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Who prescribes your anti-depressants?

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    Who prescribes your anti-depressants?

    I just started on Buproprion in April of this year and it has made such a huge difference in my mood. I have had so much more patience with my family and coworkers and I don't find myself just angry all the time.

    Unfortunately, the nurse practitioner who prescribed it (from my primary care office and who I had been seeing for 14 years) retired a month afterwards and I was sent to see a new nurse practitioner at the end of May before they would refill my prescription. The first thing she says to me is that we should set up an "exit strategy" for getting me off it. I was upset because for the first time in 3-4 YEARS, I have been feeling good. I told her that I'm not ready to have that conversation right now. I told her that maybe in 6 months (2 refills--3 months supply) I may be ready, but not right now. I knew that in 3 months, I would be stressed with the start of school for my girls, the possibility of a promotion at work, etc.

    She said okay, but then when I received the prescription (which I had to rush mail order so I didn't run out), there were "no refills remaining."

    I don't have tons of sick time at work, the meds are working for me and I am less than pleased with her and don't trust her now. The LAST thing I want to do is go and see her. But she has put in me in a position where I have no choice if I don't want to run out.

    I am NOT ready to go off it. I took my pill an hour late last night and only realized it because I started snapping at my husband and girls and had to step back and evaluate why I was angry. It's obviously working for me.

    I'm worried that if she won't prescribe it, then I'm out of luck. I don't see my neurologist until mid-September and he's new to me as well since my neuro who had diagnosed and treated me that last five years moved to Florida. So I don't know if it's something that he would prescribe me or not.

    So I guess my question (if you made it this far, thank you!) is this: Who prescribes your anti-depressants and has anyone only been on it short-term?

    Thanks in advance!

    #2
    Hi hsmaldo.

    The best person to see for anti-depressants is a Psychiatrist, these types of medications are their specialty.
    Diagnosed 1984
    “Lightworkers aren’t here to avoid the darkness…they are here to transform the darkness through the illuminating power of love.” Muses from a mystic

    Comment


      #3
      Hi!

      I don't know much about bupropion other than it has another name and is used to help with addiction (tobacco only?) withdrawal. Having been on this drug for a third of a year seems like a concern to me and apparently to your new nurse practitioner.

      You seem very upset with this drugs availability... "been feeling good", "I would be stressed", "don't trust her now" and the single hour late taking the drug.... "snapping at my husband and girls." ! ! !

      Are you preparing a case for the drugs usage and against any responsibility requirements the script writer needs to address before writing any script?

      Is it possible that you may be dependent on this drug as your post suggest? Isn't this alone an argument in favor of a professionals observation / opinion?

      Looking for someone "Who prescribes your anti-depressants..." isn't the answer but the other posters here may be able to help you with short term usage. Sounds like a much better approach IMHO.

      Jer

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        #4
        Wellbutrin (bupropion) is an antidepressant and can be used long term if needed. If you feel better on Wellbutrin then that is a good indication it is helping you.

        Some need to be on antidepressants long term and some don't. I had been off and on anti-depressants for many years and have not needed them for about 6 or 7 years.

        I tried Wellbutrin at one point but I felt like I wanted to jump out of my skin. This medication is also prescribe as an add on for those with ADHD
        Diagnosed 1984
        “Lightworkers aren’t here to avoid the darkness…they are here to transform the darkness through the illuminating power of love.” Muses from a mystic

        Comment


          #5
          Snoopy, thank you for your reply.

          I called my new NP shortly after posting this, since my fear is more about running out and quitting it cold turkey which I know is NOT recommended.

          And was having a bad morning at work with lots of stress and honestly just needed to come here and vent and ask a question which somehow turned into me looking like a dependent drug-seeker who doesn't give a hoot about what my healthcare professional has to say.

          So, for the record Jer, I don't trust her--because I don't KNOW her and she doesn't know me other than what she might see on her chart for the 2 seconds before she walked in the room. Yes, I would listen to what concerns she has about why she wants to get me off the anti-d as long as she also listens to MY concerns and we work on a plan together.

          And don't worry, I'm not running to massage therapist to see if they'll prescribe it to me when no one else does. I was wondering for those who have been on them, who manages their prescription--their PCP or their Neuro so that I could know which I should be reaching out to for the continuance of my care. THAT was the reason for the question.

          And isn't the purpose of antidepressants to help people feel better/good?

