Posted by Racer on March 19, 2006, at 1:49:30
In reply to antidepressant dosing, posted by med_empowered on March 19, 2006, at 0:11:28
>
> As for your GP...GPs tend to prescribe antidepressants too often, but RX them at too low doses--so a shrink might rx 150mgs of, say, Tofranil, but your GP might only go up to 100.GPs rarely prescribe beyond SSRIs, when you come down to it, so I doubt many GPs are prescribing Tofranil at all...
But I agree absolutely with your point: get your drugs set up by a psychiatrist, who has the experience and knowledge to find the best treatment for you. Then, if you need to, you can have your GP continue the prescriptions for you. But for finding the best treatment, absolutely go to a psychiatrist.
That's one thing I really hate about so many insurance plans: you can't go to a pdoc, you have to go to your GP, who may or may not refer you on. Some GPs may benefit from having low referal rates, so they go out of their way not to make those referrals; others may just have the ego to think that they can do just as well; I'm sure there are GPs who think that people won't go to pdocs because of the stigma, so don't bother to refer; and then there are those who just never think to refer. "My patient isn't better on Prozac (or I suppose now it's Lexapro). Well, poor thing, that's too bad. Guess that's as good as it's gonna get..." The big K would be the poster child for GPs who treat depression, I guess. (I know a woman whose K GP put her on Paxil, despite a pre-existing and serious weight problem, and either didn't tell her or didn't know that Paxil can cause weight gain! Now, we all know that weight gain can be depressing, but it's magnified a lot when the doctor tells you that it can't be the drug, because SSRIs don't cause weight loss... She ended up around 150 pounds overweight, and having bariatric surgery. That sort of thing just really disgusts me.)
Sorry. Soapbox for me. Great point, Med. Thanks for making it.
And thanks for making it much more concisely than I...
poster:Racer
thread:621882
URL: http://www.dr-bob.org/babble/20060315/msgs/621917.html