I need to pull my thoughts together in preparation for my first appointment with my new psychiatrist today, and I thought I might as well do it here.
Medication refills
The discharge prescription from the hospital was for weekly refills. I want to get more medication than this at a time, and here’s my concern. When I have meds, I take them. When the difficulty of getting them outweighs the resources I have available, I either start rationing them or I stop taking them. That’s been a big issue over the last year.
I get that there’s a concern that I might overdose if I had a larger quantity on hand, but here’s the thing. The meds I’m on wouldn’t kill me; they’d just make me barf a lot. If I wanted meds to overdose on, I’d ask to be switched to a tricyclic antidepressant (TCAs tend to be more effective than many other antidepressants, but they can cause a cardiac arrhythmia). But every time that’s been suggested, including during my recent hospitalization, I’ve said no, that’s not safe for me to have at home, because the chance of me overdosing on it at some point is a risk that’s not worth taking. That’s not the decision-making process of someone who’s intent on stocking up on meds for the purpose of suicide.
Dexedrine
I stopped taking Dexedrine last year because I didn’t have a prescriber. It helps somewhat with my mood and concentration, but mostly it helps with the psychomotor retardation (slowing of movement & thinking). I’ve never felt any effect from it right after taking it, and certainly no “high” of any kind, but I have noticed that after 3-4 days either on it or off it, there’s a change in how slow my movement is. I didn’t ask to restart it in hospital because I see it as being symptom-targeted rather than important for the illness process overall, and I wanted to see how much of a change that ECT made in how slow I was. It helped somewhat, but the psychomotor stuff has gotten worse since I was discharged.
Given that it’s hard to get out and do things like go to the pharmacy when I’m super slow, I’d like to go back on the Dexedrine. The highest dose I’ve been on is 15mg twice a day, and 15mg once a day seems to be the minimum dose where I start to notice a real benefit from it.
Appetite
My appetite has gotten worse since getting out of hospital, which is somewhat concerning, as it’s usually not an issue when I’m well-medicated. I’d like to bump up my mirtazapine from 30 to 45mg a day and see if that helps. I’ve tried taking 45mg in the past, and it disrupted my sleep (at lower doses, the antihistamine effects of the antidepressant mirtazapine make it quite sedating, but at high dose, it has stronger effects on norepinephrine, making it less sedating). However, at that time I was only on 300mg of quetiapine (antipsychotic) rather than the 600mg I’m on now. I’ve been taking 45mg for the last four nights and my sleep has been fine.
I don’t know if the psychiatrist is going to be open to doing anything with my meds on the first visit, but I want to go in conveying that I am the one in charge of my treatment. The psychiatrist may not like that, but it’s my brain and my body, so it’s gotta be me in the driver’s seat. As for increasing the dose of mirtazapine myself, she might as well get used to the fact that I’m very proactive in managing my own med regimen, and if changes need to be made, I’m not going to wait around for a doctor to make them. Wish me luck!
Good luck <3
I found 45 mg of mortazipane made me too drugged!
I had to go back down to 30 MG! X
Thank you! Too bad trying the increased dose made things worse. I guess at least now you know, though.
Exactly, at least I know now, I can tolerate 30 mg but not more than that ✨✨
Good luck!!! Hopefully your doctor is receptive and respectful of you and your being in charge of your own care. It’s important to have an active role in your care and I’m glad you do and will advocate for yourself!
I think it’s definitely a large barrier to only have one weeks worth of medicine at a time. It would definitely hinder the process, not help it. Hopefully you get the changes you need!
Thank you! 💕
Good luck! 🙂
Thanks! 😊
I don’t really believe in luck as it were, but I do believe in you Ashley, and I am impressed of how well you know your stuff when it comes to this sort of thing.
I didn’t have a clue when I went to my psychiatrist.
I didn’t know what I needed or what would be best.
But knowing what you need and what you would like, is great. You are and should be in control of what you do or don’t put in your body.
