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Dr. Bob is Robert Hsiung, MD,
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Posted by ed_uk2010 on December 4, 2010, at 9:01:52
In reply to Re: Pharmacist today said my brain damaged no repairin » Phillipa, posted by orbital on December 4, 2010, at 5:05:41
>Valium tends to build up *extremely* quickly in certain patients who are over 60
It can do, but it reaches a steady blood level after a few weeks. Phillipa has been taking it for many years. Switching to a short-acting benzo would make it more difficult to reduce her dose, if that's what she wants to do.
Posted by ed_uk2010 on December 4, 2010, at 9:05:04
In reply to Re: » glydin50, posted by Phillipa on December 3, 2010, at 21:22:39
>But he replied her brain hasn't suffered the damage yours has from all the years of prescribed benzos.
Hmm, well that could have been said in a nicer way. Daily use of benzos for many years is certainly not ideal. You've said many times over recent months that you think the benzos are making you feel tired. Diazepam is the standard benzo used for tapering off, so why not try to stop the benzos over the next few months?
Posted by linkadge on December 4, 2010, at 11:51:34
In reply to Re:, posted by ed_uk2010 on December 4, 2010, at 9:05:04
I have noticed that a lot of pharmacists seem to be anti-med. They probably see a lot of the patterns of medication use, for side effects etc.
I think the biggest think that eeks the pharmacists is that they cann't prescribe the meds. They deal in meds all day long, but really have no control over medication recomendations.
As such, I think many of them tend to develop a negative view of medications.
Linkadge
Posted by merpmerp on December 4, 2010, at 12:40:25
In reply to A lot of pharmacists seem to be anti-med, posted by linkadge on December 4, 2010, at 11:51:34
Some academic musing on the subject... I wonder if pharmacists (aka chemists) have the same skeptical tendencies in Europe, where historically I believe they have been able to prescribe meds?
I believe they probably also have anti-med tendencies because they have to deal sometimes with people who are hooked on incorrectly prescribed meds. My mom, an alcoholic, is addicted to multiple benzos and she's never been challenged on it by a doctor, but has been challenged by pharmacists when she goes to get a refill.
(I do believe benzos have their place in treatment, and can be used without being abused, but trust me when I say my mom really is addicted and does abuse them. I am not being benzophobic here.)
> I think the biggest think that eeks the pharmacists is that they cann't prescribe the meds. They deal in meds all day long, but really have no control over medication recomendations.
Posted by ed_uk2010 on December 4, 2010, at 12:44:51
In reply to A lot of pharmacists seem to be anti-med, posted by linkadge on December 4, 2010, at 11:51:34
>I have noticed that a lot of pharmacists seem to be anti-med.
I don't know about other countries, but pharmacists in the UK see a large number of heroin addicts on methadone, who are also often on benzos and other psych medications. Some pharmacies have more than 100 patients on methadone - often daily supervised pick up. I suspect that their view of benzos and other potentially addictive drugs is tarnished by their clientele ;)
Pharmacists also tend to be cautious, and are not generally well trained in psychiatry. Their views on the risks versus benefits of psych drugs are often not favourable........so I guess you would agree on many issues Link! They may hear more complaints about adverse effects than about the original condition that people were being treated for.
Posted by ed_uk2010 on December 4, 2010, at 12:47:59
In reply to Re: A lot of pharmacists seem to be anti-med » linkadge, posted by merpmerp on December 4, 2010, at 12:40:25
>...where historically I believe they have been able to prescribe meds?
There are pharmacist prescribers in the UK, but they only represent a minority of pharmacists.
>I believe they probably also have anti-med tendencies because they have to deal sometimes with people who are hooked on incorrectly prescribed meds.
Yes, you are right.
Posted by merpmerp on December 4, 2010, at 12:51:37
In reply to Re: A lot of pharmacists seem to be anti-med » merpmerp, posted by ed_uk2010 on December 4, 2010, at 12:47:59
Thanks for the info :)
> >...where historically I believe they have been able to prescribe meds?
>
> There are pharmacist prescribers in the UK, but they only represent a minority of pharmacists.
Posted by sigismund on December 4, 2010, at 13:20:28
In reply to Not the greatest advert for benzos » linkadge, posted by ed_uk2010 on December 4, 2010, at 12:44:51
A patient came into a pharmacy here with a valid script for 240mg/d methadone, and the pharmacist refused to fill it saying that the patient would have to be re-evaluated.
