![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 34. This is the beginning of the thread.
Posted by utopizen on March 20, 2003, at 15:29:59
So I told me p-doc the other day I was more articulate when I took Klonopin. When I give a presentation on it, I sound more articulate than ever, look directly at people, barely need my notecards, words seem to come out freely with no effort. And people have this "wow" feeling about what I say. Very impressive.
Well, I told this to my pdoc, and he said it was "irrational" to think this way. But I told him, I don't view Klonopin as a smart drug. I just think I get so much anxiety, the removal of this anxiety lets me think in a way that I would otherwise already think without the anxiety present.
Well, he seemed more convinced, but still didn't admit it was "rational."
I stopped listening to this doc a long time ago, but when he says things like this I look things up to confirm my hypothesis that he dismissed and find things that support it.
Well guess where I find it? In the TEXTBOOK OF PSYCHOPHARMACOLOGY, the very book he just bought and sat on his desk. !!!!
It said under benzos (side effects and toxicology):
"Although normal subjects clearly show mental impairment with the benzodiazepines, the situation with anxious patients is more complex. Because anxiety itself interferes with mental performance, alleviation of the anxiety may result in improved functioning that more than compensates for the direct drug-related decrement. The effect in some patients may be complicatied and unpredictable, even at low dosages."
The American Psychiatric Press Textbook of Psychopharmacology, p.414
I was SHOCKED to read this, because it almost paraphrases what I explained to my doc- that I was aware it is a dumb drug to most people, but in my case the anxiety makes me so dumb that the relief from the anxiety makes me smarter.
Posted by Questionmark on March 20, 2003, at 18:03:19
In reply to Klonopin- more articulate on it!, posted by utopizen on March 20, 2003, at 15:29:59
AH that PISSes me OFF how some psychiatrists can be so F***ing ignorant, arrogant, overly self-assured, and condescending!! YOU ARROGANT **** S***ers!!! Sorry. It just makes me mad. We're the ones taking the f***ing drugs (and oftentimes researching things more than they are) and we're the ones trying to get better, and yet they (some) have the ARRogance and audacity to just blow off many of our suggestions and comments. Makes me f***ing sick.
Whenever a psychiatrist tells a patient how it should be, so to speak-- or how they should feel or not feel from a certain medication-- they should take the f***ing drug themselves for awhile. Dumb pieces of ****. Sorry.
And i was never even an inpatient or psychotic-- i can't imagine some of the sh*t that they have to go through and deal with.
Forgive me-- it just infuriates me.
Posted by fayeroe on March 20, 2003, at 19:49:53
In reply to Klonopin- more articulate on it!, posted by utopizen on March 20, 2003, at 15:29:59
Posted by Ritch on March 20, 2003, at 21:15:38
In reply to Klonopin- more articulate on it!, posted by utopizen on March 20, 2003, at 15:29:59
> So I told me p-doc the other day I was more articulate when I took Klonopin. When I give a presentation on it, I sound more articulate than ever, look directly at people, barely need my notecards, words seem to come out freely with no effort. And people have this "wow" feeling about what I say. Very impressive.
>
> Well, I told this to my pdoc, and he said it was "irrational" to think this way. But I told him, I don't view Klonopin as a smart drug. I just think I get so much anxiety, the removal of this anxiety lets me think in a way that I would otherwise already think without the anxiety present.
>
> Well, he seemed more convinced, but still didn't admit it was "rational."
>
> I stopped listening to this doc a long time ago, but when he says things like this I look things up to confirm my hypothesis that he dismissed and find things that support it.
>
> Well guess where I find it? In the TEXTBOOK OF PSYCHOPHARMACOLOGY, the very book he just bought and sat on his desk. !!!!
>
> It said under benzos (side effects and toxicology):
>
> "Although normal subjects clearly show mental impairment with the benzodiazepines, the situation with anxious patients is more complex. Because anxiety itself interferes with mental performance, alleviation of the anxiety may result in improved functioning that more than compensates for the direct drug-related decrement. The effect in some patients may be complicatied and unpredictable, even at low dosages."
