Can Online Psychiatrists Prescribe Medication?

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The use of online therapy has exploded in recent years, especially in light of the novel coronavirus pandemic. Patients have access to therapists and psychiatrists at a level unparalleled to this point in history. With the expansion of telepsychiatry, moreover, patients can get the full consultation and treatments they require, rather than punctuated services via text, email, or online survey. Many patients interested in telepsychiatry are concerned, however, that they will be unable to obtain prescriptions for any medications they may need to continue their mental health journey. Below, the telepsychiatry experts at Orbit Health discuss how prescribing medication is treated in the context of telemedicine and telepsychiatry.

Properly Licensed Psychiatrists Can Prescribe Medication, Even Online

Licensed psychiatrists are legally permitted to prescribe medication to their patients. More and more, telepsychiatry is being understood as merely a different venue for the provision of mental health services than a different practice entirely. Accordingly, in most states, psychiatrists with the proper state licensing (including a specific telehealth certification, depending on the state) can prescribe medication to their patients.

Not all medications can be prescribed without any in-person consultations. In the arena of mental health, thankfully, most medications can be prescribed online. Online psychiatrists can prescribe a wide range of behavioral and mental health medications, including drugs to treat anxiety and depression as well as mood stabilizers and stimulants. Online psychiatrists can prescribe, for example, popular antidepressants such as Prozac, Lexapro, and Wellbutrin, as well as anti-anxiety meds such as Buspar.

State rules differ on the type of consultation necessary prior to prescription. In many jurisdictions, the psychiatrist must at least conduct a telepsychiatry session including video conferencing before prescribing medications. Even if the patient needs medications that are not permissible to prescribe online (such as controlled substances or ADHD treatments), a telepsychiatrist can get the ball rolling and refer the patient to a local practitioner to obtain the prescription they need.

Limitations on Telemedicine Prescriptions

Whether or not telepsychiatrists can prescribe medications remotely and which drugs can be prescribed is a matter of state and federal law. Although many states have expanded and continue to expand the practice of telepsychiatry, including by lowering the burden for cross-state practitioners and eliminating certain in-person requirements, there are still some limitations to how telepsychiatry may be practiced.

For example, federal regulators have relaxed in-person screening requirements for psychiatrists to prescribe drugs to treat substance abuse disorders. Psychiatrists can prescribe buprenorphine without the need for an initial in-person consultation, and practitioners who were already treating patients with the drug can continue to do so. However, the government still prohibits the prescription of other medications such as methadone without in-person consultations.

A number of other drugs are still unavailable for online prescription according to federal and state law. These include muscle relaxants, insomnia medications, opioids, and others. Drugs such as fentanyl, Adderall, Diazepam, hydrocodone, morphine, and Ritalin cannot be prescribed online. Most mental health drugs, however, other than those that are meant to treat ADHD or controlled substances highly subject to abuse, can be prescribed online. Consult with a telehealth expert to learn which drugs are and are not permissible to prescribe online under existing law.

If you are a healthcare provider or employer who would benefit from a variety of qualified and thoughtful psychiatric care specialists, reach out to Orbit Health to discuss your options for telepsychiatry today.

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