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Saw Pdoc twice, why refer to psychopharm? (Long)

Posted by AnneL on October 2, 2001, at 22:04:11

Hi to all,

I went to my GP in March due to a depressive episode that I believe was of a situational nature. He thought Effexor and Klonopin for sleep would be good to try. Went to a pdoc just to "make sure" that I was on the right course and no changes were made. GP said see you in six months or sooner if you need to. Fine.

At that point I was at 150 mg. daily and doing OK until
I started the birth control pill about 3 months ago and started feeling really depressed. I didn't entirely connect the Pill with the change in my mood and went to this new Pdoc I am currently seeing. The way he practices is very different in that he wants the family to be involved (my husband and my teenager) and also wanted to see us once a week x 4 weeks. It sounded at the time to be excessive, but I kind of shrugged it off. The first thing he did was to increase my dose from 150 to 225 mg. which I thought was very reasonable. I did stop the Pill and started the increased dose at the same time and felt much better. Was it the Pill or the increased dose or a combo? I don't know and don't care, I just felt better! Because I thought his plan of care was excessive and unnecessary, I just never bothered going back. That was 2 months ago.

I need to mention, however, that this Pdoc is a very good friend and colleague of my boss who is a very famous physician. I won't name names or his specialty, because thats not the point. The point is I did go back to this Pdoc last Friday because I thought I was getting into trouble again, nothing major, but some of the signs were there (sleeping too much, etc.) and although I know that these symptoms could be caused by my new progestin containing IUD (Mirena Levonorgestral releasing 20 mcg/day IUD) which
is in a last ditch effort to control my bleeding and therefore avoid a hysterectomy at age 41 and/or my really nutsy family problems (Mother and Sister thing).

The Pdoc admitted that my family situation sounded like a good one for "Ann Landers" which I interpreted as maybe a good therapist would be helpful. He was very concerned that I was on the right med and wants to refer me to a psychopharmacologist. He did not want to raise my dose and said he would call me during the week to get me an appointment with this so-called very reknown Psychopharmacologist, my husband and myself to assess my current medication regimen (Effexor 225 mg. plus Klonopin 1 mg. at bedtime). I had the weekend to think this over, plus had an absolute productive time talking over my mother/sister thing with my Dad and started thinking isn't this just a little too excessive? I mean I am functioning well, I go to work, like my job, just have one sore spot and that is the loss of my relationship with my youngest daughter which I'am sure will get better over time.

So I faxed the Pdoc a really nice letter (remember he is a dear friend and colleague of my boss) and said that I was going to give therapy a try before I consult with yet another physician and thanked him for his kindness and yada yada yada. I thought that was that and then when I get home from work there is a really nice message from the Pdoc saying he got my very nice letter and I have every right to fire any doctor, etc., but that he really wants me to reconsider seeing the Psychopharmacologist and invited me to either call him back or gave me the option of calling this other physician directly and gave me his number.

Now I am all confused. Is this excessive? Aren't Psychopharmacologists for treatment resistant individuals or for those who have had many trials of meds with problems with side effects, etc. Am I being overly paranoid? Part of me feels that because I am working for someone he really admires professionally and personally that he is really going overboard. Flattering, perhaps, but it makes me feel scared, like maybe I'am not doing as well as I think I am. Thanks for any and all responses and sorry that this is so long. :) Anne




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