When a psychiatric prescriber asks, "What else are you taking?" many people think only of prescriptions. But the full answer often includes much more: a daily multivitamin, an herbal sleep aid, allergy pills, a few drinks on the weekend, cannabis, an energy drink habit or a medication from another doctor that seemed unrelated.
All of these can matter. Psychiatric medications can interact with other substances in ways that change how well they work or how many side effects you notice. Giving your prescriber a complete picture is one of the simplest things you can do to make treatment safer and more effective.
This article explains what to share and why. It is general information, not advice about any particular combination. Ask your prescriber or pharmacist about your specific situation.
Why the full list matters
Interactions can work in a few different ways:
- One substance can change how the body processes another. Some products speed up or slow down the liver enzymes that break down medications. That can make a medication less effective or increase side effects.
- Effects can add up. Two things that each cause drowsiness can together cause much more sedation, which can affect driving, balance and breathing.
- Some combinations raise specific risks. For example, combining certain medications and supplements that affect serotonin can, rarely, lead to a serious reaction.
- Substances can affect symptoms directly. Alcohol, cannabis and stimulants can affect mood, anxiety and sleep, making it harder to tell whether a medication is helping.
Your prescriber cannot account for what they do not know.
Other prescriptions and over-the-counter medicines
Include everything, even if it seems unrelated to mental health:
- Prescriptions from your primary care provider, specialists, dentist or urgent care
- Medications you take only occasionally, like migraine treatments or antibiotics
- Over-the-counter products such as pain relievers, cold and allergy medicines, sleep aids and antacids
- Birth control and hormone therapies
- Inhalers, creams, patches and eye drops
If you start a new medication from another doctor while taking psychiatric medication, let both prescribers know. Your pharmacist can also check for interactions, especially if you use the same pharmacy for everything.
Vitamins, supplements and herbal products
"Natural" does not always mean harmless when combined with medication. Some herbal products and supplements can interact with psychiatric medications. St. John's wort is a well-known example that can interact with a number of medications.
Tell your prescriber about:
- Vitamins and minerals
- Herbal remedies and teas
- Sleep supplements
- Weight-loss, energy or "focus" products
- Sports and bodybuilding supplements
- Any product bought online or from a specialty store
Bringing the bottles or a photo of the labels can be easier than trying to remember ingredient names.
Alcohol
Alcohol can interact with many psychiatric medications, increasing drowsiness, affecting coordination and judgment, and sometimes making depression or anxiety worse over time. It can also affect sleep, which in turn affects mood.
Be honest about how much and how often you drink, even if it feels uncomfortable. Your prescriber is asking to keep you safe, not to judge you. They can tell you what is advisable with your specific medication.
Cannabis, nicotine and caffeine
These are easy to leave off the list, but they can be relevant:
- Cannabis can affect mood, anxiety, motivation and sleep, and may add to the sedating effects of some medications. Its effects on mental health vary from person to person.
- Nicotine and smoking can change how the body processes certain medications. Starting or stopping smoking is worth mentioning to your prescriber for this reason.
- Caffeine, including coffee, energy drinks and pre-workout products, can worsen anxiety and sleep problems and may interact with some medications.
Other substances
If you use other substances, including prescription medications not prescribed to you, it is important for your prescriber to know. Some combinations can be dangerous, including the risk of overdose when sedating substances are mixed. Sharing this information allows your care team to plan safely and, if you want, to talk with you about support for substance use.
If you or someone you are with may be experiencing an overdose, call 911 right away. If you are in crisis or having thoughts of harming yourself, call or text 988 to reach the Suicide and Crisis Lifeline.
What about privacy?
Some people hold back because they worry about who will see the information. It is reasonable to ask your provider how your information is recorded and who can access it. Health care providers have legal obligations to protect your health information. The goal of sharing is safer care.
Make it easy: keep a current list
A written list saves time and reduces mistakes. Include:
- The name of each medication or product
- What it is for
- How often you take it
- Who prescribed it, if anyone
- When you started
Keep a copy in your wallet or phone, and update it whenever something changes. Bring it to every psychiatric visit, especially your first evaluation and any visit where a medication change is discussed.
Do not stop things on your own
If you learn that something you take might interact with a psychiatric medication, talk to your prescriber or pharmacist before stopping anything. Some medications should not be stopped suddenly, and your prescriber can help you decide on the safest approach.
Care that sees the full picture
At SOS Wellness, our psychiatrists and psychiatric nurse practitioners begin with a thorough assessment of your history and current treatment, and our team also treats co-occurring mental health and substance use concerns. If you are in Ohio and would like help with medication care, you can request an appointment or contact us with questions.
This article provides general educational information and does not replace an individual clinical assessment. Contact your healthcare provider about your own care.