Psychiatric Medication Management in Southlake, TX
Personalized prescribing and monitoring by a board-certified psychiatrist – because medication is only part of the picture
What Is Psychiatric Medication Management?
Psychiatric medication management is the process of finding, prescribing, and monitoring medications that help treat mental health conditions. It goes far beyond simply writing a prescription. A comprehensive medication management approach includes a thorough assessment of your psychiatric history, medical conditions, current medications and supplements, past treatment responses, family history, lifestyle factors, and personal goals.
Dr. Laura Fredes, a board-certified psychiatrist, takes time to understand your unique situation—not just your diagnosis, but who you are as a person. She considers how you sleep, what stressors you face, your work and family demands, any medical conditions, and whether therapy or lifestyle changes might reduce your need for medication or enhance its effectiveness. This is why medication management with a psychiatrist differs fundamentally from getting a prescription refill from a primary care doctor. A psychiatrist has specialized training in psychopharmacology—the science of how psychiatric medications work, interact with other drugs, and affect different people differently.
The goal of medication management is not to medicate your personality away or to mask problems that need to be addressed through therapy or lifestyle change. Rather, it’s to use medication thoughtfully and strategically to reduce suffering, restore functioning, and create a foundation from which therapy and personal growth can happen.
When Medication Management May Be Right for You
While every situation is unique, medication management is commonly recommended for several categories of psychiatric conditions:
Anxiety Disorders
Generalized anxiety disorder, social anxiety, panic disorder, and specific phobias often respond well to SSRIs (selective serotonin reuptake inhibitors) or SNRIs (serotonin-norepinephrine reuptake inhibitors). Some people benefit from short-term anti-anxiety medication for acute episodes, while others need longer-term treatment to manage persistent worry, physical symptoms like racing heart or tremor, or avoidance behaviors.
Depression
Major depressive disorder, persistent depressive disorder (dysthymia), and depression with anxiety features typically respond well to antidepressant medication. If you experience persistent sadness, loss of interest in things you normally enjoy, sleep disruption, appetite changes, fatigue, difficulty concentrating, or thoughts of worthlessness, medication can help restore your mood, energy, and ability to function while you engage in therapy.
ADHD (Attention-Deficit/Hyperactivity Disorder)
Whether diagnosed in childhood or adulthood, ADHD often responds powerfully to medication. Stimulant medications (methylphenidate, amphetamine-based) and non-stimulant alternatives can significantly improve focus, impulse control, organization, and executive function. Many adults don’t realize they have ADHD until they see a psychiatrist—it’s often masked by anxiety, depression, or burnout.
Obsessive-Compulsive Disorder (OCD)
OCD typically requires higher doses of SSRIs than anxiety disorders, and sometimes combination therapy. When treated effectively, medication can quiet the obsessive thoughts and reduce the urgency to perform compulsions, making it possible to engage in behavioral therapy more successfully.
Bipolar Disorder
Bipolar disorder—characterized by alternating episodes of elevated or irritable mood (mania or hypomania) and depression—usually requires mood-stabilizing medication as a foundation. These might include lithium, valproate, lamotrigine, or atypical antipsychotics. This is one condition where medication is typically considered essential, not optional.
PTSD (Post-Traumatic Stress Disorder)
PTSD symptoms—intrusive memories, nightmares, hypervigilance, emotional numbing—often improve with SSRIs, especially when combined with trauma-focused therapy. Some people also benefit from medications that target sleep disruption or anger.
Insomnia
Chronic insomnia affects mood, cognition, and physical health. Depending on the cause and your preferences, medication options range from low-dose antidepressants to melatonin receptor agonists to other sleep-specific medications. Dr. Fredes also addresses underlying causes like untreated sleep apnea or circadian rhythm disruption.
Perinatal Mood Disorders
Postpartum depression, perinatal anxiety, and postpartum OCD are serious medical conditions that benefit from prompt medication management, especially for mothers who are breastfeeding. Dr. Fredes has experience with the safest medication options during pregnancy and lactation.
Warning Signs That Medication May Help
- Your symptoms are significantly interfering with work, relationships, or daily functioning
- You’ve tried therapy or lifestyle changes, but symptoms persist
- You have a family history of the same condition that responded to medication
- Your symptoms are causing physical effects like sleep disruption, appetite changes, or weight changes
- You’re experiencing suicidal thoughts or severe hopelessness
- You’ve had previous episodes that improved with medication
This is not an exhaustive list. If you’re uncertain whether medication management is right for you, that’s exactly what the initial evaluation is for. Dr. Fredes will help you think through the decision carefully.
