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My psychiatrist, who is in the process of being fired and was even before I met with him today, has told me that he wants me to go off of medication. I have been in treatment with him for about 8 or 9 months now, following my second psychotic break. During that time I have been on Lamictal, Latuda, Zyprexa, Abilify, and Lithium, in that order. It has been a very gradual process of getting better. I am almost free of psychotic symptoms since starting this supplement (sarcosine and NAC) about a month ago. I'm a wreck as far as anxiety and obsessive thoughts go. I have been depressed since I started lithium. Since I have been on Lithium and getting blood tests, my liver enzymes have been elevated. That's since very early March. A ton of testing later by my GI doctor, and she is leaning towards Lithium as being the culprit for my elevated LFT's. She hasn't ruled everything else out, but has said lithium could be the cause of my elevated LFT's both in person and on the portal that she uses to communicate with me. My psychiatrist has been adamant about letting me know that lithium is not metabolized and therefore does not affect the liver. He tells me this as though my doctor who specializes in liver disease doesn't know this. She does. Anyway, today, I say, I'm tired of being depressed and I'm anxious, and I'd like to go off of lithium and back onto lamictal because I felt good on lamictal, and maybe we can find out if lithium is what is bothering my liver. He says no, flat out, says I think you should go off of medication and seek alternative treatments like therapy and meditating. He said it will calm down my limbic system if I meditate. I was shocked. I dream of the day that I don't need medication. I don't think I can do without medication right now. I am in the guys office asking for medication. I ask, 'what if i go manic?' His answer is you can just take an antipsychotic. I say, 'an antipsychotic didn't really work all that well last time, I'm still recovering with symptoms.' His answer 'well I can't say as to whether it will or will not work' and the he goes on to talk more. He is great at talking. He then gave me a prescription for Neurontin. I ask 'is this a mood stabilizer?' 'No, patients say it stabilizes their moods, but double blind studies show that it sometimes works even worse than placebo. Neurontin is not metabolized by the liver, Lamictal is.' At that point my 15 minutes were up. Granted it was more like I was in there for about 30 minutes. Still, I never felt so hopeless after seeing a doctor. Anyway, I'm in the process of getting a new psychiatrist at the community center, but it is a process, and I won't get an appointment with the psychiatrist until i go through the therapist. So earliest, I can see a new pdoc in 3 weeks. I'm so lost, I don't know what to do until then, please help. I don't want to suffer for 3 weeks and I'm basically functioning without a doctor right now.

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Get that appointment with a new pdoc lined up if you haven't already.

This guy sounds all over the place. 

I have met some people that have been in substance abuse programs that don't allow medication so they have to white knuckle it through the time. It is hard.

Would one of your other docs prescribe a psych med? My gp isn't keen on it, but that was just an idea, If you get really bad and you can't get an emergency pdoc appt, go to an emergency room.

Do you have enough lithium to last 3 weeks? Could you stay on that until the new pdoc visit?

Anxiety and obsessive thoughts- for me, every thing helps a little. I don't meditate, but therapy might help you with some coping skills.

Can you try to get on a cancellation list? where if someone cancels they can call you in earlier?

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Wow, your pdoc sounds like a real jerk. I'm sorry you have to go through this. Ideally, your pdoc should be working with your other doctors to get to the bottom of the elevated LFTs, not simply pulling you off meds and telling you to meditate.

Could you get your gdoc to write your prescriptions until you can get in to see a new psychiatrist?

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Get that appointment with a new pdoc lined up if you haven't already.

This guy sounds all over the place. 

I have met some people that have been in substance abuse programs that don't allow medication so they have to white knuckle it through the time. It is hard.

Would one of your other docs prescribe a psych med? My gp isn't keen on it, but that was just an idea, If you get really bad and you can't get an emergency pdoc appt, go to an emergency room.

Do you have enough lithium to last 3 weeks? Could you stay on that until the new pdoc visit?

Anxiety and obsessive thoughts- for me, every thing helps a little. I don't meditate, but therapy might help you with some coping skills.

Can you try to get on a cancellation list? where if someone cancels they can call you in earlier?

White knuckleing seems like the best option. I was hoping I could turn around my mood sooner, but I guess I have to wait.  I suppose my GP could prescribe something, but what? And then I'd have to maybe change the med in 3 weeks when I see the psychiatrist.

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Wow, your pdoc sounds like a real jerk. I'm sorry you have to go through this. Ideally, your pdoc should be working with your other doctors to get to the bottom of the elevated LFTs, not simply pulling you off meds and telling you to meditate.

Could you get your gdoc to write your prescriptions until you can get in to see a new psychiatrist?

Yeah I think I have to move on from him. In a way I think he'd be glad to see me go, I probably haven't been the easiest patient to see.

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Get that appointment with a new pdoc lined up if you haven't already.

This guy sounds all over the place. 

I have met some people that have been in substance abuse programs that don't allow medication so they have to white knuckle it through the time. It is hard.

