Medication as One Tool Among Many

We believe in conservative, thoughtful prescribing integrated with therapy, lifestyle changes, and family support.

01

Therapy First

For many conditions, we recommend trying therapy and behavioral interventions before medication—or alongside it from the start.

02

Start Low, Go Slow

We begin with the lowest effective dose and titrate gradually, minimizing side effects while finding what works.

03

Regular Monitoring

Frequent check-ins, symptom tracking, and lab work when indicated ensure medications are working safely.

04

Integrated Care

Prescribers work closely with therapists, schools, and families through BlümConnect for coordinated treatment.

There are several pharmacological interventions available which may not be listed below. For more information about a specific medication not listed, please contact your healthcare provider.

ADHD Medications

Medications to improve focus, attention, impulse control, and executive function in children, adolescents, and adults with ADHD.

✨ Therapeutic Benefits of ADHD Medications

When properly prescribed and monitored, ADHD medications can significantly improve quality of life:

  • Improved sustained attention and focus
  • Better impulse control and decision-making
  • Enhanced working memory
  • Reduced hyperactivity and restlessness
  • Improved academic/work performance
  • Better emotional regulation
  • Improved social relationships
  • Reduced risk of substance abuse
Adderall XR
amphetamine/dextroamphetamine
First-Line
Stimulant — Amphetamine

Extended-release mixed amphetamine salts providing all-day coverage. Highly effective for core ADHD symptoms.

Ages: 6+Duration: 10-12 hrs
Vyvanse
lisdexamfetamine
First-Line
Stimulant — Amphetamine Prodrug

Prodrug converted to active form in body, providing smoother onset and lower abuse potential.

Ages: 6+Duration: 12-14 hrs
Concerta
methylphenidate ER
First-Line
Stimulant — Methylphenidate

OROS technology for consistent drug release throughout the day. Well-studied in children and adults.

Ages: 6+Duration: 10-12 hrs
Ritalin / Ritalin LA
methylphenidate
First-Line
Stimulant — Methylphenidate

Classic ADHD medication with decades of safety data. Available in IR and ER formulations.

Ages: 6+Duration: 4-8 hrs
Focalin XR
dexmethylphenidate
First-Line
Stimulant — Methylphenidate

Purified d-isomer of methylphenidate, potentially more potent with fewer side effects for some.

Ages: 6+Duration: 8-12 hrs
Strattera
atomoxetine
Non-Stimulant
SNRI — Norepinephrine Reuptake Inhibitor

First FDA-approved non-stimulant. Good for those with anxiety or substance abuse history.

Ages: 6+Duration: 24 hrs
Qelbree
viloxazine
Non-Stimulant
SNRI — Norepinephrine Modulator

Newer non-stimulant with faster onset than Strattera. Good for comorbid anxiety.

Ages: 6+Duration: 24 hrs
Intuniv
guanfacine ER
Adjunct
Alpha-2 Agonist

Helpful for hyperactivity, impulsivity, and emotional dysregulation. Often combined with stimulants.

Ages: 6-17Duration: 24 hrs
Kapvay
clonidine ER
Adjunct
Alpha-2 Agonist

Helps with hyperactivity and sleep difficulties. Often used as add-on to stimulant therapy.

Ages: 6-17Duration: 12-24 hrs

Anxiety Medications

Medications for generalized anxiety disorder, social anxiety, panic disorder, and related conditions.

✨ Therapeutic Benefits of Anxiety Medications

SSRIs and SNRIs are first-line treatments that address the neurochemical basis of anxiety:

  • Reduced frequency and intensity of worry
  • Decreased physical symptoms
  • Improved ability to face feared situations
  • Better sleep quality
  • Enhanced social functioning
  • Reduced panic attacks
  • Improved concentration
  • Better overall quality of life
Lexapro
escitalopram
First-Line
SSRI

Highly selective SSRI with excellent tolerability. First-line for GAD and depression.

Ages: 12+Onset: 2-4 weeks
Zoloft
sertraline
First-Line
SSRI

Versatile SSRI approved for multiple anxiety disorders. Strong pediatric safety data.

