Always a bit scary when people experiment on themselves. I've never understood why people would put their own brain at risk, either through untested drugs or untested therapies.
You generally need to see a doctor or prescribing nurse on a monthly basis in order to get a prescription. The value of this visit seems to be fairly low, however; all of the monitoring they do is purely through self reporting, so they are relying on someone going through complex mental issues to self report accurately about whether something is helping or hurting. I have never once had a provider actually perform any kind of testing to determine if any part of my cognition has improved or declined with the use of these drugs.
These are powerful drugs with strong side effects and withdrawal effects. Even with just self reporting, I feel like my providers frequently brush off issues I report; as long as I'm not having severe physical side effects, they figure it's fine.
Then I had my prescribing nurse quit, and my therapist quit shortly afterwards, right before I moved to a new state and had to switch primary care providers at the same time. Of course, it can take months to go through the enrollment process, wait for medical records to get transferred, wait to find an available appointment, and so on.
This gap in coverage led me not to be able get my prescriptions filled, and thus had to deal with the fairly severe withdrawal symptoms while in the middle of dealing with a fairly stressful move. I had to take some time off work because I couldn't think straight, due to the combined withdrawal effects and stress of the move, and spend a lot of time scrambling begging various people to make appointments soon to get temporary prescription refills, before eventually just giving up and deciding to finish going through withdrawal.
Given that kind of background, of how poorly managed and frustrating to deal with drug-based therapies are, I can see the appeal to self-controlled therapies that don't rely on this complex, fragile, and overbooked network of licensed medical providers.
That said, I wouldn't try this kind of thing out on myself; one of my complaints about the drug based therapies is that they are entirely based on self-reported outcomes, and I find that lack of any kind of rigorous testing of whether they are effective or whether they are having unintended consequences in other areas of cognition quite troubling. But I can see the appeal of having something that doesn't rely on this fairly unreliable and in many cases unhelpful network of medical providers.
I'm in the UK, on prescription with a fixed dose. When the tablets run out I'm responsible for renewal. Part of the problem with my "condition(s)" is memory troubles, my short term memory is terrible. I also have anxiety on communicating using the telephone.
The system is fine if one can manage oneself; I can't do that sufficiently.
What I don't understand is why, as the Doctor has prescribed a long-term regime of tablets and the dose is fixed, why there's no system to order my medication and then notify me. Now I realise that not re-ordering if it's not needed is an efficiency but if I've not reordered and the Doctor hasn't OK-ed it then something is going wrong in my life that medical authorities need to know to treat me: like I've been hospitalised, or I'm suffering flu-like symptoms (withdrawal) and starting to get encroaching thoughts of self-harm and suicide.
Last time I collected my medication the pharmacy (not physically connected to the doctor's clinic) told me I had to call the doctor for a in-person review. Took me a month to drum up the courage to phone them, first available appointment was 3 weeks away.
Now, I consider myself to be quite healthy, generally capable, not really that ill. There doesn't seem to be anything in place to allow this system (of review and medication acquisition) to take account of how my condition disables me from using the system. If I had severe memory loss I don't see how I'd manage at all - I presume I'd be treated differently and that I'm just falling through the gaps a little because my condition is not so severe.
TL;DR observations on impact of mental health on using UK health services.
Indeed, depression medication appears to be done on an individual trial-and-error basis. You go to the doctor and say, you think the medication is screwing you up and they give you something else to try, rinse and repeat. Seems lacking in rigour.
Moreover, and perhaps more importantly-- I have tried it plenty of times and have never experienced any negative effects.