Posted by Cam W. on June 16, 2000, at 13:10:46
In reply to CAM- Quick question, posted by Danielle on June 16, 2000, at 6:07:13
Danielle - You will probably need to talk to the doc about this. How a doc will take the info on increasing the Klonopin and stopping the Celexa is the key to how to approach this. The doc may increase (hopefully only temporarily) the Klonopin, until the other meds begin to noticeably work, or he may be a sticker and say, "Do it my way.". I find that docs are individualistic in how they approach therapy. You need to find out how his current doc handles non-compliant patients (some give up and others, the one's who really care, will find a way to treat their patient). A temporary increase in the Klonopin dose is usually not a problem, unless the patient is using the Klonopin as a means of escaping their problem.Unfortuanately, your husband probably has not come to terms with his disorder, yet. This coming to terms is difficult for many people, but it needs to be done for any long term medical disorder (not just a psychiatric disorder). It is basically a grieving process; he will need to go through Kubler-Ross's stages of death (modified for acceptance of long term illness). He is probably in the denial stage, right now.
The meds do not work as well if someone taking them believes that they won't. I suppose this is sort of a placebo effect; it can be equated to faith healing (in a way). Faith healing can "cure" some psychological &/or physiological disorders, but not all (similarily to, or in conjunction with medications). Basically, I think what I am trying to say is that "mind-set" (a person's attitude toward their illness) is an important part in the resolution of symptoms. One must work with the meds to get to remission.
Not complying with a medication regimen is common, especially at the start of medication therapy (1st month of meds) and after the medications begin to resolve (6-8 weeks - or more - after the start of med therapy). At first, side effects are an excuse to stop the meds and later, the person is feeling well, so they feel they do not need the meds anymore. These can basically be just excuses for not believing in the permanance of a disorder, although other reasons do enter into the equation.
I would think (just my guess) that the changes in meds from one hospital to the next could be the second doctor's frustration at you husband's of not accepting the first meds, for whatever reason (ie side effects, not believing that they are needed, etc.). The med changes could just reflect the different styles of the 2 docs in their approach to whatever disorder they believe that your husband has.
I guess, in a nutshell, what I am trying to say is that your husband needs to come to terms with his disorder. This can be done with psychotherapy (initially one-on-one, then continued in a supportive group environment). You may need to take some counseling as well (with or without your hubby) to help you help him in dealing with this problem.
Maybe you should contact his doctor and express your concerns; I am sure the doc will have run into these types of problems before. Whether you do this with your husband's blessing or not is up to you (you know him better than we do).
Others on this board are better at the psychology of disease states than I am. maybe someone else can add to this or clarify, hopefully.
I hope this is of some help - Cam.
poster:Cam W.
thread:37495
URL: http://www.dr-bob.org/babble/20000610/msgs/37553.html