How to take psychiatric medicines day to day — a practical guide

Why does the way you take medicine matter?

Many psychiatric medicines work best when their level in the blood stays fairly steady. The body gradually gets used to the medicine, and its full effect develops over weeks — so what counts is not a single tablet but consistency. Missed or irregularly taken doses lower the effectiveness of treatment, can delay improvement, and sometimes increase side effects or cause withdrawal symptoms.

The good news is that this takes nothing complicated — a few simple habits are enough. Below we go through them one by one: from the time of day you take the medicine, through what to do about a missed dose, to planning prescriptions, checking interactions and working with your doctor. Each of these is small on its own, but together they genuinely affect the outcome of treatment.

Take the medicine at a fixed time

Choose a time that is easy to remember and stick to it every day. Whether to take the medicine in the morning or the evening is decided by the doctor — it depends, among other things, on whether the medicine is more stimulating or calming, and on whether it is taken with a meal. If you have several medicines to take, it is usually possible to arrange the plan so that you take them at one or two fixed points in the day.

It is easiest not to forget when you tie the medicine to a fixed point in the day — for example brushing your teeth, breakfast or getting ready for bed. A phone reminder also helps, as does a pill organiser with compartments for the days of the week: at a glance you can check whether today’s dose has already been taken. If you are often away from home, keep a small supply of the medicine in your bag or at work, so that leaving the house does not end in a missed dose.

What to do if you miss a dose

Missing a dose happens to everyone and is usually no cause for worry — a single lapse rarely undoes treatment. The most important thing is not to try to make up for it with a double dose, because that is a more common source of problems than the missed dose itself.

The general rule: if you remember soon after the usual time, take the dose. If more than a few hours have passed, or if you are not sure whether the dose has already been taken, it is better to skip it and take the next one on time — never take two doses at once to make up. If you miss doses often or are in doubt, ask your doctor or pharmacist, because the rules differ for some medicines.

Plan prescriptions and your supply

Make sure you do not run out of the medicine. Order the prescription ahead of time — ideally while you still have a few days’ to a couple of weeks’ supply, rather than on the day the tablets run out. Take into account weekends, holidays and time off, when seeing a doctor or buying at the pharmacy can be harder; if the clinic offers a repeat prescription, find out how and how far in advance to ask for it.

Before a longer trip, take enough medicine for the whole journey, with a small reserve in case of delays. When travelling, it is best to carry the medicine in your hand luggage and in its original packaging, and for trips abroad it is worth checking whether it can be brought into the destination country. Stopping treatment abruptly simply because the medicine ran out can cause unnecessary withdrawal symptoms.

Check for interactions

Psychiatric medicines can interact with other medicines, and also with some supplements and herbs. That is why you should tell every doctor, dentist and pharmacist about the medicine you take — even when you are seeing them for a completely different reason. This helps you avoid dangerous combinations and needless duplication of medicines.

Before you add an over-the-counter medicine, a supplement or a herb (for example St John’s wort, which weakens the action of many medicines), make sure it does not interact — the simplest way is to ask a pharmacist. The same applies to the period before a planned procedure or operation: mention your medicines in advance. Be careful with alcohol, especially at the start of treatment, because it increases drowsiness and makes it harder to judge whether the medicine is working.

Keep a short diary

Memory can be unreliable, especially when mood is low, so it is worth noting how treatment goes. Write down briefly when and how severe your complaints are, at what time they appear, and when you notice the first signs of improvement. Two or three words a day in a notebook or on your phone are enough.

Such notes make it much easier for the doctor to judge whether the dose is right, and allow treatment to be adjusted more quickly — instead of relying on a general impression of the last few weeks, you talk about specifics. Ready-made mood and anxiety diaries, which you will find in the materials for patients, can be helpful. Bring your notes to your follow-up visit.

Watch for early signs of improvement

The effect of the medicines develops gradually, and improvement rarely comes overnight. Often sleep, appetite and energy return first, and concentration improves, before mood clearly lifts. This is easy to miss if you wait only for a moment of “sudden” improvement.

That is why it is worth paying attention to small changes and noting them in your diary — they are a real sign that the treatment is working. Knowing that something has already shifted helps you get through the first weeks and not give up too soon. If, after several weeks, there is still no improvement at all, tell your doctor — sometimes the dose needs adjusting or the medicine changing.

Do not stop or change the dose on your own

Even if you feel better or something is bothering you, do not stop the medicine or change the dose on your own. Improvement usually means the medicine is working — not that you can stop it already; ending treatment too early is one of the most common causes of relapse. Stopping abruptly, in turn, can cause withdrawal symptoms such as dizziness, irritability or flu-like symptoms.

This does not mean you have to put up with troublesome side effects in silence. If the medicine does not suit you, tell your doctor — usually the dose can be adjusted, the timing changed, or a different medicine chosen. Any changes are planned together, and the dose is most often increased or reduced gradually, so that the body has time to adjust.

Go to your follow-up visits

Regular follow-up visits are an essential part of treatment, not a formality. They let the doctor assess how well the medicine works, respond in time to side effects, adjust the dose and plan when and how to end treatment. They are also the moment to ask questions and discuss any doubts that have built up between visits.

It is worth attending visits also when you feel well — feeling good is a sign that treatment is working, not a reason to abandon it. At some stages of treatment, check-ups such as blood tests may also be needed. If something worrying happens between visits, do not wait until the next appointment — contact the clinic sooner.

Store medicines safely

Keep medicines out of the reach of children and away from moisture and heat — despite the name “medicine cabinet”, the bathroom is usually not a good place, because it is damp. It is best to keep the medicine in its original packaging, together with the leaflet, in a dry and shaded place at room temperature, unless the leaflet says otherwise.

From time to time, check the expiry dates and do not take medicines past their date. Hand expired or unneeded medicines in to a pharmacy, which takes them for safe disposal — do not throw them in ordinary rubbish or flush them down the toilet, because that harms the environment and creates a risk for others.

This guide gathers general rules. Always follow your doctor’s recommendations and the information in the leaflet for your specific medicine.

This article is for information only and does not replace a medical consultation. The choice of medicine, the dose and any changes in treatment are always decided by the doctor together with the patient.