Posted by finelinebob on May 7, 2004, at 23:09:20
In reply to Pdocs?, posted by Angel Girl on May 7, 2004, at 20:23:56
Figuring out whether they work. It's not a simple task, because meds can be a shotgun approach to a delicate problem.
Since there isn't any test that can tell your pdoc whether a med is "working" or not, they need a lot of data from different sources. Even when there is a test -- I take nortriptyline, which has a fairly well established therapeutic window determined by blood levels, from what I've been told -- it doesn't mean that a particular med is addressing what needs you have.
The more information you can share that tells your pdoc how your meds are influencing how you feel and how you behave, the better she can determine how to proceed -- raise or lower dosage, change meds, add a med, whatever. Being a medical doctor specialized in psychological issues, hopefully she can bring more than writing scripts to the table. For instance, my current pdoc wants me to start exercising (I've been a real troll the last 6 months or so!) before considering some other changes in my meds, largely because exercise and physical activity have psychological benefits that will probably have a bigger impact on me right now than tweaking my med levels.
Of course, he wouldn't know I needed that exercise if all we talked about was my med levels and whatever physiological or acute psychological issues had come up since the last time we met.
The pdocs I've worked with, I've tried to give them the big picture about my life -- I wasn't going to rely on them for any sort of analysis, but I wanted them to know (and they wanted to know) how well I played with others and how well I, um, was getting along with myself. Keeping a journal specifically about your thoughts on how your meds are working might be valuable, since (a) you probably don't want to share anything much more "personal" and (b) having a record of how your med responses change over time is the sort of information that pdocs find helpful. Writing it down is a lot more reliable than thinking you'll remember accurately, especially when your state of mind is fluctuating.
The bottom line is that doctors need data to do their jobs. Psychopharmacology is nowhere near "advanced" enough to hook you up to a machine, get some sort of print-out, then consult some dosing schedule to figure out what meds you need.
Then again, if you feel up to it you can always ask your pdoc straight out what sort of information she likes from her patients.
hth, flb
poster:finelinebob
thread:344553
URL: http://www.dr-bob.org/babble/psycho/20040503/msgs/344620.html