Do You Request Specific Meds?

[Horizons]

I was wondering if other people do their own research and request specific meds when they see their doctors. Every single med I take now is one I specifically requested from my doctor. I originally requested Dexedrine as a teenager after researching all the ADD drugs. I liked that it was a single pure amphetamine, which gave it a lower side-effect profile than Adderall. When I decided to go back on meds, I immediately requested it again because it has worked like a charm for half my life.

After having a nasty bad reaction to the Seroquel my doctor originally prescribed for my Bipolar, I demanded Zyprexa because, after extensive research, I thought it would be the most effective against bipolar depression. My doctor was reluctant to prescribe it because of its reputation for weight gain, but gave in after I told him I'd much rather be fatter than passing out and twitching. And, guess what, even at a high dose the Zyprexa is weight neutral for me. It also cured my depression almost entirely.

Finally there's Stelazine, an ancient typical AP which I requested for the intense anxiety and mixed episodes I've been continuing to have. My doctor seemed quite surprised I knew about this one, and had to look it up himself, but agreed that it sounded perfect for my problems. The very first dose killed my anxiety completely with zero side-effects.

I know I'm very lucky to have a doctor who listens and is willing to let me try what I want. Do others have the same experience?

[tryp]

I rarely do - I usually do research on my options so that I can have an informed conversation with my doctor where we both share our thoughts and ideas. Usually my doctor will throw out a few different options and we will talk about it and I will decide which one I prefer.  I've never had the need to ask for specific medications because usually my doctor comes up with all the options I would have suggested.

[Odetta]

Not for myself, but I did with one med for my son, and it was a bad choice.  We ended up back with what the doctor had originally recommended.   

[San]

If my doc recommends something and I don't agree with it, sometimes I'll say "Well, how about..." and we'll discuss it. Most of the meds I'm on he's suggested, or I had been on with my prior pdoc. For injections, when that was brought up, I suggested Piportil because I had been on it before, many years ago. Rather than starting something different, stick with something I had success on earlier. I don't straight out ask "Can you put me on..." but if he suggests, say, Abilify, I'll say "No, that made me even worse!"

 

I'm sort of like tryp. We can have discussions about meds and dosages. Like when discussing a med for side effects, I straight out said Artane "because I get strange side effects from Cogentin". and he agreed that was a better choice for me after I told him what Cogentin did. (Blurred vision, trouble urinating, it stopped when I stopped Cogentin)

[jt07]

Usually, my doctor and I have a conversation with both of us suggesting meds and we hash it out. I did insist on one med though -- lamotrigine. My pdoc wanted to put me on lithium, but I had tried lithium in the past and it didn't really help and I really couldn't affort the bloodwork. But the other meds are pretty much what I have taken in the past and found useful (and are in my chart) or are meds that my pdoc and I mutually agreed upon. The only med suggested solely by my pdoc was the Ritalin. Rarely will I ask for a particular med unless I've taken it before and know that it is helpful. Mostly we just throw out suggestions and talk about them.

[The Emperor]

I might have done that a couple of times. I don't remember. 

 

Generally, no. I won't do that. He knows more than I could after research on the internet, surely? 

 

However, I WILL try to refuse certain medications (the entire SSRI class is a NO) because of PREVIOUS reactions to them. I CAN know what a med will do if I've taken it. We might revisit some where the side effects were not horrible or whatever.

 

So I rarely request anything specific. But I do beg not to be put on something on occasion, so long as it's something I already have experience with personally.

[tamagotchi]

I don't demand a specific med.

 

I do suggest specific meds, or med classes.  Sometimes it is a suggestion to try something new that I have heard about, and sometimes I think it might be worth retrying something that has failed in the past.

 

I do also bring in research papers, etc. to support my ideas about specific meds.  Sometimes there are things that she hasn't considered or just doesn't know.  Or she might think something is too risky, but I have read about the risks and am willing to take those specific risks.

 

I used to refrain from making suggestions-- for example I might sit there and think in my head, "I wish she would suggest trying a stimulant" or something like that.  I didn't tell her those thoughts because it seemed impolite and I worried that she might get mad, and also I was embarrassed to suggest something stupid.  But now I try to speak up about things like that, not only because I think my suggestions can be valuable, but also because it's weird and artificial for me to just sit there without telling her all of my thoughts on the matter.  It feels like hiding something.

