Posted by shelliR on July 15, 2001, at 9:34:42
In reply to Re: I'll hold your hand if you'll hold mine » Elizabeth, posted by Lorraine on July 14, 2001, at 22:30:43
>And while my pdoc is open minded and adventurous (which helps with TRD), I don't see a real plan of attack and I'm really >at a loss on how to find another pdoc who maybe has a more concrete method of action BUT who is open minded as well (eg >will LISTEN and respect what I have to say).
Hi Lorraine,I'm jumping into the thread between you and elizabeth; I hope you don't mind.
I have been to two of the top TRD pdocs in my city. I think the only thing that separates them out from dozens of other pdocs is that they read everything, and they go to conferences, so they know what's being tried out there. On the other hand, you participate in PB, so you also know what is being tried. There is nothing that either of them have suggested that I have not already been aware of through this board. I really agree with you. A real plan of attack is an illusion. I left my pdoc of ten years because (1) she was so against opitates; and (2) She was pushing APs heavily; and (3) she told me I didn't want to get better because I wouldn't take stuff that made me gain 15 or more lbs. She was more interested in augmenting nardil than changing altogether, so I tried about ten augmentation strategies; I did have success with lamictal, but it gave me an immediate 15lb weight gain. I knew I wanted to try lamictal first; the rest of the augmentation strategy felt like picking the next try out of a hat. Even when they try to make sense (lamictal worked, let's try another anti-convulsent--topomax) my body rejects the sense--I totally slept on topomax for three weeks with no improvement.
I was sitting in the waiting room of my current pdoc and talking to another patient. She told me that this doctor was a genius with medications. I asked her what had worked for her, and also what she had tried. She was on effexor, I think, and a stimulent. She had tried about four other SSRIs which didn't help, or she couldn't tolerate. So what was the genius here; we both could have choosen for her the same route, i.e., try everything, and something will work. I do have to give this guy credit though for putting me on oxycontin--that did take some bravery. And he was aware of the ERT study and he had me try concerta before giving up on stimulents, and I didn't have the same horrible body feelings with it. Yet in the long run, I am choosing next to try Parnate. AND this guy doesn't return phone calls and makes you wait forever for your eight minute appt.
I would stay with a pdoc who was open and adventurous. If the two of you are feeling stuck, you can always go for a consultation with another pdoc, and ask what would be her/his direction with you, with your symptoms and history of meds.
BTW, I think your idea of doing nardil with a stimulent is an excellent one. I loved nardil (when it worked) because I never felt shaky or drugged. And I didn't gain weight. YMMV!
Shelli
poster:shelliR
thread:67742
URL: http://www.dr-bob.org/babble/20010714/msgs/70181.html