vectorgirl Posted June 21, 2012 Share Posted June 21, 2012 How bad is it for a doctor to start you at 200mg Zoloft and 600mg Lithium, without telling you that's a pretty major interaction, and not mentioning the blood tests you'd have to do in the future? I'm kinda ticked but I'm not sure if I'm making a big deal of it or not because I called him practically suicidal - I told him I'd written a note, and I'd never done that before - and he promised me as soon as we'd hang up he'd call in my prescriptions for a new cocktail, and he never did. His receptionist called me 2 days later because I left a message about them. Link to comment Share on other sites More sharing options...
LunaRufina Posted June 21, 2012 Share Posted June 21, 2012 Considering the nature of the reaction, the nature of your situation, and the amount of lithium he put you on, I wouldn't consider it a grave sin. What I would consider a sin is the negligence in actually failing to prescribe the medications once he told you he would, giving the urgency. The initial dosage of zoloft being 200mg is a little questionable as well, but considering you are/were in a crisis situation, I am not a doctor PLUS don't know your med history/history of tolerability with ssri's, it's kind of like I'm talking out my ass if I'm making a judgement call about that particular issue. Link to comment Share on other sites More sharing options...
Eden Posted June 21, 2012 Share Posted June 21, 2012 I agree that the doctor, under certain circumstances, could be completely justified. Though the lack of communication would piss me off to no end. It sounds to me like intervention doses, and if they were necessary they were just necessary. Link to comment Share on other sites More sharing options...
vectorgirl Posted June 21, 2012 Author Share Posted June 21, 2012 OK thanks. My GP was kind of horrified I was taking both at the same time because supposedly there's some major drug interaction. The cocktail in my sig needs to be updated. Link to comment Share on other sites More sharing options...
vectorgirl Posted June 21, 2012 Author Share Posted June 21, 2012 BTW the lack of communication is really what killed me with this guy. I was in crisis mode -- I actually am on medical leave from work and haven't been to work since June 4, and when I called my psychiatrist and if we could try something else I told him I was in crisis - I'd written a note the night before. I've never done that before. I wasn't quite emergency-room bad but was eager to start treatment right now. He promised me he'd call the prescriptions in and he never did. Two days later his receptionist called me because I'd left a message and she asked if I still wanted them. If I called and left a message for him he'd either have someone call me back and relay a message, or a few days later he'd call me. I'm beyond upset that I was almost suicidal, and he just carried on like it was nothing. And he's making it intentionally difficult for me to collect short-term disability, so my GP is trying but it's probably not going to go through because he's acting like a baby about me being upset about his lack of responsiveness, and worse, he said I could return to work in 3 days - my company said take as long as you need to get well until August 1. Who knows if this is gonna even work? I'm having major fatigue and side effects and he said if I even want my claim papers I have to pick them up -in person - and there's a $35 fee. I can't drive that far right now. That's why I need more days off. I'm completely sedated. He's no longer returning phone calls, etc. I'm shopping for a new doctor. Link to comment Share on other sites More sharing options...
gizmo Posted June 21, 2012 Share Posted June 21, 2012 I took 200 mg of Zoloft and 1200 mg of lithium for more than three years. The combo has the potential for increasing serotonin, but if you get blood tests to make sure your lithium level is ok and you watch out for negative symptoms, its a perfectly healthy combo. I would have a real issue with the pdoc not following through with the prescriptions. If he's not calling you back about your scripts or paperwork, that would be a big red flag to me. However, some offices are very particular that you need to see a pdoc in person in order to talk about forms and medications. My pdocs office is. You have to make an appointment for med refills or disability paperwork and pay your office copay. Was there a reason you didn't get paper scripts from the pdoc instead of having the pdoc call them in? I always get paper scripts. Link to comment Share on other sites More sharing options...
wj74 Posted June 21, 2012 Share Posted June 21, 2012 I would be very pissed that he never called in the new med cocktail. In that kind of situation... That could have gotten real bad fast. The med combo thing? I have had the pharmacist tell me I shouldnt be taking certain cocktails but they are just going by their computer system. I was told I shouldn't take Wellbutrin and Seroquel together because of seizure risk. But I am also on an anticonvulsant AND the computer isn't a pdoc. Lol so take that with a grain of salt. Link to comment Share on other sites More sharing options...
