Question about Doctors prescribing meds

Hi there, I have a question for those of you who are on meds.

A bit of background info - I went to my Doctor regarding my depressive and out of control moods. From my own research I thought my problems may have been hormonal so wanted to check that out first before going onto anti-depressants so had test done and results showed everything hormonal was as it should be. Therefore my Doctor put me onto Citalopram 20mg. I have been taking these for about 3 months now.

My question to you is, do you feel happy with the way your doctor handled things in terms of prescribing meds? Was there any follow up once you were taking them?

The reason I ask is because my Doctor never once asked me for details about how I was feeling. I said I felt "low" so had the hormonal tests done and when they came back A-OK he just prescibed me 3 months worth of Citalopram like that. When I went to see him for other reasons (my spider bite) he prescibed me another 3 months worth to "save me coming back". At no stage has he asked me if I am feeling any different, if I've had side effects, he didn't even ask exactly what my "low" moods were i.e. how it feels, what happens ect. And hasn't asked me if there are any reasons I might feel "low". I started trying to explain what I meant but he was already printing out prescriptions and forms and things and I got the impression that he didn't need more info.

Is this the norm? I havn't had alot of experience with Doctors by the way and I find it a bit hard asking for help and support when its for myself. It scares me that I was so freely and easily given a medication that effects my moods and inevitably my whole persona without so much as a 'background check'.

Or am I just being a drama-queen??LOL

HI,

Anti medication should be closely moinitered, in theory.

Often the doctors do not have the time to do follow up. I know my doc only does 15 min appointments. When I go and have an issue to discuss I actually ask for a half hour appointment.

In my opinion he should have asked how you were felling on the anti-d's, if they were helpping and any side effects. Also has your doc offered to put you in touch with a counsellor. Current research shows that the best results with anti d's is when they are used in conjunction with talk therapy.

Hope this helps.

The doc the put me on it was very thorough, asked a few questions and I've been on the same thing for 15 months and there has been no followup. I went to see my own doc recently so I could get a referal for counselling and had a talk with him then. He has been my Docotr for over 18 years and in his own words he had not realised how bad things were for me.

You have to do whats right for you. If the meds are working for you great.. keep it up and have regular contact with your doc or a counsellor. you dont have to do it alone. Find out every place you can get support, whether you need it now or not. Because when you really need it its almost too late to start looking!.. be prepared.

and get info on the drug if it worries you. Heck it cant hurt to know what you are dealing with!

And hang in there.. these guys will help with your questions. keep asking

JaeBee,

I think its a bit poor, but not unusual, alas.

A couple of options come to mind - print out this Thread and post it to ya doctor for his edification (it may be the prompt he needs to delve into 'things' more deeply) - or, make an appointment with the Practice Nurse at your surgery, and tell the PN what you're telling us. In as much detail as you need to. Just talk, share those thoughts and feelings etc without worry, because part of a good diagnostician is in the listening to and understanding of the 'delivery' of words we choose to use.

The Practice Nurse will have to record details of your consultation and yep, the GP will be consulted by the PN, for you. If that leads to another appointment with your GP, say that you need the PN to be present at that appointment. That way, you are less likely to 'gloss over' stuff and more likely to receive the attention and considered assistance you may need.

Have a read of this, JaeBee - 'tis your Code of Rights when using a health or disability service. http://www.hdc.org.nz/media/123229/english-leaflet.pdf

Gentle Care, eh. Good.

Paddy.

I agree with Paddy. A good doctor would be more thorough, but it's not all that uncommon. You should shop around for a good doctor. I've been with mine for a while now... and it's nice when they actually remember you without having to tell them things over and over.

Printing out this thread is a good idea - well - your post anyway. If you feel your doctor isn't being thorough enough, let him know and consider switching.

The truth about doctors and anti-depressants is... it's a very misunderstood "science". Doctors will just prescribe and hope for the best. If you don't complain about what they prescribe, they'll just assume everything is okay.

But as I say, some doctors are better than others.

Dear Jaebee

GP's haven't specialized in any field of medicine for the most part. If you get one who has, its a bonus, truly.

As Wowwinz said, find out for yourself, arm yourself with knowledge, the internet is great. Go to the library and find books written by people who know the subject and see if any of it resonates with you.

If we were diabetics, or heart patients we would be treated a lot more carefully but because we don't "show" symptoms GP's can only treat us if we tell them how it is. Ask for referral to a free counsellor, ask the reception if any of the Practice Nurses have an interest in Mental Health.

