Ask anyone who has been treated for anything over several years what they have tried, and the answer is usually a partial list with no doses and no dates. "Something beginning with S, a few years ago, made me feel sick."
That is not a memory failure. Nobody is given a copy of this and no single clinic holds it — records fragment across practices, systems and moves. The consequence is real: without it, a new clinician cannot tell whether something failed at a therapeutic dose or was abandoned at a starting dose after four days, and those two facts lead to opposite decisions.
The document takes an hour to build once and five minutes a year to maintain.
What goes on it
One line per medication, ever:
Name — generic name if you can, since brand names differ by country. What for. Dates — roughly. Month and year is fine. Highest dose reached, and how long you were on it. What it did. Any benefit, in specific terms. Why it stopped — side effect, no benefit, ran out, cost, felt better, moved practice. Anything notable — a reaction, an interaction, something that helped.
An example
Medication A — for attention. Mar–Jun 2023. Reached 20mg. Mornings clearly better, wore off by 1pm. Stopped: could not sleep, and the afternoon drop was worse than baseline. Medication B — for attention. Aug 2023 – Feb 2024. Reached 40mg extended release. Best result so far, lasted the full day. Stopped: supply shortage, could not get it for six weeks, and then never restarted. Medication C — for low mood. Sep 2021 – Jan 2022. Only reached 25mg, meant to go to 50. Stopped after four weeks: nausea, and I did not know it was supposed to settle. Medication D — for sleep, over the counter, nightly Apr 2024 – Mar 2025. Helped getting to sleep. Stopped when told it might be contributing to the fog.
Look at what that tells a clinician immediately. B worked and stopped for a supply reason, not a clinical one — so it is the obvious thing to revisit. C was never given a fair trial. D was a possible cause of a symptom that was being investigated as something else.
None of that survives in "I have tried a few things."
The current list, separately
A second short list, kept accurate:
- Everything you take now, with dose and timing
- Including over-the-counter, including supplements, including occasional things
- Including things you take rarely — antihistamines, painkillers, sleep aids
Two reasons this matters more than it seems. Interactions do not care whether you think of something as medication. And several common over-the-counter products, particularly sedating antihistamines taken nightly, are genuine contributors to cognitive symptoms and are almost never mentioned.
Allergies and reactions
A third short list, and this one is safety-critical:
- What you reacted to
- What the reaction was, specifically — a rash, swelling, breathing difficulty, nausea
- When
"Allergic to penicillin" recorded from a childhood stomach upset is one of the more consequential inaccuracies in medicine, because it removes a whole class of useful antibiotics. Writing down what actually happened lets a clinician judge.
How to build it
Start with what you remember, even partially. A rough list beats none.
Request your records. You are entitled to them. A prescribing history from a previous practice will fill in names, dates and doses far better than memory.
Check your pharmacy. Pharmacies keep dispensing histories, often going back years, and can usually print one.
Look at old bottles and old emails. People find more than they expect.
Ask family. Partners often remember what you were on when.
Accept gaps. "Something for anxiety, around 2019, do not recall the name" is still useful — it flags a period to ask about.
Keeping it current
Add a line whenever something starts, changes or stops. Same day, because it will not happen later.
Keep it somewhere you can reach from a phone in a waiting room. A note, a document, a photograph of a piece of paper. The format is irrelevant; the availability is not.
Why it earns its keep
A new clinician starts from the right place. The most common cause of a wasted treatment attempt is retrying something that already failed, or failing to retry something that worked and stopped for a non-clinical reason.
It distinguishes a failed trial from an incomplete one. Enormously consequential and almost never available.
It catches contributions nobody was looking for. The nightly antihistamine. The supplement. The interaction.
It protects against gaps in care. Moves, practice changes, insurance changes, a service that closes. The record that survives all of that is the one you hold.
It makes a fifteen-minute appointment productive. Handing over a page and saying "this is everything I have tried" changes what the fifteen minutes can be spent on.