Telehealth and Pharmacotherapy: The Role of Synchronous and Novel Asynchronous Digital Health Tools in Psychiatry

Digital psychiatry tools are increasingly woven into routine care, not only to support pharmacotherapy but also to deliver psychotherapy, sustain engagement and redesign clinical workflows. This narrative review synthesises synchronous (e.g. telepsychiatry and live chat) and asynchronous (e.g. apps, remote monitoring and digital therapeutics/software as a medical device ["SaMD"]) approaches that initiate, monitor or augment medication treatment and commonly paired psychosocial interventions. We outline how these tools can improve adherence, side-effect surveillance, psychoeducation and therapy access while highlighting persistent challenges around evidence strength, workflow integration, equity, reimbursement and regulation. Drawing on emerging hybrid models, such as digital navigators and the digital clinic model, we present pragmatic pathways for safe adoption, data triage and sustained use in real-world settings. We also discuss opportunities for artificial intelligence (AI)-driven personalisation and responsive monitoring, alongside the ethical and implementation considerations they raise. By broadening the lens beyond pharmacotherapy alone, this review provides clinicians and health systems with actionable guidance on selecting, integrating and evaluating digital tools to deliver patient-centred, scalable psychiatric care.