Jump to content
CrazyBoards.org

New P-doc suggesting I come off meds all together


Recommended Posts

I have no diagnosis, but I've been given strong indications that it's bipolar disorder. I've had strong varying moods, from depressed to manic. I've also had hallucinations; seen and heard stuff, I've also had some paranoia, delusions and anxiety. This is all still pretty new to the doctors - I've had problems for years but I've only had help from them for a year or so. Last year I had a breakdown and ended up in a psychiatric hospital.

I'm not finding the seroquel is helping at all, especially not with the depression. It just makes me tired. I even feel like it might be making it worse. I recently saw another psychiatrist - a very senior one I respect a lot - who was very worries by the treatment I was previously given.

He thinks that the anti-psychotics are doing me more harm than good. He thinks most of my problems could be controlled with intensive psychotherapy. He wants me to change doctors, get into therapy and slowly begin coming off the medication with the help of the doctor.

I'm British; I know things are very different overhere.

I'm thinking maybe this is a good idea. I've been getting worse since I've been on medication.

I don't know what you guys think about this - I just wanted to get a second opinion.

x

Link to comment
Share on other sites

That sounds pretty drastic.

Based on your signature, you've only ever been on two medications, and they were both in the same class. There are TONS of other types of medications out there, and it's a little premature to throw up your hands and say "meds don't work" at this stage.

Also, 200 mg of Seroquel is VERY low. That's really a sleep dose more than anything, and maybe the dose for anti-depressant augmentation. If you were trying to do Seroquel monotherapy or bipolar dosing, you're way too low, so I'm not surprised it's not helping.

I think you need to find out what your actual diagnosis is, what type of therapy they're recommending, and how long they want you off meds for.

If they think you have Borderline Personality Disorder without any axis 1 comorbidity, that recommendation might make a little more sense, but if you're bipolar, I'm not convinced that's the best idea.

Link to comment
Share on other sites

Thank you so much for the quick reply.

Yeah I dunno. They've been very cautious with me before. The old doctor flatly refused to go anything over 250mg and refused to try me on anything antidepressant. It's just a bit like no one's talking to me.

This new guy did REALLY listen though, and I thought he had a good idea about everything. He didn't feel comfortable with coming up with a diagnosis yet, as I understand. I don't know I'm bipolar - and he thinks a lot of the symptoms could be controlled with therapy.

I'm also really, really aware of the dangerous sides of the drugs - the possible long term side effects and everything. If at all possible I'd like to be off drugs. I think they should be a last resort rather than a first choice.

I'm feeling pretty confused about all this. It seems to me like half the people think I'm on nothing at all and the other half think what I'm on is a massive overreaction that's going to damage me. I'm not sure.

If you are bipolar is it not possible to go without medication?

Link to comment
Share on other sites

If you are bipolar is it not possible to go without medication?

Not without a quick relapse.

If your old doctor really did feel that you had bipolar disorder, I'm a little puzzled about why he didn't look at using a mood stabilizer. I'm also puzzled about his justification for maxing out a Seroquel dose at 250 mg. That dose is only barely useful as an antipsychotic.

We can't really tell you much else based on the information you've given us. Your best bet, I think, is to ask your pdoc more questions.

Link to comment
Share on other sites

+1 what Tryp and Aurochs have said. You really need a good diagnostic workup. You can help this process greatly by constructing your own chronology of your symptoms. Especially their precipitants (if any) and their severity. Using AAP's first without any prior antidepressants or mood stabilizers seems odd, unless your hospitalization was prompted by the psychotic symptoms.

It's good that you feel that your current doc is listening to you and generating some working hypotheses before medicating blindly. If you are not strongly symptomatic right now, this could take some time. I hope this works out for you.

Link to comment
Share on other sites

Your best bet, I think, is to ask your pdoc more questions.

I agree. Try and work out if he thinks you are Bipolar and why he thinks therapy would be more helpful. If there is an uncertainty, you could always try both & go off the med if and when you feel better.

Link to comment
Share on other sites

I would definitely start mood charting. And writing down all your previous symptoms in some sort of time line, as suggested. It is very odd to me that your were never given a mood stabilizer. One possibility would be to start a mood stabilizer such as lithium or depakote, and then taper down the Seroquel and see how you do. Being proactive and participating in your psychiatric care, coming prepared with a list of questions, and just learning more about bipolar through reading will help you get a handle on your diagnosis, or condition. Sometimes it takes time to sort things out. However paranoia, delusions, and mania needs more than therapy. Hang in there.

On this board and other mental health web sites the standards for practice seem very, very different in England. I knew a girl who was a medical student in Cambridge. She was having some severe mania - loss of sleep, running around taking off her clothes, and other manic behaviors- running out in pouring rain storms and general mischief. Her roommates were very bewildered. Her online friends were concerned for her safety.

Her doctor, who was prestigious and well respected in Oxford would not diagnose her as bipolar. He wanted to wait............... Wait for what I wonder? A total break from reality? And they were very, very conservative with thier medications. She eventually had to take a break from school, and with encouragement from her online friends she requested Lithium and she finally stabilized. It was odd to me. She had to really be assertive to get care. They just wanted to watch and wait. She wanted to try a mood stabilizer and get back into her academic program.

Link to comment
Share on other sites

I also think it's surprising that one wouldn't suggest trying a mood stabilizer if bipolar is suspected. from the little information you have given, it seems that bipolar should be pretty strongly suspected.

If so, it's very hard to get away with therapy alone, although some symptoms can be improved with therapy, the underlying disease process really just does respond best to medications.

anna

Link to comment
Share on other sites

The big question being, is this really bipolar disorder? It's possible that neither doctor actually thought the OP had bipolar disorder, which would explain all of their actions. I don't think we have enough information to speculate on an accurate diagnosis, which we can't reach over the Internet anyway.

The other explanation, as bpladybug pointed out, is that British doctors may just be more conservative with psych meds.

In either case, being more communicative with the doctor is the best route. The more (accurate) information he has, the better his treatment can be. Some extra assertiveness may be called for too.

EDIT: I just re-read the part about the hallucinations. That more strongly points to bipolar disorder or SZA, although paranoia, delusional thinking, and dissociation are known in borderline personality disorder. Of course, this doesn't really change my advice.

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...