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    Old 05-04-2006, 07:53 AM   #1
    jealibeanz
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    Need help asking for meds from new doctor!

    OK, this is long, but please bear with me!

    I've batteled extreme social anxiety since I was born! Throughout high school it developed in to GAD, dysthmia, and seasonal depression as well. I've always been very shy, quite, and uncomfortable in any public or social situation. I've gotten much better while in college made some great strides, but still very uncomfortable. Despite my anxiety, I've always had a great group of friends, OK social life (althought sometimes nonexistent), and do well academically.

    I tried Paxil 3 years ago for social anxiety/depression. I switched after a couple of weeks to Buspar due to weight gain, then switched to Wellbutrin due to weight gain. I stayed on Wellbutrin for 4 months, never having a recheck. I stopped it myself when I realized I'd gained 20 lbs and still had major anxiety.

    A year later I was prescribed Klonopin + Adderall. I didn't take much because a counselor told me it was a terrible combo. I didn't go back to my GP, but instead explored biofeedback therapy. Definitely helped with a form of ADD I found I had, which helped me focus more on reality and interpret things more accurately, thus decreasing my anxiety since my social skills could improve.

    This past fall I was having major anxiety again. It was actually a great deal of general anxiety and stress. I was pushing myself way too hard with school, work, interning, grad applications. I went to my GP's office and saw his PA. I asked for the Klonopin and Adderall since I'd had it before. I actually never really took them consistently took it before, so I didn't know how I'd be affected. Well, I experienced crying speells and spiraled into a quick and dark depression after a few days. I went back and was put on Effexor.

    I stayed on for about 6 weeks. I was naseated. Felt flat emotions. I was also gained large amounts of weight, again another 20 lbs. When I went back, I told my PA I was fine, I thought I was, since I was no longer in the scary deep depression from months earlier. He said that I could try another SSRI or Cymbalta, but I probably wouldn't respond well since I hadn't in the past. I agreed and decided to go without meds.

    A while later I was experiencing major anxiety. I started taking the rest of my Klonopin daily. It calmed me, but also made me tired, and maybe a decline in mood and some cloudiness. At my next appointment I told my PA about it. He thought that wasn't a good idea to take benzos. I don't blame him, he can't even prescribe them himself, must give approval, he shouldn't be encouraging it for his own sake.

    Well, anyway, I started Strattera for ADD, which is working well, but was having lots of anxiety, so made a pdoc appointment. {REMOVED}
    I took my one Klonopin I had saved for months last weekend at a party. It worked well, not too much sedation since I was taking Provigil and Strattera, maybe a little cloudy, but my body wasn't used to it at all, so it's to be expected.

    After my disappointment with a pdoc last week (no meds given), I decided to try my luck with a new GP. I asked about of GP of a friend who I know takes Xanax as needed, I wasn't able to get an appointment with him, but will see another GP in the practice. I wanted someone who wasn't afraid to give out benzos. Since this is a partner, I am unsure.

    I'm supposed to leave for Grad school in three weeks. {REMOVED} I'm soo nervous about the social anxiety of a new city, apartment complex, classes, professors,{REMOVED} I really need a doc to help me out here and try to be understanding. I made an appointment with another GP yesterday, I want to have a backup if the first appintment doesn't work out.

    So, I have 2 appointments next week. How should I approach the doctor? I'd like to try a daily benzo, continue with the Strattaram get a script for Provigil, and was thinking about EMSAM. How do I convince them on benzos? I don't even want Klonopin, not completely satisfied, but need something daily, all day. I can prove that I have Strattarra{REMOVED}Are docs OK with prescribing Provigil off label for depression fatigue, ADD, and benzo fatigu? What about EMSAM? Would this be hard to sell?

    I don't want to walk in preaching to my doc about exactly what I think I need/want, but don't have time to wast and can't afford another failed appointment. I'm not sure how to descrube my anxiety symptoms either. I'm afraid of getting another SSRI which I will refuse.

    I don't know that emphasizing social anxiety is a good idea, since they may say I need therapy instead of meds, especially since I'm a new patient. I've tried counseling, without success. I don't express my anxieties well enough, plus don't learn well or internalize the advice of other, and feel it's fairly irrelevant. Actually sessions end up with me feeling worse from insults and flaws picked at. I need positives, not negatives in my life. And I don't think the thought pattern is altered by cognitive approaches, I will always be an anxious person, which is why I'd like meds to improve the quality of my life. I don't think they're magic, just will give me the opportunity for self improvement if I find some that help and are tolerable.

    Does anyone have any suggestions? I'd appreciate some help and input!

