Who prescribes your meds? Don't know if I can WAIT for an appointment!

RoaryKennedy · 01-04-2008, 04:04 PM

Hi everyone,

I have been taking Zoloft for anxiety/depression for several years, and for quite a while, it worked well. After I had my dd, I felt like I had PPD, so my OB increased my Zoloft to 150 mg, and I was told that was the max. I also added Ambien CR to help combat sleeping issues.

Lately, I have been feeling awful--really awful. Really teary, really depressed, unable to sleep, even with the Ambien. It seems like the general pratictioner's response has always been to increase Zoloft (but I'm at the max now), so now what? I called and made an appointment to see a pyschiatrist for a med review, but the soonest appointment I can get is in 6 weeks.

So in the meantime, should I try contacting my general practitioner again, to see if there's anything else that can be done--another depression med added or something? I just don't know if I can WAIT that long to see the psychiatrist, feeling the way I do...

PBLayzod · 01-04-2008, 04:18 PM

Actually 200mg is the max, but it may be time to move on to something other than Zoloft. Your doctor may be able to do something else to help while you wait for your appointment. It's worth asking. You may also want to call around and see if another psychiatrist can see you sooner.

elocinintherain · 01-04-2008, 04:42 PM

Maybe it's time to try something else. Generally, GP can and do prescribe antidepressants for PPD and depression, but balk at messing with people with more serious mental "issues". If you really can't wait, you could always go to the GP and see if they can change your medication. You should, however, make an appointment to see somebody at your mental health clinic. A nurse (psychiatric nurse) can usually mess with medications, but it is best to see a psychiatrist. If it's going to take weeks, make the appt, but also ask if they can do an "urgent" or "emergency" appt as well. Sometimes they do. I would expect it to take at least 2 weeks at most clinics this time of year. My psychiatrist is only at my clinic one day a month.
If you feel thoughts of self harm, suicide, or feel like you are just completely losing it, call 911 or go to the emergency room IMMEDIATELY. There's always an "on call" psychiatrist available there.

Bethann · 01-07-2008, 02:53 PM

How are you doing today? If you haven't already, I'd try calling the clinic back and explaining how urgent the situation is--even if you can't see the person you will eventually be working with, it sounds like you really need to see someone now, not in 6 weeks.

RoaryKennedy · 01-07-2008, 04:44 PM

Hi Beth! Well, I called my primary care doctor, and I am going to see her tomorrow morning, so hopefully she will be able to do something while I wait for the February 21 appointment... Otherwise, I will call back to psychiatry and see if they could even put me on a cancellation call list or something, so that maybe I could get in sooner.

O Canada · 01-07-2008, 09:22 PM

Jen,

I agree with elo, if you have ANY concerns about your wellbeing, go to the emergency room. They will not turn you away and are there specifically to help you in your situation.

It won't be ideal seeing a different doctor from the one you normally see, but they will be able to assess the situation and give you the appropriate meds/dosage/etc.

I hope that you're feeling better soon. :-)

A.

weemes · 01-08-2008, 03:28 PM

How did the appointment go today?

I agree with going to the ER if necessary. My Mother just recently had to do the same thing. She drove to the hospital in the middle of the night and told them she wasn't leaving until she got to speak with a psychiatrist. She actually got admitted (voluntarily) and stayed until her meds were semi- worked out and she was sleeping again and putting some weight back on. This took about 5 weeks. They put her on Immovane. She also has anxiety depression.

RoaryKennedy · 01-08-2008, 05:03 PM

Well, I guess it went better than I thought. My PCP is having me taper off the Zoloft for the next three weeks, then I will start Effexor. And she said that hopefully, that will give me a baseline to work with when I meet with the psychiatrist, to see if that will do the trick! And she renewed my Ambien, too, which will help me sleep, since I was out of those, too!

A friend at work who also takes Effexor and has the same insurance plan as me said that the full retail price of his script is $500! Could that be right?!? Yikes. He said that our copay is $35, but it sure makes me scared if I ever lose my insurance coverage. That being said, I better get to work, so I can be darn sure that I keep that coverage!

Thank you all for your concern!

weemes · 01-08-2008, 05:16 PM

Jen: That's great news. Hopefully you will find some peace.