Would one of your other docs prescribe a psych med? My gp isn't keen on it, but that was just an idea, If you get really bad and you can't get an emergency pdoc appt, go to an emergency room.

Do you have enough lithium to last 3 weeks? Could you stay on that until the new pdoc visit?

Anxiety and obsessive thoughts- for me, every thing helps a little. I don't meditate, but therapy might help you with some coping skills.

Can you try to get on a cancellation list? where if someone cancels they can call you in earlier?

White knuckleing seems like the best option. I was hoping I could turn around my mood sooner, but I guess I have to wait.  I suppose my GP could prescribe something, but what? And then I'd have to maybe change the med in 3 weeks when I see the psychiatrist.

I hope someone comes up with a better idea and you keep us updated on how you are doing.

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Is your pdoc by any chance being fired for incompetence?

I agree with jt that if you can't get in with a new pdoc quickly you should contact your gdoc and throw yourself on his/her mercy. I think this will work best if you have an appointment with new pdoc scheduled, no matter how far out it is-that way you can say "Look! This really is just a stopgap measure while [tell story from above] gets sorted out!"

Jeez. Good luck!

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What's the old saying I've heard? "Trying to meditate away mania is like trying to pray away the gay."(?) (don't remember where I heard that, might very well have been one of you here on CB) The same goes for depression, IMO. I mean, I guess if you get into it when you're stable and learn to use I at the onset of an episode it might be useful, but in the dark depths of depression, I cannot see it being of much use. Your "psychiatrist" (and I use that term loosely) seems like a quack. I'm sorry you have to put up with his bullshit. Is he just being fired or are they revoking his credentials too for being a shitty doctor?

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What's the old saying I've heard? "Trying to meditate away mania is like trying to pray away the gay."(?) (don't remember where I heard that, might very well have been one of you here on CB) The same goes for depression, IMO. I mean, I guess if you get into it when you're stable and learn to use I at the onset of an episode it might be useful, but in the dark depths of depression, I cannot see it being of much use. Your "psychiatrist" (and I use that term loosely) seems like a quack. I'm sorry you have to put up with his bullshit. Is he just being fired or are they revoking his credentials too for being a shitty doctor?

You are exactly right. I used to do yoga. It definitely relaxed me especially while practicing and maybe for a little while after. It is not sending anything into remission. Could you imagine if it did? That would be awesome.

 

I should clarify that when I say he's being fired, that I mean he's being fired by me, as in he's not my psychiatrist anymore. lol. I'm not going to get into bashing him, because I don't think any doctor tries to do wrong by their patient. I compare him to my first psychiatrist, who is in another state, and who actually retired. He was older, and GREAT. What a great doctor he was.

 

I don't think I'm in a crisis situation, so I'm going to try to stick it out, without reaching out to my GP. It's mostly that I feel very uncomfortable for a decent chunk of the day, especially when I'm obsessing about something for hours. It is what it is for now. I talked to family and my wife and they all think that's the best thing to do for now as well. Just to stay the course until I get a new doctor who isn't petrified to prescribe something that is metabolized by the liver. A specialist who can steer me in the right direction since I've already tried a lot of meds. I feel less desperate than when I wrote the OP. You know I had just left the guy. I appreciate the support from you guys though. It's great to hear support from people you've never met but are still connected to because of crappy mental illness.

Edited by professional nut
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Are you obsessing of past, future, random things? I go over and over past mistakes and it makes me anxious and depressed. My tdoc taught me a visualization where I can visit a museum of the past, but I can't bring it into the present. It helps me some. Some people can set aside a time that they will allow themselves to worry and put it off until that time. I can't do that. If they are intrusive thoughts, some people can thought block. You say stop or visualize a stop sign when the thoughts come up, or you can try snapping a rubberband on your wrist. 

I am sure there are more ideas. CBT where you think more balanced thoughts can help, a lot.

Just some thoughts.

oh and there is a chatroom here if you like those. It can be good for distraction

 

Edited by confused
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Lithium is actually metabolized in the kidneys, and is more likely to cause kidney damage than liver damage. It barely touches the liver.

On another note, that doc is an idiot. Taking you off meds when you're still having symptoms? Really? Not giving you any time for a BIG decision is bad, too. 15 minutes is ridiculous. 

You need to find a doc you're comfortable with. I'm very open with my GP and he's always sorted things out. Does that pdoc communicate with your GP? I encourage that, so the GP knows what is going on. 

I'm sorry you're in this shitty situation. That doc sounds like a bad one, I hope you can find a better doc soon.

Being less stressed is good. But I'd really recommend to get a referral to a new pdoc ASAP. 

It's a shitty situation you're stuck in. I hope it gets better. 

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Thank you. Actually, to be exact it is not metabolized at all, since that would imply it is changed by an enzyme. You're right that it has a much greater impact on the kidney. Anyway, I'm not really looking for medical advice :-)

I feel comfortable with how I'm handling this situation and so do the ones closest to me, who I trust. I appreciate your wanting to help and your empathy. Thanks again.

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