>
>
> The American Psychiatric Press Textbook of Psychopharmacology, p.414
>
>
> I was SHOCKED to read this, because it almost paraphrases what I explained to my doc- that I was aware it is a dumb drug to most people, but in my case the anxiety makes me so dumb that the relief from the anxiety makes me smarter.
I think your doctor knows full well the benefits that Klonopin can bring and probably doesn't dispute in any way (quietly in his mind) your assertions. I think he is only interested in using newer meds and weird combos of expensive patent medicines to try out because he is chasing some NEW miracle med or combo that he can document and report on. IMO, you are just being used as a guinea pig for the pricey pharma companies and your doctor's ego. Ameliorating your symptoms ASAP with the most effective tools that are available seem to be less than foremost on his list of priorities.
Posted by mattdds on March 20, 2003, at 21:42:38
In reply to Klonopin- more articulate on it!, posted by utopizen on March 20, 2003, at 15:29:59
Utopizen,
Would it be appropriate on this board to give you the name and contact # of a very good psychiatrist in New York? He is a non-benzophobe who appears to be very knowledgable about anxiety disorders. You live around Manhattan, right?
I just had my first appointment with him last week, and here's how it went. I told him that I was experiencing a tremendous amount of anxiety last year, and that the university health center prescribed Klonopin (short term) and it really seemed to help. He nodded, and agreed, saying that Klonopin is a "great med" and he "prescribes it to a number of his patients long-term without loss of benefit or tolerance". He then proceeded to reach for his presciption pad and wrote me out for a month's supply. Wow! No weird looks like I was some sort of addict or party animal looking to augment my 6-pack. So much different from the university health center who kept saying it was too "addictive" to prescribe long term even though it helped tremendously.
Let me know if you're interested, and I'll give you his contact information, and you can dump this other mad scientist.
Matt
Posted by viridis on March 20, 2003, at 22:17:49
In reply to Klonopin- more articulate on it!, posted by utopizen on March 20, 2003, at 15:29:59
I'm definitely more clear-headed with Klonopin than without. Previously, when I had my regular (and frequent) episodes of anxiety, it interfered with my thinking, interactions with others, motivation, etc., and inevitably led to periods of intense, agitated depression. So, I was hardly articulate (or even functional) a fair bit of the time.
With K, things aren't perfect, but they're vastly better. Plus, I don't have to deal with all the weird side effects of the various ADs etc.
I just had my usual 3-month visit with my pdoc. We chatted, he asked if I was experiencing any side effects, tolerance, etc. (the answer is no) and he wrote out my regular 90-day prescription of K, Xanax, Adderall, and Neurontin.
It all seemed so civilized. It's a shame that so many people have to argue with their doctors, justify their refusal to take certain meds, and practically beg for appropriate treatment. I went through that for years, and I really have to wonder if many docs/pdocs are just clueless, are motivated by the profits/gifts associated with still-under-patent-drugs, are wowed by the sales pitches of pharmaceutical reps, are afraid of being hassled for prescribing so-called "addictive" drugs, or what?
I'm not trying to bash the pharm companies or deny that the newer meds can be great for some people, but if they don't work, why is there such reluctance to go back to the old standards?
As for "rationality", I posted about that above -- you sound quite rational to me.
Posted by zippy on March 20, 2003, at 22:27:35
In reply to Perfect example of psychiatric arrogance., posted by Questionmark on March 20, 2003, at 18:03:19
Questionmark:
Your blanket appraisals of doctors is the very reason we as physicians need to be careful in our treatment practices. I try to encourage the patients whom I see to make their own decisions based on the information I give them. However, I have limits in terms of what treatments I'm comfortable providing. You may call that "arrogance", and you're entitled to that opinion. Notwithstanding, if I come across disagreements with my patients, I'll be the first to admit that the relationship will likely not move forward, and advise them to get another opinion. I don't feel a need to control patients, nor will I allow them to control me, whether or not the treatment considerations include controlled substances. Yes, it's your body, but it's my license! I've been a patient too for treatment of a serious illness, and having been on both sides of the fence, I appreciate the anxieties that patients and doctors face in their relationships with one another. The most important point here is to find a doctor whom you trust, and you'll be more comfortable with your health care. If you really believe that all doctors are @$!!&**%'s, then you may need to take a look inside to see what role you play in the failures of your treatment experiences.
