Posted by mtdewcmu on November 22, 2009, at 23:19:52
In reply to Re: you're right - your pdoc is a jackass » PC_Load_Letter, posted by Girlnterrupted78 on November 14, 2009, at 7:06:31
> Thanks so much for the support and understanding of my situation.
>
> Unfortunately I cannot afford a different doctor. I have seen others in NYC, and this is by far the best. He's seeing me for free because I participated in a study at Columbia U/NY Psychiatric Institute, and part of the remuneration was 6 months of free treatment--so he's supposed to be very good at what he does, and he's getting grants in the millions to continue to do research on treatment-resistant depression, so just go figure.
>
> And so far he was good enough to get me out of depression after 7 years of trying with other doctors, he put me on Parnate after another doctor (a really bad one at that) had refused to, because he said "If Nardil failed, Parnate will too.."
>
> So he's supposed to be good. I just don't get his sudden change. I mean, why??? If he never said I was "too good" while I was on remission (or very close to remission) why then is he saying it now that the effects diminished and the symptoms are returning?
>
> I have no choice but to stick with him.. I just hope he won't drop me for dumping all the anger I have inside on him. I sent him two honest yet angry emails already, and he's responding professionally and telling me we will discuss this next time we meet.
>
> Thanks again
>I think you are probably right when you guessed that he said you were "too good" in order to lower your expectations. My pdoc likes to say "the perfect is the enemy of the good" when I tell him about side effects that I am having, as if I am just being too picky and difficult. Well, I have finally found a combination that is working quite well, and I feel good. So it turns out I was not being too difficult after all. I can't wait to tell him.
I don't know that much about your situation and what meds you've tried, but I gather that you are on Parnate and Adderall, at least. It seems like there are plenty of options for how you could modify that regimen. First, have you tried skipping your Adderall for a while? Drugs are funny in that many of them can cause the exact opposite of their typical effect. So, whereas Adderall makes a lot of people feel euphoric, it can also make you feel dysphoric. So why not see if that one is working against you? Secondly, have you tried adding some Abilify? Abilify was fairly recently approved as an adjunctive treatment for depression that is resistant to typical antidepressants. Also, what about Remeron? I started Remeron a few days ago, in addition to my other meds (Zoloft, Abilify, Wellbutrin), and I have been feeling good since. Unless you have tried everything else, there is no need to resort to tricyclics, much less give up hope.
poster:mtdewcmu
thread:923267
URL: http://www.dr-bob.org/babble/20091117/msgs/926637.html