Psycho-Babble Medication | about biological treatments | Framed
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Re: pdocs as the gatekeepers to meds

Posted by greenhornet on November 19, 2005, at 15:41:27

In reply to pdocs as the gatekeepers to meds, posted by Laurie Beth on November 18, 2005, at 14:49:02

Since I do have a life beyond "Babble", I totally missed this discussion and the article that stimulated it. I have just finished reading all of the posts about the issue. Whew, try that sometime!!
1.My "family doc" "monitors" all of my medications, psych and otherwise because he and I feel that he knows me better all around. He knows my body, my illnesses, etc.
2. The psychiatrist that I saw his time around saw me for a year and then made it clear that ANY physician could do what he had been doing - and in fact, some could do it better!
3. One can sometimes become TOO close to an issue, and therefore probably should NOT prescribe for family and/or friends. (It may not have become clear by now, but my husband and two of our sons are physicians, and a very firm rule in this family has been for forty years, no matter how tempting, NEVER WRITE A SCRIPT FOR A FAMILY MEMBER!!!
4. No offense to anyone on the board, but I would hope that everyone realizes that journalists ALL have agendas and preconcieved ideas when they choose to write an article/book.

It's a good discussion, and without a doubt, Dr. Bob offers a valuable service via the internet. Whether we agree with him at all times or not, he does so with relative objectivity!

> "many of todays shrinks are highly skilled drug pushers"
> I agree, with the exception of the part about "highly skilled." ;-)
> Okay, don't really want to be pdoc bashing here; I'm partly kidding. I feel frustrated lately because, among other reasons, my pdoc pretty much tells me at every visit, as I try desperately to figure out whether a drug will help me, or dramatically and possibly irreparably harm me, BEFORE I take it, that there's simply no way to predict individual reactions to specific medications, and it's just gonna have to be trial and error. Okay, fair enough, and thanks for the honesty, but then ... ummm ... why do I need him?
> I'm not impressed by the psychiatrist blog and responses mcd cited above. Most of these pdocs seem to react to patient concern about psychiatrists condescending to them and not listening to their perceptions of their illnesses and the effects of meds (which are, after all, first hand!) with more condescension and more refusal to listen. I'm sure that there are good pdocs out there (that guy Sobo, whom I read after seeing him mentioned somewhere on psychobabble, at least seems very thoughtful about individual cases), but there seem to be a lot of them that simply don't listen or care much about individual experience, despite all this jabbering about how "dangerous" it is for patients to self-prescribe and how subtle all the pdoc decision-making about meds is. The pdocs cited above make it sound like it's bipolar *patients* who are doing most of the self-prescribing of antidepressants, leading to manic reactions. I'm not a reporter and haven't done adequate research to back up this claim (!), but I am sure that far, far, far more patients have been pushed into mania, hypomania, or some kind of akisthetic (word?) crisis by prescription antidepressants legally obtained from MDs, whether generalists or pdocs, than have done the same by self-prescribing. And yet, it's made to sound the opposite.
> And as far as the strict supervision that pdocs are supposed to be doing to assure that patients take effective meds in a safe fashion ... mine just this month gave me a Wellbutrin sample (despite the fact that I'm already suffering from irritability and some obsessiveness and have said so), told me to finish the 7-pill pack and then absolutely positively to call him before proceeding ... then disappeared out of town for 10 days (probably to give speeches, though I don't know this - sometimes I wonder if he's having some kind of emotional crisis of his own) with no one covering for him. So I don't have anyone but myself to consult about whether I should continue a med that doesn't seem to be helping and may possibly be increasing feelings of rage. Fortunately or unfortunately, the staff just complied with my request to call in a continuation of the med so I didn't have to go cold turkey just because he had disappeared. But that means I *am* "self-prescribing" - unwillingly in this case. It seems like it's absolutely crucial that pdocs carefully supervise administration of prescription psychiatric meds ... unless it happens to be inconvenient for them.




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