Ages: 6+ (OCD)Onset: 2-4 weeks
Prozac
fluoxetine
First-Line
SSRI

The original SSRI with decades of safety data. Long half-life makes it forgiving with missed doses.

Ages: 8+Onset: 2-6 weeks
Effexor XR
venlafaxine
First-Line
SNRI

Dual-action antidepressant effective for GAD, social anxiety, and panic.

Ages: 18+Onset: 2-4 weeks
Cymbalta
duloxetine
First-Line
SNRI

Approved for GAD in adults and children 7+. Also treats chronic pain conditions.

Ages: 7+ (GAD)Onset: 2-4 weeks
Buspar
buspirone
Second-Line
Anxiolytic — 5-HT1A Partial Agonist

Non-addictive anti-anxiety medication with no sedation or dependence.

Ages: 18+Onset: 2-4 weeks
Vistaril/Atarax
hydroxyzine
As-Needed
Antihistamine

Non-habit forming for situational anxiety. Also helps with sleep and itching.

Ages: 6+Duration: 4-6 hrs
Neurontin
gabapentin
Adjunct
Anticonvulsant

Off-label use for anxiety, particularly social anxiety. Lower abuse potential than benzos.

Ages: 12+Onset: 1-2 weeks

Depression Medications

Antidepressants for major depressive disorder, persistent depressive disorder, and treatment-resistant depression.

✨ Therapeutic Benefits of Antidepressants

Antidepressants work by modulating neurotransmitters to restore emotional balance:

  • Improved mood and reduced sadness
  • Restored interest in activities
  • Better sleep patterns
  • Improved appetite and energy
  • Enhanced concentration
  • Reduced feelings of worthlessness
  • Decreased suicidal ideation (with monitoring)
  • Better social/occupational functioning
Wellbutrin XL
bupropion
First-Line
NDRI

Activating antidepressant without sexual side effects or weight gain. Also helps smoking cessation.

Ages: 18+Onset: 2-4 weeks
Trintellix
vortioxetine
First-Line
Multimodal

Newer antidepressant with pro-cognitive effects. May improve thinking and processing speed.

Ages: 18+Onset: 2-4 weeks
Remeron
mirtazapine
Second-Line
Atypical — Alpha-2 Antagonist

Sedating antidepressant that improves sleep and appetite. Good when insomnia and weight loss are concerns.

Ages: 18+Onset: 1-2 weeks
Pristiq
desvenlafaxine
First-Line
SNRI

Active metabolite of venlafaxine with more predictable dosing and fewer drug interactions.

Ages: 18+Onset: 2-4 weeks
Spravato
esketamine
Specialized
NMDA Antagonist — Nasal Spray

Breakthrough therapy for treatment-resistant depression with rapid onset. In-office administration required.

Ages: 18+Onset: Hours-days

Bipolar & Mood Stabilizers

Medications for bipolar disorder and mood instability to prevent both manic and depressive episodes.

✨ Therapeutic Benefits of Mood Stabilizers

Mood stabilizers help maintain emotional equilibrium and prevent extreme mood episodes:

  • Prevention of manic episodes
  • Prevention of depressive episodes
  • Reduced cycling between states
  • Improved emotional stability
  • Better sleep regulation
  • Reduced impulsivity
  • Decreased risk of suicide
  • Improved long-term functioning
Lamictal
lamotrigine
First-Line
Anticonvulsant — Mood Stabilizer

First-line for bipolar depression prevention. Weight-neutral with good cognitive profile. Requires slow titration.

Ages: 18+Onset: Weeks-months
Lithium
lithium carbonate
First-Line
Mood Stabilizer — Element

Gold standard for bipolar with proven anti-suicide effects. Requires regular blood monitoring.

Ages: 12+Onset: 1-3 weeks
Depakote
divalproex sodium
First-Line
Anticonvulsant — Mood Stabilizer

Effective for acute mania and mixed episodes. Requires liver monitoring. Contraindicated in pregnancy.

Ages: 12+Onset: 1-2 weeks
Abilify
aripiprazole
First-Line
Atypical Antipsychotic

Unique dopamine partial agonist with lower metabolic risks. Approved for bipolar, schizophrenia, depression augmentation.

