Most side effects of mental health medicines are manageable and can wait for a scheduled appointment. A few cannot. This page sorts them by how fast you need to act.
If you are unsure which band something falls into, treat it as the more urgent one.
Common side effects and early adjustment effects
Routine appointment is appropriate for effects that are unwelcome but not alarming: nausea, headache, dry mouth, mild sedation, sexual side effects, weight change, or emotional blunting that has persisted beyond the first weeks.
These are worth raising rather than tolerating, since most have options. They are simply not emergencies. See mental health medication side effects.
Serious mood, behaviour or physical symptoms to take seriously
Emergency help now:
- Thoughts of harming yourself. This does not wait for anything else on the list.
- Agitation or confusion with fever, sweating, a racing heart and muscle twitching, which can indicate serotonin syndrome
- High fever with marked muscle stiffness and confusion, a rare but serious antipsychotic reaction
- A seizure
- Difficulty breathing, or swelling of the face, lips or throat
- A rash that blisters or peels, particularly on lamotrigine
- Fainting, or a fast or irregular heartbeat
- Signs of lithium toxicity: coarse tremor, vomiting, severe diarrhoea, slurred speech, unsteadiness or drowsiness. See lithium toxicity symptoms.
Same day, do not wait for an appointment:
- New involuntary movements, particularly of the face, lips or tongue
- Severe restlessness or an inability to sit still, which is distressing and treatable
- A switch into unusually elevated mood, reduced need for sleep and racing thoughts
- Fever with a sore throat or mouth ulcers, which can indicate a drop in white cells
- Unexplained bruising or bleeding
- Marked confusion, weakness or unsteadiness, particularly in an older adult
- Yellowing of the eyes or skin
- Marked thirst with frequent urination
- Feeling unwell after stopping a medicine abruptly
Sexual, sleep, weight and emotional side effects
These belong in the routine band, with one exception: if a side effect is making you consider stopping, bring the appointment forward. A conversation now is better than an abrupt stop later, which is the usual sequence when these go unmentioned.
Interactions, alcohol, pregnancy and other risk factors
Contact someone before, not after, if you are prescribed a new medicine by someone who may not know what you take, if you are pregnant or planning to be, or if you are considering a supplement, particularly St John’s Wort.
A pharmacist can answer interaction questions quickly without an appointment.
What to ask your doctor before changing dose or stopping
Ask at the start of treatment, rather than when something goes wrong: which symptoms mean I contact you immediately, which can wait, and who do I contact outside working hours. Having that answer written down is worth more than any general list.
Tell someone close to you what to watch for, particularly in the first weeks. Some of the changes that matter most are easier for others to notice than for you.
Related mental health medication guides
- Mental health medication side effects
- Should I stop my mental health medication
- Antidepressant side effects
- Mental health medication withdrawal symptoms
- Report a side effect in South Africa
Medical Disclaimer: This content is for informational and educational purposes only and does not constitute medical diagnosis, prescription, or professional advice. Always read the patient information leaflet and consult a qualified doctor or pharmacist regarding any medicine or health concern.