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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by rjlockhart04-08 on August 18, 2011, at 17:38:53
Alrighty. I think I see my doctor in week or 2 weeks. The strattera she prescibed me is not working. I am still going to give it 2 more weeks but I really am disappointed that I am treatment-resistant with alot of medications. The only ones that do work are Wellbutrin and Stimulants. I'm going for the wellbutrin in this next session and I have to be aware that she may say no. But what should I say to a doctor that believes wellbutrin can give me anxiety and is maybe not the correct medication for my condition in this case.
I already her about Parnate and she told me its very old medication that is usally used at the last ends of antidepressants. And it's complicated because you can't eat many foods and it has side effects that are serious. SO...all I have to do is just talk her into it. But I'm not going for Parnate. I'm going for Wellbutrin at its max dose. It's gonna be difficult but what should I say to her? I've been thinking about this for a long time.
Just some tips of what I should say in session. Rerember this doctor is stuborn and avoids many medications. Yes, I will dump her in time but she's my doctor right now.
Thanks for anything.
Matt
Posted by policebox on August 18, 2011, at 20:32:17
In reply to What to say to a doctor that avoids medication, posted by rjlockhart04-08 on August 18, 2011, at 17:38:53
Although it can be frustrating for us as a patient, I think it is the correct course of action when beginning anti-depressant drug treatment with someone, to start with the medications that treat the depression and are also the safest (when I use the word "safest" I mean whose side effects are the most tolerable and that taking the medications aren't complicated).
This is going to be the SSRI class of medications most frequently. If one of those doesn't work, it's generally prudent to try another SSRI. If monotherapy on an SSRI fails, then it's generally prudent to try to augment the SSRI with another drug.
If after these trials the depression fails to satisfactorily remit, that's when I'd say it's time to try Wellbutrin as an augment to the SSRI.
Typically after trying a few things involving Wellbutrin, if the depression fails to remit, one of the tricyclic/tetracyclic antidepressants should be tried. Again, as with the SSRIs, there are several tricyclic/tetracyclic drugs to choose from, so you will want to try one or more of these, along with augmenters, to see if you can get the depression to remit.
If that fails, it's appropriate to then begin a trial on one of the MAOis. Again, there are several of these, so it's worthwhile to try one or more.
To jump right into an MAOi is akin to trying to kill a fly with a cannon. Also, wanting to jump right in at a maximum dosage isn't a good idea. "More" does not necessarily translate into "better". There are many drugs which are actually less effective at high doses than lower doses. Plus, increasing the dosage too rapidly can contribute to the medication failing to work or working for a while and then "pooping out".
I understand that when you don't feel well and you feel life kind of slipping away, the urge is to try to fix things as soon as possible. Unfortunately, psychiatric medicine is still in its infancy. It has some powerful tools at its disposal, but much of it, like all branches of medicine, is a guessing game. My advice is to try to be as patient as possible and give every new medication combination a fair trial, meaning at least a month. If the medication helps your depression, but you are experiencing side-effects that are tolerable, then try to stick it out that whole month. Generally the side-effects will go away as your body gets used to the drug. If not, there might be augmenters you can add to treat them. Of course, if you suffer any life threatening or dangerous side-effects, you should consult your doctor immediately.
I wish you all the best.
Policebox
> Alrighty. I think I see my doctor in week or 2 weeks. The strattera she prescibed me is not working. I am still going to give it 2 more weeks but I really am disappointed that I am treatment-resistant with alot of medications. The only ones that do work are Wellbutrin and Stimulants. I'm going for the wellbutrin in this next session and I have to be aware that she may say no. But what should I say to a doctor that believes wellbutrin can give me anxiety and is maybe not the correct medication for my condition in this case.
>
> I already her about Parnate and she told me its very old medication that is usally used at the last ends of antidepressants. And it's complicated because you can't eat many foods and it has side effects that are serious. SO...all I have to do is just talk her into it. But I'm not going for Parnate. I'm going for Wellbutrin at its max dose. It's gonna be difficult but what should I say to her? I've been thinking about this for a long time.
>
> Just some tips of what I should say in session. Rerember this doctor is stuborn and avoids many medications. Yes, I will dump her in time but she's my doctor right now.
>
> Thanks for anything.
>
> Matt
Posted by Christ_empowered on August 18, 2011, at 20:47:07
In reply to Re: What to say to a doctor that avoids medication, posted by policebox on August 18, 2011, at 20:32:17
Its weird to me that your doc would give straterra a thumbs up and say no to wellbutrin. My ex-shrink was the opposite; straterra was a no-go and wellbutrin was offered as a possible augmenting drug. That's one thing that bothers me about psychiatry--lots of it is based on opinions, not so much facts.
