Psycho-Babble Medication | about biological treatments | Framed
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Psychiatrists...

Posted by Questionmark on May 11, 2004, at 15:24:32

In reply to Re: Why MAOI's rarely prescribed, posted by cybercafe on May 11, 2004, at 9:01:26

harryp said:
> > The studies that exist seem to indicate that MAOI's are the most broadly effective AD's around, and they have a good side effect profile (esp. Parnate--which may have the best SE profile of any AD).
> >
> > The "fly in the ointment" is the risk of hypertensive crisis. There have been only a few cases where an untreated crisis caused a stroke or death, but that's enough to make doctors terrified of prescibing them.
> >
> > Psychiatrists loved the SSRI's because they could be prescribed like candy, with almost no liablity concerns. It's very hard to kill yourself with an SSRI!
> >
> > Part of the problem with MAOI's is that psychiatrists tend not to trust their patients, and they are afraid that their pt. will not pay attention to diet, have a crisis and just take aspirin for it, and possibly get a stroke.
> >
> > In practice, avoiding the problem foods and drugs is not hard, and if you get prompt treatment for a hypertensive crisis it will not do you any harm.
> >
> > The main problem is that you have to be careful when traveling. Carrying a copy of your medical chart with instructions from your doctor wouldn't be a bad idea, because many ER staff haven't seen a MAOI-hypertensive crises before, and may have trouble figuring out what's going on.

Those are such great points.

Cybercafe said:
> i went to the states to pick up some abilify.... it's been a wonder drug for me... and apparently the states has no walkin clinics for family doctors/general practictioners like we do in canada... but i did manage to find a special mental health walk in clinic..... so i asked them for a perscription for abilify since i saw them once before a year ago and they said it would be okay... they said no.... i said fine, i'll see a doctor and they can evaluate me.... and they gave me some long story about how you have to pay to $300 to see a counsellor and doctor every 2 weeks if you want medication...
>
> so i just told them i would wait for my antipsychotic to run out, then i would come back when i'm in a manic rage and they could deal with me then :)
>
> i ended up seeing a doctor, and had no problem getting abilify.. but was told how wrong it was that i was taking parnate .. no one takes that anymore apparently... my response was to just stare at her like she was a retard... though i'm thinking an alternative reply would have been to say .. "and in the UK they perscribe antipsychotics rather than benzos for anxiety but i don't think either country has psychiatrists who know what they are doing" ....

So true!
And when are psychiatrists going to learn that what is popular and common is NOT necessarily right and best!!! Yeah, lobotomies, excessive use of ECT, and horribly high-dose use of typical antipsychotics were once used all the time this last century, and now we (or anyone with any sense, at least) look on that with disgust and incomprehension. So why do psychiatrists think that all of toDAY's most popular treatments are fine/right/best?!!!!!!!!!!!! IDIOTS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Sorry. It just infuriates me beyond expression to hear how so often psychiatrists (those who are suppOSEd to be some of the most knowledgeable people when it comes to treating mental disorders with medications) will refuse to prescribe an MAOI or think it's senseless to do so and yet they will presribe atypical antipsychotics (usually in too high a dose as well, esp.ly since in my opinion those w/out a psychotic disorder require much less AP even if it would help them) to their patients for anything and everything. i just want to round them all up in a gigantic room and scream logical truths at them from the bottom of my lungs.
Ah, sorry again.


KittenCat said:
"I love all your posts! Thanks for the humor, guys...it really helps. And I feel guilty that my doctor just blithely handed me $450 worth of Abilify, & I'm considering throwing it out."

Don't throw it out. If you can't at least give it back to your dr (which is probably the case) then you should at least save it. You might find someone you know who takes Abilify and you could sell or give it to them. Er, no, i didn't say that. But yeah, save it just in case. You never know if it might come in handy somehow. (And that's alotta money to ditch).