My mother is also on Effexor, it seems to work well for her now. She did loose a lot of weight because her body was working overtime with all her stress while she was in the hospital but she definitely has an appetite.

isenephthys · 01-10-2008, 07:03 AM

good luck on the effexor. i hope that it helps to even out your moods. and hopefully the psychiatrist will be able to help you fine tune your meds.

RoaryKennedy · 01-24-2008, 07:58 PM

Okay ladies, so tell me what you think of this...when I called the psychiatry department a few weeks ago, I specifically requested a med review, and I explained that my current meds weren't taking care of my depression, anxiety and sleep issues.

Today, I get my intake survey in the mail, along with the appointment card. The appointment card shows that I'm scheduled with a nurse practitioner, not an actual psychiatrist.

And that attached papers said that you may need to go to an initial consulation, then be referred on if the initial consult determines that you need prescriptions. Sigh. Did I not ask for a med review, indicating that I already take some sort of med that's not working for me? And a nurse practitioner cannot prescribe psych meds, right? So, what's up? It took me 6 weeks to get this appointment, and I don't want to have to wait another 6 weeks above and beyond that to meet with someone about meds, when that's what I asked for in the first place.

To top it off, when I saw my PCP, she is starting me on Effexor, but only prescribed enough to give me a baseline until I saw the psychiatrist. No refills.

I am probably just venting. And now that I'm transitioning off the Zoloft, I'm super teary, and feel like they think I'm so crazy that I need to see a gate-keeper before they can allow me to get some real answers. What do you think? Should I call and demand an actual med review, like I requested or will this nurse practitioner actually be able to do something?

isenephthys · 01-25-2008, 03:11 AM

jen, i'm sorry your moods are so labile. it can be really tough transitioning from one med to another.

if you really need it, your primary doctor can most likely call in a refill of the effexor. just let them know that you have a psych appointment on x date and were unable to get in sooner. most md's are pretty understanding about this.

with regards to the nurse practitioner, it is becoming more and more common to see psych np's because there is such a shortage of mental health practitioners. they go through a very rigorous program and can do psychotherapy just like a psychologist/psychiatrist. depending on the state's nurse practice act, they can also prescribe medication. i am unsure of how it works in minnesota.

if you are really concerned (which obviously you are, understandably so) call the psychiatry practice back and ask some questions. ask if you are going to see the md at any point and if the np will be able to prescribe/manage your meds.

when i went to see the psychiatrist earlier this month, my first visit was a long session where we went over my sypmtoms, meds, psych history and my current symptoms. i was a bit surprised when she asked me to schedule for a week later for my treatment plan. her reasoning was that she wanted some time to think about our session, do some research into the best combos for my pcos and mood symptoms and get all my old medical records in order to come up with a more tailored (and hopefully more effective) treatment plan. yes, it is a slow and frustrating process- especially when you feel bad and want help "now!" but hopefully, it will yield some positive results for you.

RoaryKennedy · 01-25-2008, 04:58 PM

Thank you, isen, for your continual support and encouraging words--I really appreciate it!

I'm being silly, and I know that (especially for 30 years old--I should be over crap like this)--but when I called to make the appointment, the scheduler was a complete b*tch. I know that shouldn't stop me from making a call, but it's like sheesh, why should I feel like I should avoid making the call to save her from doing her job, KWIM? If Effexor kicks in so quickly, like you mentioned, maybe if I wait a couple of days, I'll be able to make the call without feeling like I will collapse in tears on the phone.

And it's good to know that it was only a week before you could come again. Maybe once you're in the system, you don't have to wait six weeks for an appointment, like I did for this initial appointment. On my intake form yesterday, it asked about serious medical problems, and I mentioned the PCOS, wondering if they would even know what that meant. So it's good to know that your practitioner took that into account, too.

I just feel so disappointed, KWIM? I was hoping for a faster answer (and to feel better!) once I finally got this appointment.

isenephthys · 01-29-2008, 10:01 AM

jen, i can totally understand the source of your frustration. it can be such a slow process to get things moving. that part of it sucks.

i'm really sorry that the scheduler was a b@tch. that's the last thing you need to deal with on top of everything else. i get the same way. when i'm feeling anxious/depressed/whatever emotional issue i tend to feel less able to stand up to the outside world. don't give yourself a hard time about it; be patient w/yourself. you're dealing with a lot.

i hope you get some relief soon!