8 Things Doctors Want You To Know Before Starting Medication For Your Mental Health

“There’s nothing worse than going to the doctor, getting a prescription, taking it to the pharmacy only to find out your copay is $100 or more,” Dr. M. Lindsey Hedgepeth Kennedy, a clinical pharmacy specialist at the UNC Medical Center and residency program director for the PGY2 Psychiatric Pharmacy Residency, tells Bustle. “You don’t have to take expensive [psychiatric] medications advertised in flashy commercials. The oldies but goodies work just as well, and often their cash price is affordable.”

"Bringing your prescription insurance information with you to the appointment can help your prescriber write a prescription that’s easily accessible the first time,” Kennedy says. The National Alliance of Mental Illness (NAMI) has a helpful list of different public and private assistance programs you can check out if you need an extra hand paying for medication or mental health treatment.

Like the majority of prescription medications, mental health medications may cause side effects. “Getting an idea of what could be expected, the rare and common side effects that occur, and the psychiatrists experience with the medication will help the patient be more informed about their prescribed medicine,” Dr. Lawrence Weinstein, the Chief Medical Officer for American Addiction Centers, says.

It’s possible for antidepressants to cause dizziness, digestive problems, as well as other mild symptoms. They can also affect your sex drive and ability to orgasm. What’s more, it’s not uncommon for people to feel fatigued or sluggish on different psychiatric medications. Kennedy says it all comes down considering the “quality of life cost,” and finding a medication with your doc that has side effects that won’t interfere with your day-to-day activities.

In addition to the immediate side effects, it's important to consider the potential long term side effects that are associated with the medication you're considering. Dr. Andy Zamar, the founder of The London Psychiatry Centre and a consultant psychiatrist, suggests talking with your doctor about "the long term effects of the drug, particularly metabolic, on the heart [and] liver, and, what can be done to mitigate the risks." Along the same line, Zamar also says to be sure to ask your psychiatrist if you'll need to take additional medications to counteract any side effects.

Research has shown that some psychiatric medications could increase your risk of developing certain physical illnesses in the long run. Talking with your psychiatrist about these potential health issues could help you both narrow down what medications you feel comfortable trying.

“It is important to ask about potential tolerance or dependence to the medication,” Wakim explains. “Many people start a drug, and do not realize that it is something that may have long-term complications if not monitored or weaned off appropriately.” For example, some people who stop an antidepressant too fast may experience discontinuation syndrome — which can bring on symptoms such as nausea, dizziness, fatigue, headaches, irritation, chills, and other flu-like symptoms.

Further, Dr. Zamar says that speaking to your doctor in advance about evidence-based "protocols" on how to manage withdrawal symptoms may help you feel more at ease (and prepared!) if you and your psychiatrist decide a medication isn't right for you.

Wakim says that, when considering a medication, it’s important to ask about the potential consequences of missing a dose, “especially if your schedule is inconsistent, or compliance has been an issue in the past.” While some psychiatric medications are commonly taken on an as-needed basis — such as anti-anxiety medications — certain antidepressants, antipsychotics, and mood stabilizers can cause side effects if not taken around the same time daily. Like stopping a medication too quickly, missing doses of different psychiatric medications can lead to symptoms of discontinuation syndrome.

Before starting a new psychiatric medication, Kennedy says to always check with your physician about any potential adverse interactions — whether that’s with other medications, substances, alcohol, or even over-the-counter supplements. “A common misconception is natural supplements are safe and don’t interact with prescriptions medications. Unfortunately, this is far from the truth,” she says. “Because of lax regulations in the Dietary Supplement Health and Education Act of 1994 (DSHEA), there’s no incentive to perform high quality studies of natural supplements. Bringing a list of all supplements will help your prescriber or pharmacist identify potential interactions.”

Weinstein adds that some psychiatric medications may even interact with food. Though not prescribed as often due to the safety concerns, monoamine oxidase inhibitors (MAOIs) are a class of antidepressants that require a special diet.

While psychiatric medications can help you better manage anxiety, depression, fatigue, or mental health symptoms you are experiencing, they are not magic. “Generally psychiatric medications, especially antidepressants, don’t work immediately. Often times, it can take a few weeks to notice an effect in yourself, but others around may notice in a week or two you are taking better care of yourself," Kennedy explains. "There is no ‘happy pill.’” As Verywell Mind reported, your psychiatrist may even want you on a medication for eight to twelve weeks before assessing how well it’s working.

However, if you don’t feel different within the first three months of trying a new medication, it’s important to make note of it, and let your psychiatrist know at your next appointment. “Medication is not a cure. [...] Not all medications produce desired results,” Weinstein says. “Approximately thirty to forty percent of antipsychotic medications are ineffective for treatment in the patient population.”

A psychiatrist can prescribe medication, but they may also make other professional recommendations to help manage your mental health. “Unfortunately, 5.5 million people in the U.S. who have depression don’t benefit from antidepressant medication,” Wakim explains. Kennedy says you can “explore all nonpharmacologic methods to improve your mood. Sleep hygiene, meditation, or other self-care techniques can be instrumental in feeling better,” though these are not necessarily a substitute for medication.

Working with a psychiatrist can be a process of trial and error. You may need to meet with a different doctors until you find one you're comfortable speaking with, and you may have to try out a few medications before finding one that works well for you. However, coming prepared with questions for your prescriber can definitely help you feel more self-assured, and informed at your first appointment.