There are many different types of mental health meds, and they all work on different time scales. Let’s look at a few different types of medications and their differences:
As needed
Some medications do not need to be taken regularly. They are taken “as needed.” (Doctors will sometimes call these PRN, which stands for “as needed” in Latin.)
These are generally taken for a very specific purpose—for example, to help you sleep, or to stop a panic attack. They last anywhere from a few hours to a few days. Sometimes these are safe to take every day, but others should be used sparingly. Your doctor will tell you how often you can take a medication like this. It all depends on what kind of medication it is, and how high of a dose you are taking.
Examples include:
- Benzodiazepines, like Xanax. These are usually prescribed for anxiety attacks.
- Sleep meds, such as Ambien.
- Stimulants, such as Adderall and Ritalin. These are usually prescribed for ADHD. They’re often taken every day, or even multiple times a day.
Medications that need to be taken daily
Some medications take some time to build up in your system. They need to be taken every day for a few weeks before you will feel the full effect. These medications usually treat long-term conditions with a variety of symptoms, like depression or bipolar disorder. Unlike as-needed medications, you can’t take an antidepressant only on days when you feel extra depressed.
It’s best to take these medications at the same time every day. It’s easier to remember that way. Plus, some medications might keep you up if you take them right before bed, or make you sleepy if you take them in the morning. Some should be taken with food. Others should be taken on an empty stomach. Ask your doctor what time of day is best.
Examples include:
- Most antidepressants, including SSRIs like Zoloft and SNRIs like Cymbalta.
- Mood stabilizers, like Lithium and Lamictal.
- Antipsychotics, like Seroquel and Abilify.
Immediate release vs. extended release
Usually when you take a pill, the whole pill is dissolved in your stomach and is absorbed into your body fairly quickly. This is called immediate release. You will feel the positive effects more quickly—but it can also make side effects worse. The medication will also wear off more quickly. Sometimes, you may need to take multiple doses throughout the day.
Some medications are available in an extended release form. The pill is designed to dissolve slowly instead of all at once. There are a couple advantages to this: First, you don’t have to take them as often. It’s easier to remember to take one pill in the morning than to remember to take it 3 times throughout the day! It can also help you feel more stable throughout the day. On the other hand, it won’t take effect as quickly.
Most medications are immediate release by default. The extended release form will usually have an abbreviation at the end to tell you that it is extended release—something like ER or XR for “extended release,” or SR for “sustained release.” For example, Adderall comes in an extended release form called “Adderall XR.”
(Sometimes you might also see “IR,” which stands for “immediate release.”)
Some medications are also available as long-acting injectables. Instead of taking a pill every day, you go into the doctor’s office every few weeks to receive an infusion. The medication is slowly released in your body until your next appointment.
Starting new medications—and stopping them
When your doctor prescribes a new medication, they are going off what they know about how a medication usually works. But everybody’s brain and body are different. A new medication may hit you faster than most people—or it might take longer to feel the effects. You may need to have the dosage adjusted.
Sometimes you’ll feel side effects right away, but it will take a few weeks to feel the positive effects. Other times the side effects will only last a few days and then wear off once your body adjusts.
Some medications have withdrawal effects when you stop taking them. With some medications, you’ll feel withdrawals if you skip a single day. With others, you can afford to forget to take them every once in a while.
If you want to stop taking something, it’s best to talk to your doctor first. Your doctor can help you reduce the dosage gradually, which will reduce withdrawal symptoms. (You can often do this by cutting your tablets in half for a few weeks, then into fourths for a few more weeks.)
There’s always some trial and error involved in finding the right medication (or combination of meds). Check out this article to learn how to make the process easier.