Posted by Kim on March 9, 2000, at 11:33:32
In reply to Pharmacists - Problems or Praise, posted by Cam W. on March 4, 2000, at 23:35:04
Cam--two stories re: pharmacists and psychiatric medications. Sorry it's kind of long; I've tried to keep the extraneous to a minimum.
(Just as background I've had treatment-resistant major depression off and on for the past 15 years; tried pretty much every AD there is. My "best" drug combo has been Parnate, dexedrine, Visken, and temazepam for sleep.)
STORY ONE
My pdoc in Utah prescribed dexedrine as an adjunct to Parnate, to which I had a partial response. The first time I went to fill the prescription, the pharmacy (a major chain which I always used) refused to fill the RX without first talking to the doctor to be sure he was aware of the theortetical problems of the combination. I assured them he had discussed the risks with me thoroughly. I was slightly annoyed at the delay, although appreciative that they were looking out for me. After talking to the doc, they filled the RX without any problems from then on.I moved to Washington (state). I didn't change pdocs immediately since I was still in Utah at least once a month and continued to see my pdoc there. The first time I submitted my RX to the Washington pharmacy (also a large chain) they, too, insisted on calling my doctor in Utah. I explained that I had been on this combination over a year, etc, but they still insisted on consulting him. My annoyance this time was not at the fact they insisted on calling the doctor, but that they had left me sitting in a plastic chair for an hour waiting for my RX before telling me they were trying to call the doctor. After the initial consultation, they had no problems filling the RX.
STORY TWO
My Washington pdoc was appalled at my parnate/dexedrine combo. He took me off first the dexedrine and then the parnate, with a 3-week washout.Tuesday, he started me on Effexor XR (I've been on Effexor with no response previously, but he says the XR is different and still might work--I'm dubious since the only partial responses I've had are with MAOIs and really think I should try reboxetine, but hey--he's the doctor, right? Sorry, that's a whole other story).
He left me on the temazepam, which he told me I could take up to 3 times a day if I needed to and that it shouldn't make me drowsy; inspite of my telling him at least twice I'd only been taking one or two capsules at night to help me sleep.
He wrote the RX for temazepam 3x daily, but told me I didn't have to take it all 3 times if I didn't need to. When I took it to my usual (chain) pharmacy, they said they'd need to call him because my previous prescription had been for only one per day, and the 3 per day was "unusual." I was annoyed at the inconvenience when I went back the 2nd time and they still hadn't talked to him. (Luckily I'm too passive at the moment to be hostile.)
I'd no sooner gotten home from the pharmacy then I got a call from my pdoc, he "wasn't thinking clearly" when he told me to take the temazepam 3 times daily, since it's supposed to be a sleeping pill (DUH!)
So this time the pharmacy averted what could have been DANGEROUS. I consider myself to be well-informed on my meds (psycho-babble, etc). When he told me I could take the temazepam not just at night, I thought it was odd but figured that maybe the only reason it was working as a sleeping pill was that I was taking it with parnate and no parnate=no drowsiness.
SUMMARY
I'm glad both chains had computer systems which alerted them to the potential problems with my meds.Kim
poster:Kim
thread:26008
URL: http://www.dr-bob.org/babble/20000302/msgs/26465.html