01
Symptom Review
How are you doing relative to your baseline? What has improved, what has not changed, and what has gotten worse?
Medication Management
Psychiatric Medication Management That Explains Every Decision.
At D&Y, no medication is adjusted, added, or changed without a clear explanation of why — and every prescription follows a thorough evaluation, not a quick assessment.
Medication management at D&Y Integrated Psychiatry is built around one principle: the minimum medication necessary to achieve meaningful improvement. D&Y uses a conservative, evidence-based prescribing approach that prioritizes getting the diagnosis right before any prescription is considered.
Telehealth · California Statewide
Our Approach
Minimum Necessary. Maximum Clarity.
A prescribing philosophy built on understanding first, medicating second.
Denis Grigorov does not believe in overprescribing. If anything, he describes his approach as underprescribing by design. The goal is not to stack medications until something works — it is to understand what is actually happening and prescribe accordingly, using the fewest medications necessary to achieve meaningful, sustainable improvement.
This philosophy has particular relevance for the patients D&Y serves most often. Adults with ADHD, anxiety, depression, and mood disorders are among the most overprescribed populations in outpatient psychiatry. Stimulants prescribed without proper ADHD evaluation. Benzodiazepines prescribed without distinguishing the type of anxiety. Antidepressants layered onto undiagnosed mood disorders. Denis has seen all of it — and built this practice specifically to do the opposite.
Every medication decision at D&Y begins with a question: do we actually know what we are treating? If the diagnosis is clear and the evidence supports medication, Your provider will recommend it, explain the reasoning, and set a clear timeline for evaluating whether it is working. If the diagnosis is not yet clear, or if the symptoms might resolve with a targeted therapeutic approach, he will say so — and explain that too.
Patients at D&Y are never passive recipients of a prescription. They are involved in every decision, informed of every rationale, and encouraged to ask questions at every visit. If something changes, your provider explains why. If something is not working, your provider explains what the options are. The medication process is never a black box.
"I don't believe in overprescribing. If anything, I under-prescribe. I don't believe in treating symptoms without taking time to understand the full picture first."
— Denis Grigorov, PMHNP-BC · D&Y Integrated Psychiatry
What to Expect
Structured Follow-Up That Actually Follows Up.
A medication management visit at D&Y is not a 5-minute check-in. D&Y conducts a structured review at every follow-up — covering how you are responding to the current medication, what side effects are present, whether the treatment goals established at the first appointment are being reached, and whether any adjustments are warranted.
If an adjustment is made, it is explained. If no adjustment is made, that is explained too. You leave every visit knowing exactly where you stand and what to expect before the next one.
02
Medication Response Assessment
Is the current medication producing the expected therapeutic effect? At the expected timeline? Is the clinical picture what we anticipated?
03
Side Effect Discussion
Are you experiencing any side effects? Are they tolerable, and how do they compare to the benefit you are receiving?
04
Functional Impact Check
Are you functioning better at work, in relationships, and in daily life? That is the actual measure of success — not just symptom scores.
05
Plan Adjustment (if needed)
If a change is warranted, your provider explains what is changing, why, what to expect, and when to follow up. Nothing happens without your understanding and agreement.
06
Next Visit Scheduled
Every appointment ends with a clear next step. You are never left wondering when to come back or what happens next.
Visit Schedule
Follow-Up at the Pace That Fits Your Treatment.
Phase 1
Early Treatment
Weeks 1–8
Follow-up visits every 2–4 weeks. This is when medication response is most variable and adjustment is most likely. Your provider monitors closely and responds to what they see — not a fixed schedule.
Phase 2
Stabilization
Months 2–4
As symptoms stabilize and the treatment plan is confirmed effective, visits transition to monthly. The focus shifts from adjustment to maintenance and refinement.
Phase 3
Maintenance
Month 4+
Once stable, follow-ups occur every 1–3 months depending on your condition and medication complexity. D&Y continues to review, adjust as needed, and track your functional goals over time.
Between visits: Secure patient portal available for non-urgent questions between appointments. We respond within 1 business day.
Our Standards
Lines D&Y Will Not Cross.
These are not policies. They are the clinical commitments Denis made when he founded D&Y — because he had worked inside a system where too many of them were crossed routinely.
No prescribing controlled medications without thorough evaluation and clear clinical indication
No medication changes without explaining the reasoning to the patient first
No trial-and-error treatment without a clear, structured rationale behind every step
No layering medications without demonstrated clinical need and transparent reasoning
No dismissing symptoms or assuming a standard diagnosis without individualized assessment
No prioritizing what the patient wants over what is clinically appropriate and in their best interest
D&Y's focus is not on pleasing patients by giving them what they ask for. It is on making solid clinical decisions that are appropriate, evidence-based, and genuinely in the patient's best interests — even when that requires a harder conversation.
Conditions We Treat
Evidence-Based Psychiatric Medication Management for the Conditions That Respond to It Most.
D&Y provides ongoing medication management for adults with the following conditions — all following a thorough diagnostic evaluation that precedes any prescription discussion.
Not sure if your condition is listed? D&Y evaluates and treats a broad range of adult psychiatric presentations. A book an appointment is the best way to find out if we are the right fit.
Practical Details
What You Need to Know Before Your First Visit.
First Appointment
60–90 minutes · Full psychiatric evaluation before any medication discussion begins
Follow-Up Length
30–45 minutes · Structured review at every visit, not a quick check-in
Format
Secure HIPAA-compliant telehealth — serving adults across California only
Insurance
Most major plans, Medicare, and VA Community Care accepted · See full insurance details →
Private Pay
Available for those without insurance or out-of-network — contact us for current rates
What to Bring
Current and past medications with dosages, any prior diagnoses, and your own honest account of what has and has not worked
Between Visits
Secure patient portal available for non-urgent questions · We respond within 1 business day
Take the First Step
Medication That Is Explained, Monitored, and Never Prescribed Without a Reason.
Book an Appointment to find out if D&Y's approach to psychiatric medication management is the right fit for where you are right now.
Now accepting new patients · Most insurance accepted · Telehealth statewide in California
Mental Health Resources
Crisis Support & Mental Health Resources.
D&Y Integrated Psychiatry provides outpatient psychiatric care — not crisis services. If you need immediate support, the organizations below provide free, confidential help 24 hours a day. You do not need to be a D&Y patient to use any of these resources.
National Crisis Lines — Available 24/7
National Mental Health Organizations
California Mental Health Resources
D&Y Integrated Psychiatry does not endorse or have a formal affiliation with the external organizations listed above. These resources are provided for informational purposes only. Listing does not constitute a referral or clinical recommendation. Links are verified at time of publication and may change.