Side Effects Q&A with Dr. Santana: What Patients Need to Know

When it comes to psychiatric medications, one of the biggest worries patients share is side effects. To clear up some common concerns, we sat down with Dr. Mailyn Santana, a psychiatrist at Santana Mental Health Services, to talk about what side effects really mean, when they can be helpful, and why open communication matters.

Q: Dr. Santana, why are side effects such a big deal for patients?

Dr. Santana: I think side effects are a deal breaker for a lot of patients. Many come in with the idea that once you get a side effect, it’s permanent. That’s not completely true. Side effects don’t always last forever, and in some cases, we can even use them to our advantage.

Q: That’s interesting—can side effects actually be a good thing?

Dr. Santana: Yes, sometimes! For example, some medications can cause sedation. If I have a patient who’s depressed and also not sleeping, I’ll choose one of those sedating antidepressants and prescribe it at night. That way, we’re treating mood and sleep with a single medication.

Another example is appetite. Certain medications can increase appetite and lead to weight gain. While that’s not ideal for everyone, it can be very useful for an elderly patient who’s barely eating and fragile. In that situation, a “side effect” actually helps restore strength and nutrition.

Q: What about the side effects that aren’t so helpful?

Dr. Santana: Of course, not all side effects are positive. Headaches, nausea, vomiting, or diarrhea are some of the most common ones. This usually happens early on, when you first start the medication.

The reason is simple: when you swallow a pill, it goes through your stomach and intestines first. That’s where it’s absorbed before it reaches your blood. Only after it’s in your bloodstream does it actually start working in the brain.

So early on, your digestive system is the first place the medication “hits,” which is why gastrointestinal side effects tend to show up first.

Q: What should patients keep in mind when they experience side effects?

Dr. Santana: First, don’t panic. Many side effects improve as your body adjusts. Second, don’t stop the medication without talking to your provider. Small adjustments—like changing the timing of the dose or switching to a different option—can often make a huge difference.

And most importantly, remember that side effects aren’t always permanent or harmful. Sometimes, with the right approach, they can actually become part of the solution.

Takeaway

Side effects aren’t always the enemy. With the right guidance, they can be managed, minimized, or even put to good use. If you’re starting a new medication and have concerns, the best step is to talk openly with your psychiatrist—because treatment works best when it’s tailored to you.