I wouldn't have liked to be that patient, but I agreed with the pharmacist.
Posted by ed_uk2010 on December 4, 2010, at 13:51:58
In reply to Re: Not the greatest advert for benzos » ed_uk2010, posted by sigismund on December 4, 2010, at 13:20:28
> A patient came into a pharmacy here with a valid script for 240mg/d methadone, and the pharmacist refused to fill it saying that the patient would have to be re-evaluated.
>
> I wouldn't have liked to be that patient, but I agreed with the pharmacist.Re-evaluated being the understatement of the year :)
Posted by Phillipa on December 4, 2010, at 21:17:32
In reply to Re: Not the greatest advert for benzos » sigismund, posted by ed_uk2010 on December 4, 2010, at 13:51:58
First thanks for the support. But now my life as it unraveled. Age 24 major panic all the time with two little kids at the time living in Florida. Husband at time drove me back to CT where we had kept our house. See a pdoc who prescribes valium open prescription at the time as was 1971. Said take 5mg three times a day with the miltown common med then. I took both and drank then three beers a night. Fast forward two maybe less years later felt great and had for a long time so said I don't need this miltown stopped it no side effects at all. Continued with the open end RX for valium as not deemed as a bad med then. As I went through Nursing took valium as needed. Stopped drinking as needed to study. By that time I had a third child who was conceived while on the meds and alchohol. Went into false labor and the ob-gyn knew what meds on and was fine with it. In the hospital false labor the ob-gyn gave me two seconals as he felt it was false labor. Three weeks later had a healthy girl. Decided since breast feeding would just not take any meds and didn't. No one of the docs cared. I guess had some sort of withdrawal as couldnt breast feed as baby awake screaming 24 hours a day. In and out of the hospital the baby. They gave her sedatives never told me so thought I was a bad Mom. As my first two never cried. I wasn't taking meds then. So I lay on the couch during one of the babies hospitalizations for two weeks and didn't take any meds. Then she was ready to come home the nurses hadn't been able to put any weight on her as she had what they called hyperkinetic legs always moving, sensitive had to be changed if even urinated, and bassinett had to be covered as light bothered her and "not one person alone could care for her". I did though and added back 5mg of valium and she gained three pounds in a month. And til she was 18months old she had a variety of problems infections and such. Then she was fine. Has two degrees. Manages a store. Has her own child now. She's super smart. As are my older two. Then at menopause time thyroid, lymes found and first ad given to me. And Obital my diagnosis is Gad. And never abused any of the meds. So do I want to add another med? As some have said life isn't perfect. Sometimes you do the best you can and that's all you can do. I could stop all the meds now again. But now all this talk about withdrawal. A problem I've never personally experience. So is too much or not enough knowledge dangerous? For all other threads that say in the future medications as known now will be archaic it's very possible. As in the past benzos were deemed safe even when pregnant. So as the pharmacist said about my Hrt question the jury is out. Will SSRI's and all the antidepressants be said to cause brain damage some day. I feel the jury is out on that also. Phillipa ps thinking out loud
Posted by Simcha on December 5, 2010, at 2:01:13
In reply to Re: My turn my life as it's unraveled, posted by Phillipa on December 4, 2010, at 21:17:32
Phillipa,
I've got to agree with other posters here. What does a pharmacist know about the biology of the brain, and more specifically your brain? They are not doctors for a reason. They are specialists in medications and filling prescriptions. They aren't licensed to prescribe, diagnose, or treat. The pharmacist that started all of this is practicing beyond the scope of his license, training, and education. Not only were his comments on the state of your brain out of line, they are unethical and they could be reportable to his State Licensing Board.
Pharmacists have tried to second guess my pdoc's mixing of antidepressants before. I nicely remind them that these medications are prescribed to me by a doctor and that they are unqualified to question my doctor's course of treatment. Their scope of practice ends at simply filling the prescriptions as written by doctors and does not include diagnosis or treatment of my conditions. I kindly refer them back to the prescribing doctor if they have questions about possible interactions or side effects since he is the only one who is qualified to make the ultimate judgment about my treatment.
So, if you feel that this pharmacist is practicing medicine without the proper education, training, or license, do yourself and everyone a favor and report him to his State Licensing Board.
Unless a qualified doctor tells you that you have actual brain damage, please disregard this pharmacist's unwelcome and unqualified diagnosis of your brain's health.
