Posted by Elizabeth on July 19, 2001, at 17:29:57
In reply to Re: Tell me about Buspar?, posted by sl on July 18, 2001, at 23:52:54
> > If it made you sleepy, my guess is that the mechanism would be decreasing the rate of metabolism of the tricyclic.
>
> Not necessarily...cuz the Prozac INCREASED the metabolism of the tricyclic.Nope. Prozac inhibits the metabolism and clearance of tricyclics. That's (probably) why you were getting more side effects: because the nortriptyline wasn't being transformed into inactive metabolites.
> Right. But a drug that takes 6 months or even 2 months wouldn't be right for me. Not if I have any choices left. I'm going back to college in 6wks and I need to get this ironed out if I want to be successful. So we need to find an anti-anxiety med that works for me, in the next 6-8 wks.
I hope so. I tried living in the fast track for a while, never taking breaks; it ended up not working out.
> I'm almost positive it was RN. And can't Registered Nurses prescribe?
No. Nurse practitioners can, though.
> I had one before, but I don't know if she checked with the doctor behind the scenes or not.
She did.
> They might be allowed because of the scarcity of doctors with volunteer tendencys. We [poor people] don't stop needing meds just cuz some doctor would rather play golf, and I'd hope the rule-makers would realize that and allow for it.
That's what Medicaid is supposed to be for. HMOs try to use nurses and physicians' assistants to cut costs too; that doesn't make it right.
> *laugh* I won't. And she didn't say that it was too addictive to be used, or too addictive to be used for anxiety, just that she would be uncomfortable prescribing it to someone she'd just met, in the absence of any history besides my intake paperwork.
Ahh. You just said that she'd said it was "too addictive." That made her sound pretty benzophobic. :-)
> I suspect that once she's gotten to know me a little and perhaps called for my records, she'll be much more comfortable (since I don't have _any_ history of substance abuse).
Yeah, being open and honest, letting them see your records and talk to past docs, etc. really helps them feel like they can trust you.
> I know. And I phrased that badly but I couldn't think of a better way to say it. I could have stuck with a MD who didn't know their stuff. But I'd rather have someone "lesser" who was more knowledgeable and open to trying different combos.
And to be sure, some non-physicians probably do know enough that they can prescribe safely. But it's sort of sleazy for them to do something that's really outside the scope of their practise. Also, the doctor who's signing off on these prescriptions could get in serious trouble if anything bad happened.
> (we even discussed the use of Zyprexa for my ruminations...when I suggested that to the MD before she looked like I'd suggested beheading chickens by moonlight!!)
Zyprexa is *awfully* sedating.
> Like I said, she didn't really mistreat me or dismiss the idea of Klonopin altogether, just used her judgement and knowledge to gently nudge me towards a less-addicting drug, at least until such time as she feels comfortable giving me something like that.
And like I said, that makes more sense.
> > Withdrawal symptoms aren't the same as drug addiction.
>
> Funny you should say that. I'll have to do some research of my own, cuz you seem fairly knowledgeable and so does the lady I saw.I'm sure she is.
> But one of you thinks it's addictive (yes, REALLY, requiring more and more to get same effect!) and one thinks it's not.
Tolerance isn't the same as addiction, either. (The definition I'm using is the one in DSM-IV, "substance dependence.") Anyway, I wouldn't say that Klonopin is not addictive at all, but I think the risk is minimal. I *don't* think you should have to wait several weeks for Buspar to kick in (or some other antidepressant that could make your anxiety worse before it made it better).
> WOW, how do you get a doctor to speak personally on the phone?? Do you pretend to be their mother or something??
< g > No, I just leave a message saying I'm looking for a psychiatrist and would like to speak to them to find out if we'd be a good match.
> I've never spoken to my doctor directly on the phone, I always talked to her nurse.
I see a psychiatrist who's in private practise. If I leave a message he either calls me back or gives his receptionist a message to give to me and she calls me back.
