Psychiatric medication while living abroad: keeping your care going

HICOA · Mental Health Clinic — Online sessions in English or Portuguese

Short answer: you can keep psychiatric care going in your own language while living abroad. The consultation happens by video call, the prescription is issued in Portugal and given to you, and with it your local family doctor issues the corresponding prescription so you can collect your medication where you live.

This is one of the most frequent — and most poorly resolved — situations among people living abroad.

The problem almost nobody solves

The typical path runs like this. Someone starts medication at home, with a psychiatrist. They move abroad. At first they bring medication back from trips, or renew remotely. Eventually that becomes unsustainable, and they turn to the family doctor where they live.

The local doctor renews the prescription — rightly, since the alternative would be stopping. But they almost always say the same thing: this needs specialist follow-up. And there the person gets stuck. Finding a psychiatrist abroad runs into three obstacles:

• Language. Describing psychiatric symptoms in German, French or Dutch requires vocabulary few people command — and nuance matters in diagnosis.
• Waiting lists. In several European countries, months before a first psychiatric appointment.
• The system. Working out who refers whom, what the insurance covers, which forms are needed.

The result: years of medication without review. Which is precisely the scenario psychiatric medication tolerates least well.

Why review matters

Psychiatric medication is not static. What worked three years ago may no longer be right — because the picture changed, because side effects appeared and were quietly tolerated, or because the time has come to reduce.

Without review, two things typically happen. Either a medication that is no longer needed is continued indefinitely, with the costs that carries. Or an insufficient dose is maintained, and the person spends years with partially controlled symptoms, convinced that this is as good as it gets.

How it gets resolved

The consultation takes place by video call, in English or Portuguese, with the psychiatrist: assessment, adjustments, plan. Specialist follow-up starts to exist — which is precisely what was missing.

As for prescriptions, they are issued as normal. The practical details vary according to the medication involved and the country where you live, and that is sorted out with you at the first consultation, case by case, so you know exactly what to expect.

What not to do

• Stop on your own because the medication ran out and you could not renew it. Abruptly stopping antidepressants, anxiolytics or mood stabilisers can have serious consequences.
• Buy online without a prescription. Beyond being illegal in most countries, there is no guarantee of what you are taking.
• Ration tablets to stretch the box until the next trip home. Irregular dosing is worse than no dose at all for several classes of drug.
• Postpone indefinitely because it seems complicated to sort out. It is usually less complicated than it looks.

When it is worth booking

If you have taken psychiatric medication for more than six months without speaking to a specialist; if your local doctor has told you that you need follow-up and you have not managed to arrange it; if you have side effects you have tolerated for too long; or if you would like to understand whether you still need what you are taking — any one of these is reason enough.