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Are you able to discuss med changes with your pdoc?


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When your pdoc changes your medication, like changing your dosage of your actual med, starting a new med, replacing another one, are you permited to discuss med changes with your pdoc?

Does your pdoc explain why he is doing these changes? What exact symptom is he trying to target? If you do not agree, are you allowed to say why? Does your pdoc listen to what you have to say concerning meds? Like if you took a certain med in the past and it didnt work or gave you side effects?

Edited by CookieN
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I'm not sure what you mean by are you "allowed" to ask these things. Ideally, you should be assertive enough to speak your mind to your pdoc. It is, again ideally, supposed to be a partnership.

All the pdoc's I've ever had though act like they are gods and it is their way or the highway. This is what we are going to do with your meds and that's that.

That is my reality. Like I said though ideally you should be able to discuss things with your pdoc and be assertive in doing so. Your pdoc should treat you like a human being and not a symptom.

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My first pdoc was authoritarian and would not listen to my suggestions but my current one will hear me out and go along with my suggestions if he thinks it's sound. In my opinion, you should get a new pdoc (if it's possible) if he/she is not acknowledging your input. Finding the right medication is a two way process. Your pdoc makes suggestions based on your diagnosis and you report whether they help and if you have any side effects.

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I've had 2 pdocs that I've actually stuck with (saw the first one only once) and both have not seemed to mind me doing research. Of course they made the decisions when it came down to it, but my current one is really good at listening to all my questions, really patiently. I realized I'd never felt that with my last one. The last one gave me a lot of time and REALLY helped me, he just didn't answer my questions that well.

 

Be assertive!

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My pdoc and I partner when making any type of med change. Well, really, what we do is talk it over. Sometimes I'll bring him articles that I've found if I want to do something outside of the usual. If he notices my mood changing he'll suggest a change in meds. The really important part is that we both agree. That's where the partner thing comes in. He can say "take this" and if I'm not on board with the change then the chances of my actually doing it are rather slim. I can have what I think is a brilliant idea and if he doesn't agree then he won't write the prescription. So, for us, agreeing is really important. 

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With my current pdoc we talk about any med changes.  I am usually the one who asks for a dose increase/decrease only because I notice changes first, and I'll ask him if I can increase/decrease, and he'll usually say yes. 

 

Before the cocktail was "perfected" (at its best), I'd ask to try a med and he would usually say yes, but he would say what dose to start out on.  It is more like a partnership for us.

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My current pdoc listens to me and takes me seriously and respectfully.  We discuss any changes until I am comfortable with it.  I have had pdocs that do not listen and rush me.  I didn't know pdocs could be any other way until my current one.

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The word allowed raises red flags. I can't imagine going to a doctor who didn't "allow" me to discuss options. After all, in the end, the decision is mine whether I agree to take what they suggest.

My doctor presents his suggestions as just that - a suggestion. And he usually presents two or three alternatives and lets me decide. Doesn't mean he'll prescribe anything I want - he won't prescribe me a stimulant because of my anxiety and risk of psychosis. But when I wanted an MAOI he was open to it, even though he rarely prescribes them.

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If you do not agree, are you allowed to say why? Does your pdoc listen to what you have to say concerning meds? Like if you took a certain med in the past and it didnt work or gave you side effects?

 

 

The ONLY reason to have a pdoc is to discuss meds and med changes and med inadequacies and med side effects and meds working or not working.  There is NO other reason to have a pdoc.  

 

You are allowed to say anything you want.  Write a list ahead of time in case of flustered thinking (which I have).  Never forget -  You are Paying Them.

 

edit: MDOC can prescribe meds but the Pdoc has much more experience with psychopharmaceuticals and their side effects and efficacy and statistics etcetera.  

Edited by water
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The word allowed raises red flags. I can't imagine going to a doctor who didn't "allow" me to discuss options. After all, in the end, the decision is mine whether I agree to take what they suggest.

My doctor presents his suggestions as just that - a suggestion. And he usually presents two or three alternatives and lets me decide. Doesn't mean he'll prescribe anything I want - he won't prescribe me a stimulant because of my anxiety and risk of psychosis. But when I wanted an MAOI he was open to it, even though he rarely prescribes them.

Its great that your pdoc presents different alternatives. As I always think there are different solutions to the same problem. I think pdoc and patient should work as a team.