I would think that if you kept at least some zyprexa on board then there would good synergy between the zyprexa and the wellbutrin. That combo is sometimes used in psychotic disorder patients to help with cognitive problems and negative symptoms.
talk to your doc. Good luck.
Posted by Zyprexa on August 18, 2011, at 20:54:09
In reply to What to say to a doctor that avoids medication, posted by rjlockhart04-08 on August 18, 2011, at 17:38:53
Tell her that wellbutrin will wake you up where zyprexa is putting you to sleep. Thats why my doc prescribed wellbutrin to me.
Didn't you try wellbutrin in the past and said it didn't work like the adderall?
Remind her that wellbutrin is a non addictive stimulant.
Posted by Zyprexa on August 18, 2011, at 21:02:50
In reply to What to say to a doctor that avoids medication, posted by rjlockhart04-08 on August 18, 2011, at 17:38:53
Matt
If you are not ADD, then why in the past did they give you ADD meds? Like Adderall.
Posted by rjlockhart04-08 on August 19, 2011, at 0:27:35
In reply to Re: What to say to a doctor that avoids medication, posted by policebox on August 18, 2011, at 20:32:17
Your post is very professional. Thank you!!
I've been on Wellbutrin in the past and it did work but I was moved to stimulant which was vyvanse. I currently take 60mg of Prozac daily. It's lost its effect but im telling you this doctor that I see is complicated because she argues with me that I'm not depressed even when I tell her that I am suffering with depression. She's a bully. I want to get away from her. But then there's ANOTHER bully called my mother who manipulates me if I want a car I have to do what she says. I am in very tough situation. 2 bullies who want to make life difficult. She thinks the Wellbutrin is going to affect my anxiety levels.
But back to what you where saying. Yes Prozac was given to me in 2006 for depression and it worked very well until 1 year ago when it pooped out. I am treatment resistant to some medications. Depakote. Strattera. Vistiril, Intuiv, Prozac which was not till a year ago. I wished Psychiatry had more options to choose from. The stimulants where effetive. I can't use them right now. It's really a difficult situation but ill get through it.
Regards,
Matt
Posted by rjlockhart04-08 on August 19, 2011, at 0:32:22
In reply to Re: What to say to a doctor that avoids medication, posted by Christ_empowered on August 18, 2011, at 20:47:07
Yea. It's her opinion that it causes anxiety. It's not fact and I have deal with this person's b*llsh*t of thinking she knows everything medicine and me. The Zyprexa has lost its effect on me. BUT I'm not saying its not effective, it just lost alot of its sedation it used to give me.
I'm losing alot of motivation and I need to stop blaming my doctor because she is the way she is. She's not going to change and I need to get a diffrent shrink if my life depends on it.
regards
matt
Posted by rjlockhart04-08 on August 19, 2011, at 0:37:28
In reply to Re: What to say to a doctor that avoids medication, posted by Zyprexa on August 18, 2011, at 20:54:09
Trust me. If I tell her the zyprexa is making go to sleep all she will do is lower the dose or take me off it. Where dealing wtih egomaniac that thinks she knows everything and puts my mental health at stake because she thinks her opinion is right. I hate the treatment. Now I do have some motivation to ditch her and get a good doctor. I mean she's has awards and maybe other people think shes a good doctor but im so sick of arguing with her about stuff she should treat as a doctor.
Posted by rjlockhart04-08 on August 19, 2011, at 0:49:09
In reply to Re: What to say to a doctor that avoids medication » rjlockhart04-08, posted by Zyprexa on August 18, 2011, at 21:02:50
I do have ADHD. I was diagnosed when I was 11 and then again 17 and they gave me adderall XR for the conditions. I began abusing it when I was 17 and it lasted till 22. My current doctor doesnt think I have it. She thinks because of this testing she did she found out I have schizo personality disorder and low processing speed which basically means with out the big words that I'm stupid and it takes a while for me to learn and adapt to infomation. And then she won't treat it because she even know how to treat low processing speed. She told me "i can't do anything" well of course she can't do anything because her opinion overrides the facts and she's flat out stuborn.
I hate opinions. I love facts. I indulge in solutions. But I havent found any yet.
But listen im just very frustrated about this and I don't want to waste people's time. It is what It is. Someday maybe ill be free to go where I want and talk to who I want without being controlled by my mother. I was hoping this website could like give me some facts on how to get out of here but they did many years ago and I didnt listen. It's a cycle im trying to break. But listen thank you for your time and your post. It is appriciated:::)))
regards,
Matt
Posted by ron1953 on August 19, 2011, at 13:09:55
In reply to What to say to a doctor that avoids medication, posted by rjlockhart04-08 on August 18, 2011, at 17:38:53
What to say to a doctor that avoids medication?
