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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 40. This is the beginning of the thread.
Posted by Brainstorm on May 21, 2010, at 13:05:31
After a lifetime of brief visits from my "dark gorilla", I was basically body slammed down to near suicide 10 years ago. The ingredients of my recovery included an M.D. psychiatrist gifted with compassion and a thorough understanding of the brain's chemistry. Eventually his practice was closed, victim as I understand it of our wonderful insurance industry's preference for general practitioners to handle this treatment on top of all else they must do. And after moving me off my SSRI completely seven months ago -- and that damn gorilla back knocking on my door harder and harder, I feel overwhelmed by this loss of my life saver -- a true professional who would have known exactly what was needed.
Posted by Phillipa on May 21, 2010, at 13:17:03
In reply to Psychiatry in U.S., posted by Brainstorm on May 21, 2010, at 13:05:31
How great it must have been to have had a wonderful doc. None on the horizon?
Posted by manic666 on May 21, 2010, at 13:21:36
In reply to Psychiatry in U.S., posted by Brainstorm on May 21, 2010, at 13:05:31
why did they take you off your med//ssri,s in generic form are cheap to buy
Posted by StillHopefull on May 21, 2010, at 16:09:11
In reply to Psychiatry in U.S., posted by Brainstorm on May 21, 2010, at 13:05:31
I have a real problem with general practitioners prescribing psych-meds. They just don't have the experience...
Be kind to yourself, Brainstorm. Hang on and this too will pass in time. If you need to get back on some meds to get through this, ask your GP to refer you to another pdoc.
Posted by Brainstorm on May 21, 2010, at 17:41:48
In reply to Re: Psychiatry in U.S., posted by StillHopefull on May 21, 2010, at 16:09:11
> I have a real problem with general practitioners prescribing psych-meds. They just don't have the experience...
>
> Be kind to yourself, Brainstorm. Hang on and this too will pass in time. If you need to get back on some meds to get through this, ask your GP to refer you to another pdoc.Thanks Hopeful. I was thinking the same thing about getting referral from the G.P.
Posted by Brainstorm on May 21, 2010, at 17:47:13
In reply to Re: Psychiatry in U.S., posted by manic666 on May 21, 2010, at 13:21:36
> why did they take you off your med//ssri,s in generic form are cheap to buy
I believe he thought that the 50mg Sertraline which he had moved me too a year earlier from Effexor to lower blood pressure was so small as to be dispensable -- and so why take it? That seemed accurate for several months, but boy, no longer.
Posted by Brainstorm on May 21, 2010, at 17:49:55
In reply to Re: Psychiatry in U.S. » Brainstorm, posted by Phillipa on May 21, 2010, at 13:17:03
> How great it must have been to have had a wonderful doc. None on the horizon?
None yet, Phillipa, but I'll do everything I can to find one -- 'cause I believe in that profession as a specialty and almost as an art.
Posted by Bob on May 21, 2010, at 19:51:02
In reply to Re: Psychiatry in U.S., posted by Brainstorm on May 21, 2010, at 17:47:13
> > why did they take you off your med//ssri,s in generic form are cheap to buy
>
> I believe he thought that the 50mg Sertraline which he had moved me too a year earlier from Effexor to lower blood pressure was so small as to be dispensable -- and so why take it? That seemed accurate for several months, but boy, no longer.
>What did your original doctor settle on that was working? Monotherapy with Effexor?
Posted by Phillipa on May 21, 2010, at 20:09:46
In reply to Re: Psychiatry in U.S., posted by Brainstorm on May 21, 2010, at 17:49:55
Very hard to find a genuinely good one. One who gives you time and listens well. Good luck Phillipa
Posted by manic666 on May 22, 2010, at 2:52:00
In reply to Re: Psychiatry in U.S. » Brainstorm, posted by Phillipa on May 21, 2010, at 20:09:46
he thought 50mg of sertraline was to small,what was he an animal vet///i take 50mg of sertraline my doc thinks im on 100mg,i keep my script that way as i can ajust it without his help if need be///even though 50mg is the starter dose lots of people are on less//its pretty sedative thats why i take 50mg ,cos im taking 2 mg of ativan as well in the morning sort of gives me the day sorted// then 2mg of ativan at 9pm covers sleep even though its 1 am before i go to bed///
Posted by Brainstorm on May 22, 2010, at 8:35:38
In reply to Re: Psychiatry in U.S. » Brainstorm, posted by Bob on May 21, 2010, at 19:51:02
> > > why did they take you off your med//ssri,s in generic form are cheap to buy
> >
> > I believe he thought that the 50mg Sertraline which he had moved me too a year earlier from Effexor to lower blood pressure was so small as to be dispensable -- and so why take it? That seemed accurate for several months, but boy, no longer.
