Too Many Meds?

[Always Unstable]

Meds are in signature. My case worker insists on telling me everytime I see her that she thinks I'm on too many medications and rely on them too much. I disagree and so does my doctor who I see every week. My doctor and I collaborate together on what meds to try etc so it'snot like he's just forcing all these meds on me either. I don't feel like I'm over medicated but my case worker thinks otherwise. My pdoc probably thinks the same as my case worker too, they're all about therapy and less meds. But I am in therapy too, I'm not relying soley on my meds. Ugh, rant over.

[notloki]

Does your case worker have any power over your meds ?She should not, she is not a medical person. NO one has ever cured BP I with therapy If she has no power ignore her,. 

[melissaw72]

2 hours ago, Always Unstable said:

Meds are in signature. My case worker insists on telling me everytime I see her that she thinks I'm on too many medications and rely on them too much. I disagree and so does my doctor who I see every week. My doctor and I collaborate together on what meds to try etc so it'snot like he's just forcing all these meds on me either. I don't feel like I'm over medicated but my case worker thinks otherwise. My pdoc probably thinks the same as my case worker too, they're all about therapy and less meds. But I am in therapy too, I'm not relying soley on my meds. Ugh, rant over.

I can empathize with you on being told that you are on too many medications.  A previous GP told me that every time I saw him for a medical reason.  It really got to me. 

(bold) My pdoc disagreed also, and like with you, pdoc and I deal with meds together without forcing them, without the involvement of others ... whether they think it or not.

I agree with @notloki ... your caseworker should not have any power over your meds. Also agree about curing BP1 with therapy ... it just doesn't happen (although if it has happened to someone, please post).  You need meds too.

It must feel like a kind of harassment when you see your case worker and hear her say that you are on too many medications, every time ... it would to me at least.

 

See sig for the number of meds I am on.

[Cetkat]

I think your meds are perfect.  I agree with the others about how it's none of the case worker's business & she is way out of line.

But, med-wise.. I actually think your combination is really smart.  

Lithium 750 mg, Thyroxine 75 mg, Topomax (titrating), Moclobemide 600 mg, Valium 7 mg, Zyprexa 20 mg, Seroquel IE 200 mg,  Seroquel 25 mg PRN

You've had ECT and a long med history, so the Moclobemide is warranted.  The Lithium and AAPs (Zyprexa/Seroquel) are a good combination with that, and would help prevent the mania and psychosis-type symptoms.  The seroquel would also help with the behavioral stuff, IMO, because it tends to reduce agitation.  Lithium also raises serotonin a bit, so it would augment the effects of the Moclobemide.  All of it also gives good coverage for the epilepsy, and the Topomax should fit in well with everything.

I also found this: "Some preclinical data suggest that moclobemide may have anticonvulsant property."

https://www.ncbi.nlm.nih.gov/pubmed/12595913

The only issue I see is that Lithium isn't good for your thyroid, and I'm assuming since you're on Thyroxine you have Hypothyroidism.  So that's something to monitor; but, in your case, I'd consider it a warranted risk.

[jt07]

If your meds are effective in controlling your BP disorder and you don't feel zombified then I don't think you are on too many meds. Fewer meds could possibly destabilize you. No one wants or would choose to be on a lot of meds so I can't see where your case worker is coming from. I completely agree with notloki that BP disorder is not cured by therapy.

[notloki]

It is easy to make these kind of pronouncements when you are not the one with 4-5 separate conditions that all need treatment. I don't see any overlap in your cocktail.

[Iceberg]

if it ain't broke, don't fix it

[Always Unstable]

Guys thank-you all for your responses, really, it made me feel better. I think she's more concerned about my Borderline and needing therapy for that but I just finished a six month DBT course and really didn'tget a lot out of it. Now I'm in one on one therapy. 

I really like my current meds cocktail, i think that once he's finished titrations my topomax it's all going to be swell. Even with two AAP's I don't feel zombie like at all. 

Any way, again, thanks for all the responses, i feel a lot less a lone Xxx

[Iceberg]

How you liking the one on one...is it more helpful? 

[Gearhead]

How you feel is the only factor that should determine how many meds you take. Period. Your case worker can blow it out her ear.

[HAL9000]

I think there are so many knee jerk reactions.   The "number" of meds is a new low.   Does anyone think we want to take more pills???  Help me Jesus.   It sounds like your doc and you tried a lot of stuff to get things going better for you and then someone who doesn't prescribe is going to say your taking too many?   Chalk it up to the stupification ray hitting that person.

[Always Unstable]

9 hours ago, Iceberg said:

How you liking the one on one...is it more helpful? 

Yeah, I like it much better. DBT was good but I really had to be in the mood to be around people and I often wasn't.

8 hours ago, Gearhead said:

How you feel is the only factor that should determine how many meds you take. Period. Your case worker can blow it out her ear.

Hear, hear.