In my case, I am just told to take a certain med, no alternatives are given. I really cannot discuss anything about meds, because my pdoc is "the expert"

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If you do not agree, are you allowed to say why? Does your pdoc listen to what you have to say concerning meds? Like if you took a certain med in the past and it didnt work or gave you side effects?

 

 

The ONLY reason to have a pdoc is to discuss meds and med changes and med inadequacies and med side effects and meds working or not working.  There is NO other reason to have a pdoc.  

 

You are allowed to say anything you want.  Write a list ahead of time in case of flustered thinking (which I have).  Never forget -  You are Paying

Thank you for your advice. It made me really think. It is useful to hear others experiences, to see other points of view. Otherwise I would think it is normal to just sit there during appointments and not refute anything. Thank you again.

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The word allowed raises red flags. I can't imagine going to a doctor who didn't "allow" me to discuss options. After all, in the end, the decision is mine whether I agree to take what they suggest.

My doctor presents his suggestions as just that - a suggestion. And he usually presents two or three alternatives and lets me decide. Doesn't mean he'll prescribe anything I want - he won't prescribe me a stimulant because of my anxiety and risk of psychosis. But when I wanted an MAOI he was open to it, even though he rarely prescribes them.

Its great that your pdoc presents different alternatives. As I always think there are different solutions to the same problem. I think pdoc and patient should work as a team.

In my case, I am just told to take a certain med, no alternatives are given. I really cannot discuss anything about meds, because my pdoc is "the expert"

 

 

Have you thought about changing DRs?  You haven't seemed happy with this DR now for awhile, and wondered if it is time to find a new one.  It is a PITA to start over, but if the new pdoc respects you and listens to you, it makes it all worth it.

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When I was in the psych unit earlier last January I had mixed experiences. For example when I was manic and not improving I was told that medication was added in to the mix. I was not asked, I was told, probably because I was too unwell to make the choice myself.

 

Later on, that same pdoc wanted to add in another mood stabiliser and gave me a choice between Lamictal and Epilim (sodium valproate).

 

My regular pdoc would mostly discuss different meds with me. He listened to a couple of suggestions I had. One time I when we were  running out of antidepressant options I suggested we try Valdoxan (agomelatine) and he agreed. It didn't help.

 

One time I suggested that I take Lamictal as monotherapy and he refused point blank, saying it would not be effective against mania.

 

During my first manic episode I vaguely remember my pdoc saying to the nurse that he was putting me on olanzapine. I was not asked, but I honestly believe I was in no fit state to discuss medications.

 

So I can say, in my experience, that the pdocs I have had, have assessed the situation, and according to my state of mind decided what to do. On the whole, I have a really good partnership with my pdoc, and I trust him.

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I take no meds without fully consenting and having full information about them.  I know more about half the meds I'm on than my pdoc does.  

 

Remember:  your pdoc works for you.  You're the paying the bill.  You're in charge.  You're the boss.  If they won't work with you, fire them.

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I take no meds without fully consenting and having full information about them.  I know more about half the meds I'm on than my pdoc does.  

 

Remember:  your pdoc works for you.  You're the paying the bill.  You're in charge.  You're the boss.  If they won't work with you, fire them.

In addition to this, you are the one who has to live with the consequences of the taking the meds.

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I've never had a pdoc that didn't listen to my concerns or preferences. Even when I was manic he asked me what I wanted to do. Those times I am usually too confused to make a choice anyway, and I tell him do whatever you want. -_-

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I talk everything out in full with my pdoc. My old one gave me too much freedom: "What med do you want? What dose?" Ugh, why was I doing his job? He retired.

 

My current one takes my suggestions into consideration, along with past side effects and other meds. We come up with it together. He won't do something I refuse, though. (For example, if he were to suggest wellbutrin, he knows damn well I won't take it, it makes me beyond anxious and causes insomnia = frustration and mixed episodes) I will straight up tell him if I am to ever vary on a medication dosage, which I rarely do. An open honest relationship is good. I trust him, and I like him. I don't pay for him (Canada) but you should get along with your doctor or its frustrating and no good for either.

 

ETA: Ultimately he makes the final decision though. I do not doctor shop or pick and choose meds. He IS the one with the MD and training. I am in Canada, so you can't exactly "doctor shop" here.

Edited by thesystemisdown
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Usually I'm the one who recommends meds to start with, and I ask about dose changes if I'm not feeling well. I think my pdoc knows I do a fair bit of research before making suggestions, though. 

 

If I didn't feel like I was permitted to have a heavy hand in my own care, I'd probably find another doctor.

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