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Can I just say No?


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I'm supposed to see my pdoc tomorrow. I've stopped the meds I was on, because it was really a lot worse than my symptoms, though I didn't tell him.

One of my biggest problems is chronic, daily anxiety. As in, don't pick up the phone unless I know who it is, I do nothing by myself, etc. In the past, I was on paxil, effexor, zoloft, and most recently, remeron. None of them really did it for me. They did, however, give me seriously bad withdrawl. I missed 3 weeks of school when I dropped paxil, so I could lie in bed and scream and cry hysterically. It's gotten better with each successive pill, but I'd still rather not have to do it, ever again.

I have a feeling he'll likely suggest starting something like celexa/lexapro tomorrow. I don't want to try it. If it doesn't work out, it's going to hurt, a lot. He didn't give me a choice when he thought up lithium, even though I protested. "Well, you can think about it and we'll start you on it next time."

if it comes up, am I safe with saying no, based on past experience? I'm canadian fwiw.

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I don't know about the law there, but in America doctors cannot force people to take drugs against their will.  What if he writes the Rx and you don't fill it?  What if you fill it but don't take the pills?  I think the worst that will happen is your doc will suggest you see somebody else instead of him/her, which might be a good thing.  It sounds like some talk therapy might be helpful.  But I'm just another crazy, not a doc.

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Heya ehygon,

As your doctor, he has an obligation to recommend -- even *strongly* recommend -- treatments to the best of his ability, in accordance with standard of care.

Like, if I have an old lady bleeding from her gut, but it's not an emergency, I *must* strongly recommend a colonoscopy, and I *must* document that she understands the risks and benefits, and that she refused.

You can take his suggestions, or not, but *please* do tell him so he can document it in your chart.  Not to be a jerk, but b/c it's relevant to your health.

And you can also switch docs -- specialists anyway -- whenever you want to.

The *only* exception is, of course, in an emergency, when the doc *must* treat you no matter what.

--ncc--

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Well, you can certainly tell him NO, however, I do want to share that it took me 11 different meds before I found the right one that helped my anxiety.  It sucks I know, but I'm not willing to let my anxiety run my life and prevent me from enjoying it.

You can always try another doctor as well.  Each has their own way of treating certain disorders and the next might have a better option for you.

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I'm supposed to see my pdoc tomorrow. I've stopped the meds I was on, because it was really a lot worse than my symptoms, though I didn't tell him.

<{POST_SNAPBACK}>

A little late for me to be saying this then, but the primary tool a psychiatrist

has to work with is the patient.  He needs to know how the medications are

affecting you - both what it does to you and what it doesn't do to you.

If you are feeling too anxious when you see him, and keep forgetting to bring

up the symptoms then write them down and bring a copy in. If he doesn't

read and heed careful documentation of the effects of the medications he

prescribes, then it is entirely his fault that you aren't feeling better. If you

haven't told him what has happened/been happening, then it's yours.

Sometimes it takes longer for medications to take hold; sometimes more

(or less!) medication is needed for a therapeutic effect. There's no way

for him to know unless there's feedback.  "It's not working" doesn't mean

anything - it covers everything from "too much" to "too little" with stops

along the way for "why do I smell smoke?" and "what's that rash?" 

Sometimes a minor side effect is an indicator of big troubles with a

medication, sometimes it's just a thing. Your doctor will hopefully know the

difference better than you will.

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crisis averted, he wants me to stay off meds, for another month. I know that not calling to tell him or seeing if he could fit me in wasn't a good idea, but he's still not helpful. He gave me a lecture about "every medication has side effects, and its about a balance between what works and what you can deal with." Don't I feel enlightened. He also checked over the other things I'd been on, and said something like "this isn't everything we have to work with, but it covers most of it."

So I've got six sheets, three to fill out every 2 weeks. I'm kind of wondering what he wants to know. Social Phobia Inventory (SPIN), BDI and BAI (depression and anxiety indexes, respectively). I hate them more than assfat.

