Medical Complexity Clinic

Overview

Mental health concerns, especially in older adults, often coexist with other common medical conditions, such as high blood pressure, diabetes, and heart disease. Patients of any age may have complex medical conditions.

St. Sophie’s has put together a group of clinicians who are knowledgeable about these medical complexities and comfortable treating psychiatric conditions for patients in this demographic. This involves thorough review of all diagnoses and medications in order to choose the most appropriate psychiatric treatment, while ensuring that there is minimal to no interference with other medications or therapies.

This is not a replacement for primary or other specialty care, but may involve lab work, minor diagnostic studies, and communication with patient’s other providers when needed.

Treatments

Some medical conditions create extra challenges affecting medication selection and dosing strategies for stabilizing the co-occurring psychiatric disorders. Treatments may include common medication classes such as SSRI/SNRI, stimulants, benzodiazepines, and antipsychotics, with consideration to potential need for lower or higher-than-average dosing due to absorption or metabolism differences. Some patients may need an atypical route of administration, such as injection, topical patch, or dissolvable tablet. Special expertise is applied in consideration of the patient’s other medical conditions and treatments.

Conditions Treated

Psychiatric disorders such as depression, anxiety, and bipolar disorder along with chronic medical conditions, which may include:

• Gastrointestinal conditions such as gastric bypass, short bowel syndrome, or gastroparesis
• Autoimmune disorders such as lupus, rheumatoid arthritis, and Sjogren Syndrome
• Neurological conditions such traumatic brain injury, stroke, and seizure disorders
• Cardiovascular conditions such as high blood pressure, cardiac rhythm abnormalities, and POTS
• Endocrine disease such as diabetes and thyroid hormone imbalances