD Menopause Psychiatrist

Dr. Darvin Hege is the expert when it comes to successful treatment of ADHD and menopause. Call the office for psychiatric treatment that will put your ADHD menopausal symptoms in check.

If times are tight, the search for ways to find discounts or save money is a common occurrence. Generic medications are often substituted when allowed, primarily due to insurance coverage policy or as a means to reduce co-pay cost out-of-pocket. Many prescribed physical health medications are used long term for chronic health issues or disorders, just as treatment for psychiatric and mental health conditions often involve long term pharmacological treatment. The monetary savings however may not be in the patient’s best interest who may discover generic is not the “right fit” for their needs.

Generic and Brand Name Psych Med Differences

The FDA’s definition of a generic drug is that it is pharmaceutically equivalent to its brand name drug, containing the same active ingredient, same strength, same dosage form as well as delivery of drug (i.e., swallowed, a patch worn, or injected). The generic version must perform approximately the same as the brand name drug. The key word approximately indicates that there will be a small or slight difference in the manufacture of the generic drug, whether it be inert ingredients added, coloring or dye used, as well as the shape or form.  In addition, the pharmacy uses a variety of manufacturers so that while the prescription itself may not change, the medication may appear different from month to month.

Generic Psychiatric Medication Concerns

While the majority who take generic psychiatric medications experience no problems, there are thousands who face increased side effects, exacerbation of their mental health symptoms, behavioral changes, development of allergies or a significant relapse that could require hospitalization. Generic psychiatric medications are supposed to deliver the same amount of active ingredient to receptors in the brain, however differences in the formulation of the product may cause more harm than help. An experienced and practiced psychiatrist is able to work with you on finding a generic medication that will work, as well as modification of the drug, dose or timing so that cost savings can be achieved without loss of mental health gain.

Top 10 Psychiatric Generic – Brand Name Medications

The top 10 prescribed U.S. psychiatric medications are ranked in a PsychCentral.com study. The medication with the highest ranking is Xanax or alprazolam used for anxiety at almost 48 million prescriptions per year. The psychiatric medication Seroquel or quetiapine, typically used for bipolar disorder or depression is ranked number 10 with over 14 million scripts per year.  The other psychiatric medications ranked in the top 10 of prescribed meds are Celexa/citalopram, Zoloft/sertraline, Ativan/lorazepam, Prozac/fluoxetine HCL, Lexapro/escitalopram, Desyrel/trazodone HCL, Cymbalta/duloxetine, and Valium/diazepam – in total, the top 10 ranking prescriptions exceed 270,000,000 a year. Working with an expert in both generic and brand name psychiatric medication is the best way to ensure you have a successful mental health treatment plan.

Atlanta Psychiatric Medication Doctor

Call Dr. Darvin Hege, the Atlanta psychiatrist of choice for successful medication management of your mental health needs using generic, brand name or a combination of psychiatric medications that work for you.

Vivitrol is a rather new treatment for alcohol abuse and addiction. The trials that got the FDA approval showed significant improvement over placebo in reducing drinking and/or helping to maintain sobriety. Vivitrol (naltrexone) is administered as an intramuscular injection once each month, and it is slowly absorbed into the bloodstream during that period. Naltrexone, the active medication, appears to help by reducing cravings for alcohol and reducing euphoria if alcohol is ingested. Naltrexone can be given orally daily to achieve the same effects. However, a patient may forget to take the naltrexone or choose not to take it for a day or longer and resume drinking. If taking an injection one time a month, the patient only has to make a decision once a month to get the benefits of that positive decision all of the next month.

Vivitrol may be free with the manufacturers discount for patients who have insurance. For those who don’t have insurance, the medication and the injection process is usually in the $600 range each month.

The patient needs to be under the care of a physician, preferably a specialist in alcohol addiction, who can order and manage the treatment and provide additional expertise in administering or referring the patient to a specialist in cognitive behavioral therapy. Cognitive behavioral therapy includes many formats such as one to one substance abuse counseling, 12 step meetings, working with a sponsor, and advocating changing one’s social life from drinking associates to recovering friends.

An addiction specialist can provide options to Vivitrol injection treatment if the patient prefers some other form of medication treatment or has side effects to Vivitrol. Options include oral naltrexone daily tablets, Campral, Topamax, or Antabuse. An addiction specialist who is also a psychiatrist is well prepared to evaluate and prescribe medication for potential co-occurring psychiatric conditions that may be contributing to the development and perpetuation of the alcohol problem. Bipolar patients have an eightfold risk of alcohol problems. Depressed patients have at least 8 twofold increase risk of alcohol problems. Anxiety disorders, ADHD, and drug abuse problems all increase the risk of alcohol problems. Patients who are properly diagnosed, treated with the appropriate medication, and improve psychiatrically have a significantly improved chance of getting away from alcohol.

