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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by kilo8 on September 8, 2015, at 20:06:00
I wonder if a patient has been on various antidepressants and none helps then should a good doctor not sooner or later measure serum levels to see if a person even reaches the necessary concentrations?
What if for example a person has a genetic abnormality and because of this metabolizes drugs much faster? Then she can take the necessary doses and still get no effect.
I asked my doc about serum levels and testing for CYP polymorphisms and he wasn't really aware of it.
He sounded like this is all far out in the future and only done by universities as research but not really available to patients yet.Is this true?
Posted by Christ_empowered on September 8, 2015, at 20:56:44
In reply to Does your doc measure Serum Levels?, posted by kilo8 on September 8, 2015, at 20:06:00
I dunno...my (public health) doc had some literature on testing. Probably not gonna happen much in that setting, but...I think there are some tests available that are supposed to help guide dosing. I dunno.
Psychiatry has never really been about "science," despite all this talk about mental problems being "brain diseases."
Most shrinks seem to go by the effects drugs have on the patient, which is kind of frightening when you think about it...just what do they *want* to happen here?
Its also frightening because shrinks often ignore dosing guidelines, especially for antidepressants and antipsychotics. I think its called "dosage optimization" or something like that. **shudder**
Posted by kilo8 on September 9, 2015, at 12:55:28
In reply to Re: Does your doc measure Serum Levels?, posted by Christ_empowered on September 8, 2015, at 20:56:44
I find it hard to even see my pdoc as a real doctor. I mean he sits behind his desk and prescribes drugs that's all he does.
He never ever checked my pulse or measured blood pressure or even told me to get an ECG or get a bloodwork done by my intern. This is all stuff I have to decide on my own.
I also don't know if he does EEG readings in his office or if he has a EEG machine.
Posted by Christ_empowered on September 9, 2015, at 13:00:44
In reply to Re: Does your doc measure Serum Levels?, posted by kilo8 on September 9, 2015, at 12:55:28
yeah...they're really not doctors. I mean, they put people on pills and then other docs, nurses, do the real medical work (labs, heart monitoring, weight monitoring, etc.).
I don't think we actually need psychiatrists anymore. I mean, any doc can prescribe meds and they'll actually keep you monitored. But...psychiatry is a valuable social control mechanism, so society is willing to spend $$$ to keep us all in line.
Hooray.
Posted by Lamdage22 on September 11, 2015, at 8:42:14
In reply to Re: Does your doc measure Serum Levels?, posted by Christ_empowered on September 9, 2015, at 13:00:44
> yeah...they're really not doctors. I mean, they put people on pills and then other docs, nurses, do the real medical work (labs, heart monitoring, weight monitoring, etc.).
>
> I don't think we actually need psychiatrists anymore. I mean, any doc can prescribe meds and they'll actually keep you monitored. But...psychiatry is a valuable social control mechanism, so society is willing to spend $$$ to keep us all in line.
>
> Hooray.LOL
Posted by herpills on September 11, 2015, at 9:14:50
In reply to Does your doc measure Serum Levels?, posted by kilo8 on September 8, 2015, at 20:06:00
I had a doctor once check my level for Lamictal. They never discussed the results with me so I guess everything was ok?
Posted by Zyprexa on September 11, 2015, at 14:10:23
In reply to Re: Does your doc measure Serum Levels?, posted by Christ_empowered on September 9, 2015, at 13:00:44
Personally I think most psych meds should be otc. I mean I know what the meds do and can judge how to take them. I don't really need a doc at this point. But a doc should be able to advise a patient if needed. I will say that i didn't know about these kind of medications before I went crazy. So its good that I had a doc to tell me to take these, even though I didn't think I needed them. But once I got on the right meds and learned what they were doing. I could have done it on my own. Thats what this website is for! And the internet. Word of mouth. ETC. But basicaly at this point I'm telling my doc what is needed. I know better than they do now.
Anyways, thats my 2 cents!
Posted by kilo8 on September 19, 2015, at 17:18:08
In reply to Re: Does your doc measure Serum Levels? » Christ_empowered, posted by Zyprexa on September 11, 2015, at 14:10:23
I think if you're lucky and find a really good experienced pdoc then this is definitely helpful. But the problem is most pdocs simply don't seem to be very experienced and only do the absolute standard stuff and if this doesn't work for a patient then they throw him out or say he needs therapy. This is really disappointing.
If you want to self-medicate you at least need a few books about psychopharmacology and also check interactions online.
My intern once suggested I should try Tryptophan even though I was on Lexapro! I told him this cannot be done. He didn't know about this. So I'd definitely want someone who knows what you absolutely must not do.
Posted by Lamdage22 on September 23, 2015, at 7:15:04
In reply to Re: Does your doc measure Serum Levels?, posted by Lamdage22 on September 11, 2015, at 8:42:14
Its just another vehicle of control.
My doctor doesnt do it because he is not a control freak.
This is the end of the thread.
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