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I'm supposed to see my pdoc tomorrow. I've stopped the meds I was on, because it was really a lot worse than my symptoms, though I didn't tell him.

One of my biggest problems is chronic, daily anxiety. As in, don't pick up the phone unless I know who it is, I do nothing by myself, etc. In the past, I was on paxil, effexor, zoloft, and most recently, remeron. None of them really did it for me. They did, however, give me seriously bad withdrawl. I missed 3 weeks of school when I dropped paxil, so I could lie in bed and scream and cry hysterically. It's gotten better with each successive pill, but I'd still rather not have to do it, ever again.

I have a feeling he'll likely suggest starting something like celexa/lexapro tomorrow. I don't want to try it. If it doesn't work out, it's going to hurt, a lot. He didn't give me a choice when he thought up lithium, even though I protested. "Well, you can think about it and we'll start you on it next time."

if it comes up, am I safe with saying no, based on past experience? I'm canadian fwiw.

<{POST_SNAPBACK}>

you're canadian?  well . . . that does change things.  if you were a rugged indivualist like us americans, i'd say you could do whatever you want.  solve your problems with whisky, gambling and an untameable wanderlust by lighting out for the territory.  but since you're canadian, i think its gonna have to be lexapro and ice hockey

sorry, i couldn't resist. 

how long have you been off meds?  i've been off of an ssri for close to six months now, and while there was some bad periods during that intervening time - and i didn't really pick myself off the ground yet - i still wouldn't say it was a mistake.  i think sometimes you need to go off meds to understand what your problems really are, and what you can do behavior/med-free wise to make yourself feel better.  and i think i'm only reaching that point now.  i had to take radioactive iodine for my hyperactive thyroid in december, and now that my thyroid is not making me psycho - i can feel a definite improvement in my anxiety.  course i feel like sludge right now, and will hopefully go on thyroid meds here pretty soon to level that off, but its always one step at a time.  i would have wasted all that time adjusting my meds, or thinking i needed to resolve all these psychological issues before i felt better - when really what i needed most was a slight improvement in my thyroid levels.  i'm not saying that that's your problem at all, but sometimes meds just prevent you from getting to the root of your problem. 

then again you may be fully aware of what your problems are and just be uneasy about starting meds again.  which is fine, but if its not going to make you a whole lot worse to try something new, and might improve other aspects for the time being i'd say try it. sometimes my anxiety just gets better if i accomplish something during the day, or hang out with my friends.  i had a really horrible weekend last week where my brain was just frying  trying to find some way to distract myself through tv, or somethign else - and i kept having these escalating  worries for the future.  it kind of continued throughout the week, but for some reason they're gone now.  i don't know if it was because i managed to hang out friday with some people on friday night, or things just kind of re-equilibrilized for me chemically for a bit.  but i could have finally said to myself - okay i need to go back on meds for an indefinite period of time (which i did for a day until i realized how screwy they make me) or i could do what i did - which was just continue to drag my feet and wait for the worst to go away.

if the anxiety won't go away, and you can't function, i'd say you should try meds.  but if its something you can deal and function with, and might improve with a little activity, i'd say give it more time.  which it looks like you're going to do anyway, i just wanted to write out my own experience.  um yeah, like i said my brain is sludge right now, so most of what i said was probably redundant. 

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Heya Phoenix,

No.

We have no Lexapro.

Cipralex, Molson, and a skidoo.

--ncc--

<{POST_SNAPBACK}>

This made me giggle, because it reminded me of an episode of will and grace;

Jack ; Say something lesbionic!

Rosie O'Donnel ; Home Depot

</hijack of my own thread>

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Sure you can refuse, but what is your alternative method of therapy?  There isnt any point seeing a dr if you are not receiving therapy and/or drug therapy (meds).

Otherwise its a waste of your time and the dr's.  Im not suggesting you take the ssri against your own judgement, but you need to talk with your dr about alternatives or see another dr, because obviously you have a problem that requires treatment.  Its in your best interests to try something.

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