If you would like to be evaluated for Vivitrol or another medicine to help reduce or stop drinking, call Atlanta psychiatrist Dr. Hege’s office today.

Patients often want some treatment that will help their ADHD without using a stimulant such as Adderall, Ritalin, Vyvanse or Concerta. They may have different reasons. Some people have intolerable side effects from the stimulants or they may have insufficient help from them. Some people don’t want to be on stimulants for fear they may become physically or psychologically dependent on them. Others may be in recovery from substance abuse problems and don’t want to relapse from taking an abusable medicine. And some people just don’t want to take any medicine.

There are several non-stimulants, non-abusable, non-DEA controlled medications. Strattera is effective in 70% of ADHD patients. Wellbutrin is effective in 57%. The stimulants are effective in 80 to 90% of ADHD patients. Provigil is effective in a considerably lower percentage of patients. Clonidine and guanfacine tend to be less robust in reducing ADHD symptoms of inattention. Omega-3 fatty acids are helpful in a small group of patients. Effexor and Desipramine help some patients.

The major drawback to Strattera is that it takes 1-3 months to get a significant to maximal benefit, and the fact that it may cause a very rare liver toxic reaction has intimidated some patients from taking it. The advantages of Strattera over the psychostimulants includes its effective benefit 24 hours a day once it is working and it’s continuing to work for days to weeks if it is missed or forgotten.

Wellbutrin, like Strattera, has a lagging onset of benefit. So it can take 6 to 12 weeks to see the full benefit. Wellbutrin is an antidepressant as well as an ADHD medication. If the patient has depression as well as ADHD, Wellbutrin may be a parsimonious solution.

Provigil is usually well received by patients for whom it works. However, it is quite expensive and is seldom covered by insurance companies because it is not FDA approved for ADHD.

Clonidine and guanfacine are often used to augment stimulants. They also are beneficial to use in evenings or at bedtime because they tend to assist sleeping rather than disrupting sleep like the stimulants.

Omega-3 fatty acids have been more effective than placebo in studies where it was used along with a stimulant.

Effexor and Desipramine are older antidepressants that are frequently limited in their use for ADHD because of side effects.

Neurobiofeedback has now been classified as an effective treatment for ADHD by the American Psychological Association. It requires 30 to 60 sessions of computer guided and psychologist supervised sessions over 6 to 12 months which usually cost in the range of $4000-$7000. By the end of the therapy there is a group of patients who have a reduction in ADHD symptoms as much as a patient who is taking a stimulant. Long-term studies of several years have found some patients maintain this level of benefit.

Contact Atlanta psychiatrist Dr. Hege’s office for an appointment for an evaluation for the most helpful treatment for you.

Seeking help for mental illness or instability is a hard yet courageous step to take. Finding out that you have a psychiatric disorder or chronic mental illness is a scary time for most people, yet finding out years later that you were wrongly diagnosed in the first place can be even more frightening.

Misdiagnosis Occurs 69% of Time

Health Line reports wrongly diagnosing personality disorders as a bipolar disorder occurs 69% of the time. In addition to this erroneous diagnosis, more than 33% remain misdiagnosed for a decade or more; the remainder live with the incorrect treatment for a period of between 6 and 7 ½ years. Because some psychiatric or mental health issues may be hard to pinpoint depending on the phase or cycle of the disorder, it is critically important to find a qualified and experienced mental health practitioner.

Misdiagnosis Brings Serious Consequences

Brown University reported on a 4 year study showing 40% of patients diagnosed with bipolar disorder were later correctly identified as having a borderline personality disorder, major depressive disorder, antisocial personality disorder, post-traumatic stress disorder or with having an eating and impulse disorder. One major consequence of having a wrong diagnosis means that it is followed by the wrong treatment. Bipolar disorder may be treated with a mood stabilizer, yet treatment for borderline personality disorder follows a different path. Prescribing bipolar medications to someone without bipolar disorder needlessly exposes the patient to serious medication side effects that include a medical impact to renal, hepatic, immunologic and metabolic functions that can have life threatening consequences.

