Posted by Louisiana Sportsman on April 15, 2014, at 20:48:18
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » LouisianaSportsman, posted by Chris O on April 15, 2014, at 15:37:50
To anyone who disagrees:
PDOCs, not so much on here which why I prefer this forum over any other, but more-so elsewhere have an almost "god-like" position.
Umm, OK, sure, I will admit that I didn't take the route the PDOC did in getting the credentials, but that's because I chose to do other things with my time. My advice should NOT EVER be taken over the advice over a patient's own PDOC who treats them, but anyone else, I don't care what degree you have, is fair game in terms of the advice game. Why should I bow down to anyone but the patient's PDOC? All I can do is give my opinion. Some forums seem to want to spank you for it. It's not I can write scripts. We're adults re.
And being a PDOC is not like some sort of revered talent or anything. I mean, pick up a book. They're human, I'm human, and I'm willing to bet that I actually know a lot more than a lot of them and vice versa. It's just how society is structured. I'm not sure why so many people would put so much confidence into a man they barely know based upon a degree from a university that they've never attended. They seem scared to even bring up counterarguments, alternative treatments, ask why this is being prescribed or what it does in depth or what you desire. It's like this man you just met is like royalty because he took some exams you didn't take.
My PDOC, however, she is awesome. I would never feel uncomfortable telling her ANYTHING. It says a lot about a patient-PDOC relationship when the patient feels comfortable enough to share the abuse of one of their medications and want to get off the script (Lyrica) and know that she would realize "hang on a sec, why would he bring this up if he wasn't genuine about wanting to get Lyrica? He's smart, he knows the game. D-amp must be therapeutic and not abusive for him." I feel like most patients would never ever tell their doctors what I told her if they were prescribed Dexedrine as well and people would say they were "stupid" if they did. That's very sad, but PDOCs have brought it upon themselves. If I admitted that to most PDOCs in the USA, I would have had my script of d-amp revoked FOREVER. I was later prescribed Neurontin by this doctor at a much lower dosage because I basically told her it was the best and that I thought gabapentin would be less abusive and that I would tell her if I abused it again. Guess what? I abused it again. Guess what? She writes Xanax XR to replace it with. Patients should feel comfortable talking about anything with their PDOC, and I felt like pointing out an extreme example. lol some people would probably stop going to their PDOC of many years if their insurance suddenly cut him or her off their coverage in a heartbeat, but not me...
Your PDOC may very well think 6 weeks is appropriate, but Brintellix is one of the faster working antidepressants. You should know rather it's going to be something that will work for you.
Significant sexual side effects with no positive anxiolytic response to compensate after 2.5 weeks? Let's get real. Your doctor is probably clinging on to six entire weeks because there may be a lack of ideas.
Looks like you need a MAOI since you've trialed all of the other options. I'm not sure Stablon is offerered where you live at, Chris?
Have you looked into the EMSAM (selegiline) patch? In terms of MAOIs, the side effect profile is less harsh and it doesn't have diet restrictions. If you remain on Brintellix, have you considered augmetation of a pramipexole to it? Both are good options.
Make sure you give the 12mg. EMSAM a chance since it acts differently at that dose.
If you don't want to fight with your PDOC, see if you can initiate Mirapex (pramipexole). It can be dosed up to 4.5mg./day and it can work in the lower dosage range too. Then with that on board, you can continue you it or not with EMSAM.
poster:Louisiana Sportsman
thread:1064210
URL: http://www.dr-bob.org/babble/20140328/msgs/1064306.html