Mental Health Prescriptions

You begin taking a new mental health prescriptions and within a few weeks you are starting to notice some positive changes.
However, as your life becomes more hectic, you may forget to take your prescribed dose of medication at the designated time.
As an example, you forgot to take your prescribed dose of medication on Tuesday, and then again on Thursday.
By the weekend, you will be questioning if you still require the use of that medication.
The frequency of taking mental health medication is quite common, and the majority of times, is due to the requirements of the medication, rather than lack of responsibility.

Mental health medication requires us to do a lot; we are required to take the medication daily for several months (or even longer) and continue to feel sick.
However, the consistency at which you use the medication will determine both its effectiveness, as well as how smoothly your body can adapt to it.
Following your mental health prescriptions as directed by your healthcare provider can help maintain consistent treatment and make it easier to monitor your progress over time.
We are able to offer adult patients throughout MA access to medication and prescription management via our secure telehealth platform.

What does “consistency” actually mean?

Taking your prescribed medication is defined by the way in which you take it, such as the dosage, frequency and duration of treatment. You can’t alter these aspects of taking your medications without consulting with your doctor. Changing how you take your medications can be harmful to you.
The final aspect is critical. Being consistent does not mean that you have to be flawless. It means that you must maintain the consistency of the pattern for as long as possible in order for the drug to function as intended, and that you should inform your physician if the pattern is no longer effective, so that the course of action can be altered, rather than simply allowed to collapse.

Why steady dosing matters.

Psychiatric drugs are most effective when the amount of drug in your body remains relatively stable. Skipping doses (i.e. taking them every other day), and/or taking multiple doses at once after skipping several, will result in an unstable experience of the drug; i.e., experiencing side effects that occur randomly, or experiencing symptoms that reappear between doses.
Medications often need some time before they fully work. It is difficult to know if a medication is not working, or has just not had a chance to work yet when the patient takes the medication inconsistently. This can create challenges for both the patient and the prescriber in determining what the best course of action would be going forward with treatment options including changing the dose of the medication or trying another treatment option.

What can happen when doses are skipped or stopped suddenly?

  • Symptoms similar to withdrawal: If you stop using an antidepressant suddenly, you may experience withdrawal-like symptoms within one to two days after you discontinued the use of the drug (especially if you used the drug for longer than a couple of weeks). The symptoms can include: anxiety, difficulty sleeping, headache, dizziness, fatigue, irritability, nausea, and flu-like symptoms. Withdrawal symptoms usually disappear after several weeks.
  • Continuing with the medication is important as well: According to the National Alliance on Mental Illness (NAMI), there are many instances where individuals will have to continue taking their medications after they stop experiencing the symptoms of their illness, as well as if the symptoms begin again. Additionally, it can be difficult for someone to differentiate between what are known as withdrawal symptoms from a drug and the re-emergence of an individual’s primary condition, thus adding further support to involving your prescribing physician.
  • Some medications require special attention: NAMI points out that many drugs such as benzodiazepines must be tapered down gradually over time instead of being stopped immediately. Your doctor or pharmacist can determine if the drug you take is classified in this manner.

Why is it so hard to stay consistent?

If you are having problems with this issue then you are not alone. There are several of the most common reasons why people have difficulty with this issue:

  • Forgetting – The first reason why many individuals on antipsychotic medications miss their daily doses is due to forgetting. The second most frequent cause is simply being too busy.
  • Feeling better – The reason for taking medication is to improve, but this can make you believe you don’t need it anymore.
  • The side effects – People are hesitant to take medication that makes them feel unwell. Most of these people will choose to say nothing rather than complain.
  • Complicated routines – More pills at more times of day make it harder to keep up.
  • You don’t have all the details – When you are unclear on why you take a certain drug, and/or what will happen when you do, it’s easy to stop taking that drug.

None of these represents a character flaw. Rather, they are functional issues and the majority can be addressed functionally.

Practical ways to stay on track.