Ages: 10+Onset: 1-2 weeks
Seroquel
quetiapine
First-Line
Atypical Antipsychotic

Approved for bipolar depression and mania. Sedating properties helpful for sleep.

Ages: 10+Onset: Days-weeks
Latuda
lurasidone
First-Line
Atypical Antipsychotic

Approved for bipolar depression with favorable metabolic profile. Must take with food.

Ages: 10+Onset: 1-2 weeks
Vraylar
cariprazine
First-Line
Atypical Antipsychotic

Newer option for bipolar mania and depression. D3 receptor preference may help motivation/cognition.

Ages: 18+Onset: 1-2 weeks

Antipsychotic Medications

Medications for schizophrenia, psychotic disorders, and severe psychiatric conditions.

✨ Therapeutic Benefits of Antipsychotics

Antipsychotics address positive symptoms and help stabilize thinking and behavior:

  • Reduction in hallucinations
  • Decreased delusional thinking
  • Improved thought organization
  • Better reality testing
  • Reduced agitation/aggression
  • Improved sleep
  • Mood stabilization
  • Prevention of relapse
Risperdal
risperidone
First-Line
Atypical Antipsychotic

Commonly used for psychosis and autism irritability. Available in oral and long-acting injectable forms.

Ages: 5+ (autism)Onset: Days-weeks
Zyprexa
olanzapine
First-Line
Atypical Antipsychotic

Very effective for psychosis and mania but carries significant metabolic risk.

Ages: 13+Onset: Days-weeks
Invega
paliperidone
First-Line
Atypical Antipsychotic

Active metabolite of risperidone. Monthly and quarterly injectable options available.

Ages: 12+Onset: Days-weeks
Clozaril
clozapine
Specialized
Atypical Antipsychotic

Gold standard for treatment-resistant schizophrenia. Requires weekly blood monitoring (REMS program).

Ages: 18+Onset: Weeks-months

Sleep Medications

Medications for insomnia, sleep-onset difficulties, and circadian rhythm disorders.

✨ Therapeutic Benefits of Sleep Medications

Improving sleep quality has wide-ranging benefits for mental and physical health:

  • Faster sleep onset
  • Improved sleep maintenance
  • Better sleep quality
  • Improved daytime functioning
  • Enhanced mood regulation
  • Better concentration
  • Reduced anxiety about sleep
  • Normalized circadian rhythm
Melatonin
melatonin
First-Line
Hormone — Sleep Regulator

Natural sleep hormone, first-line for pediatric insomnia. Helps with sleep onset and circadian rhythm.

Ages: All agesOnset: 30-60 min
Desyrel
trazodone
First-Line
Antidepressant — SARI

Commonly used off-label for insomnia. Non-habit forming. May help with comorbid anxiety.

Ages: 6+Onset: 30-60 min
Catapres
clonidine IR
First-Line
Alpha-2 Agonist

Helpful for ADHD-related insomnia and nighttime anxiety. Also reduces nightmares.

Ages: 6+Onset: 30-60 min
Ambien
zolpidem
Adults Only
Non-Benzo Hypnotic

Short-term treatment for adult insomnia. Rapid onset. Risk of complex sleep behaviors.

Ages: 18+Duration: 6-8 hrs
Dayvigo
lemborexant
Second-Line
Orexin Receptor Antagonist

Newer sleep medication blocking wake-promoting orexin. Different mechanism than traditional hypnotics.

Ages: 18+Duration: 7-8 hrs

Autism Support Medications

Medications to address associated symptoms like irritability, anxiety, and sleep difficulties in autism.

✨ Therapeutic Goals in Autism Medication

While no medication treats core autism symptoms, medications can improve quality of life:

  • Reduced irritability and aggression
  • Decreased self-injurious behaviors
  • Severe anxiety relief
  • Reduced repetitive/rigid behaviors
  • Improved sleep
  • Better attention and focus
  • Mood stabilization
  • Better participation in therapy
Risperdal
risperidone
FDA Approved
Atypical Antipsychotic

First FDA-approved medication for autism irritability. Effective for aggression and tantrums.

