Common Questions
Answered

Dr Kenchaiah sees adult patients generally between 18 and 65 years of age. Referrals outside this range are considered on a case-by-case basis depending on the clinical presentation. He does not provide paediatric or child and adolescent psychiatry services. For patients over 65, suitability depends on the nature of the referral — please contact the rooms to discuss.

Yes. A referral from your GP or treating specialist is required. Please ask your doctor to send a referral to Dr Kenchaiah's rooms at Delmont Consulting Suites, 314 Warrigal Road, Glen Iris VIC 3146, with a summary of your medical and medication history.

Dr Kenchaiah's private rooms are at Delmont Consulting Suites, 314 Warrigal Road, Glen Iris VIC 3146. He also holds public appointments at St Vincent's Hospital Melbourne and Goulburn Valley Health, Shepparton.

The initial assessment typically takes 45–60 minutes. On occasion, more than one appointment may be needed to complete a comprehensive assessment, particularly where the clinical picture is complex or records are still being gathered.

Please bring your referral letter (if not already sent), any relevant past medical records, investigations, or specialist letters, and your completed consent and privacy forms. Close family members or carers are welcome to attend with your consent. Please be aware that part of the consultation time may be used to write correspondence to your GP or other treating clinicians.

Private consultations at Delmont are on Mondays and Fridays. Dr Kenchaiah does not offer after-hours or emergency consultations. 24-hour support is available through Lifeline (13 11 14), DirectLine (1800 888 236), or your local Crisis Assessment Team via health.vic.gov.au. This is a private specialist practice. All consultations attract a gap fee above the Medicare rebate — please contact the rooms on 03 9834 3600 for current amounts.

Telehealth is not offered at this time. The nature of the clinical work — which often involves complex medication reviews, deprescribing, and addiction psychiatry — is best conducted in person, particularly for initial and ongoing assessment. Telephone consultations may be arranged between face-to-face appointments where clinically appropriate.

Both. While deprescribing and complex medication management are a significant focus, Dr Kenchaiah prescribes medications where clinically indicated. Not every patient seen requires deprescribing — some present to initiate treatment, others to optimise or rationalise an existing regimen, and others for a comprehensive psychiatric assessment where medication is one part of a broader plan.

Yes. Second opinions are particularly welcome for patients or clinicians seeking clarity around prescription medication dependence, polypharmacy, or addiction-related presentations. This may include reviewing an existing treatment plan, offering a structured clinical reassessment, or helping to map a path forward where previous management has been complex or prolonged.

A referral letter from a GP or treating specialist is required.

No — and honest acknowledgement of that is part of good clinical practice. Setting a shared agenda at the outset matters: it clarifies what both patient and clinician are working toward and makes it easier to recognise when a plan needs to change. It also means being transparent about the limitations of the scientific literature; guidelines and trials provide a framework, but individual responses are rarely predictable.

A productive therapeutic relationship depends partly on fit. At times, after careful exploration, it may become clear that another clinician would be better placed to help — and saying so is a clinical responsibility, not a failure. Misunderstandings, when they arise, are best addressed directly and early.

Dr Kenchaiah draws on relational principles from the deprescribing literature — collaborative decision-making, transparency about uncertainty, and a willingness to revisit and revise plans — as a framework for navigating complexity honestly.

Collaboratively and flexibly. There is no single prescribing arrangement that suits every patient. In some cases Dr Kenchaiah manages all prescription medications directly; in others the GP or a treating specialist continues to prescribe based on Dr Kenchaiah's recommendations. Shared care arrangements are discussed openly and agreed upon based on what best serves the patient's clinical needs, the prescriber's scope, and regulatory requirements.

Clear communication — including letters that summarise goals, plans, and who is responsible for what — is central to making these arrangements work. Patients are encouraged to keep all treating clinicians informed so that care remains coordinated.

Yes. Assessment and management of alcohol use disorder is an important part of Dr Kenchaiah's addiction psychiatry practice. This includes medically supervised withdrawal, pharmacological treatment (naltrexone, acamprosate), relapse prevention, and integrated care for co-occurring mental health conditions.

Opioid substitution therapy (OST) involves transitioning from a problematic opioid to a regulated, prescribed alternative such as Buprenorphine (Suboxone™, Buvidal™, Sublocade™) or Methadone. For some individuals, OST can be transformative, significantly improving functioning and quality of life. Suitability is assessed individually.

Yes. Antidepressant and benzodiazepine deprescribing is a significant clinical focus, especially where patients have struggled with standard tapering approaches or where co-occurring medical complexity or polypharmacy is present.

Deprescribing is the planned and supervised process of reducing or stopping a medication that may be causing harm or is no longer providing benefit. It is not simply stopping a drug abruptly — it requires careful clinical assessment, a strong therapeutic alliance, and a flexible, patient-centred approach.

Polypharmacy generally refers to the use of five or more medications concurrently. Problematic polypharmacy — where accumulated drugs cause more harm than benefit — can lead to debilitating side effects, falls, worsening mental health, hospitalisation, overdose, and death.

