What to consider before taking medication

How do you decide if psychiatric medication is right for you? If a doctor offers medication to treat your mental health problem, you might want to try it. But there are some important things to think about before deciding to start a prescription.

You're not alone, and our information is here to help you. We'll share practical tips and ideas to help you feel informed before taking medication for mental health.

It took several months and a number of different pills to find the right ones, but once I did things started looking up.

What to check before taking psychiatric medication

Before agreeing to start taking medication for your mental health problem, you should have all the information about it. Having this helps you to make an informed decision.

If your doctor prescribes psychiatric medication and you'd like to try it, follow these checklists before taking it.

If you're unsure about any of the details in these lists, talk to your doctor or pharmacist. If this feels like a difficult conversation, go to our page on how to get help from your GP.

Although I was apprehensive about taking medication, it is probably one of the best decisions I ever made. After a few weeks I went from not wanting to leave the house at all, to planning days out and trips with friends.

Understanding your right to refuse medication

In most cases, health professionals cannot force you to take medication. If they offer medication, you usually have the right to refuse it. You might want to ask for another type of treatment, like therapy for example.

It's not common for doctors to force you to take medication. But in these cases, it might be legal to give you medication without your consent:

• If you're detained in hospital under certain sections of the Mental Health Act 1983.
• If your section has ended and you've left hospital, but you're now under a community treatment order (CTO).
• If someone assessed you under the Mental Capacity Act as ‘not having capacity’ to consent to treatment. You might have to take medication if the assessment proves this is in your best interests.

You might feel worried about being forced to take medication if you become very unwell in the future. Try planning for this while you're feeling well. You might hear this called crisis planning.

Having a plan helps healthcare professionals know your wishes in advance. This is useful in case you lose capacity to make decisions about your treatment.

Certain legal systems exist to help you do this: 

• You can make an advanced decision about any treatments you wish to refuse. This is a legally-binding statement of instructions for healthcare professionals.
• You can set out an advance statement to outline your general wishes for future treatment. Advance statements are not legally binding. But they can help healthcare professionals know your treatment preferences.

I would miss doses, bin my meds, pretty much do everything except consistently take them. This obviously affected how successful my treatment was, but I didn't see that at the time.

How to check if medication is working for you

Psychiatric medication can work in different ways for different people. It's not always possible to predict exactly which drug or dose will suit you.

But once you've started taking medication, try these tips to keep checking whether things are working for you:

• Review your medication regularly with your doctor. You should have regular reviews to talk about how you're getting on with your medication. They should ask how you're feeling and whether the medication is helping. You can also tell them about any side effects.
• Tell your doctor about any problems. They might be able to offer a different type of medication or treatment. Or they can suggest ways to manage your medication to reduce the problems.
• Ask another healthcare professional for a second opinion. Sometimes you might feel worried or unsure about your diagnosis or medication. You can ask your GP or psychiatrist to refer you to another professional for a second opinion. You have the right to do this.
• Talk to your local pharmacist for information. Most in-person pharmacists have a private consulting room. This can help if you don't feel comfortable talking to them over the counter. You could take a list of questions with you to help remember everything you want to ask.
• Remember that some drugs take a while to start working. Before deciding whether certain medication feels suitable, you might need to take it for a set period of time. This can feel difficult, but it might help to check the drug's half-life to guide you on when you might reach a stable level.

I rang my doctor to discuss the side effects, and I decided to keep taking the medication to give it time to work. We agreed that I should increase my dosage due to feeling more able to function in daily life.

Side effects of psychiatric medication

As well as helping you manage symptoms of your mental health problem, psychiatric medication can cause side effects. You might experience side effects with short-term use, long-term use or never experience any at all.

Side effects usually depend on:

• Which type of medication you take
• The dose of active ingredients
• Your body's reaction to the drug

Side effects range from mild to moderate, to severe. There's no way to know how you'll react before you start taking the medication.

You might ask yourself whether the benefits of your medication are worth the side effects. You can discuss this with your GP or pharmacist.

Antipsychotics are effective but they make me really tired. I just cannot think straight when I'm on them.

How to find out possible side effects

To find out possible side effects of any medication, read the Patient Information Leaflet (PIL) that comes in the packaging. Or you can search for and download PILs by going to our A to Z of psychiatric medication.

The likelihood of experiencing different side effects varies for each drug. Most PILs describe the risk of experiencing a side effect. It usually describes the risk level like this:

• Very common – affects more than 1 person in 10
• Common – affects between 1 in 10 and 1 in 100 people
• Uncommon – affects between 1 in 100 and 1 in 1,000 people
• Rare – affects between 1 in 1,000 and 1 in 10,000 people
• Very rare – affects fewer than 1 in 10,000 people
• Not known – we do not know how many people this affects

I started taking antidepressants and had to phone in every 2 weeks at the start so they could monitor how I was coping. The only side effect I felt was a few mild headaches at the start.

What to do if you get side effects

Depending on how your side effects make you feel, follow the actions in the lists below.

I feel seriously unwell:

• Contact your GP or pharmacist right away, or call 999.
• Do not drive or operate machinery. You should not drive to seek medical help.

I feel moderately unwell or very worried:

• If you feel the same within 12 hours, get medical advice.
• You can get advice from NHS 111 England or NHS 111 Wales, or see your GP or pharmacist.

I feel mildly unwell or uncomfortable:

• Wait a few days before seeking medical advice.
• You can get advice from NHS 111 England or NHS 111 Wales, or see your GP or pharmacist.
• Contact your nurse prescriber or care co-ordinator, if you have one.
• If you've just started the medication, try waiting a few days to see if the side effects wear off. But if you feel concerned, speak to your GP, pharmacist or call NHS 111.

My doctor warned me of side effects for the first couple of weeks. I would recommend staying in a safe place with someone you trust while starting mental health medication.

How to report side effects of medication

If you experience side effects from psychiatric medication, you can report them through the Yellow Card scheme. But if you feel seriously unwell, seek medical advice first. You can report your side effects after you're feeling better.

The Yellow Card scheme collects information about side effects of different drugs. Reporting is voluntary, so you don't have to report anything unless you want to.

Reporting side effects can be helpful for several reasons:

• Making sure drug manufacturers list side effects accurately. For example, if lots of people report a side effect, manufacturers might need to reconsider how common it is. In some cases, they might need to add a new warning to the PIL. Or change the description in the PIL.
• Assessing whether a drug or a batch should be removed from the current supply. This might be necessary if enough people report a very serious side effect. Especially if the drug is quite new to UK prescriptions.
• Helping people decide whether to take the drug in future. In general, reporting side effects means that everyone has more accurate and up-to-date information. This helps you to make an informed decision before starting a course of medication.

If you experience side effects from taking medication, you can report them online through the Yellow Card website. Or you can ask your pharmacist for a report card to fill in by hand. You can also ask a healthcare professional to report the side effects for you.

When I first read the list of side effects of the medication I'd be taking, my first impulse was to flush it down the toilet. It was scary stuff. But I took it and I feel that medication has really helped me over the years.