Reviewed 2026-09-21 · DNP, FNP-BC, PMHNP-BC
ADHD medication titration after a real differential
Insurance coverage of a medication is not the same as a clinical indication.
What Medication Management actually includes
Leftover 'affordable refill' slugs are not a cash-pay promise.
Tapering is scheduled. Paroxetine, venlafaxine, benzodiazepines, and stimulants each have different withdrawal physics.
Stressors we document in Hollywood
Antidepressant-induced mixed features were never named.
Trazodone plus an opioid plus a benzodiazepine was never reconciled.
A genetic test PDF sits in your email with no clinician interpretation.
What we rule in — and rule out
Not indicated as a replacement for inpatient care when risk is high.
Hypnotics only after sleep differential, not as a standing nightcap.
Not indicated to supply controlled substances without a supporting diagnosis and monitoring plan.
Perinatal prescribing only with risk-benefit counseling.
Protocol elements we do not skip
Lithium: level, TSH, creatinine, pregnancy test as indicated.
MAOI diet and washout rules if that class is ever used.
New antidepressant: short-interval follow-up for activation and SI.
Informed consent stored in the chart.
From intake to follow-up: Medication Management
Revisit the original diagnosis if two classes have failed.
Counsel on onset, alcohol, driving, pregnancy, and overdose risk.
Reconcile the current list, including OTC, cannabis, and hormones.
If side effects appear, do not wait for the next quarterly slot — tighten follow-up.
Questions we hear about Medication Management
What if side effects start this week?
Call the office. Do not wait for a distant follow-up if symptoms are severe. ER for emergency symptoms.
Will you take over my current list?
After a diagnostic review. We do not rubber-stamp unsafe combinations.
What is GeneSight?
A pharmacogenetic panel that may adjust probabilities for certain antidepressants. It does not diagnose ADHD or depression.
Can you prescribe if I am traveling?
Only if you are physically in a state where we are licensed — currently Florida telehealth.
Are leftover 'affordable refill' URLs a discount?
No. They are retained slugs. Billing follows insurance contracts.
Do you prescribe benzodiazepines long-term?
Rarely, with a documented indication and a taper orientation. They are not a standing plan for GAD.
Medication Management versus a generic template visit
We will not 'optimize' a regimen that was never indicated.
A pharmacy auto-refill is not medication management.
Primary-care SSRIs without a bipolar screen are a common reason people land here.
Next step
Crisis now is 988 or the ER — not the booking form. For non-urgent Medication Management, use (888) 307-2199 during weekday hours.
Questions about insurance, labs, or whether Medication Management can be done by video: call (888) 307-2199 before you book so the visit type matches the clinical need.
Related care
Clinician: Dr. Dorothy Chatelier, DNP, FNP-BC, PMHNP-BC, Psychiatric Mental Health Nurse Practitioner. Last medical review: 2026-09-21.
Florida telehealth psychiatry is available to established and new patients located in Florida at the time of the visit, subject to licensure and clinical appropriateness. An in-person evaluation at the Hollywood office may be recommended when a physical exam, vital signs, or a more complete diagnostic interview is needed.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. It does not establish a provider-patient relationship. Always seek care from a qualified clinician for questions about a medical or psychiatric condition. If you are in crisis, call 988 or go to the nearest emergency department.