True Bipolar Disorder Also Misdiagnosed

Bipolar disorder is a biological illness where specific medications are essential for treatment. It is a chronic illness that requires life-long treatment and monitoring. Health Line reports that while many patients are misdiagnosed with bipolar disease, it is not uncommon for a bipolar diagnosis to be missed as most patients will seek out treatment during the depressed phase of their bipolar cycle. Mental health professionals may see the depressed state as just that and give a misdiagnosis of unipolar depression, or some other form of depression. Finding a qualified psychiatrist or mental health professional who is capable of making the correct diagnosis is important in that it will point the way to the right effective treatment – not to years of suffering through an incorrect treatment plan.

Atlanta Diagnostic Psychiatrist

Misdiagnosis is a common problem that can impact not only the patient’s life, but their family’s lives for 5 to 10 years before the correct diagnosis and treatment is discovered. Dr. Darvin Hege is a highly regarded Atlanta psychiatric doctor with decades of experience and decades of developing a successful treatment plan for his patients. Call for an appointment today – help really is only a phone call away.

There are three main advantages to psychiatric self-pay over health insurance coverage to pay for psychiatric evaluation, treatment and follow up. While many feel managed care reduces out of pocket expenses, this decision comes with a price. With so much variation between insurance companies including the types of policies they offer, it is not feasible to discuss all the differences between individual plans or work supplied group coverage. Today use of “networks,” “managed care,” or “HMO’s” may help cut costs for the patient as well as the insurance company; however, these types of policies typically place restrictions on who you can see, what you may pay “out of network,” as well as provide incentives to mental health providers to provide less treatment overall to their patients.

Insurance Plans Interfere with Process of Therapy

There is a growing trend among mental health professionals to provide services on a self-pay basis. The U.S. mental health system has serious coverage gaps, where psychiatric service is generally slated for limited payments and encounters. Very often group insurance plans require the patient to start with telephone-based counseling through an employee assistance program, or require first starting with a limited number of mental health practitioners including social workers or a family counselors, before authorizing an evaluation and treatment by a network or plan psychiatrist. Even if the plan allows partial payment for an out of network practitioner, the paperwork,  appeals for denied treatment, wait time for additional authorizations or restrictions to time or number of days, directly impact and interfere with the process of therapy and developing a therapeutic working bond.

Psychiatric Self Pay vs. Insurance Coverage

The Therapist Directory  categorizes the three main differences as  1.  Payment,   2.  Choice of Therapist,  3.  Choice of Length / Type of Treatment

Here are some of the other differences:

Privacy

• Self Payment: Info strictly confidential; therapists unable to share information about treatment without prior patient written consent, except in cases of danger to self or others.
• Insurance: Info required to justify treatment. Therapist must provide a diagnosis, treatment plan and progress notes. Info put in database where others may access it.

Choice

• Self Payment: Freedom to pick a therapist, get a second opinion, or change therapists.
• Insurance: Some plans limit choice of therapist, require treatment through a psychiatrist in their network, or provide no reimbursement for out-of-pocket care

Duration & Type of Treatment

• Self Payment: Patients active participants in their care. Treatment sessions continue as long as necessary without interference or restriction.
• Insurance: Plan determines session length, type of treatment, maximum dollar payout, or visit frequency

Atlanta Psychiatric Self Pay Treatment

Dr. Darvin Hege, a leading area self pay psychiatrist for over 30 years does not subscribe to insurance company restrictions or third party privacy invasions, but rather works with you to provide a successful mental health treatment plan that is unique to your needs. Call us today.

National Institute of Health (NIH) research have taken a clinical look at “winter blues” in comparison with a more severe type of depression called seasonal affective disorder or SAD. NIH research has looked at over 30 years of data to report the term “winter blues” is not a medical diagnosis. “Winter blues” may come and go over a period of a few days or weeks at a time. Seasonal affective disorder / SAD interferes with the ability to function on a daily basis for up to 5-6 months a year. Suffering through months of depression that not only affects you, but also family, friends and co-workers can be successfully treated by an experienced mental health practitioner.

Seasonal Affective Disorder a Form of Depression

Seasonal affective disorder is a form of depression characterized by recurring episodes of mild to severe periods of depression. In addition, other psychiatric disorders, such as bipolar illness, also experience seasonal changes with depressive episodes that may mimic seasonal affective disorder. Receiving mental health treatment from a well-qualified experienced psychiatrist is critical in assuring an accurate diagnosis or multiple diagnoses in the evaluation and treatment planning for your unique set of symptoms and behaviors. Medicine.net reports that up to 10% of adults suffer through SAD, with women diagnosed four-times as often as men. While the average age to develop SAD depression is 23, people of all ages can develop this form of recurring depression.

