Shown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by pragmatic-attack on December 21, 2010, at 1:36:18
Im having a bit of a crisis. I have clinical major treatment resistent depression/ possible bp 2. Was on lamictal celexa and vyvanse. combo was working not greatly, still debilitated but better than before. The vyvanse has been helpful except that it would wear off in the afternoon. told doc this and he said it was "impossible" because it's a "prodrug" hence lasts for days. I was having severe cognitive problems in the morning till the vyvanse would kick in. He said it was probably due to the Lamictal not the vyvanse-despite the fact that I was on the lamictal for a year prior to starting the vyv with this not happening. He decided to take me off the lamictal(400mg) and celexa(20mg) abruptly, no titration, for two weeks, in preperation to start parnate. He replaced the lamictal with kepra not because he thought it would help stating "Kepra is not a mood stabalizer" but because he wanted to "make a deal" with me to start the parnate, since I had told him I had a good response to kepra which was prescribed because had an abnormal eeg on left temporal lobe . He "knows" I don't have TLE though because tle has no relation to depression apparently. When I mentioned that I also have weird language problems that occur periodically. Words get mixed up. Able to read one second next second everything slows down and the words get jumbled. His response" could be a million things". No elaboration. Anyway, after stopping this and starting the kepra had a week of pure torture. unable to get out of bed. felt like there was this constant zapping tingling pulsations happening, super tired, depressed. Told him about this and said "it's impossible. the drugs were too low to have reactions like that". At a certain point the zapping sensations wore off but got extremely depressed, irritable, unable to sleep and unable to think straight on the most basic level. Finally called him and asked if there was anything that would help me till the parnate could be started. He said "nothing that would work". I said" but I have tried zyprexa before and it seems to help short term so what about that" he responds saying "it would just be a placibo" ...anyway, I finally convinced him to prescribe it. Long story short it has worked a little bit but still totally out of it haven't slept but tired and confused. Anyway I saw him today and asked if there was anything else I could take durring this period that would help with the problems. I suggested Namenda, tried it before , helpful short term for cognition and mood. His response" thats ludicrious" me responding "how is it ludicrious if it has been effective?". His response "I've decided not to put you on an maoi, my gut feeling is that you are going to imagine a bunch of false symptoms". So I went this this total HELL for no reason. What is the next step. I don't it would be helpful for me to continue to see him but I don't have another doctor and don't want to end up in the hospital.
THIS IS THE DUDE...JUST FYI...http://www.roberthlevinemd.com/
Posted by bleauberry on December 21, 2010, at 16:52:43
In reply to Bad Doctor-what to do...http://www.roberthlevinemd, posted by pragmatic-attack on December 21, 2010, at 1:36:18
I don't see that you have any choice except to get another doctor. It's not an option. At least, if it were me, that's how it would be. I couldn't even imagine putting my brain in the hands of someone like that.
He violated basic medical skills taught during training. That is, respecting the patient, gaining their trust, not talking down to them, making them comfortable to open up about anything. Trust. It's all about trust. He doesn't trust you, he doesn't believe you, there is nothing you can do to convince someone like that. And you don't trust him.
And if it were me, I would refuse to pay for that final visit.
In addition, treatment resistant in psychiatry in my way of thinking is not complicated. It simply means the drugs you were given are not hitting the appropriate biology that is impacting your brain.
I think the greatest gift any treatment resistant patient can receive is the gift of wisdom. Wisdom to know the array of identifiable biological causes of depression. This is especially critical when drugs that manipulate brain chemicals have not helped. The clues are there....it's something else somewhere else. You and the pdoc are probably both frustrated because you've both been looking in the wrong place....the brain. The depression is from somewhere else in the body. What you are feeling is only the impact of that on the brain. Extra serotonin or whatever aint gonna turn that around. It already would have if that was on target.
But that's just the way I approach any kind of chronic illness. My curiosity wants to know....what is going on. Because without knowing that, I can't embark on a journey of improving any better than randomly aiming a flashlight in the dark.
Posted by pragmatic-attack on December 22, 2010, at 2:55:26
In reply to Re: Bad Doctor-what to do...http://www.roberthlevinemd, posted by bleauberry on December 21, 2010, at 16:52:43
thanks bleauberry. You're right on the mark.
Posted by Shadus on December 26, 2010, at 22:29:20
In reply to Bad Doctor-what to do...http://www.roberthlevinemd, posted by pragmatic-attack on December 21, 2010, at 1:36:18
I had a really bad aggressive doctor once, you can deal with it in some instances (gen prac) but in your psyche doctor it's not a functional relationship you can maintain. Find a new one no matter how infeasible that is. You must have a good trusting functional relationship with a psychiatric doctor.
Posted by pragmatic-attack on December 26, 2010, at 22:53:13
In reply to Re: Bad Doctor-what to do...http://www.roberthlevinemd, posted by Shadus on December 26, 2010, at 22:29:20
yep I agree. in the process of looking for one. They all have egos. i called an old psychiatrist-old on many levels-to ask him to prescribe something for me to get me through this state. His respone: "I don't prescribe medicine to people who leave me for somebody else". It's not a f'ing romantic relationship. So pathetic.
Posted by emmanuel98 on December 27, 2010, at 19:44:58
In reply to Re: Bad Doctor-what to do...http://www.roberthlevi, posted by pragmatic-attack on December 26, 2010, at 22:53:13
They don't all have big egos. I've had two (one for therapy and meds, one for addiction issues) who were wonderful. I think the older ones tend to be better -- at least 50, since more likely they were trained in therapy and have good empathy and listening skills. If you have insurance, you can go through their list of docs. These lists usually include ages.
Posted by pragmatic-attack on December 27, 2010, at 20:12:14
In reply to Re: Bad Doctor-what to do...http://www.roberthlevi » pragmatic-attack, posted by emmanuel98 on December 27, 2010, at 19:44:58
actually my experience has been the older ones are the ones with egos-. if you leave them for somebody else they take it personal
Posted by pragmatic-attack on December 27, 2010, at 21:12:01
In reply to Re: Bad Doctor-what to do...http://www.roberthlevi, posted by pragmatic-attack on December 27, 2010, at 20:12:14
it all depends on what your problem is too.
This is the end of the thread.
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