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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Conundrum on June 22, 2010, at 22:23:36
...do you have to try before the pdoc throws there hands up in the air and lets you try what you want?
I'm on a failing trial of lamictal, my pdoc may order a blood test to see if I'm at the right level, but I feel so spacey that I doubt I could tolerate a dose increase. I feel no benefit and only spacey dizziness on this drug. I hope she doesn't want me to try an AAP after this.
I would rather try mirtazapine, some TCAs, and Parnate before then.
Posted by Christ_empowered on June 22, 2010, at 22:44:51
In reply to How many drugs..., posted by Conundrum on June 22, 2010, at 22:23:36
I wish I could say "after 4 drugs, your p-doc will listen to your suggestions," but...that's not the case. It depends on SO MANY factors. This is one reason I have serious problems with psychiatry and psychiatrists. Here are some factors that will affect the drugs you get:
1) your age 2) your race 3) your gender 4) your shrink's age, sex, and gender 5) when your shrink went to medical school 6) your previous diagnosis/diagnoses 7) your current diagnosis 8) your socio-economic status 9) whether you are dealing with a public health, prviate practice (insurance) or "self-pay" (no-insurance, out-of-pocket only) shrink. 10) history of substance abuse (and how your shrink views people w/ history of substance abuse) 11) your real or perceived risk of suicidal or violent behavior 12)what the drug companies are telling your doc (and how pretty the reps are)
So, there you have it.
Posted by g_g_g_unit on June 22, 2010, at 23:12:29
In reply to Factors that affect the meds you get, posted by Christ_empowered on June 22, 2010, at 22:44:51
I think Christ-Empowered is right. Are you seeing someone privately? If not, it may be worth 'shopping around'. Where I used to live, the public health system was a joke, while private health insurance didn't cover psychiatric costs, meaning I was paying out of my *ss for pdoc appointments. Consequently, I never had any difficulty getting pdocs to agree to drug trials (except where stimulants were concerned); in fact, the more I paid, the more agreeable they were. Unless you're psychotic or manic or completely unstable, I think you should be entitled to negotiate with your pdoc.
Posted by Phillipa on June 23, 2010, at 0:33:35
In reply to Re: Factors that affect the meds you get, posted by g_g_g_unit on June 22, 2010, at 23:12:29
Today I saw my pdoc and she said I might be one of the people meds dont work for. Suggested some herbs seriously, and alternative theaphys. But she gave me the xanax and valium and I asked to try low dose lexapro to get off luvox she thought it might help to take 5mg of lexapro and the 50luvox since so low doses. So she doesn't push meds at me at all. Medicaire. Phillipa ps she gave me two months of lexapro samples
Posted by zonked on June 23, 2010, at 10:30:50
In reply to Factors that affect the meds you get, posted by Christ_empowered on June 22, 2010, at 22:44:51
You summed that up really well!
Perfect example: I see a pdoc in a clinic that largely serves indigents and people on government insurance, and have found out that docs CANNOT prescribe Xanax (which is the most effective benzo I've ever used with the least side effects) or stimulants for ADD. Now, that is f-up--I think part of the reason for my recent destabilization was becaused I'd moved, could no longer see my previous pdoc (Medicaid county changed), and had to stop Adderall abruptly--which is never a good idea.
Looking in the waiting room, and talking to patients in there, my easy guess is that they have to deal with a lot of substance abuse and consider illegal diversion of psychotropics. It's just too bad that I have to pay the price for the irresponsibility of others. If I ever want to add a stimulant, I'm going to have to find an experienced psychiatrist/psychopharmacologist who takes Medicare and Medicaid...
I'm looking forward to being well enough to work, get off SSDI and government insurance, so I really can choose my own
doctor and clinic.-z
I wish I could say "after 4 drugs, your p-doc will listen to your suggestions," but...that's not the case. It depends on SO MANY factors. This is one reason I have serious problems with psychiatry and psychiatrists. Here are some factors that will affect the drugs you get:
>
> 1) your age 2) your race 3) your gender 4) your shrink's age, sex, and gender 5) when your shrink went to medical school 6) your previous diagnosis/diagnoses 7) your current diagnosis 8) your socio-economic status 9) whether you are dealing with a public health, prviate practice (insurance) or "self-pay" (no-insurance, out-of-pocket only) shrink. 10) history of substance abuse (and how your shrink views people w/ history of substance abuse) 11) your real or perceived risk of suicidal or violent behavior 12)what the drug companies are telling your doc (and how pretty the reps are)
>
>
> So, there you have it.
This is the end of the thread.
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