Posted by utopizen on March 20, 2003, at 22:55:52
In reply to Re: Perfect example of psychiatric arrogance., posted by zippy on March 20, 2003, at 22:27:35
Zippy,
I've been seeing this p-doc for like a 1 1/2 yrs. I couldn't be a more tactful person if I tried.
My pdoc, at this last visit I'm talking about, noted how much I keep referring to a consult I once had with a colleague of his whenever I suggest a med to try. In this case, it was how his colleague suggested I take Klonopin long-term. Well he responded by saying "I think you have more faith in him, so I think it would be best if you started seeing him instead. I don't research social anxiety like he does." or something like that.
Anyway, so he admitted he didn't know enough about social anxiety, even though he's one of the top psychopharma names in Boston. (I live in Boston). I present my ideas very rationally to him, in a very straight-forward and logical way. What's ironic is that I'm the reasonable one when I say something he claims is irrational, and I can prove this through the texts I find that support my ideas. And these aren't ideas that I got from texts, but things that just made common sense to me at the time. Later I read texts to affirm their validity, but only to prove it to my doc.
As for the poster who claims that my doc knows better, I wouldn't be so confident in his knowledge of these things. I truly believe he doesn't understand how anxiety can impede one's thoughts, because at every appt. he has said "so if you have to choose between focusing on your ADD and your anxiety, which one would you pick?" as if to suggest treating my anxiety will worsen my ADD.
I've tried to explain to him my anxiety and ADD can't be compartamentalized like that, because anxiety itself can affect my thoughts. But he doesn't "get" it.
I think he approaches this as a "this drug's a downer, that'll bring you down, calm you down, make you stupid. but the ADD drugs are stims, they're uppers, make you smarter, but anxious." He's over-simplifying things and over-generalizing in the process. And last time I checked the psych books, over-generalization is a form of irrational thinking...
Posted by cybercafe on March 21, 2003, at 0:20:26
In reply to Re: Klonopin- more articulate on it! » utopizen, posted by viridis on March 20, 2003, at 22:17:49
heh... i'm trying to beg my doctor for an antidepressant ... got any tips?
> I'm definitely more clear-headed with Klonopin than without. Previously, when I had my regular (and frequent) episodes of anxiety, it interfered with my thinking, interactions with others, motivation, etc., and inevitably led to periods of intense, agitated depression. So, I was hardly articulate (or even functional) a fair bit of the time.
>
> With K, things aren't perfect, but they're vastly better. Plus, I don't have to deal with all the weird side effects of the various ADs etc.
>
> I just had my usual 3-month visit with my pdoc. We chatted, he asked if I was experiencing any side effects, tolerance, etc. (the answer is no) and he wrote out my regular 90-day prescription of K, Xanax, Adderall, and Neurontin.
>
> It all seemed so civilized. It's a shame that so many people have to argue with their doctors, justify their refusal to take certain meds, and practically beg for appropriate treatment. I went through that for years, and I really have to wonder if many docs/pdocs are just clueless, are motivated by the profits/gifts associated with still-under-patent-drugs, are wowed by the sales pitches of pharmaceutical reps, are afraid of being hassled for prescribing so-called "addictive" drugs, or what?
>
> I'm not trying to bash the pharm companies or deny that the newer meds can be great for some people, but if they don't work, why is there such reluctance to go back to the old standards?
>
> As for "rationality", I posted about that above -- you sound quite rational to me.
Posted by Smallchange on March 21, 2003, at 0:27:02
In reply to Perfect example of psychiatric arrogance., posted by Questionmark on March 20, 2003, at 18:03:19
I have had lousy docs too. But keep searching. After lots of sucky ones, I have found the doctor of my dreams. He ALWAYS listens to me and even asks me what I think. He knows that I am in tune with my body and that I watch carefully for what works and what doesn't. He is just so awesome and he is always willing to try something new if what I am on is not working. There are good doctors out there, just keep searching.