> >
>
> What did your original doctor settle on that was working? Monotherapy with Effexor?
>
> Yes, Effexor SR which worked very well but was diagnosed as leading to high blood pressure problems.
Posted by Brainstorm on May 22, 2010, at 8:40:57
In reply to Re: Psychiatry in U.S., posted by manic666 on May 22, 2010, at 2:52:00
> he thought 50mg of sertraline was to small,what was he an animal vet///i take 50mg of sertraline my doc thinks im on 100mg,i keep my script that way as i can ajust it without his help if need be///even though 50mg is the starter dose lots of people are on less//its pretty sedative thats why i take 50mg ,cos im taking 2 mg of ativan as well in the morning sort of gives me the day sorted// then 2mg of ativan at 9pm covers sleep even though its 1 am before i go to bed///
Thank you for that perspective. Was not aware of the sedative effect but perhaps I just got used to that as being "normal". I like your term "keep my script". Who knows more about what's going on up there than you?
Posted by Brainstorm on May 22, 2010, at 11:23:31
In reply to Re: Psychiatry in U.S., posted by manic666 on May 22, 2010, at 2:52:00
Thank God, my GP's office finally put through a prescription for 50 mg Sertraline which is being filled right now. Finding a new psychiatrist won't happen until next week earliest , and I've been in a downward spiral for a few weeks, accelerating strongly the last three days. Understanding that the brain doesn't turn this thing around on a dime, still would there be any benefit to doubling my intake to 100 mg to break the fall? The pain sucks.
Posted by manic666 on May 22, 2010, at 12:25:32
In reply to Re: Psychiatry in U.S., posted by Brainstorm on May 22, 2010, at 11:23:31
now dont rush it ,less is more to start with ,let your body adapt to it or you will over cook.//i no the feeling, im simular to you //, when ill i want he largest dose possible ,but i have learned my lesson, dont overload slide your way back in an stay safe
Posted by Brainstorm on May 22, 2010, at 12:46:16
In reply to Re: Psychiatry in U.S., posted by manic666 on May 22, 2010, at 12:25:32
> now dont rush it ,less is more to start with ,let your body adapt to it or you will over cook.//i no the feeling, im simular to you //, when ill i want he largest dose possible ,but i have learned my lesson, dont overload slide your way back in an stay safe
Can't begin to thank you enough for that, manic. Just reading you say "i no the feeling" made be shiver. I just KNEW you've walked down this road too....and come back. And what you advise makes SO much damn sense. A very sincere thank you for being out there and taking the time.
Posted by manic666 on May 22, 2010, at 13:14:46
In reply to Re: Psychiatry in U.S., posted by Brainstorm on May 22, 2010, at 12:46:16
thanks my friend ,glad to help //a week on 50mg should be ok// then 100mg if you stablise on that cool stay there//if not 150 mg you can always lower as you feel better in time//you no the score, dont forget i have 4mg of ativan to //but dont go down that road if possible//i am addicted
Posted by bulldog2 on May 22, 2010, at 14:53:00
In reply to Psychiatry in U.S., posted by Brainstorm on May 21, 2010, at 13:05:31
There is another one out there waiting to help you. Just look and you will find this person.
Posted by Brainstorm on May 22, 2010, at 15:45:48
In reply to Re: Psychiatry in U.S. » Brainstorm, posted by bulldog2 on May 22, 2010, at 14:53:00
> There is another one out there waiting to help you. Just look and you will find this person.
Oh yes, I know that to be true and find no small comfort there. Thanks, bulldog.
Posted by bulldog2 on May 22, 2010, at 17:13:34
In reply to Re: Psychiatry in U.S., posted by Brainstorm on May 22, 2010, at 15:45:48
> > There is another one out there waiting to help you. Just look and you will find this person.
>
> Oh yes, I know that to be true and find no small comfort there. Thanks, bulldog.Sometimes you have to be assertive with these GPs. They may only have a basic knowledge of these meds as taught to them by a pharm. rep. Until you find a new p-doc you may be the one who has the best knowledge of what works. Sometimes you have to be assertive in a diplomatic way and tell them what you need. I agree with manic that you should start out with 50 mg of sertraline. But if you find yourself still falling you may have to move up to 100 mg for awhile until you stabilize. If you have a history of depression you may consider staying on at least 50 mg of sertraline for a long time.
