Controlled Substance Medication Policy

Controlled substances are medications regulated because of their potential for misuse, dependence, or other safety concerns. Some are used in psychiatric treatment, including:

• Stimulants: Certain medications used for ADHD, including Adderall, Vyvanse, Ritalin, and Concerta.
• Benzodiazepines: Certain medications used for anxiety or panic symptoms, including Xanax, Ativan, and Klonopin.
• Certain sleep medications: Including Ambien and Lunesta.

These examples explain which medications this policy covers. They are not a list of medications Lyte routinely prescribes or promises to provide.

A controlled medication may be considered only when the treating clinician determines that its expected benefits outweigh its risks and prescribing is within that clinician’s legal authority and Lyte’s available services.

Your clinician may recommend a noncontrolled medication, psychotherapy, additional evaluation, an in-person appointment, or referral to another level of care.

You may receive appropriate psychiatric treatment without receiving a controlled medication.

Before starting or assuming responsibility for a controlled medication, your clinician will evaluate your symptoms, medical history, previous treatment, and safety risks.

Depending on your situation, this may include:

• Confirming your identity and physical location.
• Reviewing previous psychiatric evaluations and prescribing records.
• Reviewing all medications, supplements, alcohol, cannabis, and other substance use.
• Reviewing your controlled prescription history through the applicable prescription monitoring program.
• Assessing sleep, mood, anxiety, substance use, and relevant medical conditions.
• Obtaining blood pressure, pulse, weight, or other measurements.
• Requesting relevant records, laboratory testing, an ECG, or consultation when clinically indicated.
• Discussing treatment alternatives, expected benefits, risks, and monitoring.
• Completing a controlled medication treatment agreement when required by your clinician.

An evaluation may require more than one appointment. A screening questionnaire alone does not establish a diagnosis or determine which medication is appropriate.

An ADHD diagnosis does not automatically qualify a patient for stimulant medication. Contact Lyte before booking to confirm current ADHD evaluation and treatment availability.

When an ADHD evaluation is available and appropriate, it considers developmental history, symptoms across settings, functional impairment, and other possible explanations for attention difficulties. Sleep problems, anxiety, depression, substance use, and medical conditions may affect concentration.

Previous records, school history, rating scales, or information from someone familiar with your symptoms may help clarify the diagnosis. Additional testing may be recommended when clinically indicated.

Stimulants are not prescribed solely to improve academic performance, increase productivity, stay awake, or support weight loss.

A previous stimulant prescription does not guarantee that Lyte will continue the medication, dose, or combination. Schedule II prescribing also depends on the individual clinician’s authority under Texas law.

Benzodiazepines require careful assessment because they can cause sedation, impaired coordination, physical dependence, and withdrawal.

When considered, treatment must have a specific clinical purpose and a monitoring plan. Routine long-term daily use is not the default treatment approach. Your clinician may recommend psychotherapy, noncontrolled medication, or another treatment based on your needs.

If you already take a benzodiazepine regularly, tell us before your appointment. Do not suddenly stop or rapidly reduce it without medical guidance. Abrupt discontinuation can cause serious withdrawal, including seizures.

Continuation, a temporary prescription, or a taper must be evaluated individually; none is guaranteed by booking an appointment.

Tell your clinician about every medication you take, including prescriptions from other practices.

Combining controlled medications with alcohol, opioids, sleep medications, or other sedating substances can increase the risk of serious harm. Do not drink alcohol while taking a benzodiazepine. Discuss other combinations with your prescriber before use.

Stimulant and benzodiazepine combinations require additional review and may not be appropriate.

A history of substance use does not automatically exclude someone from psychiatric care. It may change which medications are appropriate, the monitoring needed, or whether specialty treatment would better meet the patient’s needs. Honest disclosure helps us plan safer care.

Controlled medication treatment requires ongoing follow-up. Lyte’s existing clinic policy requires at least monthly follow-up for controlled-medication prescribing. Your clinician may require more frequent appointments based on your medication, symptoms, response, risks, and applicable requirements. This visit interval is a clinic policy, not a statement that federal law requires monthly visits.