  • Attach it to an activity that is a part of your daily routine: Some examples include brushing your teeth, brewing some coffee or giving food to a pet. These activities can be used as anchor points.
  • Pill organizers: Check if you have taken your daily dose!
  • Set an alarm on your phone: Name it so that you know what it is for, and only turn off the alarm (or snooze) when you are able to take your medication immediately.
  • Ask about when you should take the medication: Some medications can be taken before bed or during meals! Your doctor can typically create a schedule that will allow you to incorporate taking the medication into your daily life.
  • Simplify your schedule: If you feel like your schedule is too busy, ask if you can make it easier. There might be a simpler way.
  • Keep a brief record: Taking a few moments to make notes on your feelings/emotions, how well you are sleeping, and any other symptoms or side effects you may be experiencing will provide you with factual information that can be discussed during your next appointment.
  • Refill early: Request refills before you run out, and plan ahead for trips.
  • Speak out when you experience side effects: It shouldn’t be necessary for you to endure these silently as there is usually a way to alleviate them.

What if you miss a dose?

You can find a solution that works for almost everybody.
To determine the correct action to take, either read the product label, or consult with your pharmacist or prescribing physician to find out how to handle the situation for your particular medication.
In most cases, you should never take more than one dose of medication at the same time, unless specifically instructed otherwise by a healthcare professional.
If you regularly miss taking doses of medication, please bring this up with your physician during your next visit.
This information may help your physician develop alternatives which would simplify the process for you.

Feeling better? Talk before you stop.

The fact that you are feeling better is positive, and may indicate that your prescribed medication is working.
However, this does not necessarily suggest that you should immediately discontinue taking the medication.
Consult with your doctor prior to discontinuing use of any prescription drugs, and you should never discontinue the use of a prescription drug abruptly.
When you and your doctor agree on when to begin phasing out of a medication, a gradual decrease will minimize the likelihood of experiencing unpleasant side effects.
This is exactly why we offer medication tapering assistance: to closely monitor and gradually adjust, making the experience as comfortable and safe as possible.

How Mindset & Work supports consistency.

Staying consistent with your mental health prescriptions can be much simpler when you have someone to share the journey with. This is how we assist:

  • An excellent beginning point: A thorough initial psychiatric evaluation examines your previous experiences, what you’re experiencing now (your symptoms), and where you want to be (your goals) to create a plan that works best for you.
  • Clear instructions: With the help of prescriptions and medications, you can know what are the benefits of using a particular drug, what might be some of its potential adverse effects, and what other treatments or therapies are available to you prior to starting it.
  • Regular check-ins: We continue to monitor and adjust as necessary to determine if the medication is effective and then based upon what you provide us with in terms of feedback, we will modify the plan.
  • Accessibility: With telehealth visits, you are more likely to attend your scheduled appointment and therefore, you will be able to maintain your course of treatment. Learn more about what to anticipate prior to your initial telehealth visit.

We have an experienced professional in charge of our care, Ms. Angela Wandungu, a Psychiatric Nurse Practitioner (PNP) who has specialized in medication management.
Our clinic provides help for individuals with issues such as Depression, Bipolar II Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Insomnia, and other mental health conditions.
Additionally, we offer many different areas of specialty that you may want to review.

FAQ

Is it okay to skip a dose once in a while?

The odd occasion where a dose has been missed does not generally create an emergency situation, however, how to react will depend upon what type of drug was missed!

Does having withdrawal symptoms mean I’m addicted?

No.
It indicates your body requires time to adapt; therefore, a gradual reduction (tapering) is usually suggested.

What if the side effects are bothering me?

Let your doctor know when you want to change things up. There are usually multiple possibilities for this; either adjust the dosage, alter the schedule of taking it, or try an alternative drug.

Can I get medication management through telehealth?

Yes, we at Mindset & Work do. We provide medication management via secure telehealth to all adult residents of Massachusetts.

Ready to talk about your treatment plan?

If you are having trouble maintaining consistency in your life and/or if you are unsure if your current medication is the correct one for you, we would love to assist you with figuring out what to do.

Emergency Notice: If you’re in crisis, or if you’re thinking about suicide, please reach out by calling or texting 988, or call 911 for emergencies.

This article is intended only for educational purposes and does not constitute medical advice. You should consult with your healthcare provider before beginning, stopping, or altering any prescription medication.

Sources

  1. MedlinePlus: Depression: Stopping your medicines
  2. National Library of Medicine (PMC): Partial adherence to antipsychotic medication and relapse risk
  3. National Library of Medicine (PMC): Adherence to Medication in the Treatment of Psychosis
  4. 988 Suicide & Crisis Lifeline: 988lifeline.org
  5. Mindset & Work: mwmhs.com

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