Definition and Overview

In a psychiatric medication review, a general physician or a psychiatrist reviews all the medication that a patient is taking for an existing mental illness. The purpose is to promote safe and effective medication use and ultimately, improve patient outcomes.

Who Should Undergo and Expected Results

A psychiatric medication review is beneficial for psychiatric patients who are being treated for a mental health problem using medications such as antipsychotic drugs, mood stabilizers, and antidepressants. The goal is to ensure that the medications do not cause unwanted side effects (listed below) that may harm the patient or hinder effective treatment.

Common side effects of psychiatric medications

  • Weight gain
  • Drowsiness
  • Loss of appetite
  • Changes in diet
  • Excessive saliva or dry mouth
  • Nausea
  • Upset stomach
  • Increased urine quantity
  • Sleep disorders or excessive sleepiness
  • Movement disorders

These side effects affect each patient differently, and sometimes, they may not wholly be prevented. Thus, the goal of prescribing doctors is to find medications that help with the patient’s condition but has the least number of side effects that the patient can tolerate.

Expected results

A medication review gives the patient a chance to discuss these side effects with his general physician or attending psychiatrist. If any potentially harmful side effects are experienced, the physician or psychiatrist can:

  • Adjust the dosage
  • Adjust the schedule of taking the medications
  • Change the prescription
  • Prescribe lifestyle changes, such as getting more exercise
  • Refer the patient to a nutrition specialist to help improve his diet
  • Update a patient’s medications in case his symptoms and diagnosis change and in case newer medications become available that may work better for the patient than his previous ones

The end goal of the review is to improve the effects of the medications on the patient’s condition, which means that the drugs should effectively reduce symptoms while causing minimal and only mild side effects that will not harm the patient’s overall health.

How Does the Procedure Work?

A psychiatric medication review is provided by a general physician, a psychiatrist, or a pharmacist, usually upon the patient’s request. During the review, the following information will be required:

  • Complete list of medications being taken
  • Complete list of vitamins, food supplements, and herbal supplements being taken
  • Dosage of each medication
  • Schedule of each medication

It is best for patients to bring actual samples of all the medications they are taking during the review. The doctor will then evaluate each medication based on its purpose, dosage and administration, expected outcome, desired effects, side effects, and drug interactions.

If any issues are found, the doctor will revise the patient's medication plan. In some cases, the doctor may request for a follow-up visit.

Possible Risks and Complications

A psychiatric medication review does not pose any harmful risks and complications in itself. Rather, there are potential risks and complications in not seeking such a review.

Psychiatric medications need to be reviewed more often than other types of medications. This is because aside from common or mild side effects, psychiatric medications can also have long-term and more serious neurological complications when they are not working properly. These include:

  • Type 2 diabetes
  • Tardive dyskinesia or a permanent uncontrollable twitching
  • Impaired cognitive function
  • Memory impairment
  • Liver problems
  • Pancreatitis
  • Thyroid problems
  • Chronic fatigue
  • Pulmonary hypertension

The risk of withdrawal symptoms upon changing or stopping a medication without a psychiatric medication review first include:

  • Insomnia
  • Fatigue
  • Anxiety
  • Depression
  • Agitation
  • Psychosis
  • Hypersensitivity

Thus, in order to prevent long-term complications and harmful withdrawal symptoms, patients should request a psychiatric medication review at least once a year or when they deem necessary.

References:

  • National Institute of Mental Health (NIMH). Antidepressant medications for children and adolescents: information for parents and caregivers. Available at: www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/antidepressant-medications-for-children-and-adolescents-information-for-parents-and-caregivers.shtml. Accessed October 31, 2014.

  • US Preventive Services Task Force. Screening and treatment for major depressive disorder in children and adolescents: US Preventive Services Task Force Recommendation Statement. Pediatrics. 2009;123:1223-1228. PMID 19336383 www.ncbi.nlm.nih.gov/pubmed/19336383.

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