Medicines: a guide for supporters

Help them describe what has changed: when it began, how often it happens and what it stops them doing. “Too sleepy to get up for work since Monday” is more useful than “not themselves”. Include recent dose changes and other medicines or supplements.

Ask the prescriber or pharmacist what needs reviewing and how soon. Do not dismiss a problem because the medicine is helping something else. For severe or rapidly worsening symptoms, follow the medicine’s urgent instructions or get urgent help.

Prepare questions for a medicine review.

Ask when the next review is and who to contact between appointments. Antidepressants can help, but some people develop suicidal thoughts or an urge to self-harm when treatment starts. Take new or worsening thoughts seriously: contact the GP or prescriber straight away. If they may act on these thoughts or cannot stay safe, get urgent help now; do not wait for the medicine review.

NICE recommends a review one week after starting an antidepressant or increasing its dose for people aged 18 to 25, or anyone thought to be at increased risk of suicide. Ask the prescriber about the review plan and what changes they want to hear about. Do not change or stop the medicine yourself.

Sources checked on 5 October 2026: NHS: antidepressants, NHS: depression treatment and NICE NG222, recommendation 1.4.22.

Ask the prescriber or pharmacist to review all their medicines, including non-prescription products. In older people, antidepressant choices and monitoring need to take account of physical health, interactions, falls and low sodium in the blood, especially alongside medicines such as diuretics.

Report new side effects, unsteadiness or falls and ask what monitoring is needed. Sudden confusion needs immediate medical help: call 999 or go to A&E. Do not assume it is simply ageing or stop or change a dose yourself.

NICE: antidepressants in older people · NHS: sudden confusion. More about supporting an older parent.

Ask why. Side effects, feeling better, difficulty remembering or not believing the medicine helps are different problems. Listen before trying to persuade them.

Offer to contact the prescriber together to discuss options and a safe plan. If they have already missed or stopped doses, say what was last taken and when. Do not guess a catch-up dose, double a dose or restart an old prescription without medicine-specific advice.

You can support a conversation without becoming responsible for making them take treatment. If their mental health is deteriorating, tell the care team what has changed; do not wait for a routine review.^[1]

Lithium needs blood tests to check the level. Ask the team when the next test is due and what to do if they become ill. Severe vomiting, diarrhoea, fever or not eating or drinking can affect lithium levels: get urgent medical advice.

Possible lithium toxicity is an emergency. New confusion, marked drowsiness, difficulty speaking, blurred vision or pronounced shaking can be warning signs. The NHS lists the full signs and actions: stop lithium and call 999 or go to A&E. Taking more than the prescribed dose also needs emergency help, even if they feel well.^[2]

Clozapine needs regular blood monitoring and specialist follow-up. Keep the clozapine team’s number with the medicine details. Tell them promptly about an infection, fever or sore throat, or a change in smoking.

If it has been more than 48 hours since their last dose, do not restart their usual dose. Contact the clozapine team for instructions; restarting needs specialist supervision.^[3]

Report constipation to the team immediately. A swollen abdomen, vomiting, or moderate to severe abdominal pain lasting over an hour needs immediate assessment at A&E. Clozapine-related constipation can become dangerous quickly; do not wait for the next routine appointment.^[4]

Some antipsychotic medicines are given as a slow-release injection, sometimes called a depot or long-acting injection. The time between doses depends on the medicine and treatment plan. Ask for the medicine’s name, the next appointment date and the clinic’s contact number.

If an appointment is missed, contact the clinic or prescribing team promptly. Tell them which injection it is and when the last dose was given, if known. Ask what should happen next; do not guess how long it is safe to wait or add tablets to make up for it. Missed-dose instructions differ between medicines.

Report side effects to the team, including pain, redness or swelling where the injection was given. An injection keeps releasing medicine over time, so side effects cannot necessarily be resolved quickly by stopping it. Ask which changes need urgent advice.^[5]

If they want your help, offer a reminder, a lift or company at the appointment. If they do not want the injection, help them discuss their reasons with the prescriber. If their mental health is worsening, get urgent help rather than waiting for the rescheduled appointment. You can pass on a concern even when staff cannot discuss their care with you.

• What is this medicine intended to help, and when will you review whether it is working?
• Which side effects need a call that day, and who answers outside normal hours?
• Are any blood tests or other checks due?
• What should they do if they miss a dose, are sick, run out or want to stop?
• Would reminders, different packaging or another treatment help?

Write down the answer for this medicine. The information-sharing template can help them discuss what the team may tell you.