Ages: 5-16Onset: 1-2 weeks
Abilify
aripiprazole
FDA Approved
Atypical Antipsychotic

Second FDA-approved medication for autism irritability. Lower metabolic risk than risperidone.

Ages: 6-17Onset: 1-2 weeks
Intuniv/Tenex
guanfacine
Off-Label
Alpha-2 Agonist

Helpful for hyperactivity, impulsivity, and emotional dysregulation in autism.

Ages: 6+Onset: 1-2 weeks
NAC
N-acetylcysteine
Supplement
Amino Acid Derivative

Antioxidant supplement with emerging evidence for irritability and repetitive behaviors.

Ages: All agesOnset: 4-12 weeks

OCD Medications

Medications for obsessive-compulsive disorder, typically used alongside ERP therapy.

✨ Therapeutic Benefits in OCD Treatment

SSRIs at higher doses reduce OCD severity and improve response to therapy:

  • Reduced frequency of obsessions
  • Decreased compulsion intensity
  • Better ability to resist urges
  • Reduced anxiety about obsessions
  • Improved functioning
  • Better response to ERP therapy
  • Decreased time spent on rituals
  • Improved quality of life
Prozac
fluoxetine
First-Line
SSRI

FDA-approved for OCD in children 7+ and adults. Higher doses often needed than for depression.

Ages: 7+Onset: 4-8 weeks
Luvox
fluvoxamine
First-Line
SSRI

FDA-approved for OCD in children 8+ and adults. Strong evidence base for OCD.

Ages: 8+Onset: 4-8 weeks
Anafranil
clomipramine
Specialized
TCA

Most effective medication for OCD but with more side effects. Reserved for treatment-resistant cases.

Ages: 10+Onset: 4-8 weeks

Trauma & PTSD Medications

Medications supporting treatment of post-traumatic stress disorder and trauma-related symptoms.

✨ Therapeutic Goals in PTSD Treatment

Medications can reduce PTSD symptoms and support engagement in trauma-focused therapy:

  • Reduced intrusive memories
  • Decreased nightmares
  • Lower hyperarousal
  • Improved sleep
  • Reduced avoidance behaviors
  • Better emotional regulation
  • Decreased startle response
  • Better engagement in therapy
Zoloft
sertraline
FDA Approved
SSRI

One of two FDA-approved medications for PTSD. Reduces all symptom clusters.

Ages: 18+Onset: 4-8 weeks
Paxil
paroxetine
FDA Approved
SSRI

Second FDA-approved PTSD medication. More sedating than sertraline. Requires careful tapering.

Ages: 18+Onset: 4-8 weeks
Minipress
prazosin
Nightmares
Alpha-1 Blocker

Specifically targets PTSD-related nightmares and sleep disturbance. Blood pressure medication used off-label.

Ages: 18+Onset: Days-weeks
Inderal
propranolol
As-Needed
Beta Blocker

Reduces physical symptoms of anxiety and hyperarousal. Can be used PRN for triggering situations.

Ages: 12+Duration: 3-6 hrs
⚠️

FDA Black Box Warning for Antidepressants

Antidepressants may increase suicidal thoughts and behaviors in children, adolescents, and young adults under 25 during initial treatment. This risk must be balanced against the significant danger of untreated depression. Close monitoring during the first weeks of treatment is essential. If you notice worsening depression, unusual behavior changes, or suicidal thoughts, contact your provider immediately or call 988 (Suicide & Crisis Lifeline).

Careful Monitoring at Every Step

Your safety is our priority. We monitor all medications closely with regular check-ins and appropriate lab work.

Baseline Assessment

Complete evaluation before starting any medication, including physical exam, relevant labs, and mental health assessment.

Regular Follow-ups

Frequent check-ins during initial treatment (1-2 weeks), then monthly until stable, then every 3-6 months.

Lab Monitoring

Appropriate blood tests for medications that require it—metabolic panels, drug levels, blood counts as indicated.

Between-Visit Support

BlümConnect portal for messaging, symptom tracking, and reporting concerns between scheduled appointments.

Questions About Medications?

Our psychiatric team is here to discuss options, answer questions, and work with you to find the right approach for your family.