MedStart Psychiatry · Patient Tools
Medication Side Effect Log
Track how your medication is affecting you between appointments
Why this matters: Detailed, written records help your clinician make better decisions about your medication. Memory is unreliable — patterns that seem obvious in the moment are easy to forget by your next appointment. Complete this log daily for the most useful picture.
Medication Information
Medication Name
Dose & Frequency
Prescribed For
Time of Day Taken
Other Medications / Supplements Being Taken
Severity Scale — Use This for the Daily Log Below
0None — not present
1Mild — noticeable but not bothersome
2Moderate — bothersome, affects daily activities
3Severe — significantly impairs functioning
Daily Side Effect Log (Rate 0–3)
| Date | Nausea | Headache | Fatigue / Sedation | Sleep Problems | Appetite Change | Sexual Side Effects | Anxiety / Activation | Mood | Other (describe below) |
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Describe any "Other" side effects or additional observations
Overall — Is the Medication Helping?
Rate overall symptom improvement since starting this medication (circle one):
Much worse
A little worse
No change
A little better
Much better
Questions for My Next Appointment
⚠ Contact your clinician or go to urgent care immediately if you experience: chest pain, difficulty breathing, severe rash, thoughts of self-harm or suicide, or any symptom that feels like a medical emergency. Do not wait for your next appointment.
Call MedStart Psychiatry: (480) 420-8204 · Emergency: 911 · Crisis: 988