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Frequently Asked Questions about Psychiatric Medication

What are the common types of psychiatric medications?

Common types of psychiatric medications include antidepressants, antipsychotics, mood stabilisers, tranquilizers and hypnotics, etc. However, this traditional way of classification is actually imprecise. For example, the medications used to treat depression are also useful in treating anxiety disorders, and the second generation antipsychotics are found to have therapeutic effect on bipolar disorder as well.

What are the dos and don’ts on taking medication?

Don't

✅ Strictly follow your doctor’s instructions
✅ Read the prescription label carefully
✅ Pay attention to the drug name, dosage and frequency, etc. before taking your medication
✅ Pay attention to the dosage, indication, contraindication and side effects
✅ Store your medication properly
✅ Complete the prescribed course unless otherwise directed
✅ If you have any questions or experience any side effects, talk to your family or ask your doctor for advise

❌ Change the dosage of your medication on your own
❌ Stop taking your medication except on your doctor's advice
❌ Drink alcohol with your medication
❌ Put your medication in other bottles
❌ Take other medication unless directed by your doctor
❌ Take two doses at the same time when you forget to take a dose
❌ Lie to your doctor about your compliance

How to deal with side effects?

New generation of medications with less side effects

Every medication, no matter Western or Chinese medicine, has numerous possible side effects. Among these, only a few are common. In recent decades, the new generation of psychiatric medications have already improved significantly in side effect profile.

Side effects can be controlled and adapted gradually

Some side effects subside as the body starts to adapt to the medications. For example, some patients might have exacerbation of anxiety and appetite problems in the first week of antidepressant treatment; these symptoms usually subside gradually.

There are also some side effects which are amendable to some other methods. For example, the second generation antipsychotics have side effects of increasing the risk of metabolic syndrome which includes high blood sugar, high blood lipid, high blood pressure and weight gain. If the patient adopts a healthy lifestyle, e.g. having adequate exercise and diet control, the risk of having these side effects can be lowered.

Report to doctors to adjust dosage, frequency and time of taking medications

It is important for patients to report to their doctors any discomfort after taking the prescribed medications. Doctors will judge whether the discomfort is a medication side effect, a symptom of the mental illness or the symptom of another illness.

It is unwise to totally refuse medication treatment due to fear of side effects. Even if certain side effects are not avoidable, the doctor will discuss with the patient to decide on the plan of medication treatment, after balancing the risk of relapse and the harm of side effects. Doctors can minimise the side effects by adjusting the dosage, frequency and time of taking medications.

Why should patients continue medications after recovery?

Mental illness is a kind of chronic illness; continuous medication helps consolidate recovery

One common misconception about recovery in mental illness is about the role of medication treatment in maintenance. This misconception is common because in many acute illnesses, e.g. pneumonia, the patient stops taking the antibiotics after the infection has been cleared.

For chronic illnesses, like mental illness, even after the patient has all the symptoms subsided and has fully resumed his work and normal family life, in many cases, the psychiatrists advise the patient to continue the medication for a period of time ranging from months to years to consolidate the recovery and preventing relapse.

*Know more – The risk of relapse after medications stopped

Taking psychosis as an example, according to medical research, the chance of relapse would be 77% and 90% after medications stopped for 1 year and 2 years respectively. Therefore, it is very risky to stop medications without consulting your doctors, and maintenance therapy plays an important role to prevent relapse. In fact, mental illness is like a storm and maintenance therapy is playing a preventive role to prevent the coming back of a storm.

What should the caregivers do if patients refuse to take their medications?

Do not criticise the patients. Try to find out the underlying reason for their refusal, e.g. the patients experience any undesirable side effects or have any necessary worry about their medications, etc. Encouragement from the family and explanation of the treatment plan by healthcare professionals are crucial. Contact the healthcare professionals if the patients still refuse to take the medications.

How to ensure patients taking medication on time?

Doctors will take account the patient’s condition when prescribing medication. For example, try to arrange taking all the drugs once in the evening. Sometimes patients may need to take medication at different times of the day. Here are some simple methods to help ensure patients taking their drugs on time:

Prepare a pill organiser
Set a cue on your mobile phone
Try to link taking medication with a lifestyle habit, such as taking the medicine before teeth brushing in the morning

Other than oral medications, doctors can consider prescribing the longer acting, less side effects injections.

Reference source(s): Websites of the Institute of Mental Health of the Castle Peak Hospital and Kwai Chung Hospital