Our Medication Management Process
At MindMED, we follow a structured, thoughtful approach to medication management:
Initial Evaluation (60–90 minutes)
What to expect: A comprehensive appointment where Dr. Fredes gathers a complete psychiatric history, reviews your current symptoms, explores past psychiatric and medical history, discusses all current medications and supplements, assesses family history, explores substance use, and discusses your goals for treatment. Depending on your situation, baseline lab work (bloodwork, sometimes EKG) may be ordered to establish a safety baseline before starting medication. Together, you’ll discuss treatment options, potential benefits and side effects, and create a collaborative plan.
Ongoing Care (Regular Follow-ups)
What to expect: Follow-up appointments typically occur 2–4 weeks after starting a new medication, then monthly until stable, then as-needed or every 3–6 months depending on your condition and medication. During these visits, Dr. Fredes monitors how you’re responding, assesses for side effects, adjusts doses if needed, coordinates care with your therapist (if you have one), reviews any new symptoms or medication interactions, and ensures you’re on the lowest effective dose. You’re always welcome to reach out between appointments if urgent questions arise.
Medications We Prescribe: An Evidence-Based Overview
Dr. Fredes prescribes a wide range of psychiatric medications, always informed by current scientific evidence and your individual situation. Here’s an overview of the main categories:
SSRIs (Selective Serotonin Reuptake Inhibitors)
The first-line treatment for depression and anxiety disorders. SSRIs include sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil), fluoxetine (Prozac), and citalopram (Celexa). They work by increasing serotonin availability in the brain. Side effects are generally mild and often improve over time, though sexual side effects and weight changes can occur in some people.
SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
Similar to SSRIs but also increase norepinephrine, making them useful for depression with low energy or motivation, or anxiety with pain symptoms. Common SNRIs include venlafaxine (Effexor), duloxetine (Cymbalta), and desvenlafaxine (Pristiq).
Mood Stabilizers
Used primarily in bipolar disorder, these include lithium (a natural salt with strong evidence in bipolar treatment), valproate (Depakote), lamotrigine (Lamictal), and others. Some are also used to augment antidepressants in treatment-resistant depression.
Stimulant Medications for ADHD
Medications like methylphenidate (Ritalin, Concerta) and amphetamine-based formulations (Adderall) work by increasing dopamine and norepinephrine, improving focus and impulse control. Dr. Fredes has expertise in dosing these carefully and monitoring for side effects or misuse.
Non-Stimulant ADHD Medications
For patients who don’t respond to stimulants or prefer to avoid them, atomoxetine (Strattera) and guanfacine (Intuniv) offer alternatives. These have a lower abuse potential and different side effect profiles.
Atypical Antipsychotics
Medications like aripiprazole (Abilify), quetiapine (Seroquel), and lurasidone (Latuda) are used in bipolar disorder, treatment-resistant depression, and psychotic disorders. They’ve also been shown to augment antidepressants in some cases. Monitoring for metabolic side effects (weight, blood sugar, cholesterol) is important with this class.
Sleep Medications
Options include melatonin receptor agonists (ramelteon), sedating antidepressants at low doses, and others. Dr. Fredes focuses on sleep hygiene and addressing root causes first, but medication can be helpful when insomnia significantly impacts mental health.
Anti-Anxiety Medications
Benzodiazepines (alprazolam, lorazepam) are effective short-term but carry risks of dependence. Dr. Fredes prescribes these conservatively and typically as part of a time-limited protocol, not as long-term monotherapy. Buspirone offers an alternative for chronic anxiety with lower abuse potential.
Dr. Fredes’ Integrative Approach to Prescribing
What sets Dr. Fredes apart is her commitment to seeing psychiatric medication as one tool within a much larger context—not as the only solution. Her training at Mount Sinai – Elmhurst and her years of clinical experience inform an approach that considers the whole person.
This means she asks questions like: How is your sleep? What does your daily routine look like? Are you getting any physical activity? How’s your relationship with food and nutrition? Are you using any substances (alcohol, cannabis, other drugs)? What’s your stress level? Do you have meaningful relationships and social connection? Are there any unresolved trauma or major life stressors we should address? This information shapes the medication recommendation and the decision of whether medication is even necessary right now.
For many people, addressing sleep problems, increasing exercise, reducing caffeine, improving nutrition, or starting therapy can significantly improve mood and anxiety. Sometimes medication reveals itself to be unnecessary once these factors are optimized. Other times, medication becomes a bridge that stabilizes your mood and energy enough to do the work of therapy and lifestyle change.
