Question:

I am on a psychiatric pill which is required to be taken every single day at the same exact time for it to properly work. This is my first Yom Kippur on the pill and I would like to know what I am supposed to do on Yom Kippur regarding taking it.

Answer:              

If indeed you are on the pill due to reasons of mental and emotional health, as prescribed by a doctor, then technically it remains permitted for you to take the pill on Yom Kippur. However, you may only swallow the pill plain, without water. [Alternatively, some Poskim suggest that if the pill has a bitter taste, then before Yom Kippur you can crush the bitter pill into powder, add it to the water, and then drink the bitter mixture.] Practically, you should consult with your doctor who prescribed the pill [or others who have expertise in this pill if you cannot reach him], and ask as to the ratio of hours that the pill can be taken without any real adverse effect. For example, if you normally take the pill at 9 PM and sunset is at 7 PM, then perhaps you can take it on erev Yom Kippur before 7 PM, and taken after Yom Kippur take it at its regular time. If you are told that it should or must be taken at a time which is in the midst of Yom Kippur, then you may do so as we stated above, without using water.

Explanation:

Taking a pill on Yom Kippur enters into two possible prohibitions, the more severe one being the prohibition against eating and drinking, and the less severe one being the general rabbinical prohibition against taking medicine on Shabbos. Practically, the Poskim explain that the swallowing of an inedible pill or the consumption of a bitter inedible pill, is at most a rabbinical prohibition of eating on Yom Kippur [and according to some opinions not forbidden at all], and is waived for the sake of a medical need, such as for a person who is sick, bedridden, or if he is weak in his entire body even though it is not a life-threatening situation. Likewise, the rabbinical prohibition against taking medicine on Shabbos is waived in these cases that a person who is sick, bedridden, or if he is weak in his entire body. Furthermore, even if one is not sick, but not taking the pill can cause him to get sick, then the rabbinical prohibition is waived. Accordingly, it is understood that one who was prescribed psychiatric medication for his or hers mental and emotional health [which its deterioration can also be considered an illness], may continue to take the pill on Yom Kippur in order to prevent them from becoming ill with the mental, or emotional “illness” that may occur. Furthermore, even if they will not reach the state of getting mentally, or emotionally sick to the point of being bedridden, one can argue that a psychiatric issue such as anxiety or depression is always innately judged as either a matter of danger or a status of “Shoteh,” which is also judged similar to a matter of danger. [And likewise taking the pill in such a situation would not transgress the prohibition against eating on Yom Kippur, as we already explained above that some opinions hold that there is no eating prohibition applicable to inedible foods that are eaten less than the amount, aside for the idea that a psychological condition can always be defined as an illness.]

Nonetheless, the above letter of the law allowance, it is obviously better to take it before and after Yom Kippur if it is possible to do so, and not have to take it on Yom Kippur itself, as aside for the ideal avoidance of consuming even inedible items on Yom Kippur, the above allowance only allows one to take the pill without water using their saliva which is most difficult, and hence for practical and leisure purposes it should only be taken on Yom Kippur using one’s saliva if absolutely necessary.

Sources: Encyclopedia Hilchatit Refuit Erech Yom Kippur Volume 3 p. 794; See regarding the status of the prohibition of consuming inedible items on Yom Kippur: Admur 612:8 and Michaber 612:6 based on Rambam that it is forbidden; Tur 612 in name of Avi Ezri [i.e. Ravayah] that there is no even rabbinical prohibition involved; Beis Yosef 612 that possibly there is no prohibition even according to Rambam if less than the Shiur; Meishiv Shalom 179 that according to the final ruling of the Michaber [and Admur] who omitted all the above leniency’s, one is to be stringent even by less than the Shiur; Shevet Halevi 10:89 that one who is lenient for the sake of a mitzvah is not to be protested; See regarding the general allowance for taking pills on Yom Kippur for one who is ill or to prevent an illness: Sdei Chemed Yom Kippur 3:8; Yeshuos Yaakov 612; Kesav Sofer 111; Pischeiy Teshuvah Y.D. 155:6; Shoel Umeishiv Mahdura Daled 1:55; Orchos Chaim 618:1; Eretz Tzevi 88; Kaf Hachaim 554:34 in name of in name of Kesonos Yosef 4, Ikarei Hadaat 29:36, Pischei Olam 554:6 regarding regular fast days; Meishiv Shalom 179; Igros Moshe 3:91; Tzitz Eliezer 10:25; Shevet Halevi 10:89; SSH”K 39:8; Nishmas Avraham 612:7; Toras Hayoledes 52:9 footnote 27; Piskeiy Teshuvos 612:2; Nitei Gavriel 37:23; 39:12-15; Encyclopedia Hilchatit Refuit Erech Yom Kippur Volume 3 p. 794; See regarding crushing the pill and drinking it with water: Kaf Hachaim 554:34 in name of Poskim regarding Tisha B’av; Heard from Rav Yaakov Yosef that the same applies on Yom Kippur, and so seems Pashut; Nishmas Avraham 5 612:2; SSH”K ibid; Piskeiy Teshuvos ibid; Nitei Gavriel ibid; Encyclopedia Hilchatit Refuit Erech Yom Kippur Volume 3 p. 795 footnotes 340-343