I. Storage of Medications

Keep medications in their original bottles.  Do not mix different medications in the same bottle. Please store medications as directed by the pharmacist.  Keep medications out of sight and out of reach of children because an overdose can be dangerous. Make sure the labels are clearly readable. Do not dispose off any discontinued medications without talking to the prescribing doctor.

lI. Side Effects & Risk/Benefit Analysis

No psychiatric medication is completely risk-free. In weighing the pros and cons of a given treatment decision it is important to weigh the potential harm from treatment against potential harm from not treating the illness.

Most medications have a long list of medication side effects listed in the Prescribing Information that is freely available online. We are happy to discuss any questions about these side effects. It may be difficult for you to remember every single side effect of each medication that you take. It is therefore important for you to report any physical or mental discomfort or worsening of your condition to the prescribing doctor. There may be yet unknown or long-term side effects, especially of medications taken over a long period of time. It is therefore important that you partner with the prescribing doctor in ongoing risk-benefit analysis during your regular follow-up appointments.

 It is possible to have an allergic reaction to any medication. This may show itself in the form of skin reactions, breathing difficulties, or other allergic responses. These must be immediately reported to the prescribing doctor. If they are causing serious discomfort, please seek emergency help at your nearest Emergency Room/ Urgent Care facility. Any new generalized rash or unexplained fever occurring in the weeks following the start of a new medication should be immediately reported to our office.

Dangerously low white blood cell count can be a rare side effect of some medications. Common symptoms of this are fever and sore throat. These need immediate attention.

Some medications can cause liver problems so infrequently that regular blood tests are not recommended by the FDA.  Immediate attention is needed however, if signs and symptoms of liver problems are noted. These include Itchy skin, Jaundice (yellow coloring of skin and eyes), dark urine, upper right-sided abdominal tenderness or unexplained “flu-like” symptoms

Regular medication blood level tests are essential to monitor dosing of certain medications like lithium carbonate where the difference between therapeutic blood levels and toxic blood levels is rather small.

lll. Pregnancy and Sexual Health

In the interest of having a healthy baby, you may need  to avoid pregnancy and breast feeding during the time when you are taking psychiatric medications. When you do plan a pregnancy, inform your doctor well in advance so that he can discuss the possibilities of risk to your baby during pregnancy and breastfeeding. We suggest you visit www.womensmentalhealth.org for additional education in this matter.

Many psychiatric medications may affect sexual desire or orgasm negatively. Please discuss any such side effects with the physician.

Some psychiatric medications can cause Priapism, a persistent, usually painful, erection of the penis that lasts for an unusually long time and occurs without sexual stimulation. It is a medical emergency needing immediate emergency room visit. 

IV. Machinery & Driving

Many psychiatric medications can, for some people, cause tiredness, sleepiness, delay in  reaction time or decrease in concentration. Since there are wide variations among different people in this regard it is important that you avoid driving or operating machinery until you are quite familiar with how your medication affects you. In any case, exercise extra caution in driving and operating machinery.

V. Sun Exposure/tanning

Some psychiatric medications make you more sensitive to sunburn. They may also cause skin damage in a tanning bed situation. Please be extra cautious and use sunscreen in these situations. Also, in the summer months it is particularly important to stay cool and drink plenty of water and liquids unless otherwise directed by your doctor.

VI. Medication Interactions

To avoid and manage medication interactions it is important to inform ALL your current and new doctors and dentists of ALL your medications and supplements. We have seen cases of serious lithium toxicity after patients taking lithium were started on a diuretic (water pill) because the patients failed to inform the other prescribing doctor that they were taking lithium.

VIl. Alcohol & Drugs

It is important to avoid any street drugs or alcohol when you are being treated with psychiatric medications. If you use drugs or alcohol, unpredictable and unusual side-effects and reactions may occur.

VIII. Over-the-Counter & Herbal Medications

It is important to keep your doctor informed about any herbal or over the counter medications that you are taking or planning to take.

IX. Overdose

Call 911 Or Poison Control immediately in case of overdose.

X. Dosage Instructions

Make sure you understand exactly how the medication is to be taken.  If in doubt, ask your doctor or pharmacist. Please call if there is a difference between what the doctor has told you and what the bottle says. Do call our office if you notice a change in the size or color of your pills on a refill. Parents need to supervise medication intake by their children

XI. Refills

It is important to keep taking your medication unless directed by your doctor to stop. Please be sure to make and keep regular follow-up appointments. In case you run out of medication because of unforeseen problems, please call us for refills until your next appointment. Please note that schedule 2 controlled substances commonly used for ADHD need a new prescription each time they are filled. Refills are not allowed on these drugs. For each medical appointment, please bring a very accurate list of all medications that you are taking from any doctor.  In place of list, you may bring all the original medicine bottles.

X.  FDA Labeling

It is common in the present day psychiatric practice to use medications for different purposes and in different age groups than what the U. S. food and drug administration approved them for. We apply the principles of risk-benefit analysis to these situations. This is particularly important for children because few commonly used medications have FDA labeling for children with psychiatric problems. Risk of not treating must also be taken into account in risk-benefit analysis. 

XI. Falls

Some psychiatric medications cause dizziness, lightheadedness, and a blackout like feeling.  These problems can be minimized by getting up slowly from lying down or reclining positions. It helps to move your legs before you get up. These precautions for slow change of position can help minimize falls. These precautions are critical for elderly people because falls in this age group can have very serious consequences.