A psychiatric medication review is an appointment where a psychiatrist checks whether your mental health medication is still working, safe,e and right for you, then decides whether anything should change.
It looks at your symptoms, side effects, other medicines and physical health, and it is a routine part of care.
Many people think a review means treatment has failed. It does not. Medicines that suit you at one point in life may need adjusting later, because your health, stress, age, weight and other medicines all change.
This guide explains what a mental health medication review involves, who can do one in Australia, what happens at the appointment, how often it should happen and what might change afterwards.
Key takeaways
- A review is a checkpoint. It is normal, and it does not mean something has gone wrong.
- A good review asks four questions: Is it working? Is it safe? Is it still needed? Is it being monitored?
- Psychiatrists, GPs and pharmacists all review medicines, but they check different things.
- Possible outcomes range from changing nothing to adjusting, switching, adding, or slowly reducing a medicine.
- Never stop or change psychiatric medication on your own. Some medicines cause withdrawal effects or relapse if stopped suddenly.
What Does a Medication Review Check?
A review answers four questions. Each one maps to a part of the appointment.
Is it working?
Are your symptoms better than before, and can you do the things that matter to you?
Is it safe?
Are side effects or interactions causing problems?
Is it still needed?
Does the dose, the combination, and the diagnosis still fit?
Is it being monitored?
Are the right physical checks happening?
Is Medication Still Helping?
Your psychiatrist will compare how you are now with how you were before treatment began. They will ask about mood, anxiety, concentration, energy, sleep, and daily functioning, and about your own goals.
Benefit is not only about symptoms. Being able to work, study, parent, or enjoy life again is part of the picture.
Some medicines take weeks to show their full effect, so timing matters. A review helps tell the difference between “not enough time yet”, “not the right dose,” and “not the right medicine”.
What Does a Medication Review Check?
A review answers four questions. Each one maps to a part of the appointment.
Is it working?
Are your symptoms better than before, and can you do the things that matter to you?
Is it safe?
Are side effects or interactions causing problems?
Is it still needed?
Does the dose, the combination, and the diagnosis still fit?
Is it being monitored?
Are the right physical checks happening?
Is Medication Still Helping?
Your psychiatrist will compare how you are now with how you were before treatment began. They will ask about mood, anxiety, concentration, energy, sleep, and daily functioning, and about your own goals.
Benefit is not only about symptoms. Being able to work, study, parent, or enjoy life again is part of the picture.
Some medicines take weeks to show their full effect, so timing matters. A review helps tell the difference between “not enough time yet”, “not the right dose,” and “not the right medicine”.
Side Effects
Side effects are a standard part of any review. Common ones include changes in sleep, appetite, weight, energy, concentration, and sexual function.
Your psychiatrist will weigh them against the benefit you are getting. Sometimes a side effect settles with time. Sometimes the dose, timing, or medicine needs to change.
It also helps to tell your psychiatrist about side effects you are embarrassed by. They are common, and there are often practical fixes.
Interactions and Polypharmacy
Polypharmacy means taking several medicines at the same time. In mental health, it can build up gradually. A new medicine may be added at each visit, sometimes by different doctors, or to treat a side effect of another medicine. This is called a prescribing cascade.
A review looks at every medicine you take, including prescriptions from other doctors, over-the-counter medicines, herbal supplements, alcohol, and other substances.
The aim is to check for interactions and to ask whether each medicine is still doing a job. Sometimes fewer medicines are the safer choice, and sometimes a combination is exactly right.
Blood Tests and Physical Health Checks
Psychiatric medicines can affect the body, so reviews often include physical checks. Which ones depend on the medicine:
What Can Change After a Review?
A medication review helps determine whether your current treatment is still appropriate for your needs. Depending on your response, side effects, and overall health, your doctor may recommend one of six options.
1. Continue Your Current Medication
If the medicine is working well and remains safe, your doctor may recommend continuing the current treatment without changes.
2. Adjust the Dose
Your doctor may recommend increasing or decreasing the dose to improve the balance between benefits and side effects.
3. Change the Timing or Formulation
Changing when you take your medication or switching to a different formulation, such as a slow-release version, may help address specific treatment needs.
4. Switch to Another Medication
If your current medicine is ineffective, poorly tolerated, or unsuitable, your doctor may consider an alternative.
5. Add Another Treatment
Depending on your circumstances, your treatment plan may include psychological therapy or another medication alongside your existing medicine.
6. Gradually Reduce or Stop the Medication
If stopping treatment is appropriate, your doctor can develop a supervised plan to reduce the dose gradually where needed. Some medicines can cause withdrawal symptoms if stopped abruptly, so changes should be guided by a healthcare professional.
These checks are often arranged through your GP, and results are shared with your psychiatrist.
