An online psychiatric appointment is often only the start of treatment. If medication is part of the plan, you will deal with pharmacies, prescription rules and regular reviews for months or longer.
Knowing how this works makes it easier to stay safe, avoid running out and keep costs predictable. This page focuses on what happens after the video call ends.
From consultation to pharmacy
When a private psychiatrist prescribes, they issue a private prescription. Depending on the prescriber’s system and the medicine, this may be paper or electronic. Ask at the end of the appointment how it will reach you or the pharmacy, and when.
At the pharmacy you pay for the medicine itself. The pharmacy may also charge a dispensing fee. Because this is private, the price is set by the pharmacy, so it can differ from one to the next. It helps to call ahead.
Timing matters. The NHS says most prescriptions are valid for six months from the date they are signed. Prescriptions for most controlled drugs are valid for only 28 days.
Online pharmacies. If you order medicine online, check the pharmacy is genuine. The General Pharmaceutical Council (GPhC) says to find the pharmacy’s registration number on its website and search for it on the GPhC register. If it isn’t listed, don’t buy from it.
Rules for controlled medicines
Some psychiatric medicines are controlled drugs under UK law. Examples include methylphenidate (sometimes sold as Ritalin) and some sleeping tablets and sedatives. The rules exist because these medicines can be misused.
What this means for you:
- Shorter validity. Community Pharmacy England confirms that Schedule 2, 3 and 4 controlled drug prescriptions are valid for 28 days.
- Smaller quantities. Government guidance recommends limiting these prescriptions to up to 30 days’ treatment, although a longer supply can be justified clinically.
- Extra paperwork. In England, private prescriptions for Schedule 2 and 3 controlled drugs dispensed in community pharmacies must use a special form with a six-digit prescriber identification number.
Plan ahead so a new prescription is ready before the old supply runs out, especially around bank holidays.
When you collect any medicine, check the label shows your name, the right medicine and the dose you agreed with your psychiatrist. If the tablets look different from last time, ask the pharmacist. It may be a different brand, but it is worth confirming.
Inside a medication review
A medication review is a planned conversation about whether your treatment is still right. It is not just a rubber stamp for another prescription. NICE guidance on medicines optimisation describes what a structured review should look at, including:
- your views and understanding of your medicines, and any concerns
- every medicine you take, including over-the-counter and herbal products
- how safe the medicines are, how well they work for you and whether their use fits national guidance
- any risk factors for side effects
- any monitoring you need
For psychiatric medicines, a review often also covers sleep, appetite, mood, concentration, alcohol and drug use, and how you are managing at work or at home. For some medicines, such as those used for ADHD, physical health checks and monitoring may be part of it.
Come prepared. Write down what has changed, any side effects and when you take each dose. Have your medicine boxes with you on the video call.
Side effects and Yellow Cards
Unwanted effects are possible with almost any medicine. Plenty are mild and fade as your body adjusts. Some need action.
- Serious or sudden symptoms, such as trouble breathing, swelling of the face or chest pain: call 999 or go to A&E.
- Worrying but not an emergency: contact your prescriber, a pharmacist or NHS 111.
- New or worsening thoughts of suicide: get help the same day. You can ring Samaritans on 116 123 at no cost, at any hour.
The Yellow Card scheme is run by the Medicines and Healthcare products Regulatory Agency (MHRA). Anyone can report a suspected problem with a medicine, including patients and carers, through the website or the Yellow Card app. Reports help the MHRA spot safety issues.
Why repeats need a review
It can feel frustrating when a repeat prescription isn’t instant. There are sound reasons.
Whoever signs a prescription carries responsibility for it. Before issuing more, they need to be reasonably sure the medicine is still safe and still working. Your weight, blood pressure, other medicines, pregnancy plans or alcohol use may all have changed.
Long-term treatments also get checked for whether they are still needed. For example, NHS information on methylphenidate for adults says people have a check-up every 12 months to see if they still need it.
A request may be approved as it stands, approved with changes, or turned into a recommendation to book a follow-up. Send requests in good time, since clinical review is not instant.
A few habits make repeats smoother:
- note the date you started each pack so you can see when it will run out
- set a reminder about a week before you need a new prescription
- tell the prescriber about any new medicines, including ones bought over the counter
- mention any missed doses honestly, as this can affect decisions about the dose
Travelling with your medicine
Travel needs extra planning when you take a psychiatric medicine, and more still for controlled drugs.
- Check the quantity. GOV.UK says you can only bring up to three months’ supply of your medicine into or out of the UK. A personal licence may be possible in exceptional circumstances.
- Get a letter. For controlled drugs, the letter should include your name, travel dates, a list of medicines with doses, strengths and amounts, and the prescriber’s signature.
- Check the destination’s rules. Some countries restrict medicines that are legal in the UK. Contact the embassy or high commission before you book.
- Pack sensibly. TravelHealthPro advises carrying medicines in hand luggage, correctly labelled and in the original pharmacy packaging.
- Mind the time zones. Ask your prescriber how to adjust dose timing on long journeys.
Sharing care with your GP
Shared care means a specialist and a GP agree to split responsibility for a medicine. Typically the specialist starts treatment and stabilises the dose. The GP then takes over prescribing, while the specialist stays available for advice and reviews. NHS England has published guidance on how prescribing responsibility is divided between specialists and GPs.
For this to work, your GP needs clear letters setting out the diagnosis, the medicine, the dose, what monitoring is needed and when to seek specialist advice. You may also be asked to agree to the arrangement and to attend checks.
GPs are not required to accept shared care, and local policies vary. A GP may consider whether the medicine is usually prescribed that way in their area.
Once someone’s ADHD medicine dose has been steady for a while, a Happy Clinic psychiatrist can write to the NHS GP suggesting a Shared Care Agreement. There is a dedicated 30-minute appointment for this, costing £500, and it only goes ahead with GP approval. The final say rests with your GP.
Happy Clinic prescription costs
Here is how medication-related costs work at Happy Clinic:
- A prescription written in your consultation costs nothing on top of what you paid for that consultation.
- Pharmacy dispensing charges are separate and paid to the pharmacy.
- Follow-up appointments cost £200 for 20 minutes.
- Repeat prescription requests cost £150 for existing patients and are subject to clinical review.
All fees are payable before the appointment (fees checked September 2026 — see Happy Clinic’s pricing page for current fees).
Happy Clinic sees adults aged 18 and over by video across the UK. It doesn’t provide emergency or crisis care, so keep your GP and NHS 111 details to hand.