What is a psychiatric medication review and when is it needed?
- Author:
- Emotral editorial team
- Published:
A medication review examines the medications you currently take: combination, dose, side effects and interactions. This article explains when it is needed and how it differs from issuing a prescription.
A psychiatric medication review is a session in which a physician goes through your current medications, how you take them, possible side effects and interactions, and advises what to raise with the doctor who prescribed them. It is needed when you have side effects, take several medications at once, have been on a medication a long time without a review, or continued a medication after changing country or doctor.
What does a medication review cover?
In a medication review the doctor usually works through these questions:
- What was each medication prescribed for, and is that reason still valid?
- Do the dose and timing match current recommendations?
- Are the side effects you notice expected, or a sign of a problem?
- Are there interactions between your psychiatric medications and other medicines or supplements?
- Which questions should you raise with the prescribing doctor?
When is a medication review needed?
Common situations in which a review helps:
- You have troublesome side effects or a change in your physical health.
- You take more than one medication, especially if prescribed by different doctors.
- You have taken a medication for a long time and the last review was long ago.
- You have emigrated and are continuing a medication prescribed in Iran in your new country.
- You are thinking about continuing or stopping a medication and want accurate information first.
How a review differs from issuing a prescription
A medication review is an assessment and a consultation, and it can be done online. Issuing a prescription, changing a dose or stopping a medication is a separate medical act that depends on the country you live in, the professional licensing rules that apply there and the doctor’s clinical assessment. For that reason Emotral does not promise that a medication will be started, changed or stopped online; medication changes are coordinated with the prescribing doctor or your treating doctor.
Stopping some medications suddenly can cause relapse or withdrawal symptoms. The NICE depression guideline recommends that antidepressants be reduced gradually under medical supervision. Never stop a medication without coordinating with a doctor.
Why the choice and follow-up of medication matter
Psychiatric medications differ in effectiveness and tolerability. A network meta-analysis in The Lancet comparing 21 antidepressants found that all were more effective than placebo but differed in the size of their effect and in how often people stopped them because of side effects. In other words, there is no single right medication for everyone, and regular follow-up is needed to find the right option for each person.
What to prepare for a medication review
An exact list makes the session several times more useful:
- The name of each medication, its dose, when you take it and for how long.
- Non-psychiatric medications, supplements and herbal remedies.
- Side effects you have noticed and when they started.
- The name of the prescribing doctor and the date of your last visit.
This article is educational and is not written as individual medical advice. Decisions about diagnosis, medication or treatment are made only after a direct assessment by a physician or therapist.
Common questions
Will my medication be changed during a review?
A review is an assessment and a consultation. Changing a dose, substituting or stopping a medication depends on the rules in your country of residence and on the doctor’s assessment, and is coordinated with the prescribing doctor.
Can I have medications prescribed in Iran reviewed?
Yes. A review does not depend on where the medication was prescribed. Bring an exact list of your medications.
References
- Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018;391(10128):1357-1366. DOI PMID 29477251
- National Institute for Health and Care Excellence (NICE). Depression in adults: treatment and management. NICE guideline NG222. 2022.
- World Health Organization. mhGAP Intervention Guide for mental, neurological and substance use disorders in non-specialized health settings, version 2.0. Geneva: WHO; 2016.
