Five Things to Ask Your Psychiatrist When Starting a New Medication

Seeing any doctor can be nerve-wracking. You may have spent time thinking about all the things you want to bring up at your appointment but as soon as the doctor steps into the room, everything has slipped your mind! I always recommend writing down your concerns before an appointment to make sure you don’t forget to talk about anything. And here are a few more questions for you to add to that list - specifically about starting or changing your medications!

What is it supposed to do?

This may seem obvious, but it can be a tricky question. If you come into the clinic and report anxiety and depression and I start you on a medication, then this medication should treat your anxiety or depression.

But how? What is it doing? How does it work? What is that supposed to feel like?

When is it expected to help?

Some mediations, notably the SSRIs like prozac (fluoxetine) zoloft (sertraline), and lexapro (escitalopram), can take a few weeks to work. In fact, it can take up to eight weeks for the full effects of a medication to finally be realized. Often, people notice improvements earlier than this but setting expectations is an important part of understanding your treatment plan.

How should the medication be taken?

Do I take this every day? At night-time? Day-time? Twice a day? Is it ever ok to skip a dose? What should I do if I realize I skipped a dose?

What are the expected side effects?

We’ve done a lot of research looking into psychiatric medications, how effective they are, and why people stop taking them. And a lot of research has shown that people stop taking medications because of the side effects - not because they aren’t working.

Understanding and knowing potential side effects also helps with setting expectations. If you have a good idea of what’s coming up, you’ll be in a better position to handle it. The most common side effects with SSRIs, for example, are some gastrointestinal symptoms. However, these symptoms often get better or stop completely! But if you don’t know this, it may be a bit concerning when the side effects start.

Unfortunately, a lot of patients do report side effects with many psychiatric medications. Which is why it’s so important for your psychiatrist to talk to you about them.

But the question that only YOU can answer is, “Is it worth it?” Is the side effect manageable? Tolerable? Or do we need to try something else? Should we consider alternate therapies?

Remember, talk to your psychiatrist before stopping a medication completely. Some medications need to be discontinued slowly as to not cause other problems. Which leads us to the final question…

What happens if it doesn’t work?

First: don’t panic! We have options!

Whether this is your first medication or your tenth, we still have options. There may be other medications that work a little differently that will be a better fit for you. We have non-pharmacological interventions like ECT, TMS, esketamine, and IV ketamine therapy. There’s CBT, DBT, and so many other therapy modalities as well as lifestyle and behavior modifications. If something isn’t working and you’re still not feeling well, don’t hesitate to let your psychiatrist know so we can make changes appropriately and do what’s best for you.