Love,
Simcha
Posted by Phillipa on December 5, 2010, at 11:07:26
In reply to Re: My turn my life as it's unraveled, posted by Simcha on December 5, 2010, at 2:01:13
Simcha that was lovely and brings back all the years where pdocs always had me on two benzos at once which pharmacists always almost refused to fill. The pdoc had a hard time convincing them to fill the rx for both valium and xanax which today am still on. Funny how something someone says cause you to remember. Love Phillipa
Posted by linkadge on December 5, 2010, at 14:29:45
In reply to Re: Not the greatest advert for benzos » ed_uk2010, posted by sigismund on December 4, 2010, at 13:20:28
>A patient came into a pharmacy here with a valid >script for 240mg/d methadone, and the pharmacist >refused to fill it saying that the patient would >have to be re-evaluated.
>I wouldn't have liked to be that patient, but I >agreed with the pharmacist.
This may sound harsh, but I personally don't feel that its the pharmacists buisness to have an opinion. Their job is to dispense the medications. Unless, it is in the case where there has been a medical error.
Doctors and psychiatrists go through a hell of a lot more education for a reason. If the pharmacist does not want to dispense the medication, you can bet there will be another pharmacy which will fill it. The pharmacist has no control over whether the patient gets the med. I guess all they have control over is their own conscience.
Linkadge
Posted by linkadge on December 5, 2010, at 14:41:20
In reply to Re: My turn my life as it's unraveled, posted by Simcha on December 5, 2010, at 2:01:13
I agree with your comments Simcha. If a pharmacist has a real beef with how medications are prescribed, then they need to go back to school for another 10 years and become a psychiatrist.
Psychiatrists have spend time with the individual patient and probably understand the cost/benefit analysis better for an individual patient.
For exmaple, suppose a patient comes in, hooked on high doses of valium. Perhaps the doctor intends to get the patient off, but due to a major life stressor feels that now is not the time. The psychiatrist will have a better feel for these factors. The pharmacist just sees this as a high dose of an addictive drug.
Linkadge
Posted by linkadge on December 5, 2010, at 14:44:23
In reply to Re: My turn my life as it's unraveled » Simcha, posted by Phillipa on December 5, 2010, at 11:07:26
There are many resons why a patient might be on two benzos. A benzo with a long and short half life can be combined to provide longer term coverage plus shorter, as needed coverage which will not hang over too long.
Eg. a shorter acting benzo for sleep, plus a longer acting one for dayimte anxiety...etc. etc.
Linkadge
Posted by glydin50 on December 5, 2010, at 15:20:34
In reply to Re: My turn my life as it's unraveled, posted by linkadge on December 5, 2010, at 14:44:23
Not intending offensive of any type... so please don't jump in my ---
First of all, I don't know for sure a compounding pharmacy is being discussed.... but my experience - I recently visited a compounding pharmacy. They are new to my area. This place had a newspaper ad which was an endorsement of "How to ditch your dangerous Blood Pressure drugs"... being hypertensive this peaked my interest althought kinda knowing what THAT was all about. I found the ONE I visited had a focus very different from other pharmacies I visited. This pharmacist works with a number of alternative practioners.... not a problem but prehaps that's something to consider in discussing how various "types" of dispenseries see things.
I didn't ditch my B/P med btw.... : )
Posted by ed_uk2010 on December 5, 2010, at 18:26:19
In reply to Re: Not the greatest advert for benzos, posted by linkadge on December 5, 2010, at 14:29:45
>This may sound harsh, but I personally don't feel that its the pharmacists buisness to have an opinion.
That's b*llsh*t. When a dose of medication is such that the patient may be killed, it is very much the pharmacists job to have an opinion.
>Doctors and psychiatrists go through a hell of a lot more education for a reason.
Pharmacists go through plenty of education.
Posted by ed_uk2010 on December 5, 2010, at 18:30:44
In reply to Re: My turn my life as it's unraveled » Simcha, posted by linkadge on December 5, 2010, at 14:41:20
>Psychiatrists have spend time with the individual patient and probably understand the cost/benefit analysis better for an individual patient.
Funny that you suddenly respect psychiatrists Link, I thought they ruined your brain with dangerous drugs that don't help.