    Last edited by msmod; 05-04-2006 at 03:37 PM. Reason: Read and follow all of the posting rules as well as ALL "sticky" posts at the top of this board. Ms_Mod

     
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    Old 05-04-2006, 08:07 AM   #2
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    Re: Need help asking for meds from new doctor!

    Please read and follow all of the posting rules as well as ALL of the "sticky" posts at the top of this board.
    Also, please don't discuss ordering prescription medication online, any further discussion of that will be removed.
    Please read the "sticky" at the top of this board about ordering prescripition medication online.
    Thank you for your understanding and cooperation.

    Ms_Mod

     
    Old 05-04-2006, 11:52 AM   #3
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    Re: Need help asking for meds from new doctor!

    most of us get better with a combination of meds and CBT but it does require some effort to learn and practise the CBT
    I have doubts that some of your meds are suitable for anxiety, research all your meds on the net

    klonapin always helps, if it makes you tired, simply reduce the dose

    its generally accepted that the meds you mention dont directly cause weight gain, this happens from eating more and/or exercising less, occasionally a med may cause compulsive eating though
    whan seeing anyone about your problems it helps to take along a list of things to say and try to tape record the session and listen back later
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    Old 05-04-2006, 02:32 PM   #4
    jealibeanz
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    Re: Need help asking for meds from new doctor!

    I've seen some indication that MAOI's can be used to treat anxiety. My weight gain definitely was not due to increased food or less exercise. I was a competitive athlete training hours a day and eating very healthy foods. The energy balance doesn't make sense, but it does happen with some people.

     
    Old 05-04-2006, 02:59 PM   #5
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    Re: Need help asking for meds from new doctor!

    I agree with hry33 about simply reducing the dose of your Klonopin. Cut the pills with a pill cutter if you can.

    I don't know anything about ADD meds other than they are usually stimulants, which are not good for people with anxiety problems. The MAOI's have problems with food and drug interactions. It sounds like your problem is more anxiety than depression...is that a fair statement? Maybe you don't need an antidepressant. If you want an antidepressant, maybe you could try a tricyclic like Elavil.

    {REMOVED}

    I totally sympathize about the weight gain problems of these meds...I've experienced it too. It's like you have to choose between being thin and depressed, or fat and happier (or whatever AD's do to us). Not much of a choice. Good luck.

    Last edited by msmod; 05-04-2006 at 03:39 PM. Reason: No longer applies, in response to part of a post that was removed. Ms_Mod

     
    Old 05-04-2006, 04:23 PM   #6
    jealibeanz
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    Re: Need help asking for meds from new doctor!

    The newly FDA approved EMSAM patch, an MAOI called selegiline, does not require dietary restrictions in the two lower dosages. My depression is under control right now, although I've definitely experienced numerous major depressions in the past. I assume them to be chemical in nature since a life event did not bring them on. They are also highly correlated with fall/winter, which is a great deal of the time where I live.

    BTW, I'm 23. I've always had the anxiety and the depressions started in high school.

     
    Old 05-05-2006, 04:44 PM   #7
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    Re: Need help asking for meds from new doctor!

    I'd try another p-doc if the GP didn't work out.

    My friend went to a p-doc who didn't prescribe benzos and actually took away their remaining Niravam because he said it was "horrible medication". (Why she let him take the medicine, I don't know! She payed for it!).

    But, I went to a p-doc who had no problem at all prescribing Xanax. In fact, I was on .25mg as needed before I went to see him, and he said it was too low of a dose and I needed to up it to .25mg 3 times a day everyday to get me out of the house and doing things so I didn't get worse.

    My point is that you just have to find the right doctor. It may take going through another GP and then making another trip to a p-doc, but ultimately, if it's what works you "gotta do what ya gotta do".

    P-docs, IMO, are the best chance of getting daily benzos prescribed. You just found one that didn't prescribe them. Was this p-doc part of a bigger mental health clinic?

    My p-doc has his own small, private practice and he has no fears of prescribing benzos. He'd rather prescribe them than anti-depressants for anxiety, if that tells you anything (he thinks benzos are the best meds available for anxiety).

    Not all doctors do the same things, you just have to find one you like.

     
    Old 05-05-2006, 05:05 PM   #8
    jealibeanz
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    Re: Need help asking for meds from new doctor!

    He was a part of a state funded facility. It's a huge mental health complex. I actually heard from my boss yesterday that the place has a terrible reputation!

    At least I have 2 different primary care physicians to try out next week! I'm not sure how to explain the anxiety so that I has a good chance of getting proper medical treatment. My problem right now is that I need a little disinhibition to get out, be social, move out of state in two weeks to go to grad school! Long term treatment is a must, but also need this short term band-aid, if you will.

     
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