Adherence, Life Changes and Diagnosis
Your psychiatrist will also ask how you take the medicine in real life: whether you forget doses, skip it when you feel well, or run out. This is not about blame. Missed doses change how a medicine works, and it is important information.
They will also ask what has changed in your life, such as a new job, a loss, pregnancy plans, or a physical illness. Finally, they may check whether the original diagnosis still fits. Sometimes the picture becomes clearer over time.
Medication Review vs Medication Management vs Second Opinion
These three terms are often mixed up.
- Medication management is the ongoing process of prescribing, monitoring, and adjusting your medicine over time.
- A medication review is a checkpoint within that process, where everything is looked at again.
- A second opinion is a review by a different psychiatrist to give a fresh view. It can help if you are unsure about a diagnosis or treatment plan.
Types of Medication Review in Australia: Psychiatrist, GP or Pharmacist?
Several health professionals can review your medicines, and each does it differently. A psychiatrist medication review is the most specialised for mental health. The others are valuable for different reasons.
Who | What they focus on | Best fit when |
Psychiatrist | Whether psychiatric medicines are working, safe, still needed, a nd the right choice for your condition | Treatment is not working, you take several psychiatric medicines, you have bipolar disorder or psychosis, you take ADHD stimulants, you are planning pregnancy, or the diagnosis is uncertain |
GP | Your overall health, all your medicines, shared monitoring and repeat prescriptions. | Routine check-ins, stable treatment, physical health checks, coordinating care |
Community pharmacist (MedsCheck) | A shorter review of your medicines at the pharmacy: how you take them and common problems | You take several medicines and want a quick check. Free for eligible people, with no referral needed |
Accredited pharmacist (Home Medicines Review) | A detailed review of all your medicines, usually at home, with a report to your doctor | Your medicine list is complex,x or you have had problems. Needs a referral from a GP or specialist |
Can a GP review psychiatric medication? Yes. GPs review and monitor psychiatric medicines every day, particularly when treatment is stable. They may refer to a psychiatrist if things are complicated, symptoms return,n or a change in specialist treatment is needed.
When a Psychiatrist Review Is the Better Fit
Consider asking your GP about a psychiatrist review if:
- Your symptoms are not improving, or are getting worse
- You take several psychiatric medicines
- You have bipolar disorder, psychosis or severe depression
- You take ADHD stimulant medicine, and your prescriber has changed or retired
- You are pregnant, planning pregnancy or breastfeeding
- You have had troublesome side effects
- You are unsure your diagnosis is right
What Is a Home Medicines Review?
A Home Medicines Review (HMR) is a free, government-funded service where an accredited pharmacist reviews all your medicines.
It usually takes place in your home, so the pharmacist can see how you actually store and take them. The pharmacist then reports back to your doctor.
HMR is not a psychiatric review. It does not decide whether a psychiatric medicine is the right choice for your condition, but it is excellent at spotting interactions, duplicate medicines, and practical problems.
A referral from a GP is the most common route, though specialists, including psychiatrists, can also refer. You can ask your GP or psychiatrist whether you are eligible.
Signs Your Medication May Need Changing
You do not need to wait for a crisis. Consider asking for a review if:
- Your symptoms are returning or not improving
- You have new or worsening side effects
- The medicine seems to be “wearing off”
- Another doctor has added or changed a medicine
- You are pregnant, planning pregnancy, or breastfeeding
- A big life change has happened, such as loss, a move, or a new job
- You have been well for a long time and are wondering about reducing
- You have trouble remembering to take it
You can also ask for a review when you feel fine. It is a good time to check that everything is still right.
Medication Not Working? Common Reasons
If your medication is not working, there are several possible reasons, and most are fixable:
- The dose or timing may not be right yet
- It has not had enough time to work, since many medicines take weeks
- Stress or life events may be outweighing the benefit
- An interaction with another medicine, alcohol,l or substances may be reducing it
- Missed doses may be changing how it works
- The diagnosis may need another look
A review helps find the real reason, rather than assuming the medicine has failed.
What Happens in a Psychiatric Medication Review?
Before the Appointment
In Australia, you generally need a valid referral from your GP to see a psychiatrist and to claim a Medicare rebate. If you are an existing patient, your psychiatrist will already have your records. The clinic may ask you to complete a questionnaire or update your medicine list beforehand.
During the Appointment
A follow-up review often runs for about 30 to 45 minutes, though this varies. Your psychiatrist will usually:
- Ask how you have been since the last visit
- Go through each medicine, the dose,e and the timing
- Ask about side effects, sleep, appetite, mood, and concentration
- Check your physical health measures, such as blood pressure and weight
- Ask about alcohol, caffeine, and other substances
- Discuss your goals and any concerns
Questions you might hear include “What has changed since we last spoke?” “How are you sleeping?” “Are you taking it every day?” and “Is there anything about the medicine that worries you?”
