Sometimes patients report to me that they have forgotten to take the medicine.
Most psychiatric medicines are 'long acting', which means their action lasts more than 24 hours. So if anybody misses a dose, they will not face any immediate consequences. The good part of this is- patient remains without symptoms even if one medicine dose is missed. The bad part is- even if the patient wants to take the medication without fail, there is no symptom by which his body may remind him that a dose has been missed.
Even though psychiatric medications are long-acting and do not give symptoms if 1-2 doses are missed, I would recommend that patient MUST take every dose without fail. This is because all psychiatric medications depend on 'steady' drug levels in the body for their proper action. The drug levels remain steady only if medicne is taken very regualry. Besides, a person who forgets to take one dose is likely to miss many doses. Eventually the drug levels will fall so low that medication becomes ineffective.
A patient who remains well inspite of missing some doses, will begin to feel that he is well and probably does not need medication. A patient who takes medicine irregularly but falls sick, may feel that the medicine is ineffective. By forgetting even a few doses, the patient runs the risk of misinterpreting the effectiveness of his medications at the least. At the worst, he may suffer a relapse.
In my exprience, forgetting is a genuine problem. All patients should take proper action once they realise that forgetting is a problem for them. In the initial phase of treatment, every patient should be closely supervised by a responsible relative. Medicines should not be with the patient. Every dose should be given to the patient by the relative, and the relative should stay there till a few minutes after the patient swallows the medicines. After the patient recovers, relatives should remind them to take medicines and set up some way to check that the patient is taking medicine regularly. Both patient and relatives should keep track of the medicine stock, to ensure proper availability.
A pill-box is a very practical way to organise doses. It also helps to keep track of the doses and the stock of medicines. By keeping the pillbox in prominent place and checking frequently, forgetting can be reduced. Patient should try to tie up medicing-taking with some regular activity such as teeth brushing, breakfast, etc. One can go as far as storing the medicine near the toothbrush or keeping it near the breakfast cutlery. Soon it becomes a part of the regular routine. Whenever the patient forgets to take medication, he will feel odd as if something is missing and that will remind him to take medication. Some patients maintain a chart to keep record and minimise forgetting.
Taking medicine regularly is a habit like any other. Initially one has to make effort to include it in our routine. But soon it becomes a part of our subconscious memory and we will automatically be drawn to take medicine when the time comes.
Some patients do not like to take medicines. Because of this dislike, their mind makes them forget to take medicines. This is 'motivated forgetting'. If this is the problem, the patient and family should discuss with the Psychiatrist their true feelings about the medicines. Otherwise the forgetting is likely to continue, inspite of trying all of the above.
Most psychiatric medicines are 'long acting', which means their action lasts more than 24 hours. So if anybody misses a dose, they will not face any immediate consequences. The good part of this is- patient remains without symptoms even if one medicine dose is missed. The bad part is- even if the patient wants to take the medication without fail, there is no symptom by which his body may remind him that a dose has been missed.
Even though psychiatric medications are long-acting and do not give symptoms if 1-2 doses are missed, I would recommend that patient MUST take every dose without fail. This is because all psychiatric medications depend on 'steady' drug levels in the body for their proper action. The drug levels remain steady only if medicne is taken very regualry. Besides, a person who forgets to take one dose is likely to miss many doses. Eventually the drug levels will fall so low that medication becomes ineffective.
A patient who remains well inspite of missing some doses, will begin to feel that he is well and probably does not need medication. A patient who takes medicine irregularly but falls sick, may feel that the medicine is ineffective. By forgetting even a few doses, the patient runs the risk of misinterpreting the effectiveness of his medications at the least. At the worst, he may suffer a relapse.
In my exprience, forgetting is a genuine problem. All patients should take proper action once they realise that forgetting is a problem for them. In the initial phase of treatment, every patient should be closely supervised by a responsible relative. Medicines should not be with the patient. Every dose should be given to the patient by the relative, and the relative should stay there till a few minutes after the patient swallows the medicines. After the patient recovers, relatives should remind them to take medicines and set up some way to check that the patient is taking medicine regularly. Both patient and relatives should keep track of the medicine stock, to ensure proper availability.
A pill-box is a very practical way to organise doses. It also helps to keep track of the doses and the stock of medicines. By keeping the pillbox in prominent place and checking frequently, forgetting can be reduced. Patient should try to tie up medicing-taking with some regular activity such as teeth brushing, breakfast, etc. One can go as far as storing the medicine near the toothbrush or keeping it near the breakfast cutlery. Soon it becomes a part of the regular routine. Whenever the patient forgets to take medication, he will feel odd as if something is missing and that will remind him to take medication. Some patients maintain a chart to keep record and minimise forgetting.
Taking medicine regularly is a habit like any other. Initially one has to make effort to include it in our routine. But soon it becomes a part of our subconscious memory and we will automatically be drawn to take medicine when the time comes.
Some patients do not like to take medicines. Because of this dislike, their mind makes them forget to take medicines. This is 'motivated forgetting'. If this is the problem, the patient and family should discuss with the Psychiatrist their true feelings about the medicines. Otherwise the forgetting is likely to continue, inspite of trying all of the above.