Dr. Fredes also takes your supplement use and over-the-counter medications seriously. Many supplements interact with psychiatric medications or have their own psychoactive effects. She’ll review everything you’re taking and help you make informed decisions about what to continue, what to change, and what might be redundant.
Finally, she prioritizes coordination with your therapist (if you have one) and your primary care doctor. Mental health and physical health are deeply connected. Medication management works best when all your providers are aware of what’s happening and communicating regularly.
Frequently Asked Questions About Medication Management
How long does the initial medication management evaluation take?
The initial evaluation typically takes 60-90 minutes. This comprehensive appointment includes a detailed psychiatric history, review of current medications and supplements, assessment of medical conditions and past treatment responses, baseline lab work if needed, and collaborative discussion of treatment options and goals.
Will I need to be on psychiatric medication forever?
The duration of medication varies based on your condition, history, and treatment response. Some patients benefit from medication for a defined period and then discontinue successfully. Others manage chronic conditions more effectively with ongoing medication. Dr. Fredes works with each patient to determine the right timeline and regularly reassesses whether medication remains necessary or if adjustments are appropriate.
What if I’ve had bad experiences with medication before?
Past medication challenges are important information. Dr. Fredes carefully reviews what happened—whether it was an ineffective medication, a side effect that was intolerable, or a dosing issue that wasn’t optimized. She uses this history to inform a more thoughtful prescribing approach, often starting at lower doses, choosing different medication classes, and monitoring more closely to avoid repeating negative experiences.
Can I do telehealth for medication management?
Yes, many medication management appointments can be conducted via telehealth video visits, which is convenient for busy schedules and ongoing follow-ups. However, the initial evaluation may benefit from an in-person visit to allow for a more thorough assessment, though telehealth is available if that’s your preference. Texas telehealth regulations support psychiatric medication management via video.
Do you prescribe controlled substances?
Yes. When clinically appropriate, Dr. Fredes prescribes controlled substances including stimulant medications for ADHD. All controlled substance prescribing follows a comprehensive evaluation and is carefully monitored. For telehealth patients, controlled substances are available for patients located in Texas.
How quickly does psychiatric medication start working?
Timeline varies by medication class. Some medications (like stimulants for ADHD or sleep aids) work within hours to days. Others, particularly SSRIs and SNRIs for depression and anxiety, typically require 4-6 weeks at an effective dose to show full benefit. During this time, Dr. Fredes monitors your response closely and makes adjustments as needed. Patience and regular follow-up appointments are important for finding the right medication and dose.
What insurance does MindMED accept for medication management?
We are in-network with Aetna, BCBS TX, Cigna, Oscar Health, and United Healthcare. We also accept other insurance plans—please contact us at (817) 203-4179 to verify your specific coverage. We handle all insurance billing and prior authorizations, so you can focus on your care rather than administrative hassles.
Can you coordinate medication management with my therapist?
Absolutely. Integrated care—where psychiatry and therapy work together—produces better outcomes than either alone. We regularly communicate with your therapist (with your consent) to ensure medication and psychotherapy are aligned and supporting each other. This coordination is one of our core values and something we actively prioritize in your care.
What if medication isn’t working for me?
If a medication isn’t producing the expected benefit after an adequate trial, Dr. Fredes explores several options: adjusting the dose, switching to a different medication in the same class, trying a completely different medication class, adding a complementary medication to boost effectiveness, or reassessing whether non-medication factors (sleep, stress, substance use) are interfering with response. Finding the right medication sometimes takes time and patience.
Insurance & Pricing
We accept major insurance plans to make quality psychiatric care accessible:
For patients without insurance coverage, we offer self-pay options with transparent pricing. We also provide superbills for out-of-network reimbursement. View full pricing details →
Why Choose MindMED for Medication Management?
- Board-certified psychiatrist – Dr. Fredes trained at Icahn School of Medicine at Mount Sinai – Elmhurst and brings evidence-based expertise to every patient
- Integrative approach – We treat the whole person, not just symptoms, addressing biological, psychological, and lifestyle factors
- Unhurried appointments – Your initial evaluation is 60-90 minutes, allowing Dr. Fredes to truly understand your situation
- Bilingual care – Services available in English and Spanish to serve our diverse community
- In-person and telehealth – Convenient options for patients across Texas, New York, and Virginia
- Insurance accepted – Aetna, BCBSTX, Cigna, Oscar, and United Healthcare, with transparent pricing
- Dr. Fredes sees every patient herself – No physician assistants or nurse practitioners handle your care; you work directly with a board-certified psychiatrist from day one
Ready to Take the Next Step?
Schedule a consultation with Dr. Fredes to discuss your care.