More frequent appointments may be needed when:

• Starting treatment or changing a dose.
• Symptoms are not adequately controlled.
• Side effects or new medical concerns arise.
• There are concerns about interactions, medication use, or safety.

Monitoring may include symptom review, prescription history review, vital signs, medication reconciliation, or clinically indicated testing.

Drug testing or medication counts may be requested when relevant to safe prescribing. Your clinician will explain their purpose and how the results affect treatment.

Missing an appointment or required monitoring may delay prescribing. If you are at risk of withdrawal or running out of medication, contact the office promptly so your clinician can assess the safest next step.

Controlled medication prescriptions are not renewed automatically.

Use the secure patient portal or call the front desk and follow the Medication Refill Requests page. Request medication before your supply runs out and allow time for clinical review, pharmacy processing, and any required appointment.

Include:

• Medication name and current dose.
• Your pharmacy’s name and location.
• How much medication remains.
• Any side effects, missed doses, or changes in your health.
• Any new prescriptions from another clinician.

A request does not guarantee approval or same-day processing. Your clinician may need an appointment or additional information before making a decision.

Some controlled medications require a new prescription rather than a refill. Do not increase your dose or change how often you take medication without your prescriber’s instructions.

Early prescriptions and replacement prescriptions are not routinely provided. Requests related to travel, a lost or stolen supply, accidental disposal, or a pharmacy shortage require individual review.

Contact the office as soon as a problem occurs. Do not submit overlapping requests to multiple clinicians or obtain duplicate prescriptions.

A pharmacy change may require cancellation, verification, and a new prescription. Availability, insurance coverage, and dispensing remain subject to the pharmacy’s requirements. Lyte cannot guarantee that a pharmacy will have a medication in stock or dispense it.

A police report, travel itinerary, or other documentation does not automatically authorize a replacement prescription.

Controlled medication treatment should be coordinated through one responsible prescribing clinician or team.

Tell Lyte if another clinician prescribes a controlled medication, including after surgery, dental treatment, an emergency visit, or hospitalization. Use one pharmacy when feasible and notify us when a change is needed.

Do not share medication, sell it, borrow another person’s prescription, or use someone else’s medication.

Store controlled medications securely, preferably in a locked location, away from children and others. Ask your pharmacist about safe disposal of unused medication.

A video appointment does not guarantee eligibility for a controlled prescription.

At each telehealth appointment, you must provide your actual physical location. For Lyte’s Texas telehealth services, you must be physically located in Texas unless the practice has explicitly confirmed another lawful arrangement.

An in-person evaluation may be required because of your clinical needs, the medication, your clinician’s authority, or applicable rules. Tell the office before your appointment if you will be traveling outside Texas.

Federal and state prescribing requirements can change. If a change affects your treatment, your clinician will discuss available next steps, which may include an in-person visit, a treatment adjustment, or referral.

Bring or arrange access to your previous evaluation, medication history, recent treatment notes, and pharmacy information.

Your Lyte clinician makes an independent assessment. We may recommend continuing treatment, changing the medication, gradually reducing a medication, obtaining more information, or transferring prescribing to a more appropriate service.

Lyte does not guarantee bridge prescriptions while records are pending or before an evaluation is completed. Contact your existing prescriber before your supply runs out to discuss continuity of care.

Your clinician may recommend changing or stopping a controlled medication when risks outweigh benefits, treatment is ineffective, required monitoring cannot be completed, or prescribing is no longer legally or clinically appropriate.

When physical dependence or withdrawal risk is present, the clinician will assess an appropriate transition plan. Depending on the circumstances, that may involve a supervised taper, referral, or urgent evaluation.

A prescribing concern does not automatically mean all psychiatric care must end. Available treatment options and next steps will be discussed individually.

If you are running out of a medication that may cause withdrawal, contact your prescriber promptly. Do not wait for a routine follow-up appointment.

Call 911 or go to the nearest emergency department for seizures, trouble breathing, suspected overdose, severe confusion, or another medical emergency. Routine messages and prescription requests are not emergency services.