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How many pdoc changes have you had?


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I'm going through a rough patch. I seem to get in weird funks that last a week or 2 and then I get better a bit. I'm starting to wonder if my doctor is doing enough to help me. I've only ever had one psychiatrist. He's nice and all but I'm starting to question some of his methods. For example, I've been on Ambien for 3 years and was kept on Lamictal for a long time even though my hair was falling out ;)

Also, the total "Effexor" office decor is starting to irk me. Staplers, pens, pads-you name, it's there. With a few Wellbutrin accents.

So, just wondering if a second opinion is worth it. I'll also add that anything serotonin seems to go down really bad with me, so maybe doc's getting frustrated. But I just really hate the feeling of getting worse.

Thanks in advance for advice. This board is so nice about these questions that I can't just throw out there at lunch club or wherever.

Birdie

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I've had one pdoc change. My first one was really nice and helped therapy-wise, but she was older and not up on the newer bipolar medications. My tdoc knew her and agreed, so she referred me to a new pdoc. I have been with the new pdoc for about three years (maybe longer) and she has been great. The one really good thing is that my first pdoc referred me to my tdoc who was really wonderful. I saw her for six years and just stopped seeing her in December when she felt that I didn't need to be in therapy anymore. Never really had a second opinion. Of course, I've had numerous different pdocs when I've been hospitalized.

Tommy

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Keeping someone on Lamictal despite hair loss is not in itself a questionable method. If it was keeping your brain from falling out, so to speak, then the hair loss is something to be considered but maybe tolerated.

Why don't you directly ask him? Frustration with failure to progress is pretty common. It's also important clinical information he might need or be able to use.

A second opinion is often worth it. It might seem awkward, but I'd suggest letting him know that you want one (nice lead-in to the "I'm feeling stuck" discussion.) Most docs aren't offended, and they find the other reports valuable information one way or the other.

And, as far as "not doing enough to help" you, I'd contemplate what you think he could be doing. Switching rapidly every month, without ever giving a drug a fair trial, would be unhelpful, too, so there's some middle ground between the two extremes.

Does he know about your alcohol use patterns? Very hard for your psychiatrist to work without full information. Again, not scolding, just saying.

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I think I am going to start looking around for a second opinion, not dumping this doc, but keeping options open. I bring up the Lamictal thing because my depression and ADHD is milder than most and the hair loss was very troubling to me.

I have more recently been very honest about alcohol use. And I've actually improved with drinking less. Which adds to my frustration with not feeling better. I was hoping that might be one of the rewards.

Just kind of grasping at straws here to pull myself out of the funk.

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Cool.

I have always been able to ask whoever I'm seeing for recommendations for a second opinion. If anything, they have bent over backwards to find someone who doesn't "think the same way" they do, which has been really nice - the providers, too, have been interested in a true second opinion, rather than validation of what they already thought.

Good luck!

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I have no real advice to offer, except that it sounds like a second opinion might be in order.

I have a question, though. Does anyone know how your average U.S. insurance company handles second opinions? Do you have to pay the full price because they already paid for the original specialist (or they paid whatever % of the original specialist's bill that they felt like)?

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