by Beth Salcedo, MD
psychotropic medications

The decision to take medication for mental health is a very important one, and it often takes place when symptoms of anxiety, depression, or other mental health issues have intensified, which can make the decision process much harder. The following questions can help ease the process and guide you in your conversation with your doctor and in the ongoing treatment process.

Ask Your Doctor:

  1. If medication is the only option, or if there are other potential treatment avenues. You should work with someone who is well versed in treatments for your specific symptoms that have been proven to work. For example, Cognitive Behavioral Therapy, or CBT, has been shown in studies to provide just as much benefit as medication for the various anxiety disorders.
  2. What the different medication classes are, and how they differ in terms of benefit and side effects. You can use medications on an as needed basis, called PRN, or you can use medication that you take daily and whose benefit builds up. Sometimes it makes sense to go with the former, sometimes the latter, and sometimes both. Your doctor should be able to clarify for you which avenue is best and why.
  3. What common side effects to watch for, and how to manage them. Many people are afraid of side effects of medications, but what they don’t realize is that only a small percentage of people actually experience the side effects, and most go away in just a few days.
  4. What time of day you should take your medication, and whether it should be with food or on an empty stomach. Should you stay away from certain foods, other medications, or alcohol? You should be aware of any potential interactions that your medication can have.
  5. How long you should stay on the medication. One mistake people can make is that they will assume that once they feel better that they can stop taking the medication. But research shows that having a certain amount of time in remission, or symptom-free, can increase the likelihood of avoiding a relapse once off the medication. Your doctor should discuss this with you early on in your treatment to give you an idea of how the treatment will go.
  6. What you should do if you forget to take your medication. Should you take it later in the day, or skip it until the next day’s dose, or double up? These questions are important as inevitably there will be a day or two when you forget.
  7. What the process of coming off medication looks like. You need to be aware of any withdrawal symptoms you could have, as these could show up if you forget a dose as well.

Questions to Ask About a New Drug/Treatment on the Market:

  1. Is this new drug/treatment appropriate for me?

  2. What are the drawbacks, if any of this new treatment?

  3. What might be the benefits over my current regimen?

  4. Is the price (typically high when a drug is new) worth the added benefit?

  5. Is this treatment ready for widespread use?  Meaning, does it have safety established? Do we know how long people need to be on this treatment? Do we know about any long term issues that could result from this?

These questions should be easily answerable by your psychiatrist, psychiatric nurse practitioner, or other mental health provider. Make sure you have a venue with your treatment team for ongoing conversation as issues arise, or as you come up with other questions you want answered.

About the Author

Beth Salcedo 2017_0_0.jpgBeth Salcedo, MD, ADAA's current board president, is the medical director of The Ross Center for Anxiety and Related Disorders, LLC. She is also clinicalfellows.jpga partner in Manhattan Psychiatric Associates, PLLC. 


I was on SSRI for 20 years, mainly for social anxiety, and they served me well. However, in recent years I felt they had lost their efficacy. The reason was when I missed a dose I had no adverse effect and in general, I felt anxiety was increasing.

Over the past year, I went through some serious trauma, losing a few close family members, in particular, my younger brother and best friend in a RTA.

Since then my anxiety was chronic and constant. Doc put me on Mirtazapine 30mg and it had some small benefit. Until say about 3 weeks ago when I decided to cease the SSRI completely after 20 years. In a strange twist of faith, I started to feel much better. Definite some withdrawal symptoms but the alleviation of anxiety was profound.

Have you seen this before? Any advice on my next steps re my meds?