Posted by glenn on March 21, 2003, at 5:04:36
In reply to Re: Perfect example of psychiatric arrogance., posted by Smallchange on March 21, 2003, at 0:27:02
That's some docs for you I am afraid, one I saw a few years ago wrote in his notes:" Glenn is a difficult patient, if I tell him anything he goes away and reads about it!"
Wierd aren't I ?Glenn
ps I don't see him anymore, my current one is just like that described in the previous post!
Posted by falconman on March 21, 2003, at 6:56:38
In reply to Perfect example of psychiatric arrogance., posted by Questionmark on March 20, 2003, at 18:03:19
Give me the internet and a drug store and I'll treat myself better and faster than any pdoc could. Its a shame there are so many people going through pdoc school that haven't an ounce of logic. In short most of them suck big time!!
Posted by zippy on March 21, 2003, at 14:28:23
In reply to Klonopin- more articulate on it!, posted by utopizen on March 20, 2003, at 15:29:59
Utopizen,
You responded to my earlier email as if I were responding to your email. If you go back and look at it, I was addressing it to "Questionmark". I thought your email was very thoughtful, and it does sound like your pdoc has an unreasonable orientation. I'd find another if I were in your shoes.
Posted by stjames on March 21, 2003, at 14:54:21
In reply to Klonopin- more articulate on it!, posted by utopizen on March 20, 2003, at 15:29:59
You have posted several time about problems with
your doc. It does seem he/she is not al all good for you. This begs the question, why do you stay, and pay ?
Posted by utopizen on March 21, 2003, at 16:04:38
In reply to Why do you continue with this doc ?, posted by stjames on March 21, 2003, at 14:54:21
> You have posted several time about problems with
> your doc. It does seem he/she is not al all good for you. This begs the question, why do you stay, and pay ?I've called a dozen docs already, and they all want to hang up the phone when I tell them what meds I've been on (I've tried a lot, from ADs to APs).
I told this to my doc, so he's called a person that will see if she can schedule something so I can switch to his colleague. I'm in the position right now where it's best to have him take things over with switching me to another doc, because the hospital I want to use as an outpatient requires that my doctor arrange the switch for "conflict of interest" purposes.
Posted by Krissy P on March 21, 2003, at 22:11:47
In reply to Klonopin- more articulate on it!, posted by utopizen on March 20, 2003, at 15:29:59
Hi, good for you, glad you told your doc this>> I don't view Klonopin as a smart drug. I just think I get so much anxiety, the removal of this anxiety lets me think in a way that I would otherwise already think without the anxiety present.
I agree, I take 2mg of Klonopin-but lately have been taking extra PRN. It helps me think more clearly too, but what doesn't is the Seroquel I take. I also had ECT and my brain has never felt the same. I'm already blonde and really do feel like a dumb blonde sometines LOL
Take care:-)
kristen
--------------------------------------------------------------------------------------------------> So I told me p-doc the other day I was more articulate when I took Klonopin. When I give a presentation on it, I sound more articulate than ever, look directly at people, barely need my notecards, words seem to come out freely with no effort. And people have this "wow" feeling about what I say. Very impressive.
>
> Well, I told this to my pdoc, and he said it was "irrational" to think this way. But I told him, I don't view Klonopin as a smart drug. I just think I get so much anxiety, the removal of this anxiety lets me think in a way that I would otherwise already think without the anxiety present.
>
> Well, he seemed more convinced, but still didn't admit it was "rational."
>
> I stopped listening to this doc a long time ago, but when he says things like this I look things up to confirm my hypothesis that he dismissed and find things that support it.
>
> Well guess where I find it? In the TEXTBOOK OF PSYCHOPHARMACOLOGY, the very book he just bought and sat on his desk. !!!!
>
> It said under benzos (side effects and toxicology):
>
> "Although normal subjects clearly show mental impairment with the benzodiazepines, the situation with anxious patients is more complex. Because anxiety itself interferes with mental performance, alleviation of the anxiety may result in improved functioning that more than compensates for the direct drug-related decrement. The effect in some patients may be complicatied and unpredictable, even at low dosages."