"Thank you"
Posted by Christ_empowered on August 19, 2011, at 13:27:10
In reply to Re: What to say to a doctor that avoids medication, posted by ron1953 on August 19, 2011, at 13:09:55
dude, your doctor sucks. I had a counselor who tried to pull that personality testing crap on me. If you're doped up, of course you'll come back stupid. Its common sense AND she just doesn't want to give you anything that might make you feel good.
Now..I think you take too many drugs and you focus way too much on this issue. Try to self-taper (my advice) and lower your meds a little bit. A new doc will only help so much; awards and BS aside, they all do pretty much the same thing.
Good luck.
Posted by rjlockhart04-08 on August 20, 2011, at 0:18:16
In reply to Re: What to say to a doctor that avoids medication, posted by Christ_empowered on August 19, 2011, at 13:27:10
<<<<<<<<<<dude, your doctor sucks. I had a counselor who tried to pull that personality testing crap on me. If you're doped up, of course you'll come back stupid. Its common sense AND she just doesn't want to give you anything that might make you feel good. >>>>>>>>>>>>>>>
I'm not doped up. Why do you think im doped up? This is an addiction specialist. Her whole name means a non narcotic specialist. These are my medications
Prozac 60mg
Zyprexa 20mg
Clonodine .1 x twice daily.
This is not a good cocktail with me and I'm tired of wasting my time trying to explain to people whats wrong. I need to know "how" to tell her to get me on Wellbutrin and off Prozac. I don't think you understand how hard each day is with me but I'm sure you do understand.<<<<<<<Now..I think you take too many drugs and you focus way too much on this issue. Try to self-taper (my advice) and lower your meds a little bit. A new doc will only help so much; awards and BS aside, they all do pretty much the same thing.>>>>>>>
I am not on too many drugs. I only take 3. And don't work worth a danm. Sure yea I would ditch these meds certainly because what do they do?? zero. I actually wanted to know how could this board help me get away from my doctor and get to new one. I HATE my doctor. All of this stuff I wrote is so that you can understand whats going on. I have to get away from this house and my doctor and I don't know how im going to do it. It's very frustrating being stuck.
Thank you for your time.
regards,
Matt
Posted by Zyprexa on August 22, 2011, at 1:57:08
In reply to Christ Empow, posted by rjlockhart04-08 on August 20, 2011, at 0:18:16
You know you could take over the counter diet pills. A lot of them are stimulants!
Posted by rjlockhart04-08 on August 24, 2011, at 17:41:32
In reply to Stimulants » rjlockhart04-08, posted by Zyprexa on August 22, 2011, at 1:57:08
I take Stacker 3 sometimes but I hate it because of the anxiety it gives.
Posted by Chris O on August 26, 2011, at 9:30:05
In reply to What to say to a doctor that avoids medication, posted by rjlockhart04-08 on August 18, 2011, at 17:38:53
Rich:
My name is Chris. I've read your posts many times on this board, and found them very moving, but have never responded to you before.
I think you should get a new psychiatrist. It is ridiculous that she is arguing with you, especially when you are depressed. I know the feeling. I have seen psychiatrists like that. I once say someone who talked like 80% to 20% him to me. It was like going to a lecture. It's extremely unpleasant to interact with a professional who is unempathic to our situations. If she (your p-doc) is not willing to up the dosage of Wellbutrin a bit at your request, well, that's not acceptable. It's also not acceptable that she will not let you try an MAOI, as you seem to be treatment resistant and those drugs do seem to work for a lot of people who are treatment resistant. I myself fall into that category. I am currently trying one more trial of an SSRI (Viibryd) before I go to an MAOI. I wish you luck and hope that you can find someone who will treat you with the respect you deserve as a person and patient.
Chris
Posted by creepy on August 28, 2011, at 3:41:13
In reply to What to say to a doctor that avoids medication, posted by rjlockhart04-08 on August 18, 2011, at 17:38:53
Stimulating meds sure can help depression. Most folks get really good relief on adderall, for example. Problem is these sorts of drugs dont have a very long effect without dose escalation. Even wellbutrin will poop out on you over time. Ive been through 4 or 5 trials of it. It doesnt do a whole lot but my doc refuses to try other drugs.
I tried to avoid serotonin meds due to weight gain and apathy but even with all the extra energy the depression was still there. Guess I need the serotonin.
Be careful when pushing medication ideas on a doc. Some might get really resentful about it and youll wind up in a sort of counter-transference that makes the relationship unproductive. Kind of like what I have now, lol.
Wellbutrin at larger doses just gives me anxiety now. I cant go much higher than 150mg before I get super jumpy.
This is the end of the thread.
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