I hope it goes well ❤
Thanks, lovely. ❤️
A good psychiatrist will be happy to work with you with your meds. I’m so reticent to bring things like these up (please, perform, perfect), but every time I do, my psych tells me he’s proud and how vital it is that the patients get to have a say in how we’re medicated. You sound knowledgeable and reasonable, so let the discussions commence. I hope it goes well 💝
Thank you 💕
That’s good that your psychiatrist takes that perspective. There are far too many who don’t.
True story.
I like that you advocate for yourself and how you take charge of your care.
Good luck Ashley!
Thanks! 💕
Good luck 🍀💚
Thank you 💖
Good luck! I feel some doctors can be defensive if a patient goes in with a clear idea of what they want to do, even if they know their stuff, as you do. I hope they don’t try to establish a “I’m the doctor, you’re the patient, I speak and you do as you’re told” scenario.
Thank you!
Best of luck! 🍀 When I started seeing my current psychiatrist, he was totally on board with my medication recommendations, including the Xanax, which is the best anti-anxiety that I’ve found personally. I’ve been (and off) Xanax for about eight or ten years now, and I haven’t gotten addicted. He monitors it very well and I’m comfortable with him doing that. He takes an active part in decision making and is informative of what the risk/benefit ratio is, and the impact on my other co-morbidities (diabetes, arthritis, chronic pain). I think your goal to claim your own care vis a vis medications is certainly logical. Take care!
Thank you! I’m glad your psychiatrist is one of the good ones.
Does your pharmacy deliver? Mine does although I don’t use it. That could solve a big problem. I hope you like your new psychiatrist. I hope you will tell us how it goes 😊 💕
Thank you! The pharmacy I’m using doesn’t deliver, but there’s another one that’s further away that does, so that’s an option. ❤️
Good luck! I can imagine it’s a tough process, with the new person, and with the meds. I’ve always had a firm ‘no’ attitude towards meds. The only exception, ever, was half a dose of 15 mg Mirtazapine for maybe ten days total during a time when I simply couldn’t sleep for days and days in a row. It made me feel very trippy, and all sensory inputs seemed to be activated at all times. I found it horrible. Stopped taking and never looked back.
It’s interesting how some people are so susceptible to side effects and others aren’t. I don’t get side effects from most meds.
I found out fairly recently that I belong to the highly sensitive person crew. Sensitive to overwhelm, fear, impulses, certain foods, and apparently it also includes meds side effects.
But not fear of snakes. 😉
Snakes, spiders, and every other creepy crawler in the book are fine. But pretty high anxiety about many other things. Although lately I’ve been quite in control of my GAD…
Oh that’s good.
Good luck.
Thanks!
I wonder if dexadrine is more tightly controlled than some meds not considered to be habit-forming. I think it’s the kind that one would only feel a “high” effect if one were to abuse it; like say, take six at a time. I’m thinking it’s an amphetamine (or in that class) but not sure how it relates to other controlled substances.
A lot of doctors are fairly uptight about stimulants, probably because of the potential for abuse.
I would think so.
I hope all will go well and that he or she will take your questions seriously and hopefully also act on that. 🍀
Thank you! 💕
You got this Ashley! Stand in your truth!
Thank you! 💖
I agree with my entire being in the last paragraph of this post. When we are not allowed to be in charge, and when providers refuse to listen, then it is time to find a new provider. My psychiatrist bumped my Buspirone from 20 mg/day to to 60 mg/day and it caused panic attacks and heart palpitations and “syncopated episodes”. I didn’t wait the two months it would take to see him again to reduce the dose on my own; and when I did see him, he was unconvinced of what I was telling him. But I stood my ground, and told him I would not take more than 20mg/day ever again. I too take mirtazapine to combat night terrors and induce sleep, but do think it is somewhat responsible for the night time binge-eating that occurs after taking it. I wish you the best of luck, my beautiful friend. You deserve proper care!
Thank you! And good for you for standing up for yourself! ❤️