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PinkCupcakes

Switching pdoc-again

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Hi everyone. i need some advice. i just changed pdocs about a month or so ago and I'm not really feeling it with this new doctor. I liked him at first but he address my sleep issues, which are huge for me. i think he could be overmedicating me as well. I'm on Saphris, Geodon, Prozac, Seroquel and tranxene, all at the same time. i know what to do since just had all of my records transferred to him. Does anyone out there have any suggestions for me? I don't want to look like a doctor-shopper.

Thanks in advance for your responses!

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Not knowiing you diagnosis, history, or symptoms, it's impossible to give you advice. However, I can give you a rule of thumb - only be on one antipsychotic at a time. Some people will be on one main one and a very low dose of Seroquel for sleep. That's usually about as far as the rule is stretched. The reason is that more than one AAP increases the odds of EPS. BUT, that risk can be worth taking depending on what your symptoms and history are. So, this circles back to not being able to give you advice without knowing what your diagnosis, history, and symptoms.

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Hi there -

Have you tried discussing this issue with your doctor? They can't read our minds, so if there's some aspect of your care that you aren't satisfied with, and you don't tell them, they don't know. Sometimes they are genuinely trying to help, but since they aren't in your head, and you aren't in theirs, it can be hard to get things right. This beginning stage of the relationship can be difficult because the doctor doesn't know you well, so there is more room for misunderstandings.

Generally speaking, a good doctor should be open to listening to any concerns you have, and should, within reason, provide justification of their approach and/or modify their approach to take into account your preferences. You can even write him a letter about it if you don't think you can say it to his face. You could ask why he feels so many meds are necessary, if he thinks that at some point you might drop one, why he is choosing to focus on certain symptoms, etc.

Another option is to ask for a second opinion from a more expert doctor and have the recommendations sent to your current doctor to maybe inform their treatment of you. When I had some weird mood shit going on that my doctor wasn't too sure what to do with, she sent me to a psychopharmacologist, a psychiatrist who specializes in medicating difficult to treat cases. He was able to recommend several new avenues that my doctor had not considered, and we were eventually able to get my symptoms better under control. For example, as Stacia mentioned, you may want a second opinion about taking a bunch of antipsychotics at once and maybe some alternatives, from a doctor who has more experience with complicated cocktails.

I suggest these options as alternatives to switching, because I know that switching doctors all the time can be stressful, and it's better if you can let one get to know you for a while. I would at the very least try to talk to him about this, because he might have good reasons and be able to justify himself to your satisfaction.

That said, if you really don't like or trust him, or feel you can't work with him (I'd recommend trying to discuss your concerns and giving the relationship a little bit of time to shake down first, unless you completely cannot stand it) switch. Psychiatrists are so important to our care - you have the right to keep trying until you find one who works for you, even if it takes a while (sort of like meds!)

Edited by tryp

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I've done med doses of 2 antipsychotics for a while, though now my plan is like risperdal as main one, and probably as low as I can get on quel for sleep (probably around 50--100 m.g., I'm guessing, based on when I stopped it before). I HAVE been on high doses of two aaps before but usually only when I'm in the hospital and highly symptomatic.

I do get checked regularly for EPS and I think it's great if you don't have to double up on the AAPs, unfortunately my killer AAP for mood/psychosis just does nothing for sleep whatsoever. So for a long time I was on quel alone, but I found myself much less stable on it.

I agree about talking with the doc about the whats/whys and plans, before switching. That said, if you don't get good answers, it is well within your rights to switch to a doc that meets your needs. Really. i am all for that. Just make sure you are understanding his plan and why, for example when I am highly symptomatic it takes about 6 or 7 meds to keep me out of the hospital, and while I am not OVERJOYED with that, it beats not functioning. Seriously.

Anna

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