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A second opinion on medication you're already taking

If you're already taking psychiatric medication — started by another doctor in Nepal, a physician abroad, or a previous prescriber — and want an independent review, Dr. Kushal Kharel offers medication review and second-opinion consultations. This isn't about automatically changing what's working; it's a fresh, structured look at your diagnosis, current medications, doses and response, so you and your doctor can decide together whether to continue, adjust or taper anything.

Who this is for

  • Patients already on psychiatric medication who want an independent review
  • People whose medication was started abroad or by a non-specialist and want specialist confirmation
  • Patients unsure if their current dose or combination is still appropriate
  • People experiencing side effects who want a second opinion before changing anything themselves
  • Patients relocating to or from Kathmandu who need continuity of psychiatric care
  • Family members seeking a second opinion on a relative's treatment plan, with the patient's consent
Bring (or send in advance) your current prescriptions, past reports and a note of when each medication was started and any doses that have changed. A medication review usually takes longer than a routine follow-up, since it involves going through your full history rather than a quick check-in. Never stop or change a psychiatric medication on your own before this review — some medications, particularly benzodiazepines and antidepressants taken regularly, need to be adjusted gradually under medical supervision to avoid withdrawal or relapse.

Common concerns

Whether current medication and dose are still appropriate
Bothersome side effects that haven't been addressed
Long-term use of benzodiazepines or other sedatives
Medication started without a clear diagnosis being explained
Multiple medications prescribed together (polypharmacy)
Wanting to reduce or safely stop a medication

Frequently Asked Questions

Can I get a second opinion on medication another doctor prescribed?

Yes. A second-opinion consultation reviews your diagnosis, current medications and response so far, and gives an independent view on whether the current plan still fits, without requiring you to have already decided to switch doctors.

Will Dr. Kharel automatically change my medication?

No. Many patients are already on a reasonable treatment plan, and a second opinion may simply confirm that. Changes are only suggested when there's a clear clinical reason — such as inadequate response, troublesome side effects, an outdated diagnosis, or a safer alternative — and are discussed with you rather than made unilaterally.

What should I bring to a medication review appointment?

Current prescriptions or medication packaging, any past psychiatric reports or discharge summaries, a rough timeline of when each medication started and any dose changes, and a list of side effects or concerns you want to raise.

Is it safe to stop my psychiatric medication on my own before this review?

No. Stopping antidepressants, antipsychotics, mood stabilizers or especially benzodiazepines abruptly can cause withdrawal symptoms, rebound symptoms or relapse. Continue your current medication as prescribed and raise your concerns at the review rather than stopping beforehand.

Can medication started abroad be reviewed and continued in Nepal?

Yes. Many patients return to Nepal or move to Kathmandu already taking medication started by a doctor abroad. These can be reviewed, confirmed or adjusted, and prescriptions can be continued locally where the medication is available and clinically appropriate.

How is a medication review different from a first psychiatric consultation?

A first consultation usually starts from scratch with a full diagnostic assessment. A medication review starts from your existing diagnosis and treatment history and focuses specifically on whether the current medication plan is working well, though a fresh diagnostic assessment can still be part of it if needed.

Ready to book a consultation?

In-person at the Kalanki clinic in Kathmandu, or online from anywhere.

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