What this series is
Most people are handed a psychiatric medication with about ninety seconds of explanation and a leaflet written by lawyers. Then they go home and type the name into a search engine at eleven at night, and what comes back is a forum thread, a lawsuit advert and someone selling supplements.
This is one post a day, in plain English, about the medicines used in mental health care in the UK. What they are for. What the first few weeks actually feel like. Which side effects settle and which ones mean you ring someone today. What the blood tests are for. What to ask before you agree to anything.
I'm a registered mental health nurse and a teacher. I am not your nurse, and this series is not treatment. What it is, is the explanation you should have been given in the appointment and probably weren't.
The rules I've set myself
These are not disclaimers bolted on the bottom. They shape what does and doesn't get written.
- No doses. Ever. Not a milligram, not a titration plan, not "most people start on…". Doses belong to a prescriber who has seen you, your bloods and everything else you take.
- Nothing that tells you to start, stop or change anything. The single exception on this whole site is the NHS's own emergency wording for lithium toxicity, and it is quoted as theirs.
- No "best" medication. There isn't one. There's the one that fits you, and finding it is a process.
- Everything drug-specific is sourced to the MHRA, NHS, NICE, the BNF or a Royal College, and the sources are listed at the bottom of each page.
- Nothing from inside the ward. No patients, no stories, not even disguised ones.
- No money from anyone who makes medicines. There are no drug company links here and never will be.
Where to start
If you've just been prescribed something, read Day 1 and Day 5. If you started an antidepressant in the last month and feel worse rather than better, read Day 2. If you're thinking about coming off something, read Day 3 before you change anything. If you're worried about a side effect right now, go straight to Day 4.
Published so far
- Day 1What psychiatric medication actually does — and what it doesn'tWhy the “chemical imbalance” story got retired, what the tablet is really doing, and the difference between a floor and a cure.
- Day 2Starting an antidepressant: what the first six weeks actually feel likeWhy week two is where most people quit, what usually settles, and the extra caution for under-25s.
- Day 3Coming off antidepressants: withdrawal, tapering, and how to tell it from relapseWhy “zaps” are a withdrawal signature, what hyperbolic tapering means, and the three tests that tell withdrawal from relapse.
- Day 4Side effects: what usually settles, and what needs a phone call todayThe settles / doesn’t settle / ring-today split, plus lithium toxicity, clozapine fever, NMS and serotonin syndrome.
- Day 5Twelve questions worth asking before you start a psychiatric medicationThe twelve questions, why each one matters, and how to get real answers when the appointment is ten minutes long.
Coming up
The rota runs to ninety posts. New ones go up daily.
- Day 6Who can actually prescribe your psychiatric medication in the UK
- Day 7How to read the leaflet in the box without frightening yourself
- Day 8Why it takes weeks to work when the tablet is absorbed in an hour
- Day 9Medication and therapy: not a competition, and not either/or
- Day 10What 'it's working' actually means — and why 'no symptoms' is the wrong target
- Day 11You missed a dose. What now?
- Day 12Shared decision making: how to disagree with a prescriber without walking out
- Day 13Psychiatric medication and alcohol: the honest version
- Day 14The two-minute medication diary that changes your next appointment
- Day 15SSRIs explained in plain English
- Day 16SNRIs: what's different about them
- Day 17Mirtazapine: the one that makes you hungry and sleepy
- Day 18Tricyclic antidepressants: old drugs still doing a job
- Day 19MAOIs, and why the food list matters
- Day 20Sexual side effects: the thing people stop taking medication over
- Day 21Emotional blunting: when the lows stop but so do the highs
- Day 22Antidepressants and weight: what's known and what isn't
- Day 23Antidepressants under 25: the extra caution in the first weeks
- Day 24Do antidepressants actually work? What the argument is really about
- Day 25Switching antidepressants: cross-tapering and why it feels rocky
- Day 26When one antidepressant isn't enough: adding rather than swapping
- Day 27St John's wort and other things people take without telling anyone
- Day 28Antidepressants in older adults: hyponatraemia, falls and slower starts
- Day 29Antipsychotics: what they treat and what the name gets wrong
- Day 30First and second generation antipsychotics: what actually differs
This page names medicines but gives no doses and no instructions. It is written to help you have a better conversation with the person who prescribes for you — not to replace them. Do not start, stop, increase or reduce any medication because of something you read here. If something on this page worries you about your own treatment, ring your prescriber or your pharmacist, or call 111.
If you need help now, don't wait for tomorrow's post
Crisis numbers, what happens when you call, and how to get seen — all in one place.
Last reviewed: 20 August 2026. Next review due: February 2027.
Written by Dereck Tafuma, Registered Mental Health Nurse (NMC PIN held) and qualified teacher. Medicines guidance changes — if you find something out of date on this page, please tell me and I'll correct it.
This page is general information for the public. It is not personal medical advice, it contains no doses, and it cannot take the place of an assessment by someone who can actually see you. Nothing here is written on behalf of any employer.