>
>
> The American Psychiatric Press Textbook of Psychopharmacology, p.414
>
>
> I was SHOCKED to read this, because it almost paraphrases what I explained to my doc- that I was aware it is a dumb drug to most people, but in my case the anxiety makes me so dumb that the relief from the anxiety makes me smarter.
Posted by Krissy P on March 21, 2003, at 22:13:34
In reply to Re: Klonopin- more articulate on it! » utopizen, posted by Ritch on March 20, 2003, at 21:15:38
Posted by Krissy P on March 21, 2003, at 22:17:43
In reply to Re: Klonopin- more articulate on it! » utopizen, posted by viridis on March 20, 2003, at 22:17:49
HI again, yes, you sound quite rational to me too, I agree here too that it is a shame that so many people have to argue with their doctors, ESPECIALLY justify their refusal to take certain meds, and practically beg for appropriate treatment. I also went through that for years.
I wonder too if docs are more motivated by the profits/gifts associated with still-under-patent-drugs, and wowed by the sales pitches of pharmaceutical reps, are afraid of being hassled for prescribing so-called "addictive" drugs, or what? I can't say enough how well Klonopin does for my anxiety-it just calms my ass down quite well:-)
All the best, Kristen:-)
--------------------------------------------------------------------------------------------------I'm not trying to bash the pharm companies or deny that the newer meds can be great for some people, but if they don't work, why is there such reluctance to go back to the old standards?I'm definitely more clear-headed with Klonopin than without. Previously, when I had my regular (and frequent) episodes of anxiety, it interfered with my thinking, interactions with others, motivation, etc., and inevitably led to periods of intense, agitated depression. So, I was hardly articulate (or even functional) a fair bit of the time.
With K, things aren't perfect, but they're vastly better. Plus, I don't have to deal with all the weird side effects of the various ADs etc.
I just had my usual 3-month visit with my pdoc. We chatted, he asked if I was experiencing any side effects, tolerance, etc. (the answer is no) and he wrote out my regular 90-day prescription of K, Xanax, Adderall, and Neurontin.
It all seemed so civilized. It's a shame that so many people have to argue with their doctors, justify their refusal to take certain meds, and practically beg for appropriate treatment. I went through that for years, and I really have to wonder if many docs/pdocs are just clueless, are motivated by the profits/gifts associated with still-under-patent-drugs, are wowed by the sales pitches of pharmaceutical reps, are afraid of being hassled for prescribing so-called "addictive" drugs, or what?
I'm not trying to bash the pharm companies or deny that the newer meds can be great for some people, but if they don't work, why is there such reluctance to go back to the old standards?
As for "rationality", I posted about that above -- you sound quite rational to me.
Posted by Krissy P on March 21, 2003, at 22:22:08
In reply to Re: Perfect example of psychiatric arrogance., posted by zippy on March 20, 2003, at 22:27:35
zippy, you say here: "I don't feel a need to control patients, nor will I allow them to control me"-well, you forgot one VERY IMPORTANT thing that you didn't even mention in your post. DOCS AND PATIENTS NEED TO WORK AS A TEAM TOO!!!!!!!!!!!!!!!! I am a patient that will not allow a doc to control me and it may be your license but it's MY body, did you remember that when you took the oath of FIRST DO NO HARM???
Excuse me for saying, but you seem a little like one of the arrogant docs and you just proved it by your post. Do you really even get it?
Regards.........--------------------------------------------------------------------------------------------------
> Questionmark:
> Your blanket appraisals of doctors is the very reason we as physicians need to be careful in our treatment practices. I try to encourage the patients whom I see to make their own decisions based on the information I give them. However, I have limits in terms of what treatments I'm comfortable providing. You may call that "arrogance", and you're entitled to that opinion. Notwithstanding, if I come across disagreements with my patients, I'll be the first to admit that the relationship will likely not move forward, and advise them to get another opinion. I don't feel a need to control patients, nor will I allow them to control me, whether or not the treatment considerations include controlled substances. Yes, it's your body, but it's my license! I've been a patient too for treatment of a serious illness, and having been on both sides of the fence, I appreciate the anxieties that patients and doctors face in their relationships with one another. The most important point here is to find a doctor whom you trust, and you'll be more comfortable with your health care. If you really believe that all doctors are @$!!&**%'s, then you may need to take a look inside to see what role you play in the failures of your treatment experiences.
