Psychiatric medication management for Hollywood — measurement-based, in-person.

Hollywood clients drive 50 minutes north on I-95 to RECO Integrated Psychiatry's Delray Beach office for evaluations that a 15-minute primary care slot cannot deliver: 60-to-90-minute DSM-5-TR formulations, PHQ-9 and GAD-7 tracked across visits, and the full pharmacologic algorithm — augmentation with lithium or aripiprazole, MAOI reconsideration, pharmacogenomic testing where indicated, and escalation to rTMS or Spravato when first-line SSRIs and SNRIs plateau. Follow-ups convert to telepsychiatry once the regimen is stable.

Hollywood sits about 35 miles south of RECO Integrated Psychiatry’s Delray Beach office — roughly 50 minutes up I-95 outside of rush. For adults in Hollywood Beach, Emerald Hills, Hollywood Lakes, Hollywood Hills, and Oakwood, that drive is what makes the appointment cadence workable: long enough to justify batching labs and consolidating follow-ups, short enough to preserve continuity when a regimen change demands tight iteration. Most Hollywood clients establish care in person, then transition to telepsychiatry for interval visits once the regimen has stabilized.

What a real psychiatric evaluation actually covers

The initial visit runs 60 to 90 minutes and produces a documented DSM-5-TR diagnostic formulation — not a checklist of symptoms mapped to the first plausible code. History includes every prior psychotropic trial with dose, duration, and the specific reason for discontinuation (side effect, non-response, partial response, cost, adherence). Family psychiatric history is taken systematically, including first-degree relatives with bipolar disorder, completed suicide, psychiatric hospitalization, or substance use disorder — information that changes prescribing decisions.

Anyone presenting with “depression” or “anxiety” is screened for bipolarity with the MDQ, adult ADHD with the ASRS, and OCD with a targeted Y-BOCS interview. Missed bipolar II in a patient started on SSRI monotherapy is one of the more common — and consequential — errors in outpatient psychiatry. A substance use screen and, where clinically relevant, a trauma history are taken as well, because unrecognized alcohol use disorder or untreated PTSD will blunt any antidepressant response.

Baseline labs are ordered where indicated: CBC, CMP, TSH, B12, folate, and vitamin D, with HbA1c and a fasting lipid panel added before initiating a second-generation antipsychotic. This is the visit primary care simply does not have room to run in a 15-minute slot.

Measurement-based care and why it changes outcomes

RECO uses the standard instruments: PHQ-9 for depression, GAD-7 for anxiety, MDQ for bipolar screening, ASRS for adult ADHD, and Y-BOCS for OCD. Scales are completed through the patient portal before the appointment, scored in the visit, and tracked longitudinally in the chart. The published evidence is unambiguous — measurement-based care produces meaningfully better outcomes than clinical impression alone, largely because it forces earlier recognition of non-response and partial response.

Medication decisions are anchored to scale trajectory rather than to whether the client “feels better today.” A PHQ-9 that has moved from 22 to 14 at week six is a partial response that warrants augmentation or dose optimization, not reassurance. A GAD-7 stuck at 15 after eight weeks of sertraline at 100 mg is a signal to switch class or add buspirone — not to keep waiting.

The pharmacologic toolkit beyond the first two SSRIs

First-line pharmacotherapy is well established: SSRIs and SNRIs for depressive and anxiety disorders, stimulants and non-stimulants for ADHD, mood stabilizers and second-generation antipsychotics for bipolar disorder, and SSRIs paired with an ERP referral for OCD. The value of a specialty psychiatric medication management practice is what happens after first-line fails.

That includes augmentation with aripiprazole, lithium, or thyroid; switching within class (sertraline to escitalopram) and across class (SSRI to SNRI to bupropion to mirtazapine); appropriate use of MAOIs in treatment-resistant depression; pharmacogenomic testing with GeneSight or Genomind in complex cases; and timely escalation to interventional treatment — rTMS for treatment-resistant unipolar depression and Spravato (esketamine) where clinically appropriate. RECO’s psychiatrists work through the STAR*D-style algorithm rather than getting stuck at step two.

For bipolar spectrum illness, that means lithium optimized to serum level, lamotrigine titrated over eight weeks for bipolar depression, quetiapine or olanzapine where clinically indicated, and avoidance of antidepressant monotherapy. For OCD, it means SSRIs pushed to antidepressant-plus doses (fluoxetine 60-80 mg, sertraline 200 mg) with clomipramine or aripiprazole augmentation when the Y-BOCS does not move.

Monitoring: the labs, the metabolic panel, the drug levels

Lithium requires baseline and periodic TSH, serum creatinine, and calcium, plus quarterly serum levels drawn 12 hours post-dose. Atypical antipsychotics require baseline and annual metabolic panels — HbA1c, fasting lipid panel, weight, and blood pressure — with more frequent monitoring in the first six months. Valproate requires baseline LFTs and platelets, with levels drawn at steady state and after any dose change.

Stimulants require a documented cardiovascular history and blood pressure plus pulse at every visit, with dose adjustments driven by both symptom scales and side-effect burden. Clozapine, when used, follows the REMS ANC monitoring protocol without exception. RECO’s visit templates build these into the cadence so nothing gets missed because the client did not remember to ask.

What to expect on your first visit

Hollywood clients complete intake paperwork, releases, and baseline scales through the patient portal 48 hours before the appointment. The initial evaluation is scheduled for 60 to 90 minutes in person at the Delray Beach office; telepsychiatry follow-ups are typically available after the first in-person visit once a therapeutic relationship and physical exam baseline are established.

The visit ends with a written diagnostic formulation, an initial treatment plan, lab orders where indicated, and a return appointment — usually two to four weeks out for a new medication start and six weeks for a stable regimen adjustment. Prior authorization for non-formulary medications is handled by the practice rather than left to the patient to chase.

Insurance and admissions from Hollywood

RECO Integrated Psychiatry is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS commercial plans. Benefits are verified before the first visit — deductible status, mental health copay or coinsurance, and whether the outpatient psychiatric evaluation code (90792) is subject to prior authorization on the specific plan. Written out-of-pocket estimates are provided in advance, and self-pay rates are published for clients whose plan the practice cannot bill.

Scheduling is direct — no referral is required for most Broward County commercial plans, though HMO products may require a PCP referral that the intake team helps coordinate. From Hollywood, most clients drive north on I-95 to the Atlantic Avenue corridor; the office is a short block off the exit with dedicated parking on site.

Serving residents of: Hollywood Beach, Emerald Hills, Hollywood Lakes, Hollywood Hills, Oakwood.