Symptoms of SAD Depression

While some do not exhibit all of these symptoms, the most common characteristics of recurrent depression or seasonal affective disorder reported by the National Alliance on Mental Illness include:

• Recurrent episodes of depression, usually seen in the late fall and winter
• Periods of depression are typically mild to moderate, but can reach severe states
• Thoughts of suicide is a risk during more severe depression episodes
• Pattern of insomnia or complaints of poor sleep patterns
• Recurring pattern of oversleeping
• Reports of carbohydrate craving and accompanying weight gain
• Decreased sexual interest and libido
• Feelings of hopelessness with daily life
• Lack of interest in normal daily activities
• Decreased socialization and interaction with peers

When SAD depression occurs in the summer, the symptoms most commonly exhibited include:

• Insomnia
• Poor appetite and weight loss
• Difficulty concentrating on basic tasks
• Crying spells
• Irritability
• Thoughts of suicide with severe depressive episodes

Atlanta Seasonal Affective Disorder Depression Psychiatrist

The “winter blues” are a form of depression that can be successfully treated following a comprehensive psychiatric evaluation to determine the type, form and degree of depression being experienced. Treatment and management is tied to correct diagnosis of one, two or multiple mental health issues being exhibited. Call the office and schedule an appointment if you’re experiencing these issues.

The National Association of Mental Illness reports that bipolar disorder can be successfully treated following an accurate diagnosis. While there is no cure for bipolar disorder, finding the correct medication regime is an essential part of treatment. The quantity and severity of bipolar episodes can be regulated via a medication maintenance program; however, the appearance of sporadic episodes of mania or depression require additional treatment, which can include medication adjustments and management.

Bipolar Medications Require Discovery Time for Optimal Dosage

Bipolar disorder is a complex illness that often requires patience by the patient. Determining the right bipolar medication(s) typically revolves around your psychiatrist making critical adjustments over time to achieve the desired effect. Mayo Clinic reports show some bipolar medications may take weeks to even months to take full effect; changes are often made one medication at a time to properly evaluate which one will not only work to relieve your symptoms, but which also has the least troubling side effects.

Common Medications for Bipolar Disorder

There are three main types of medications that are used to treat bipolar disorder. The National Institute of Mental Health defines these psychiatric medications as including mood stabilizers, antidepressants, and atypical antipsychotics. Examples of these three types of bipolar medications are:

• Mood Stabilizers include the use of Lithium (Lithobid), and anticonvulsants such as valproic acid (Depakene, Stavzor), divalproex (Depakote), or lamotrigine (Lamictal). Lithium requires periodic blood tests. Common side effects include dry mouth, digestive issues, restlessness, weight gain, drowsiness, or dizziness. Medication may require periodic blood tests to determine medication blood levels and physiological effects on internal organs.
• Antidepressants may be used by your psychiatrist depending on your symptoms. Some of these drugs include MAO inhibitors, tricyclics, or Symbyax. Common side effects with antidepressants include reduced sexual desire and response, weight gain, drowsiness, or increased appetite. Some of these bipolar medications require careful monitoring for potentially dangerous side effects.
• Antipsychotics include aripiprazole (Abilify), olanzapine (Zyprexa), risperidone (Risperdal), and quetiapine (Seroquel). Side effects may include weight gain, sleepiness, tremors, blurred vision and rapid heartbeat. Use of antipsychotics for bipolar disorder may also affect memory, attention, focus, as well as the possibility of causing involuntary facial or body movements.

Your bipolar disorder psychiatrist will determine which medications fit with your symptoms and lifestyle following a comprehensive evaluation. Adjustments and changes will be made over time to provide you with an optimal psychopharmacology regime that meets your unique needs. An experienced psychiatrist may also prescribe other medications such as anti-anxiety medications on a short term basis to address anxiety and poor sleeping patterns.

Atlanta Bipolar Disorder Psychiatrist

Dr. Hege, your bipolar disorder psychiatrist, can help turn your life around without years of suffering through misdiagnosis. Contact us today to request a consultation.

There are numerous reasons why a person taking psychiatric medication will decide to stop taking them. The decision to stop made without mental health consultation may because they feel better and believe they no longer need the medications. Additional influences include family or friend pressure to stop, feeling a stigma is attached to those who take psych meds, fear of personality change, discomfort from side effects, or other personal reasons.

Stopping Psych Meds Abruptly Release Many Symptoms

Psychiatry Online reports abruptly stopping psych medication can quickly cause a rebound or return of the symptoms that had previously been held under control for months or years. Depending on the medication being taken, the consequences of stopping their use include withdrawal symptoms, occurrence of new symptoms, or even the appearance of worse symptoms then were experienced prior to the start of psychiatric treatment.