If effexor xr works the best could you keep blood pressure in check with a blood pressure med?
Posted by Brainstorm on May 22, 2010, at 18:18:25
In reply to Re: Psychiatry in U.S. » Brainstorm, posted by bulldog2 on May 22, 2010, at 17:13:34
> > > There is another one out there waiting to help you. Just look and you will find this person.
> >
> > Oh yes, I know that to be true and find no small comfort there. Thanks, bulldog.
>
> Sometimes you have to be assertive with these GPs. They may only have a basic knowledge of these meds as taught to them by a pharm. rep. Until you find a new p-doc you may be the one who has the best knowledge of what works. Sometimes you have to be assertive in a diplomatic way and tell them what you need. I agree with manic that you should start out with 50 mg of sertraline. But if you find yourself still falling you may have to move up to 100 mg for awhile until you stabilize. If you have a history of depression you may consider staying on at least 50 mg of sertraline for a long time.
>
> If effexor xr works the best could you keep blood pressure in check with a blood pressure med?A series of blood pressure meds failed to do much about it, but since January I've been running and watching salt intake better. But Effexor XR was definitely my most effective medication, so maybe the question to next p-doc, as you say, is what comes closest to that but without the side effect of raising blood pressure.
Posted by manic666 on May 23, 2010, at 3:28:52
In reply to Re: Psychiatry in U.S., posted by Brainstorm on May 22, 2010, at 18:18:25
yes GP,s are a special breed///i said i need a med change because of fast weight gain an i eat f all//he said these meds dont alter your weight///ooooooooooooooo f*ck// hear i have to say it again????doc look on the leaflet an the main prob on most meds is weight an no sex////oooooooo i will have to check that out///see what i mean,i talked mine into tapper meds only srri to srri simple enough ,but not in the british guild book//he has never done it//that why i save meds i have left over //if a doc says no i do it myself//nothing dangerouse just common sence//the hospital zoo wont tapper an wave the rule book in your face like a flag//thats why im a security risk at hospital //i tell the new qualifide p docs//they are sh*t//they say may be but im the sh*th**d giveing you a script// time to cool it?????????
Posted by Brainstorm on May 23, 2010, at 8:36:15
In reply to Re: Psychiatry in U.S., posted by manic666 on May 23, 2010, at 3:28:52
> yes GP,s are a special breed///i said i need a med change because of fast weight gain an i eat f all//he said these meds dont alter your weight///ooooooooooooooo f*ck// hear i have to say it again????doc look on the leaflet an the main prob on most meds is weight an no sex////oooooooo i will have to check that out///see what i mean,i talked mine into tapper meds only srri to srri simple enough ,but not in the british guild book//he has never done it//that why i save meds i have left over //if a doc says no i do it myself//nothing dangerouse just common sence//the hospital zoo wont tapper an wave the rule book in your face like a flag//thats why im a security risk at hospital //i tell the new qualifide p docs//they are sh*t//they say may be but im the sh*th**d giveing you a script// time to cool it?????????
There's that manic thing kicking in I guess. Hope you were able to chill it down my friend.
Posted by manic666 on May 23, 2010, at 11:01:02
In reply to Re: Psychiatry in U.S., posted by manic666 on May 23, 2010, at 3:28:52
i only see the hospital shrinks once every 6 months now///but im on an open apointment//that mean.s if the family think i may flip is just a phone call///this is how it goes ,i changed my own meds at the gp,he said ok //never tells the hospital//so now i have changed back ,an as far as the hospital think //i never changed in the first place//do you get that ,it kinda does your head in
Posted by Brainstorm on May 23, 2010, at 11:11:50
In reply to Re: Psychiatry in U.S., posted by manic666 on May 23, 2010, at 11:01:02
> i only see the hospital shrinks once every 6 months now///but im on an open apointment//that mean.s if the family think i may flip is just a phone call///this is how it goes ,i changed my own meds at the gp,he said ok //never tells the hospital//so now i have changed back ,an as far as the hospital think //i never changed in the first place//do you get that ,it kinda does your head in
Very weird...... but whatever gets you to where you need to be with that system.
Posted by floatingbridge on May 23, 2010, at 14:19:00
In reply to Re: Psychiatry in U.S., posted by Brainstorm on May 23, 2010, at 11:11:50
Good luck for speedily finding that good doctor. Bulldog is right--he or she is out there. And lucky you that you'll know based on positive experience what to look for.
Right on!
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Dr. Bob is Robert Hsiung, MD,
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