[tryp]

It has to be a middle ground.  Doctors are neither omnipotent arbiters of truth, nor are they walking prescription pads.  They have a special education and set of skills, while you are the expert on yourself and your symptoms.  The most effective doctor patient relationships occur when each person respects the other's unique areas of knowledge and expertise.

[Indigo 'n dye]

It has to be a middle ground.  Doctors are neither omnipotent arbiters of truth, nor are they walking prescription pads.

Yes, yes, and yes! I practice due diligence and have an understanding that I can (and do) have veto power. I do not blindly take any medication, but respect my doctors education, insight, and understanding.

[Gearhead]

 

It has to be a middle ground.  Doctors are neither omnipotent arbiters of truth, nor are they walking prescription pads.

Yes, yes, and yes! I practice due diligence and have an understanding that I can (and do) have veto power. I do not blindly take any medication, but respect my doctors education, insight, and understanding.

 

 

That's the relationship I have with my pdoc too. We've worked together for years and she knows I do my research, and furthermore she trusts me to take my meds as prescribed and to call if something goes wrong. Probably the most recent example of our working together was when she wanted to put me on Prozac for anxiety, and I requested Lexapro instead on the grounds that it has a shorter half-life, so it would be out of me faster if it disagreed with me. I've just had too many negative reactions to meds over the years, and she knows that. She was fine with the Lexapro idea, and it's worked out well. But if it hadn't I would have taken her advice on what to try next, knowing that she would take my objection to Prozac under consideration.

[melissaw72]

With current pdoc, I might suggest something and sometimes he will say ok, but sometimes he'll say no ... but if he does he'll tell me why.  And I trust him.  I know he knows what he is doing because out of 19 or so pdocs, he was the first one to find the cocktail that stabilized me.  And none of the others were even close.

[IsabelleStPierre]

I don't think I've ever demanded specific medications from my doctors before. I will suggest a medication and we'll discuss that medication and work it out together. Yes, I have been put on medications that I've suggested, but only after a discussion with my doctor. All my doctors also know that since I'm uninsured cost is a factor when selecting medications...no generic available means that medication is most likely one I just can't afford.

 

I've never demanded a certain medication, but I do make suggestions. I also research the hell out of any medication I'm taking since I have 127 know medication allergies so I'm always super vigilant when it comes to medications...

[HAL9000]

There are times I really don't have an opinion (Or have studied something) and I go with GDoc.    I have been reading up more about the drugs (Like different classes of drug *Blood pressure for example)  I did do one really detailed study on a drug and told GDoc what I read and asked if it would be ok to switch.    The drug btw is really old stuff and you need to take it twice a day rather then once but it works really well for me and GDoc even tried it with some of her other patients who were not responding to the more popular meds.   She said thanks for the tip which really made my day.   I worry (One of my issues) a lot and it was a relief to know she wasn't insulted or annoyed.   She told me she is not upset when people try to read up about therapy or meds.   She told me she is more concerned when patients stop taking meds without informing her. 

 

I can think of one other example.  She decided I should have some kind of Benzo on hand for when things go really bad and I asked to not be prescribed Xanax.   I worked with a guy who took it (A lot probably?) and I didn't want to "veg" like I thought he was.   We had a really interesting talk about all the options and I gave my "vote" (That she could override)   I would trust her to do the best for me and I think she is capable of making good choices for me.   I'm glad she will discuss and not just command.

[rowan77]

I think I only once asked my pdoc to try me on a new anti-depressant. I had started running out of choices and heard about this new called Valdoxan (agomelatine) which works on melatonin receptors, and was said to improve sleep quality, with no reported daytime drowsiness.This was what attracted me to it, I was having sleep problems.

 

It did not work for me. Afterwards my pdoc said that he didn't think it would help severe depression but decided to give it a shot.

 

Now I have had my pdoc offer me a choice on what medication would be the best, weighing up the pros and cons.

 

However this does not happen when I'm in a very acute phase of depression or mania. He just goes ahead and prescribes it for me, and explains how it will help me.

[discomposed]

Typically, no. While I may have a good amount of knowledge on these medications, my psychiatrist still has way more knowledge than myself. I go in there knowing what medications I won't take and why, and we work from there. He'll typically suggest one or two medications, I might decline one or both and explain why, and he'll adjust his suggestions based on my rejection and our history. The only suggestions I make for drugs are based specifically on my drug history, so I might ask if we could restart risperidone for my anxiety when I need it since it worked in the past for reducing that symptom.

[melissaw72]

 

I'm glad she will discuss and not just command.

