Medication review and prescribing

What is a psychiatric medication review?

A psychiatric medication review is an appointment with a doctor — often a psychiatrist or a GP — to look carefully at the medicines you take for your mental health, such as antidepressants, mood stabilisers, antipsychotics or anti-anxiety medicines. It is a chance to step back and ask: are these medicines still helping, are the doses right, are there side effects, and is it time to continue, adjust, switch or carefully reduce them?

Good prescribing is a shared decision. The clinician brings knowledge of the medicines, the evidence and the risks; you bring how you actually feel on them, what matters to you, and your goals. The aim is to use the most helpful medicine at the most appropriate dose for the right length of time — no more, and no less.

A review is also where stopping a medicine is planned, if that is right for you. Psychiatric medicines should almost never be stopped suddenly. Many, including most antidepressants, need to be reduced gradually ('tapered') to lower the chance of withdrawal symptoms and to watch for the original condition returning. How quickly this is done is decided with you and adjusted to how you cope.

A review does not have to mean changing anything. Sometimes the safest, most helpful outcome is to continue as you are, with a clear plan for monitoring.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Continuing, adjusting and stopping medication

There is no single right answer — it depends on your diagnosis, how long you have been treated, how you are now, and what matters to you. Abrupt stopping is not recommended.

Preparing for your appointment

• Bring an up-to-date list of all your medicines and supplements, including doses, or bring the packets.
• Note how you actually feel on each medicine — benefits, side effects, and anything that bothers you.
• Think about what you want from the review: to feel better, reduce side effects, simplify, or consider stopping.
• Note your alcohol and any recreational drug use honestly, as these interact with psychiatric medicines.
• Write down any other health conditions and medicines from other doctors, as interactions matter.
• If you are considering stopping a medicine, note why, and any previous attempts and how they went.
• Bring relevant past letters or results if you have them, and details of who currently prescribes for you.
• Have your questions written down — it is easy to forget them in the appointment.

What happens

The clinician reviews your diagnosis, the medicines you take, how long you have taken them, and how you are now. They will ask what is helping, what is not, and about side effects, and will check for interactions with other medicines and any monitoring a medicine needs.

Together you weigh the options: continue, adjust the dose, switch, or reduce and stop. The clinician explains the likely benefits, the risks, and the alternatives — including non-drug options such as talking therapies — so the decision is genuinely shared. If a medicine needs blood tests, blood-pressure or heart checks, or weight monitoring, this is arranged.

If the plan is to reduce or stop a medicine, the clinician sets out a gradual tapering schedule, what withdrawal symptoms to watch for, and what to do if the original condition starts to return. Any reduction is paced to how you cope. You should leave with a clear, written plan, knowing who is prescribing and monitoring, and how to get help if things change.

Is this appointment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The biggest risks cluster around medication changes — both starting and stopping. Stopping psychiatric medicines abruptly can cause withdrawal symptoms and a return of the original condition, which is why changes are made gradually and with monitoring. Around any change, watch for worsening mood or thoughts of self-harm and seek help quickly. Ask exactly how a change will be made, how it will be monitored, who to contact if you struggle, and — if seen privately — whether your GP will take on ongoing prescribing.

Published figures to discuss

Numbers are of limited use for a medication review itself, because the appropriate medicine, dose and duration depend heavily on the diagnosis, the individual and the specific drug. The most concrete numerical area is withdrawal (discontinuation) symptoms when reducing medicines such as antidepressants: these are common but usually mild and short-lived, while a minority of people experience more difficult or prolonged symptoms. Exact rates vary widely by medicine, dose and duration of use, so the range below is a broad guide and should not replace an individual discussion.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery. What matters afterwards is following the agreed plan, attending any monitoring, and knowing how to get help quickly if your mood worsens or a medication change is hard.

• Some side effects when starting or increasing a medicine, often easing over the first weeks.
• Mild, temporary withdrawal symptoms when reducing a medicine, settling before the next reduction.
• Benefits of a new or changed antidepressant taking some weeks to become clear.
• Needing to adjust the plan as you see how you respond, rather than getting it perfect first time.
• No change at all if the review concludes your current medicines are right for you.

Aftercare

• Follow the agreed plan exactly, and do not change or stop a medicine on your own.
• Never stop a psychiatric medicine abruptly — if you want to stop, agree a gradual plan with your prescriber.
• Keep a note of how you feel, including mood, side effects and any withdrawal symptoms, to discuss at review.
• Attend any blood tests or other monitoring your medicines require.
• Tell your prescriber about any other medicines, supplements or recreational drugs, and any new health problems.
• Confirm who is responsible for ongoing prescribing and monitoring, especially if you were seen privately.
• Contact your prescriber promptly if a change is hard, side effects are troubling, or symptoms return.
• Seek urgent help if your mood worsens significantly or you have thoughts of self-harm.

• An up-to-date list of all medicines and supplements, or the packets
• Notes on benefits, side effects and how you feel on each medicine
• A written copy of the agreed plan, including any tapering schedule
• Clarity on who prescribes and monitors going forward
• Dates booked for any blood tests or other monitoring
• Your prescriber's contact route for problems between appointments
• Crisis numbers saved: 999/A&E, Samaritans 116 123, NHS 111 mental-health option (England, Scotland or Wales) or your GP out-of-hours / HSC Phone First service (Northern Ireland), text SHOUT to 85258

⚠ Get urgent help if…

• Thoughts of suicide, or feeling you cannot keep yourself safe — get urgent help now.
• If life is at immediate risk, call 999 or go to your nearest A&E.
• For urgent out-of-hours mental-health support in England, Scotland or Wales, call NHS 111 and choose the mental-health option; in Northern Ireland, contact your GP out-of-hours service or your HSC Trust's Phone First service.
• Samaritans are free, day or night, on 116 123; or text SHOUT to 85258.
• A significant worsening of mood, agitation or anxiety, especially soon after a medication change.
• Withdrawal symptoms that are severe or not settling when reducing a medicine — seek advice rather than stopping suddenly.
• Signs of a serious medication reaction, such as a severe rash, swelling, high fever, confusion, a very fast or irregular heartbeat, or fainting.
• Any new thoughts of self-harm after starting or changing a medicine — seek medical advice urgently.