Not at all. Polypharmacy is sometimes not only appropriate but necessary — this is referred to as rational polypharmacy. It arises in two distinct ways, and both are clinically legitimate.

First, a single condition may itself require more than one medication to manage adequately. Combination therapy is standard practice across medicine: two antidepressants used together for augmentation in treatment-resistant depression, multiple antihypertensives targeting different pathways to achieve blood pressure control, or combinations of antidiabetic agents — such as metformin alongside an SGLT2 inhibitor and a GLP-1 receptor agonist — where each drug adds distinct benefit. In these situations, the polypharmacy is intentional, evidence-based, and regularly reviewed.

Second, a person with several co-existing conditions may genuinely require a range of medications across those conditions simultaneously. Someone managing treatment-resistant depression, chronic pain, and a seizure disorder may need several agents working together — not because of careless prescribing, but because the conditions themselves demand it.

The clinical concern is problematic polypharmacy — where drugs have accumulated over time without regular review, where the original indication no longer applies, where side effects of one drug are being treated by another, or where the combined burden is causing more harm than good. Dr Kenchaiah's aim is to distinguish carefully between the two. The goal is never to minimise a medication list for its own sake, but to ensure that every drug a person takes is still earning its place. Sometimes the outcome of a thorough review is to continue all existing medications with greater confidence — and that is equally valid.

This varies considerably — from weeks to years — and cannot be predicted in advance for any individual. For many people, a meaningful taper takes at least several months, and for those on high doses of long-standing medications, a process spanning one to several years is not uncommon.

The pace depends on many factors: the specific medication, the dose and duration of use, the reason it was originally prescribed, co-existing conditions, life circumstances, and — crucially — how the individual responds at each stage. Tapering is adjusted in response to the person, not adhered to rigidly on a fixed schedule.

Equally important are the less tangible factors that determine whether a taper succeeds. A strong therapeutic alliance — a trusting relationship between patient and clinician — is often the single most important ingredient. Continuity of care with a consistent treating team reduces dropout and allows for timely adjustment when things become difficult. Understanding what a medication means to someone — the sense of safety, control, or identity it may have come to represent — matters enormously; change is far harder when that meaning is not acknowledged. And deprescribing tends to go best when it is oriented toward the patient's own recovery goals: what they want their life to look like, not just what the prescription list looks like.

It is also worth noting that not everyone experiences withdrawal or discontinuation symptoms during a taper. Some people reduce and stop with little difficulty; others find certain stages very challenging. This unpredictability is itself a reason why supervised tapering — rather than attempting it alone — tends to produce better outcomes.

This is a common and very reasonable question — it comes up frequently in patient communities and online forums, particularly for people attempting slow tapers. The honest answer is that it is genuinely tricky.

Australia has limited access to smaller-dose tablet formulations and liquid preparations for many psychiatric medications. Cutting or crushing tablets can work for some preparations but is inappropriate for others — modified-release tablets, for example, should generally not be cut or crushed as this alters how the drug is absorbed. Evidence-based guidance on the specific physical manipulation of tablets is sparse.

That said, some practical approaches — including tablet splitting, bead counting (for capsule formulations), or compounding by a specialised pharmacy — are considered on a case-by-case basis where the clinical need is clear. These are discussed openly, with full informed consent, and with the understanding that they represent off-label, pragmatic solutions rather than formally validated protocols. The goal is always a safe, tolerable taper — and sometimes that requires practical creativity alongside clinical judgement.

Dr Kenchaiah holds admitting rights at Delmont Private Hospital. Hospital admission is one tool within a broader treatment plan and is considered where clinically appropriate — however, it is not arranged before an initial consultation and assessment. The decision to proceed with admission is made collaboratively, based on clinical need and circumstances, following a thorough assessment.

If you are a patient or GP wondering whether an inpatient stay may be helpful, this can be discussed at the time of consultation.

Referrals specifically for an ADHD assessment are not accepted. However, Dr Kenchaiah's approach is a comprehensive psychiatric assessment — and where ADHD appears to be part of the clinical picture, it is assessed and managed as part of that broader evaluation.

This distinction matters: many patients present with overlapping conditions — addiction, mood disorders, sleep problems, polypharmacy, and attentional difficulties — and a siloed ADHD-only assessment would not serve them well. The goal is to understand the whole picture.

It is also important to note that Dr Kenchaiah would not simply take over prescribing of stimulant medications from another doctor without conducting his own assessment. This is particularly important in complex presentations where stimulants may be contraindicated or where significant interactions exist in the context of polypharmacy. A thorough assessment does not automatically lead to a diagnosis of ADHD or a stimulant prescription — the outcome depends on what the assessment finds.

Medicinal cannabis is a regulated therapeutic option in Australia and, in appropriate circumstances, may be considered as part of a broader treatment plan.

A thorough clinical assessment is required before any decision is made. That assessment does not automatically lead to a prescription — medicinal cannabis is not appropriate for everyone, and the evidence base in psychiatry remains limited and evolving. Where it is considered, it is as part of a carefully reasoned treatment plan, not as a standalone intervention.