 

^Exactly.  Same with mine.  If I dont want to take something he'll ask why and we'll discuss it, but he doesn't force me to take anything.

 

Also, if I do go on a new med, or one I haven't been on in a long time, I will definitely research it before taking it.

[Mirazh]

I've brought up my own suggestions for meds, therapy, etc. before.  And so has my pdoc.  Sometimes we reject the others' suggestion.  We always talk about it.  I make sure to do my research on stuff before asking about it, and I make sure to do my research on things she brings up.  Most of my meds were not my suggestion, ever, but I did request a switch to Dexedrine after a year's trial with Concerta, and we talked about it, and eventually that's what we did.

[San]

With my current pdoc, he knows that I've been on a LOT and gone through a lot, so he does value my input. I really appreciate it. 

[Horizons]

I'm really glad most of you have found doctors you work with well. The only med I demanded was the Zyprexa. I only suggested Stelazine, but since I don't respond to benzos my doctor didn't really have a ton of options for anxiety. Plus my doctor is a general practitioner, not a paychiatrist, so my experience is probably a little different than most. He only has a couple of bipolar patients and doesn't really have many opinions on what works and what doesn't.

I know I'm a difficult, demanding patient, but I've been witness to some very bad medicine and think my paranoia is somewhat justified. My doctor thinks I should see a real psychiatrist, but with a combination of meds which seem to finally be working, the last thing I want to do is screw with changing anything.

[Mirazh]

I've had experiences with awful, awful doctors.  I've had to demand tests (like the time I had a kidney infection... and that's not exactly a complicated test.  And oh hey I was right!)  I've been a lot more, ah, "demanding" on the IP ward... not my first IP stay for hypomania, but I was for my IP stay for my depression.  But that's because all the effing doctors and nurses seemed to be utterly incapable of, oh, doing anything without wading through five hundred layers of bureaucratic red tape first.  I may have been suicidally depressed but GEEZ I knew what we should try first, it was very simple to the part of my brain that wasn't yet overtaken by the depression... I'm very logical, methodical, with my health plans especially so now.  It seemed so simple - stay in hospital so I don't kill myself, play with meds, wait and see if that works.  And by 'play with meds' I knew we should start with what had already been proven to work on my depressive episodes in the past - raise my mood stabilizer dose.  My own psychiatrist thought this was pretty sound reasoning, and it is what the docs on the ward did anyway (though I'm pretty sure it wasn't because I'd been stating that's what we should do the whole time, they came to it on their own 'cause I'm the lowly patient who can't possibly know anything about myself or my needs especially when on the ward.)  Gah.

 

I've been spoiled by my GP in the first place.  And by 'spoiled' I mean that I've had her my whole life and she's awesome, she treats me like an equal in terms of humanity, she's still the doctor of course and I both trust and respect her knowledge, but she knows I'm intelligent and has always preferred me acting like an equal partner in terms of my health care.  And then she found me a psychiatrist who is the same way.  It wasn't until I got hit with that walk-in clinic doctor who I had to beg and plead with just to get a simple pee test for a kidney infection, who also declared that I was experiencing PMS when I complained that ever since taking the powerful antibiotics I'd been in a constant raging mode for well over a month (I'm pretty sure I had a hypomanic episode - it lasted like, six to eight months.  PMS MY ASS.)  It wasn't until I'd seen him, 'cause the clinic was right behind my house and not across the fucking city, that I started to really fully appreciate my GP.  And I've had other experiences since then, and read about some real horror stories on here too.  It does depend on the doctor.  If I am able to make the choice, if there are other choices, then I have zero time or patience for a doctor who refuses to treat me like an equal partner in my health management -- I'm not expecting them to treat me like a colleague because I'm not.  I know very damn well who's had the years and years of schooling and experience and who has not.  But I'm intelligent, I am thoughtful, I have a lot of insight, and I know my own self and life better than they do.  I've also sometimes known far more about shit like ADHD than, say, most of the psychiatrists I dealt with on the IP ward -- and that's scary.  Because they should know better.  Augh.  So yeah.  Don't always have a choice.  And I'm quite certain the docs on the IP ward would say I'm difficult.  But I don't really give a shit.  I work with them when I have to, and I avoid them otherwise once I am able to do so.

[PseudoLucky_Peach]

I don't demand a specific med.

 

I do suggest specific meds, or med classes.  Sometimes it is a suggestion to try something new that I have heard about, and sometimes I think it might be worth retrying something that has failed in the past.