After the Appointment
Your psychiatrist will explain their recommendation and agree on a plan with you. This may include a letter to your GP, a new prescription, requests for blood tests,s and a date for the next review.
If the plan changes your medicine, you should leave knowing what to do, what to watch for, and who to contact if something goes wrong.
What Can Change After a Review?
A medication review helps determine whether your current treatment is still appropriate for your needs. Depending on your response, side effects, and overall health, your doctor may recommend one of six options.
1. Continue Your Current Medication
If the medicine is working well and remains safe, your doctor may recommend continuing the current treatment without changes.
2. Adjust the Dose
Your doctor may recommend increasing or decreasing the dose to improve the balance between benefits and side effects.
3. Change the Timing or Formulation
Changing when you take your medication or switching to a different formulation, such as a slow-release version, may help address specific treatment needs.
4. Switch to Another Medication
If your current medicine is ineffective, poorly tolerated,d or unsuitable, your doctor may consider an alternative.
5. Add Another Treatment
Depending on your circumstances, your treatment plan may include psychological therapy or another medication alongside your existing medicine.
6. Gradually Reduce or Stop the Medication
If stopping treatment is appropriate, your doctor can develop a supervised plan to reduce the dose gradually where needed.
Some medicines can cause withdrawal symptoms if stopped abruptly, so changes should be guided by a healthcare professional.
Safety note: Never stop or change psychiatric medication on your own. Some medicines cause withdrawal effects or bring symptoms back if stopped suddenly. Always talk to your treating doctor first.
Reducing or Stopping Medication (Deprescribing)
Deprescribing is the planned, supervised process of reducing or stopping a medicine that may no longer give enough benefit to justify its risks or burden. It is gradual, and it is never the same as stopping suddenly.
A psychiatrist may consider it when someone has been stable for a long time, when side effects outweigh benefits, when several medicines overlap, when pregnancy is being planned, or in older age.
International consensus guidance on deprescribing psychotropic medicines emphasises individual decisions, regular reviews, and weighing the risk of relapse, which can be high after stopping some psychiatric medicines.
Reducing a medicine can cause two different things. Withdrawal (discontinuation) symptoms are the body adjusting, and they often start within days. They are often mild and short, but can last weeks or longer for some people.
Relapse is the original condition returning, which tends to develop more gradually. A doctor can help tell them apart. Close follow-up during the process is important, and the pace is often slow.
How Your Psychiatrist and GP Work Together
After a review, your psychiatrist usually sends your GP a letter with their findings and the plan. Many people then use shared care: the GP continues prescribing and routine monitoring, such as blood tests, while the psychiatrist reviews periodically or when something changes.
For ADHD stimulant medicines, whether a GP can keep prescribing depends on Schedule 8 rules, which are set by each state and territory and have been changing. Our guide to ADHD medication prescribing in each Australian state explains the current position.
A GP may refer you back to your psychiatrist if symptoms return, new side effects appear, another medicine is added, or you plan a pregnancy. A practical tip: tell both doctors about every medicine change, however small.
How Often Should Psychiatric Medication Be Reviewed?
There is no single schedule that suits everyone. Your psychiatrist decides how often you are reviewed, based on your condition, the medicine,e and how stable you are. As a general guide:
Stage | How often reviews usually happen |
Starting a new medicine | More often, commonly within the first few weeks |
Adjusting the dose or changing medicine | Frequently until things settle |
Stable and doing well | Less often, commonly around every 6 to 12 months |
After any significant change (new symptoms, side effects, pregnancy, new medicine from another doctor) | Sooner than planned |
Medication Reviews for Specific Conditions
ADHD Medication Reviews
ADHD reviews focus on how well the medicine helps attention and daily functioning, and on physical monitoring: blood pressure, heart rate, appetite, sleep, and weight.
In the early stage, doses are adjusted gradually (titration). Once stable, reviews are commonly yearly, and an annual review is often needed to continue treatment.
Because ADHD stimulants are Schedule 8 medicines, rules about who can prescribe vary by state and territory. If your psychiatrist retires or you move, you may need to change prescriber, and the process depends on where you live. Learn more on our ADHD page and see who can diagnose ADHD in Australia.
Antidepressant Review
An antidepressant review for depression or anxiety checks whether the medicine has had enough time to work, which can be several weeks, and how you are tolerating it.
It also looks at how long treatment should continue. Many guidelines suggest a course of around 6 to 12 months after an episode, though this depends on your history. Stopping is planned gradually.
Mood Stabilisers and Bipolar Disorder
For bipolar disorder, reviews check mood stability, sleep and early warning signs. Some mood stabilisers need regular blood tests, and your psychiatrist will arrange or request them. Pregnancy planning should always be discussed in advance.