[Cetkat]

On 4/12/2017 at 6:30 PM, Always Unstable said:

Guys thank-you all for your responses, really, it made me feel better. I think she's more concerned about my Borderline and needing therapy for that but I just finished a six month DBT course and really didn'tget a lot out of it. Now I'm in one on one therapy. 

I really like my current meds cocktail, i think that once he's finished titrations my topomax it's all going to be swell. Even with two AAP's I don't feel zombie like at all. 

Any way, again, thanks for all the responses, i feel a lot less a lone Xxx

Yeah, people like to push their favorite pet therapy on people.  You went, you did it, you don't have to stay with DBT  forever.  Being borderline doesn't mean you can't do other types of therapy or that you can't also have conditions that require medication.  Ugh! People like that annoy me.

I'm glad you like your cocktail. I think your pdoc is pretty smart to come up with it.  You're definitely not alone.  All of us here can relate.

Gear and Hal expressed it perfectly.

If it were me, I'd just tell her that you hear what she's saying, and you disagree - and you're just not going to talk about it any more. And any time she brings it up, I'd say, "I'm not going to discuss this with you, stop bringing it up, you're not a doctor and it's none of your business."

[HAL9000]

On 4/12/2017 at 5:30 AM, Always Unstable said:

Guys thank-you all for your responses, really, it made me feel better. I think she's more concerned about my Borderline and needing therapy for that but I just finished a six month DBT course and really didn'tget a lot out of it. Now I'm in one on one therapy. 

I really like my current meds cocktail, i think that once he's finished titrations my topomax it's all going to be swell. Even with two AAP's I don't feel zombie like at all. 

Any way, again, thanks for all the responses, i feel a lot less a lone Xxx

I don't want to diss CBT because I know some people that have had success with it but...  I went through that more times then I can count and there are some things that are organic and drugs are around that treat a lot of different things.   I was really excited to see a study where they did MRI?  or CAT Scan of people with depression and saw serious before and after effects based on medications.   That might seem like a small thing but according to my TDoc this "proof" that mental health problems even exist is huge.   Now that it can be measured?   H U G E...   Its not just "All in your head"

[mcjimjam]

I've encountered this attitude, too. I can't see what meds you take but I don't think any of us can say whether or not you take too many meds. That is a medical judgement. In any case, the right amount of meds is however many you need to feel as best as possible with the least side-effects.

[Cetkat]

On 4/21/2017 at 4:39 AM, HAL9000 said:

I don't want to diss CBT because I know some people that have had success with it but...  I went through that more times then I can count and there are some things that are organic and drugs are around that treat a lot of different things.   I was really excited to see a study where they did MRI?  or CAT Scan of people with depression and saw serious before and after effects based on medications.   That might seem like a small thing but according to my TDoc this "proof" that mental health problems even exist is huge.   Now that it can be measured?   H U G E...   Its not just "All in your head"

It was probably PET.  I actually sent my new pdoc a message asking if there was any diagnostic worth to having one done.  They're able to see which sections aren't operating correctly (which is interesting in and of itself).. but that doesn't necessarily equate to them knowing how to target it or why it's occurring.  I'd like a look at my hippocampus more than anything.

Previous imaging, I think MRI, could show the overall gray matter loss over time.. but other than finding that Lithium was neuroregenerative, I don't think they studied individual meds.  It's definitely not in anyone's head.

[Cetkat]

On 4/21/2017 at 7:33 AM, mcjimjam said:

I've encountered this attitude, too. I can't see what meds you take but I don't think any of us can say whether or not you take too many meds. That is a medical judgement. In any case, the right amount of meds is however many you need to feel as best as possible with the least side-effects.

It's in the sig.  The biggest thing is, her and her medical professional agree on the treatment.  It's a case worker who has nothing to do with prescribing that's saying this.  That in and of itself is a problem.  I'm happy to use my best judgement based on my own history and research to belay her fears on that and share my opinion that what they're doing together makes sense.  It would be horrible if a case manager got in the way of a working treatment.

[notloki]

You could tell her flat out you don't want medical advice from nonmedical people. Or have her call your pdoc. You will need to sign a release and you can specify what can and cannot be disclosed or discussed.

Or learn to ignore her.

 

 

[melissaw72]

5 hours ago, notloki said:

You could tell her flat out you don't want medical advice from nonmedical people. Or have her call your pdoc. You will need to sign a release and you can specify what can and cannot be disclosed or discussed.

Or learn to ignore her.

 

 

Completely agree.

[mcjimjam]

Can you ask for a new case worker? Most social workers I have have respected that the drugs are outside their area of expertise and left it alone, besides encouraging me to take them as I am supposed to. It's part of their job to raise the flag when a client seems to be unwell and needing a review earlier than scheduled due to deterioration or if the client is deemed to be unsafe but the specifics of meds they should leave alone.

If you ever have doubts about the way your doctors are treating your illness, getting a second opinion could help you feel more confident about it. Also if you are unsure of a diagnosis. I mostly accept my BP dx because a series of pdocs have assessed me. Same with meds.

Edited April 27, 2017 by mcjimjam