Posted by atmlady on July 1, 2008, at 19:43:23
In reply to Re: How's the Dostinex Working?, posted by undopaminergic on June 30, 2008, at 6:30:01
Thanks, Undopa, for the info!
I'm amazed that you can remember what I've already taken, when my pdoc apparently cannot. Background to the conversation between dumb and dumber below:
Ixel + provigil working great 6 months, then all of a sudden - depression and crying come back. I know from experience that my pdocs first response is to up the dose of whatever I'm already taking, so on my own I experimented with upping the ixel, which blew my head off, then upping the provigil, which didn't really do much for the mood, then tried adding 150 wellbutrin xl which really brightened my mood, but again blew my head off. So I'm like, hmmm... I could use something like wellbutrin, but without the NE stim.
So I make my appointment. Pdoc says same thing, I need more dopamine, so let's try a really low dose of wellbutrin. I'm like YEAH, I can't wait, I really want this to work. But unfortunately, it was still too much NE I think. My heart hurt, was beating fast, my throat hurt, and I was kinda spacey, not driving well. Disapointed to say the least.
So I call my pdoc yesterday and the "assistant" answers, and here I relate the incredible frustrating experience for my psychobabble friends' enjoyment. You decide which one of us is dumb, and which one is dumber.
Me: Yes, this is Ms. X and I need to make an appointment with Dr. Y.
Assistant: Weren't you just in here?
Me: Yes, but the doc made some changes to my meds and they aren't really working out, so I need to come in.
Assistant: Well, how about if she just calls you?
Me: Sure, I didn't know she did that. (So I relate the story and she says "we'll get back to you")
Later that day ....
Assistant: The doctor says she can prescribe either celexa or lexapro instead of the wellbutrin, which do you want?
Me: Uhhh. Well, those are SSRI's I think - lemme look online real quick - why, yes, those are SSRI's, and I already use an SNRI and it's working well. Is she wanting me to replace the Ixel with one of the others?
Assistant: Uhhh. No, she wants you to add it to what you are already taking.
Me: Well, I'm just kind of confused because those two act on serotonin and her objective with the wellbutrin was to give me more dopamine.
Assistant: Well, I don't know, this is just what she said.
Me: THh other thing is, it's in my records that I can't take the side effects of SSRI's, and I've already taken lexapro and I don't like it!
Assistant: Well, you should have told her you'd already tried lexapro when she took your medical history at your first visit, or she would have known that.
Me: But she's the one who prescribed me the lexapro!
Assistant: Oh? Lemme see. Oh, I see it. Well..... do you have some other medication in mind that you think would work?
Me: Well, maybe something like ritalin would do the job of increasing the dopamine.
Assistant: What? That's not for depression, that's for ADD!!!
Me: Well, I know, but it's also used to augment anti-depressants sometimes, so I have read.
Assistant: Well, it's really expensive, you know. (She remembers I am self-pay)
Me: Well, I don't mind paying for something that works. My god, the provigil and the wellbutrin are expensive too! Maybe she could just give me a 7 day sample or something, and I could just experiment and see if it works.
Assistant: Don't you know that's a controlled substance? We can't give out samples!
Me: OK, so a 7-day prescription, maybe, I don't know. Could you just talk to her? I think she is not remembering what we discussed during the appointment and she's not remembering my issues with SSRI's.
Assistant: OK, I'll call you back.
(24 hours later, no call back, so I initiate the call, today.)
Me: Hi, it's Ms. X, did you get a chance to talk to her about all that?
Assistant: Yeah, she said she was *NOT* going to prescribe adderall.
Me: Well, Ok, so then what are my options? Did she have any other suggestions?
Assistant: Well, either the celexa or the lexapro, that's it.
Me: I don't understand. Did she say why? Has her theory changed about the dopamine or does celexa work in some way on dopamine too? I mean, what's the rationalization behind those two choices for my specific problem?
Assistant; I don't know. She's just not going to prescribe adderall.
Me: OK, but I just threw ritalin out there because you asked me for a suggestion. I'm not a doctor, like she is, I just pulled ritalin off the top of my head, but I'm open to other options, if they make sense to me. Did she mention any other options, other than the celexa and lexapro?
Assistant: Nope.
Me: (Well, speechless for a minute) BYE
So. Now, after two years of building a relationship with a pdoc, a partner who could work with me at managing my depression. And now what? I gotta find another because this one thinks I'm a speed freak or something? I've never taken ritalin before - I have NO idea if it will work, I just figure it's worth a try. Isn't that what these pdocs do anyway? Make an educated guess and throw out a med in the hopes it will work? And when it doesn't work, well, hey, you've added another bit of info to use in your next educated guess, right? I don't get it. The assistant made it sound like I had asked for the most outrageous thing on earth by asking to try ritalin!So anyway, Undopa, I will peruse your list some more later this week and do some more research and heck, I don't know, keep experimenting on my own, I suppose. Shoot, you'd think she's WANT to keep me as a customer, being self-pay I have to pay the "regular" rate of $100 per 15 minutes, as opposed to the lower insurance rate. Geez.
poster:atmlady
thread:835768
URL: http://www.dr-bob.org/babble/20080626/msgs/837564.html