Posted by Phillipa on December 5, 2010, at 19:07:03
In reply to Re: My turn my life as it's unraveled » linkadge, posted by ed_uk2010 on December 5, 2010, at 18:30:44
There are compounding only pharmacies and combined traditional pharmacies but both know how to compound. This was a traditional pharmacy not the one I use for the bioidenticals. Must find a few links for this. I find pharmacists a great source of knowledge for things apdoc might not have time to discuss. When I have a question of how long a med stays in your system til all gone it's the pharmacist that knows the correct answer. This my experience. Phillipa
Posted by Phillipa on December 5, 2010, at 19:15:19
In reply to Re: My turn my life as it's unraveled, posted by Phillipa on December 5, 2010, at 19:07:03
Worth reading seriously Phillipa
Posted by emmanuel98 on December 5, 2010, at 19:26:52
In reply to Re: My turn my life as it's unraveled, posted by Phillipa on December 5, 2010, at 19:07:03
My p-doc prescribed trazadone 100mg to help me sleep because I have insomnia from taking parnate. Parnate and trazadone are contra-indicated. I talked about this with my p-doc and talked about early symptoms of serotonin syndrome. When I went to the pharmacy, the wouldn't fill the prescription until they talked to my p-doc. I wasn't offended. They are being careful and want to make sure the doctor and patient understand the risks. At hospitals, the pharmacist is responsible to vet doctors' prescriptions and make sure the right med is sent and there are no contra-indications or errors. Retail pharmacists have the same responsiblity.
Posted by glydin50 on December 5, 2010, at 20:06:07
In reply to Re: Pretty Good Summmary One Near Me, posted by Phillipa on December 5, 2010, at 19:15:19
It was an interesting experience.
Large on the supplement side and pharmacy area was like an afterthought. Had an interesting discussion w/ PharmD on the Renin-Angiotensin-Aldosterone System and modes of process/aid of homostasis w/ that. He believed my thoughts were incorrect and I believed the same of his.... Ended in a draw.
I didn't like the push of suggestions of practioners for "their" believe in treatment. Generally, the info and suggested consults were a bit over the top in claims, imo.... If alt. ideas work for folks, great. I fault no one's path if it's not dangerous and WORKS. I've not had ANY success w/ such endeavors despite many trys at it and much $$.
Posted by Phillipa on December 5, 2010, at 21:20:42
In reply to Re: Pretty Good Summmary One Near Me » Phillipa, posted by glydin50 on December 5, 2010, at 20:06:07
These just customize doses that are unconventional dose size of the med companies and help make some for kids they will take. And make a lot of liquids for hard to swallow. Bet could get a customized dose of an ad also if asked then no splitting pills. Alternative meds are very common here as when I had the scar revision the plastic surgeon had me take arnica montana. Day before surgery and right before and then three times a day for three days. Not a bruise to be had. Lots use it for preventing bruises. It's homeopathic. The plastic surgeons sister is a homeopatic doc in Florida where he performed surgery when he lived there on a man whose ear lobes had been cut to steal his diamond studs. He went to see him two days later and the doc didn't recognize him as no bruising at all. Asked him what he did and he said the arnica hence the plastic surgeon asked his sister about it. Now he routinely gives it to all his surgical patients before surgery. I'm noticing a huge blending of Eastern and Western Meds. Homeopathy has been around for centuries. Need another site about medical drugs. I once took lopressor and thought I'd die as couldn't raise my pulse when excercised so couldn't get an aerobic excercise in. They just made me tired. So went off it as was supposed to calm anxiety so could take paxil that first time. I didn't need it for blood pressure. Phillipa
Posted by Glydin50 on December 6, 2010, at 10:16:00
In reply to Re: Pretty Good Summmary One Near Me » glydin50, posted by Phillipa on December 5, 2010, at 21:20:42
Whatever blows one's skirt up : ) Mine just stayed in place w/ those ideas.
Posted by gardenergirl on December 6, 2010, at 11:53:07
In reply to Re: Not the greatest advert for benzos » linkadge, posted by ed_uk2010 on December 5, 2010, at 18:26:19
>
> Pharmacists go through plenty of education.Yes they do, and it's not at all easy. It's quite rigorous. And pharmacists can quite appropriately have opinions and consult with physicians and patients about medications. That is within the scope of their training and practice. What the physician and/or consumer does with that information is on them. My beef was a pharmacist telling someone their brain was damaged. That is clearly outside the scope of their training and practice.
gg
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