vectorgirl Posted July 16, 2012 Author Share Posted July 16, 2012 Gizmo I'd had an appointment with the doc a week earlier and got paper scrips, but when I got severly worse very quickly I called and left a message for him and he called me back and that's when he said he'd call in the second set of scrips and didn't. I would have gone in for another appointment if he could have seen me quickly but it was, for me at least, a dire state of emergency. I'm really confused about why he hasn't been cooperative about filling out my paperwork for me to collect short-term disability while I'm off work. He felt writing me a note for me to be absent for work for a few days was sufficient, but I had to pick it up and he was going to charge for it. Finally after weeks of me nagging he finally filled out the paperwork, and on phone calls we'd agreed that my employer told me to take whatever I needed off to recover before August, and me and doc verbally agreed I needed a few weeks. The past few years I've been hospitalized in patient or out patiend around this time of year, and I was concerned and committed to finally get as stable as I can be. By the time he finally filled out the paperwork (and he charged me to do it btw), he wound up suggesting I be paid for 3 days off work and no more. The diagnosis says "Major Depressive Disorder with Psychosis" and the degree of severity is "Severe" and I was still adjusting to my cocktail to the point where I was sleeping all day and couldn't drive. He wrote about my hallucinations, dellusions, etc. but was insistent I would be fine in 3 days and I could resume heavy lifiting of 50-100 lbs continuously. (That has nothing to do with my job, just thought it was strange). My GP wound up filling out the paperwork for a month for me off out of pity because I showed up to her office shaking and unable to stand for long periods of time. I'm completely baffled by my psychiatrist's feeling about the disability. It absolutely surprised the crap out of me, especially after verbally agreeing to do it and talking about how important it was to keep me out of the hopsital this year. He's mixed me up with other patients before, I'm wondering if he was confused about something but his receptionsists insist he wasn't. They told me some strange things. I'm finding a new psychiatrist, but nobody can see me soon. I haven't been to work since June 4 and I'm still not well. I'm getting better and am a lot better than I was when I first stopped workd but I don't feel ready to go back to work. This is not like me. I'm always itching to go back to work after an episode like this. I just feel so unwell. I thought I'd already stopped doing everything I liked, I didn't think there was more to give up. Then I even stopped coming online and I gave away my cat. I can't do my own laundry or dishes. And I haven't really been able to relax because I'm freaked out now that any psychiatrist I trust in the future someday will let me down and not help me get what I need to get better. Link to comment Share on other sites More sharing options...
AirMarshall Posted July 17, 2012 Share Posted July 17, 2012 I don't see a problem with the Lithium / Zoloft combo. Yes there is the small potential for Serotonin Syndrome, but that exists with nearly all Anti Depressants, even when taken alone. The Zoloft dosage of 200mg is the maximum recommended dosage. Lithium is rather modest, and the recommended dosage for treatment of acute mania is 1800mg. It can be scary when starting new meds particularly when you are unfamiliar and at your very worst. Try to follow your doctors directions. If you have problems talk to your pharmacist or call your psychiatrist. Understand that no drug is without potential side effects and risks. Try not to panic over them, since the lists of potential interactions and potential side effects are meant to be informative. Link to comment Share on other sites More sharing options...
minouette Posted July 17, 2012 Share Posted July 17, 2012 Speaking purely from my own experience, I've found that most psychiatrists have let me down at one point or another while I was under their care. Those that I found were somewhat empathetic are those that offer talk therapy and med evaluation so the visit can be anywhere from 45 minutes to an hour long. But, these are a rare species of pdocs and they usually don't take insurance. I've been seeing my current pdoc and paying out of pocket and then filing for reimbursement from my insurance. You may want to look into pdocs that aren't covered by your insurance and then try some out and compare with pdocs who are in network with your insurance. Good luck, I know how difficult it is to do this pdoc shopping especially when one is in a state of crisis. Link to comment Share on other sites More sharing options...
vectorgirl Posted July 20, 2012 Author Share Posted July 20, 2012 I took the plunge and finally made an appt. with a well-regarded pdoc that doesn't accept insurance. Not looking forward to the payment for the initial consult, but supposedly he's very throrough and I explained my situation to the receptionist and she said if I have issues with my short-term disability insurance they'd have no problem whatsoever filing the paperwork for me, so that's comforting. Link to comment Share on other sites More sharing options...