Going “Cold Turkey” with Psych Meds Life Threatening

The decision to stop taking psych meds without benefit of mental health or psychiatric planned medication reduction or change can be dangerous, even life threatening. Withdrawal can bring distressing reactions including potentially fatal seizures with unmonitored stoppage of psych meds. It is critically important to have medical guidance when stopping any psych meds that affect the central nervous system; the biochemical balance of the brain needs to adapt and stabilize to changes over time to prevent a medical crisis.

Management of Time Course and Side Effects Important

Working with an experienced psychiatrist specializing in psych meds ensures a smoother transition during reduction of medications if that is the decision you have reached. Other options your Atlanta psych med psychiatrist may present include switching medications, slow reduction in dosage, cognitive behavioral therapy, reducing or eliminating some psych meds while keeping essential psych medication in place, adjunct therapy, as well other proven strategies.

Psych Med Psychiatrist Alerts you to Expected Symptoms

Working with your Atlanta psych med psychiatrist is crucial throughout changes or reductions in prescribed psychotropic medications. Side effects and possible problems are more tolerable when you know what to expect as well as being aware of certain symptoms or behavioral changes that need to be immediately reported to your psychiatrist. Changes or return to prior dosages are more easily managed when you are working closely with your Georgia psychiatric med psychiatrist.

Slow Dose Reduction of Psych Meds Most Successful

Psych Central.com reports some psychiatric medication studies have shown the slower the dose is reduced the chance of relapse is reduced by one-half or more. With many psychotropic drugs however, such as antipsychotics and mood stabilizers, studies have not been well established to determine percentage of success or relapse. The best recommendation is to work closely with your psychiatrist to gradually make changes and adjustments over time.

Dr. Darvin Hege, a highly regarded Atlanta psych meds psychiatrist, brings decades of successful experience to your evaluation, program strategy, medication regime, and in working with you to achieve optimum results. Contact us to schedule a consultation.

The Journal of Lifetime Learning in Psychiatry reports a growing number of pregnancies where psychiatric illness either predates or emerges during the course of the pregnancy. There are more than 500,000 pregnancies in the U.S. every year with a documented psychiatric illness and 33% of all pregnant women are prescribed a psychotropic medication at least once during the course of their pregnancy. While use of psychotropic medications may be a cause of concern of fetal safety during pregnancy, 30 years of research indicates many medications may be used safely. In some cases, discontinuing use of prescribed medications is not a safe option when reviewing the risks associated with psychiatric illness.

Psychiatric Illness Relapse up to 68% in those who Discontinue Medications

For many, pregnancy is a time of feeling both emotionally and physically well, however up to 20% of women develop a mood or anxiety disorder during pregnancy. Women with a history of psychiatric illness who choose to stop their psychotropic medications are found to be highly vulnerable to relapse. Women’s Mental Health online report studies show a 26% relapse rate for those who continue with psychopharmacology treatment as opposed to 68% that relapsed after discontinuing their prescribed psychiatric medication. Data indicates the risk of relapse was five times greater for those pregnant women who stopped their treatment medication for a mental illness or disorder. Relapse rates show similar findings for those women diagnosed with anxiety, panic, depression, mood disorder or bipolar disease.

Risks of Discontinuing Psychiatric Medications During Pregnancy 

It is critical to develop, pre-pregnancy if possible, a good working relationship with an expert not only in psychiatric treatment, but with a psychiatrist who combines a long standing history of successful individualized treatment strategizing, with the ability to tie in adjunct therapies or cognitive behavior intervention. Some of the risks involved in stopping psychiatric medications during pregnancy include:

• A decrease in the likelihood to receive adequate prenatal care
• A decrease in the ability to make good decisions
• An increase in use of alcohol, tobacco or illegal substances
• An increase in the potential to take part in dangerous behaviors
• Delivery of a child with low birth weight, or fetal growth retardation in depressed mothers
• Preterm delivery as a complication with mothers experiencing anxiety, panic or distress
• Increased risk for development of pre-eclampsia for mothers experiencing depression or anxiety/panic
• Increased risk of immediate treatment for infant respiratory distress, hypoglycemia or other health issues

Atlanta Mental Health Pregnancy Psychiatrist

Careful management of mental illness medications along with cognitive behavioral therapy during pregnancy can provide the optimal outcome for mother, family and baby. Dr. Darvin Hege is committed to providing individualized treatment planning that works for you.

Call to schedule a personal appointment with Dr. Hege today.