"The diet sounds fine for me for an MAOI...I don't eat or drink any of those things, normally.
By the way, my doctor's response was similar, after I burst into tears when he told me I needed Zyprexa. "KittenCat!" (ok, ok, I know). "I think we may be on to something here!! Try these pills...take 15 mg a day...it will stop your bipolar!" "But doctor, I'm not bipolar...I'm just really, really depressed...I don't think I'm psychotic...plus, I'm a ballerina & can barely get off the couch. I need to be a million pounds underweight...won't these make me gain weight??" "Well, just give 'em a go and see...then we'll go from there". Awesome. So when I'm fatter than ever & puking my guts out every day, in between my four hour medication induced naps, will that be enough to convince him I don't think this is right??"

That story infuriates and enrages me more than i could even begin to explain. How STUPID must your doctor be to prescribe you 15mg Zyprexa deSPITE everything you said to him/her? AH!!! Don't take it. Seriously. If you're not bipolar or schizo-anything or psychotic, don't freaking take it. It's not worth. Why waste your time with something that will inevitably do nothing but make you feel like crap for various reasons? i told my good (OCD and neurotic) friend this when he was seeing a moron of a psychiatrist that i used to see and he kept prescribing him antipsychotic after antipsychotic. Then my friend would go back to him and complain about how bad he was feeling, and the dr would either just lower the dose, switch to another AP, or tell him that it's not going to work if he doesn't have patience and give it an adequate chance (and this is all while he is feeling like absolute S**T from these drugs!!!)!. He went from Zyprexa to Risperdal to Abilify, and THEN, to the typical antipsychotic Loxapine, which he likened to torture. During this time, the only other med changes that occurred were taking him off Paxil near the beginning (which another stupid dr had prescribed him), adding low dose Klonopin at his request (as i suggested), and, when he complained about how bad he was feeling and how lethargic he was, and how he wanted to just try Klonopin for a little while, the stupid idiot took him OFF Klonopin and kept him ON Risperdal!!

Take a stand people! You are the patient and the client; you are paying the money; YOU are the one taking the DRUGS-- do not allow them to prescribe you something that you are adamantly (and knowledgeably) against. Ask for what you really think is necessary (such as quitting an AP or what have you) and do not back down. Tell them to just listen to you for a minute, then tell them the reasons for why you believe what you believe, and then if they are still arrogantly and ignorantly stubborn, then tell them that if they continue to act so foolishly (or whatever) then you will look for treatment elsewhere-- in as kindly but assertive manner as possible. Okay, i know how unrealistic this is considering that good doctors are hard to come by and you have to wait so long to even get another appointment with a different one, but still, stand up for your rights.

i WISH SO DESPERATELY THAT EVERY PSYCHIATRIST WOULD HAVE TO TRY BEING ON A DRUG THAT DID NOT MESH WELL WITH THEIR CHEMISTRIES AND THEREFORE GAVE THEM HORRIBLE SIDE EFFECTS-- ANY KIND OF PSYCHIATRIC DRUG THAT IS PARTICULARLY UNSUITABLE FOR EACH OF THEM-- AND THEN BE TOLD THAT THEY HAD TO STAY ON IT FOR A MONTH OR SO LONGER TO SEE IF IT EVENTUALLY STARTS TO MAKE THEM FEEL BETTER. i think the compassion and intelligent decision-making of psychiatrists would then be increased tremendously.

Goodness. i've wasted another half-hour of my life on another fruitless rant.

"Bugger. Well, today is fourth day on 3.75mg Abilify. So far I don't feel abilified to do anything except sleep, but I have committed to one week. Or two. Not sure.
You guys are great! Thanks..."

Oh, well at least you're off Zyprexa now. 3.75mg is a pretty low dose too. i've heard mostly good things about very low dose Abilify though. i hope it works out for you.


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Psycho-Babble Medication | Framed

poster:Questionmark thread:345262
URL: http://www.dr-bob.org/babble/20040510/msgs/345811.html