Same here. I suggest. But this was a change from when I was only seeing my PCP for anxiety/depression issues. I felt like I was limited in what I could ask for b/c they were limited in their knowledge of MI. When I finally met with a pdoc to better address my MI, I became a lot more vocal on what I needed from my meds. He has more experience, but, this is my body.

 

I listen to my pdoc's recommendations, look it up myself, and we discuss the pros and cons. I wanted a long-term med that would help with anxiety, panic and depression. He suggested celexa, I went with it. It worked well, but after a year, the side effects--(weight gain, never wanting to be intimate)--were too much. I researched SSNRIs which I had never even considered. He was one step ahead of me and suggested Cymbalta or Effexor. I told him I preferred something not quite as damaging for my liver, and I had read that Pristiq (sister of Effexor) met that criteria. He went with it.

 

I loved Pristiq, but gained a ton of weight on it and eventually became lethargic. So, I asked if we could try something more along the lines of a stimulant, and I threw Wellbutrin out there. He was apprehensive b/c there is the possibility it will make anxiety/panic worse, but then again, meds affect every body differently, so he was willing to give it a go. And it's still too early to tell.

My pdoc and I seem to agree that managing MI is trial and error when it comes to meds. He understands that I am proactive/bossy, I understand that he writes the 'scripts. We talk.

[mcjimjam]

I do sometimes suggest meds. Usually it's because I've taken it before and think it would be a good idea to go back on it. I suggested Concerta instead of Ritalin because I had heard of it and prefer the convenience of extended release formulations where they are available. I didn't ask for Cymbalta specifically but I did ask if I could take an antidepressant. Remeron I had been on years ago so I did suggest that. My pdoc gave me the choice of going back on Lamictal or starting lithium and I chose lithium.

 

ETA: I also suggested propranolol and Ativan, both of which I had taken in the past. 

Edited March 21, 2014 by mcjimjam

[Reverse The Polarity]

There was a point in my treatment where I was suggesting meds to my pdoc, because he was at a loss regarding what to do with me. So we tried them, with varying degrees of success: lamotrigine was good, clozapine was a fail, saphris was a fail. There were some modifications that I suggested, like taking Zyprexa PRN instead of daily that worked as well.There were some meds he suggested that I rejected - i.e. I did not want risperidone.

 

I appreciated him taking my opinions on board and I felt we were partners working together for a common goal, rather than him having ultimate power over me. 

[Horizons]

 

I appreciated him taking my opinions on board and I felt we were partners working together for a common goal, rather than him having ultimate power over me. 

That's definitely the way it should be, IMO.

 

Out of curiosity, why did you reject Risperidone? I rejected that one as well because my fiance had a bad reaction and almost died from it (I cognitively know that this doesn't mean I'm any more likely to react badly to it, but emotionally my reaction is still "oh, hell no." )

[Reverse The Polarity]

I had a very bad response to Invega - I had Parkinsonism, my anxiety skyrocketed and it felt like I was given a lobotomy because I couldn't hold conversations. All that happened on just 3mg. Risperidone is related to Invega and I was afraid that I would have a similar response. I also felt like there were other meds I hadn't tried at the time, so I thought I would try those instead first. 

Edited March 26, 2014 by Reverse The Polarity

[San]

I had a pdoc that told me to "be my own doctor" and he'd ask "What do you want to be on?" and I'd be like "Uh... *med*?" and he'd be like "Oh, good choice, what dose?"

It was a little... well, really, outrageous. He retired.

 

My gdoc wanted to put me on Champix yesterday to quit smoking. When he said "It'll make you moody", and knowing my dad's experience with it, I immediately refused, and said "Moodier, you mean!" and he laughed and said "Well, I guess that's off the table!" and I suggested Zyban (Wellbutrin) and he agreed immediately and faxed in the 'script. He respects that I don't take hormones for my bad periods because they make me crazy too! I appreciate this a lot. He listens. So does my pdoc. Neither would put me on something I have had bad experience with or flat out disagree with.

 

I fired my old ob/gyn for dismissing every word out of my mouth and writing a script for Depo Provera ("It has no side effects and will stop your period!") when the referral said "No hormones" and he said "You need to work with your pdoc so you can take hormones". Um, I have my tubes tied so I don't need to take hormonal BC. I don't need you lying either, if it stopped my period and had no side effects, every woman would want it. I walked out on that appt. My GP told me I did the right thing.