> *chuckle* If you take the point of view that attitude and consideration are as important to competence as knowledge, then there's a LOT of incompetent folks practicing!!
There sure are!
> Unfortunately, I don't think they test for people-skills in med-school. :P
Not that I know of, nope.
[re medical records:]
> Oh, I think (but don't remember) that form was in the intake paperwork somewhere, cuz I know they need a signature for that. So anyway, she WILL have my records I hope, but I didn't fill out intake papers til I got there, so she couldn't have it for first appt.Ahh, that makes sense. Hopefully your records aren't full of glaring errors, so they will actually give her a good idea of what your story is rather than a distorted one!
> Of course I can't be in her head, but I think that if nothing else worked and I had no more options left, she wouldn't just say "deal with the anxiety and ruminations" and ditch me. :P
> If I go to her and say I'm still having these horrible things stuck in my head for days on end, she'll do what it takes. That was the impression I got. And that's what I need.That's what we all need. :-)
> > That's cool. (I think you should read about the use of higher doses for depression and severe anxiety, of course. :-) )
>
> Yes. Will do some more research on that tomorrow. :) I've decided that I'll go up to 30mg/day eventually and see how I feel then.30 mg is enough for some people. I'm worried that it will take too long to work (especially if you're increasing the dose slowly) and you'll get impatient and want to give up on it, and then you'll be back to square 1.
> > They look like little white coffins, don't they?
>
> Umm...not to me. They're strips divided by 5mgs, scored into thirds, but then there's a side-score for breaking them in halves.Those are the 15 mg ones, then? I was thinking of the 5's and 10's.
> > > I'll probably stick with just 10mg/day until then (4 more days!).
>
> > That's a sensible idea, assuming you can afford to take the time.
>
> Well, the other meds will be done then, and it's 3 wks til the next appointment.Wow. If you only have six weeks to lick this thing, you're cutting it close.
> So I'll have two weeks to figure out about BuSpar and if it has _any_ effect then I can stay on it and up-dosage.
The problem with that is that 15 mg isn't really all that likely to do anything. So if you base your decision on whether 15 mg helps, you're most likely just going to give up on it.
> > (Taking more Klonopin than is needed just makes me more likely to fall asleep).
>
> *laugh* that's what I wanted Klonopin for. But I do know that I can take herbal sleeping pills and sleep okay most of the time, too.I never got anything out of "herbal remedies" -- other than morphine, of course. Which one(s) do you use?
> And if I was already on them and they worked for me, she might have been more apt to keep it going. I can't imagine a doctor refusing to refill a scrip for something you're already on...that's terrible.
I moved recently and I had a hard time finding a pdoc in the area who would consider prescribing buprenorphine, which I really need.
> If there's anything I've learned in my time on this board and dealing with psychiatric meds, it's that if you've got a good thing, go with it!
I'll drink to that! (err)
> > Let's hear it for samples! (I got my month's worth of Remeron that way, too.)
>
> *grin* yeah, I was pretty happy. She could only give me 3 wks of Wellbutrin, cuz samples are smaller packages, but the jar of BuSpar is enough to take it at 30mg/day for a month. :) So I hope it works, it'd be such a waste to throw that out.Yeah, I don't know what you can do that's legal if you have pharmaceuticals that you don't want to waste but for which you have no use. (If "legal" isn't of concern to you, you could give them to someone else who needs them, of course.)
> > Say, isn't there generic buspirone now?
>
> Yup. But the savings isn't extreme. It's $120 for brand-name and $96 for generic.I think it's like that when drugs first go generic: the generic is almost as much as the name brand. Once there's more competition -- once more companies are marketing buspirone -- the prices of generics will go down.
Desipramine is cool because it's *cheap*.
> I'm tired out. G'night. :)
And g'day to you!
-elizabeth
poster:Elizabeth
thread:70523
URL: http://www.dr-bob.org/babble/20010714/msgs/70928.html