Antipsychotic Medication Reviews
For conditions such as schizophrenia and some mood disorders, reviews look at symptoms, side effects and physical health. Metabolic monitoring is important: weight, waist measurement, blood pressure, blood sugar and cholesterol, because some antipsychotics can affect these.
Medication Reviews in Australia: Referral, Medicare and Costs
To see a psychiatrist and claim a Medicare rebate, you generally need a valid referral from a GP. Rebates depend on your eligibility and the type of appointment, and out-of-pocket costs vary between psychiatrists. For current fees and rebates, see our fees page. To learn how referrals work, see our guide to GP referrals.
Our overview of psychiatric assessment and ongoing care explains what is included.
Can a Medication Review Be Done by Telehealth?
Yes, most reviews can be done by video or phone. Your psychiatrist can discuss symptoms, side effects, and treatment plans online. Some checks, such as blood pressure, blood tests, or an ECG, may need to be arranged locally through your GP or a pathology service.
How to Prepare for Your Medication Review
A little preparation makes a review more useful. Bring or prepare:
- A list of all your medicines, including supplements and over-the-counter products, with doses and times
- Notes on any side effects you have noticed
- A 1 to 2 week log of your mood, sleep and symptoms
- Recent blood test results, if you have them
- A list of questions you want answered
- A support person, if that helps you
Questions to Ask Your Psychiatrist
- Is this still the right medicine for me?
- How long should I stay on it?
- What side effects should I watch for and report?
- What would a dose change involve?
- Are there any interactions I should know about?
- What happens if I miss a dose?
- Do I need any blood tests or physical checks?
- When is my next review?
Therapy can also work alongside medicine. You can read about psychology and therapy as part of your treatment plan.
FAQs
What is a psychiatric medication review?
A psychiatric medication review is an appointment where a psychiatrist checks whether your mental health medication is still working, safe, and right for you. They look at your symptoms, side effects, other medicines,s and physical health, then decide whether anything should change. It is a routine part of care.
How often should psychiatric medication be reviewed?
It depends on you. Reviews are usually more frequent when you start or change a medicine, then less often once you are stable, commonly every 6 to 12 months. Your psychiatrist decides the schedule, and you can ask for an earlier review if something changes.
What signs mean my medication needs changing?
Signs include symptoms returning or not improving, new or worse side effects, a medicine that seems to wear off, a change made by another doctor, planning pregnancy, a major life change,e or trouble remembering doses. Feeling well for a long time and wondering about reducing is also a good reason to ask.
Can my GP review psychiatric medication?
Yes. GPs review and monitor psychiatric medicines regularly, especially when treatment is stable. For complex cases, treatment that is not working, or when specialist input is needed, a psychiatrist medication review is the better fit, and your GP can refer you.
What should I bring to a medication review?
Bring a list of all your medicines, including supplements and over-the-counter products, with doses and times. Add notes on side effects, a short log of your mood and sleep, any recent blood test results, and your questions. A support person can also come along.
How long does a medication review with a psychiatrist take?
A follow-up review often takes around 30 to 45 minutes, though this varies by clinic and by how complex your care is. The first appointment with a new psychiatrist is usually longer, because they need to understand your history and current medicines.
Do I need a referral for a medication review?
Generally yes, if you want to see a psychiatrist and claim a Medicare rebate. You need a valid referral from your GP. A pharmacist MedsCheck does not need a referral, while a Home Medicines Review is usually arranged by your GP or a specialist.
Is a psychiatric medication review covered by Medicare?
Medicare provides rebates for eligible psychiatrist appointments with a valid referral, but rebates depend on your circumstances and the type of appointment, and out-of-pocket costs vary. Check current fees and rebates with your provider. MedsCheck and Home Medicines Review are government-funded for eligible people.
Can a medication review be done online?
Yes. Most medication reviews with a psychiatrist can be done by telehealth, so you can talk through symptoms, side effects, and your treatment plan from home. Some physical checks, such as blood pressure, blood tests or an ECG, may still need to be arranged locally with your GP or a pathology service.
Will I need blood tests for my medication?
Maybe. It depends on the medicine. Some mood stabilisers need blood levels checked, some antipsychotics need metabolic tests such as blood sugar and cholesterol, and ADHD stimulants need blood pressure and heart rate checks. Your psychiatrist will tell you what you need.
Will my psychiatrist take me off my medication?
Not necessarily. Many reviews end with no change at all. If reducing a medicine is considered, it is a shared decision that is planned gradually, supervised by your doctor, and only done when it is safe. You will not be taken off a medicine suddenly, and you can always ask questions first.
Can I ask for a medication review if I feel fine?
Yes. Feeling well is a good time to check that the medicine is still needed, the dose is right, and your physical health is on track. You can also ask whether reducing might be possible, and your psychiatrist will talk through the benefits and risks.
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