Cetkat Posted July 20, 2012 Share Posted July 20, 2012 I told him I'd written a note, and I'd never done that before - and he promised me as soon as we'd hang up he'd call in my prescriptions for a new cocktail, and he never did. Two days later his receptionist called me because I'd left a message and she asked if I still wanted them. Finally after weeks of me nagging he finally filled out the paperwork, and on phone calls we'd agreed that my employer told me to take whatever I needed off to recover before August, and me and doc verbally agreed I needed a few weeks. By the time he finally filled out the paperwork (and he charged me to do it btw), he wound up suggesting I be paid for 3 days off work and no more. I could resume heavy lifiting of 50-100 lbs continuously. (That has nothing to do with my job, just thought it was strange). He's mixed me up with other patients before (*emphasis mine) I'm wondering if he was confused about something but his receptionsists insist he wasn't. They told me some strange things. Bingo. That absolutely sounds like two patients getting mixed together. That's the only explanation I can think of for the inconsistencies. I'm glad you found a new pdoc. Link to comment Share on other sites More sharing options...
Catnapper Posted July 21, 2012 Share Posted July 21, 2012 Glad you're getting a new pdoc, sounds like maybe your current one is trying to see too many patients, or something. I have a fairly common name and have had mix-ups at doctor offices, too. I'm not saying that's what happened to you, just that the possibiiity does exist Link to comment Share on other sites More sharing options...
crtclms Posted July 22, 2012 Share Posted July 22, 2012 Lithium can be involved in seratonin syndrome? I never knew that. But I guess it is okay with imitrex, because I realize there are a ton of people on the boards on lithium and imitrex as well. I'm not scared, just curious. Link to comment Share on other sites More sharing options...
adianoeta Posted July 23, 2012 Share Posted July 23, 2012 I think if you are going to quite literally put your life in a pdocs hands, he needs to be there when the shit hits the fan. I admire your determination to get through to him-- not that you really had a choice in the matter. I'm glad you've moved on from that practice. Sounds like a bad egg. It took me 16 years to find the right pdoc. I have been treated very poorly by so many quacks. Don't settle, don't stop looking-- the right help IS out there. Link to comment Share on other sites More sharing options...
gizmo Posted July 23, 2012 Share Posted July 23, 2012 Yes, lithium can raise serotonin. It's one of the reasons my old neuro wouldn't prescribe me triptans (but I am on the max dose of Zoloft as well). That's why I switched from lithium to depakote. But each person is individual, and only your dr. Can tell you what meds are right for you. Link to comment Share on other sites More sharing options...
vectorgirl Posted July 23, 2012 Author Share Posted July 23, 2012 My new doc is AWESOME. Only glitch is my workplace's owner wants to have a face-to-face "meeting" with me Friday that I'm pretty sure is going to result in my firing. I specifically asked when I went out on medical leave if there were FMLA papers I needed to fill out and the HR person assured me over email that it was covered within the short-term disability paperwork I filled out. I'm thinking he was wrong. I called the owner to ask him if I needed to bring anything, like documentation or say, my laptop and access card to turn in. He said no, nothing like that, but he'd ask HR if they needed anything specific. I have documentation on everything from 3 different doctors. The meeting was supposed to be tomorrow but got pushed back to Friday. I'm not sure they understand what a wait like that does to a person with an anxiety disorder. I'm not going to be able to relax this week. He said he had some questions and it's better to talk face-to-face. I don't understand wtf you can't ask me over the phone with faxed medical documentation when you know I'm sick and live a fucking hour away. I'm driving out there to get bullied into resigning or get fired. Link to comment Share on other sites More sharing options...
gizmo Posted July 23, 2012 Share Posted July 23, 2012 No, your hr contact is wrong. FMLA is Legally-protected time off, STD is insurance that pays you for time off. You can get fired while on STD. There are almost always different paperwork for the two, as STD paperwork is provided by the insurance co, and FMLA is provided by your employer. You need to print out that email and take it to the HR manager and demand FMLA paperwork. Tell them that the information given to you was incorrect, and is a violation of your rights under FMLA. And that should make them realize that you are willing to sue over this mistake should you get fired because your paperwork wasn't filled out in time. Link to comment Share on other sites More sharing options...
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