Medication Management
Medication, with someone paying attention.
Psychiatric evaluation and ongoing medication care with a board-certified psychiatric nurse practitioner. Not a fifteen-minute refill and a wave — a plan that gets revisited as you change.
What this actually is
Psychiatric medication works — for a lot of people, remarkably well. But it only works when someone is genuinely tracking whether it's working, and adjusting when it isn't. That's the part that gets skipped.
Your first visit is a full evaluation. What's going on now, what's been tried, what happened when it was tried, what your life actually looks like. Then a plan you agree to — not one handed to you.
After that, you're seen on a schedule that fits what you need. Some people stabilize and check in a few times a year. Others need closer contact for a while. Both are fine.
Evaluation
A full psychiatric assessment. History, symptoms, what's worked and what hasn't, and what you're actually trying to get back to.
A plan you agreed to
Options, tradeoffs, and side effects — discussed, not assumed. You should understand why you're taking what you're taking.
Follow-up that means something
We check whether it's helping. If it isn't, we change it. Nobody should be on a medication for a year because nobody asked.
What we treat
- Depression — including depression that hasn't responded to previous medications
- Anxiety disorders — generalized anxiety, panic, and the anxiety that rides along with everything else
- ADHD — in adolescents and adults, following evaluation
- Bipolar and mood disorders — mood stabilization and long-term management
- Trauma-related symptoms — where medication supports the therapy rather than replacing it
- Sleep problems — which are almost never just sleep problems
Medication isn't the only tool, and it's rarely the whole answer. Because therapy, TMS, and psychiatry all happen under one roof here, your prescriber and your therapist can actually talk to each other. That's not how it usually works, and it matters more than people realize.
Who you'd see
Dr. Karena Rother, DNP,APRN,PMHNP-BC — a board-certified psychiatric mental health nurse practitioner and the owner of the practice. She's a lifelong Hastings resident with more than twenty years of nursing behind her, most of it spent with people struggling with their mental health.
Her approach isn't medication-first by default. A plan might include medication, supplements, TMS, therapy, sleep, nutrition, or exercise — assessed carefully and built with you rather than prescribed at you.
Common questions
Will I be on medication forever?
Often no. For many people, medication is a bridge — it creates enough stability for therapy and lifestyle changes to actually take hold. That conversation is part of the plan from the beginning, not something you have to bring up later.
I've tried antidepressants and they didn't work.
That's common, and it doesn't mean you're out of options. Sometimes it's the wrong medication, sometimes the wrong dose, sometimes the wrong diagnosis underneath. And if several have genuinely failed, TMS is a non-medication treatment worth talking about.
Can I do medication management without therapy?
Yes. Plenty of people do. But if therapy would help and you're open to it, having both in one place makes the care noticeably better.
Do you prescribe controlled substances?
Some medications used for ADHD and other conditions are controlled substances, and they carry additional requirements — in-person visits, prescription monitoring, and closer follow-up. We'll walk you through what applies to your situation.
Is telehealth an option?
For many appointments, yes. You must be physically located in Minnesota at the time of the visit — a licensing requirement, not a preference. Some appointment types, including ADHD evaluations, are in-person only.
What should I bring to my first visit?
A list of every medication and supplement you currently take, with doses. Any past psychiatric medications and what happened on them. Your insurance card and photo ID. The full checklist is on the New Patients page.
Start with an evaluation.
Bring what you've tried, what worked, and what didn't. We'll build the plan from there.