Posted by Krissy P on March 21, 2003, at 22:23:44
In reply to Re: Perfect example of psychiatric arrogance., posted by Smallchange on March 21, 2003, at 0:27:02
Posted by Krissy P on March 21, 2003, at 22:26:20
In reply to Re: Perfect example of psychiatric arrogance., posted by glenn on March 21, 2003, at 5:04:36
Any doc that tells you you are a difficult patient oughta be shot-that is WRONG! Who do some of these docs think they are? I hate to hear other people having gone through this. NOT all docs are great-PERIOD
So happy to hear that you are seeing a great one now-you don't need that, and docs should think
about what they say sometimes to their patients-their job depends on it.Take care, Kristen:-)
--------------------------------------------------------------------------------------------------
> That's some docs for you I am afraid, one I saw a few years ago wrote in his notes:" Glenn is a difficult patient, if I tell him anything he goes away and reads about it!"
> Wierd aren't I ?
>
> Glenn
> ps I don't see him anymore, my current one is just like that described in the previous post!
Posted by Krissy P on March 21, 2003, at 22:43:24
In reply to Klonopin- more articulate on it!, posted by utopizen on March 20, 2003, at 15:29:59
Posted by Krissy P on March 21, 2003, at 22:44:12
In reply to Re: Why do you continue with this doc ?, posted by utopizen on March 21, 2003, at 16:04:38
Posted by falconman on March 22, 2003, at 0:20:50
In reply to Re: Perfect example of psychiatric arrogance., posted by zippy on March 20, 2003, at 22:27:35
hi,
i appologise for my statement which suggested that most pdocs are incompitant. I have had a rough experiece with several pdocs in which i perceived their manner to be particulary unproffesinal and led to a anything but theraputic relations.However i am aware that i should not express my bitterness on this board, in which so many people offer such great support and understandingThere are good pdocs out there and I suppose I have just had a run of bad luck.
I particulary I apologise to zippy as he/she stated being in the proffesion of psychiatry, and taking part in posts of this nature proves that he/she takes a more attive role in understanding patients. If only there were more docs like this!!
zippy you deserve respect and I hope my earlier post did not offend you.I also take on board your comment about looking inside to gain insight into why treatment has failed so many times with several pdocs.
Regards
Falcon
Posted by Ted1962 on March 23, 2003, at 12:18:48
In reply to Re: Klonopin- more articulate on it! » utopizen, posted by viridis on March 20, 2003, at 22:17:49
> I'm definitely more clear-headed with Klonopin than without. Previously, when I had my regular (and frequent) episodes of anxiety, it interfered with my thinking, interactions with others, motivation, etc., and inevitably led to periods of intense, agitated depression. So, I was hardly articulate (or even functional) a fair bit of the time.
>
> With K, things aren't perfect, but they're vastly better. Plus, I don't have to deal with all the weird side effects of the various ADs etc.
>
> I just had my usual 3-month visit with my pdoc. We chatted, he asked if I was experiencing any side effects, tolerance, etc. (the answer is no) and he wrote out my regular 90-day prescription of K, Xanax, Adderall, and Neurontin.
>
> It all seemed so civilized. It's a shame that so many people have to argue with their doctors, justify their refusal to take certain meds, and practically beg for appropriate treatment. I went through that for years, and I really have to wonder if many docs/pdocs are just clueless, are motivated by the profits/gifts associated with still-under-patent-drugs, are wowed by the sales pitches of pharmaceutical reps, are afraid of being hassled for prescribing so-called "addictive" drugs, or what?
>
> I'm not trying to bash the pharm companies or deny that the newer meds can be great for some people, but if they don't work, why is there such reluctance to go back to the old standards?
>
> As for "rationality", I posted about that above -- you sound quite rational to me.> You mentioned in your posting that you take Klonopin and Xanax, along with adderall and Neurontin. How are you dosing the Klonopin and Xanax each day? I think the combination makes great sense.
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