You owe it to yourself to know about your condition and what it takes to treat it.

Love Martinexx

Reading about the experiences posted above I feel very lucky to have had the doctor I had to prescribe my AD's. She had just qualified and was taking her responsibility to her patients very seriously. Firstly she prescribed for only two weeks then she got me 12 free mental health appointments and tried to goad me into counselling which I actually managed to get out of. The offer and information was definiately there. For the next three months I had to go in monthly to see how the meds were going, after a couple of months we decided to increase the dose. After she left the practise I changed onto one of the permanent doctors and I have to see her at least once every three months. She ALWAYS asks how I am feeling no matter what I go in for. If I just go for a mental health visit the visits are still free. If the visits involve anything else then I have to pay. I am still on AD's but haven't felt down for ages but I do feel well looked after and feel confident that if my doc can't handle whatever is going on she would refer me to someone who could and make sure that the help was made available.

Hi Jaybee - perhaps you should change your doctor (if there is another one available) ?

My doctor asked lots of questions and got me to fill in a questionnaire about how I was feeling. He then advised me to take a break from things and saw me again in a few days to check I was ok on the meds (seems citalopram can precipitate manic episodes in some people) so it looks like you have been treated a bit poorly.

I think that knowing what it is all about is important for recovery so if you haven't I would do wgat I did and get a few books out of the library and do some reading . . .

peter

My doctor was the same. I had to come in after the first two weeks to see how things were going. I then had a visit every 2 or so months to either change the dose or meds.

Unfortunately, I think this seems to be quite rare. I've heard a lot of horror stories when it comes to gps and dealing with mental health issues.

Yep agree DocLazy - my doctor told me about a patient of his that after a couple of days on Citalopram decided he was the King of Fiji and so got his passport and went off to the airport with $50 to fly out and take over . . .

peter

Its scary. This illness has a major influence on my life. It was a huge thing for me to ask for help and the person, the Doctor, the professional who I put my trust in to help me (with any illness) just hands out AD's to me with no explanation as to what they are going to do to me or even what depression is. I image if I had, say, diabetes it would be different.
I am especially disappointed because he knew I was reluctent to go on AD's straight away thats why I wanted to see if it was hormonal first.
It shouldn't matter how busy he is or whatever, when I go to the Doctor I expect to be throughly assessed and given the treatment that is most likely to be effective. Not some half-ass, quick fix, "next patient please." Is that too much is ask?

Nope, its certainly not too much to ask.

The Code of Rights I Linked to in my previous post is very plain on how you have the right to information and information delivered in a way you can understand.

I know that in theory you shouldn’t have to go via the Practice Nurse, but I still think it’s a valuable chance to have your first ‘Them really listening to me’ session which must be recorded and acted on – the Nurse has a duty of care to make the GP aware of your visit and the reasons why, along with I would hope, a suggestion as to what to do next, so that you are helped to learn – as opposed to your being a patient / consumer who probably has grounds for a complaint to be lodged against the Medical Practice and the GP if things don’t improve quickly.

But, you have a duty to make sure that they understand that you don’t; and that you need them to help you understand and to develop with you a Wellness Plan in which you are an informed and willing participant.

Next move may be, yours back to them. If they don’t realise the communication isn’t adequate, they have no way of knowing it needs to be goodera, do they?

Paddy.

The way you have been treated is just plain wrong. The kind of doctor you end up with is often just luck as it was with me getting a new graduate who was trying very hard then passed me on to oneone experienced but equally caring. There are other doctors in the same practise that are not as thorough and caring when it comes to MH issues. Are you in a position to change doctors? As with any other professional one size doesn't fit all and it sounds as if your doc and you are NOT a good fit. Good luck and get us posted on how you get on.

ha it must be some dr the area as i have just has to change my dr as she had no idea about mental health poven when i went to talk to her about migriane her4 face lit up and she explained ever4ything r4eally well then i talked about mental health and you saw her turn off anf became very abupt. so shop around i have just changed again so here is hoping.

I was really lucky. When I went in I burst into tears with my doc (totally not my norm!), and he just talked with me and held my hand as I bawled. Wrote me off work (growling me when I protested), started treatment, and arranged to phone me every few days to see how things were going, rather than making me get all anxious about going in to the GP practice for a follow up. He was really lovely, and was honest with me when he felt out of his depth and wanted to refer me in to "the big docs"... but has continued to be incredibly supportive and lovely throughout.

A good GP is worth their weight in gold!