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your psychiatrist gives you.

Results & realistic expectations

A good outcome is a medication plan that genuinely fits you: the most helpful medicines at the right doses, with side effects you can live with, and no medicine you no longer need. For some people that means continuing as they are; for others it means adjusting, switching, or safely reducing and stopping a medicine.

Getting there often takes time and more than one review, because medicines work differently in different people and changes are made gradually. The aim is not simply 'more' or 'less' medication, but the right medication for you, reviewed as your needs change — alongside non-drug support where that helps.

How long you stay on a psychiatric medicine depends on your diagnosis, history and how you respond. Some people need a medicine for a defined period; others benefit from longer-term treatment to stay well. Plans are not fixed — they should be reviewed regularly, and revisited if your symptoms, circumstances or other health conditions change. Stopping, when appropriate, is planned and gradual rather than sudden.

Related tests, treatments or support

Medication is often only part of the picture, and a good review considers what else helps. Talking therapies, lifestyle measures, sleep, alcohol and physical health all affect mental health and may be addressed alongside medication. Where you take medicines from more than one doctor, the review checks for interactions and aims to simplify and coordinate care. If a physical condition or its treatment affects your mental health, that is taken into account too.

Follow-up & long-term care

Follow-up depends on the plan. After starting or changing a medicine, you are usually reviewed within a few weeks to check benefit, side effects and safety. During a taper, reviews track withdrawal symptoms and the return of the original condition. Any required monitoring — blood tests, blood pressure, heart or weight checks — is arranged and the results discussed. If you were seen privately, follow-up should clarify whether your NHS GP will take on ongoing prescribing through shared care.

• Attend regular medication reviews rather than relying on repeat prescriptions alone.
• Keep up any required monitoring, such as blood tests or blood-pressure and heart checks.
• Tell your prescriber about new medicines, supplements, recreational drugs or health problems.
• Never stop or change a psychiatric medicine abruptly — agree any change with your prescriber.
• Raise any new or worsening side effects, or return of symptoms, promptly.

Repeat, follow-on and what comes next

• Medication plans are expected to be adjusted over time rather than fixed at one appointment.
• A taper may need to be slowed, paused or stepped back up if withdrawal symptoms are difficult or the condition returns.
• More than one review is often needed to get the medication right.
• A private recommendation and an NHS service may differ, which can affect ongoing prescribing.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear, written medication plan, including any tapering schedule and what to watch for.
• A named prescriber and a clear agreement on who monitors and prescribes going forward.
• Any required monitoring arranged, with results discussed.
• A prompt contact route if a change is difficult, side effects trouble you, or symptoms return.
• A safety plan and crisis information in case mood worsens or thoughts of self-harm arise.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether you use NHS care or pay privately for the review.
• The seniority of the clinician (for example a consultant psychiatrist) and the length of the appointment.
• The number and complexity of your medicines, and whether more than one appointment is needed.
• Whether tests or monitoring (blood tests, blood pressure, heart or weight checks) are included or charged separately.
• Whether a written report or letter to your GP is provided, and any cost for it.
• Ongoing prescription and monitoring costs, and whether your NHS GP takes over prescribing.
• In-person versus online appointments, and the provider's location.

• Who carries out the review and their professional registration.
• What the appointment includes — review, plan, and any report or letter to your GP.
• The cost of any follow-up appointments needed to make changes safely.
• Any costs for tests or monitoring the medicines require.
• How private prescriptions are issued and dispensed, and the cost.
• Whether and how your NHS GP could take on ongoing prescribing (shared care).
• How urgent concerns or difficult medication changes are handled between appointments.
• The cancellation and rescheduling policy.

On the NHS? Medication reviews are a routine part of NHS GP and mental-health care and can be requested; private reviews are used by some for speed, choice or a second view, though ongoing prescribing often works best in partnership with your NHS GP.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the psychiatrist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good psychiatrist will welcome every one of these.

• Is each of my medicines still needed, at the right dose, and working as it should?
• What are the main side effects and interactions I should know about?
• If we change or stop a medicine, how will that be done and over what timescale?
• What withdrawal symptoms might I get, and what should I do if they are difficult?
• What monitoring (blood tests, blood pressure, heart or weight checks) do my medicines need?
• Who will prescribe and monitor going forward, and will my NHS GP take on shared care?
• What non-drug options could help alongside or instead of medication?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the psychiatrist who carries out my appointment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this appointment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified psychiatrist for medication review and prescribing

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE NG215 — Medicines associated with dependence or withdrawal symptoms NICE QS8 — Depression: stopping antidepressants (quality statement) Royal College of Psychiatrists — Stopping antidepressants NHS — Antidepressants (including coming off them) GMC — Good practice in prescribing and managing medicines and devices Samaritans — free 24/7 support, 116 123 MHRA — valproate reproductive risks MHRA — valproate use in men (precautionary contraception advice) nidirect — urgent and emergency care services (Northern Ireland) nidirect — GP out-of-hours service (Northern Ireland)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.