Posted by micro on February 19, 2004, at 0:38:19
In reply to EFFEXOR for ADD? frustrated w/ my psychiatrist, posted by snarley on February 12, 2004, at 16:52:25
> Hi all, first time poster here, but i've read pretty thorougly most of the last month's threads. So here's my situation:
>
> I've been seeing a psychiatrist for depression for years, been on effexor for the past year @ 150mg a day. My psychologist did some tests on me (memory test, iq, symptom questionairres, etc) for ADD and found that I am adult ADD. He sort of laughed about it, saying that he should have noticed it sooner (jeez that made me feel great). I have been terrible in school for my entire life (but due to high iq it didnt become REALLY noticeable until high school-- at which point it was attributed to chronic depression). My grades never really improved, and have always had focus issues, i just got less depressed. So anyhow, now i'm finally diagnosed as ADD (overfocused type or something), so everything should be fine once he relayed the info to my psychiatrist and we could get the medication thing going...right?
>
> Wrong. My psychiatrist doesnt like to prescribe normal ADD meds. he instead said he wanted to raise my Effexor over a several week period (to above the fda approved max dosage of 225) to see how i react to that (is Effexor even for ADD??). I've been fine on the effexor 150/day for my depression and am worried increasing it might screw up something that already works for that.
>
> I also have been reading about the effexor withdrawal posts other folks have made on this board. So if it doesnt work i'm going to have to go through hell withdrawals from the extra 150/day i'll be taking? which will make me worse??? and then trial-and-error with strattera when it seems from stuff i've read (including books by Dr. Amen, renowned ADD doctor guy) that neurostimulants are the only things that work reliably?? not to mention that from friends whove been on it, straterra has really rotten/raunchy side effects?? (the psychiatrist said he would try strattera next because he doesnt believe in stimulants or something)
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> I have tried talking to the pdoc about it but he is adamant that this is the route he wants to take even if it costs me another quarter at school (i'm a 23 year old 3rd or 4th year freshman in college, on and off academic probation all the time, no financial aid because of bad grades/low courseload, with my grade records having been wiped a grillion times due to medically excused poor performance from my "depression", parents flipping out about the money they dump into therapy just to maintain my gross underachievement).
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> I'm seriously at the end of my rope here. not to mention that the extra effexor (been on the first dose increase for a few days so far) is tying my stomach in knots and i'm a lil sweaty and dizzy.
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> What should i do? Should i try to find another psychiatrist? call him and talk to him about it some more (he already hates me this week i think)? what the heck am i supposed to be doing about my midterm exams in the meantime? no matter what, if i try to find another doctor it's gonna take like a month to get to the point he'd prescribe something?? i'm a worse mess than i was before the ADD diagnosis and the effexor getting ramped up (which is pretty freaking bad). Also given my tendency to overfocus on certain things, all i want to do is punch a wall, i've just been fuming about this whole thing since it happened and thus its even harder to get my school stuff done.
>
> Thanks,
> Marley (snarley when i'm cranky, or so my friends have affectionately nicknamed me when i'm in a rotten mood)Hello, Marley your Pdoc sounds as if he is out of his league. If you truly have ADD, and it appears likely that you do based on the info. which is posted here. Please note that stimulants are not euphoric when ADD is present. I think that is safe to say that a calming affect to a stimulant is somewhat diagnostic because stimulants are just that to the general population [which is why college students etc. take them to stay awake]!
It is healthier to avoid taking medication of any kind, however, it is unethical to withhold a medication from a patient who clearly may benefit from it{safety taken into consideration}.The bottom line is... the experience and the diagnostic abilities of your caregiver.
You appear to have lost confidence in your Pdoc. Therefore, I humbly suggest that you find a more experienced one as well as a Pdoc that has an extensive understanding of Psychopharmacology.
Docs in general tend to treat what they are most comfortable with [if they do not continue to educate themselves and keep up with their readings]- Their treatment modalities and skills plateau. Top docs are top Docs for a reason- IT is your Pdocs narrowed thinking that may slow the progression of many patients therapy.Also,please keep in mind that any Physician who side steps answers to logical questioning or becomes defensive is revealing their inadequacies or lack of confidence in their own skills. There is a bottom half to every class regardless of the profession! There is never a day that goes by that I don't try to learn something new for the benefit of others. That my friend is the true calling to medicine. Some have it/Some don't/ Some can't/ some won't/some could, but never will! Its personal motivation. IT can't be taught!!!!
You will have you day in the sun. You have my best wishes in your search and may it be short lived. Regards, MicroP.S. Please seek out a Pdoc at Teaching Institution who specializes in the treatment of ADD and its comorbid disorders.
poster:micro
thread:312542
URL: http://www.dr-bob.org/babble/20040218/msgs/315472.html