          Comment


            #6
            Hi,
            I agree with you .
            I have been on valium (only small doses but taken daily) for over 10 years now. Not for the usual reasons it was prescribed for me along with an antihistamine by a very old and experienced doc after all the usual meds for spasticity had been tried and it has worked well.
            a few months ago i had to go to a new doc and he flat out refused to give me a script. I had previously given this practice access to all my records a my regular practice and i had a script also given by another doc at this practice as well. They don't come with repeats so i need scripts regularly.
            His reason was its an addictive drug and he just chooses not to prescribe them.
            The thing is i'm 51 , had ms aprox 33 years, been taking this drug in small doses successfully for over 10 years, who cares if i'm addicted , at this stage its a matter of managing symptoms not stopping a drug suddenly and having to cope with other problems to do with that.
            In my opinion he was just being 'anal' and not focusing on the best course for his patient.
            I haven't seen him again.
            It is always difficult 'breaking in' a new doc etc.
            I am on paroxetine for moods and definitely can not stop suddenly. I was told that i may have to take this for the rest of my life.
            I believe that a medical professional should be encouraged to examine the whole array of a patients circumstances before making a change to treatments already in place and offer an alternative at least. the patients best interest should always be paramount.
            It is a concern that we may become dependent on meds and this added stress can add to problems so i encourage you to choose a time to try and do 'without' with medical support, and see how you do.
            Caroline.

            Comment


              #7
              Carolinemf

              Was your Benzodiazepine (valium) prescribed by a Psychiatrist? If not I would suggest seeing a Psychiatrist as Benzodiazepines as well as antidepressants are the specialty of psychiatry.

              I have used a Benzo (Clonazepam) for 14 years. I am not addicted nor do I want to be. I use Clonazepam as needed but my prescribed dosage is 1mg 2x a day.

              When I was on a antidepressant it was prescribed by a Psychiatrist as is the Clonazepam.
              Diagnosed 1984
              “Lightworkers aren’t here to avoid the darkness…they are here to transform the darkness through the illuminating power of love.” Muses from a mystic

              Comment


                #8
                Wellbutrin isn't really a big thing. A pdoc put me on 450mg years ago, and now the new insurance will only give me 150mg. It's an ongoing discussion.

                Back on topic, go to your PCP. They should be far more willing to prescribe it than a neuro. It is a psych med, not a neuro med, but it's a "weak" psych med that a PCP should be all good with prescribing.

                Comment


                  #9
                  Some primary care doctors will prescribe them if you have a good relationship. For long-term use, a psychiatrist should be the preferred option.

                  Comment


                    #10
                    My first neurologist prescribed it when I was first diagnosed, as long as I went to a psychologist. After I adjusted to MS, I weaned off. Then again, when I was trying to figure out whether I could work or not, he prescribed it again , but this time, the same med was not a good fit, as it made me anxious. He then said a psychiatrist was needed and got me in one ASAP.

                    I am off it for a few years now, but wouldn't hesitate to call the psychiatrist if needed and go back. His requirement was that I also see a therapist to supplement and develop better stress management skills. I got to the point that I no longer needed those sessions, and just saw the psychiatrist every 4 months, then weaned off again.

                    I know my current neuro, nor my PCP (an internist) would prescribe them for long term usage. They both feel strongly that like other medical issues, it is a specialty that needs to be handled by a specialist.

                    Good luck.
                    Kathy
                    DX 01/06, currently on Tysabri

                    Comment


                      #11
                      I was watching the news last night and this story made me think of this thread. Please use caution when viewing this as the pictures are graphic:
                      https://kdvr.com/2018/07/26/parker-m...kin-condition/

                      I strongly believe in getting Psychiatric medications from a Psychiatrist who diagnoses and treats Psychiatric problems. The article provided is a good example of a PCP diagnosing and/or treating something he had no knowledge of.

                      All of the Psychiatric medications have side effects and your PCP might not be aware of them. Wellbutrin can cause hand tremors. Although not a serious side effect would you just think it was your MS?
                      Diagnosed 1984
                      “Lightworkers aren’t here to avoid the darkness…they are here to transform the darkness through the illuminating power of love.” Muses from a mystic

                      Comment


                        #12
                        Update

                        After posting this, I did call my NP at the pcp to see if she wanted to see me before prescribing a refill because although I stated that I did not WANT to see her, I would be willing to be seen if she felt it was necessary. Dr's office said that it was not necessary until November and they would pass the Rx on for her approval. She approved it and sent it off to the pharmacy. But apparently, she didn't do it correctly and did not fill in the Dr's information--since she is only a NP, she needs to include that information on certain Rx. So pharmacy won't fill it until she provides the necessary doctor's info.

                        So we'll see how that all works out, but this lack of her following procedure adds to my initial misgivings about her.

                        Snoopy, I appreciate your feedback and respect your stance on psychiatrists. I have looked into seeing a psychiatrist. The hurdles that I have come up against is 1) they aren't taking new patients. 2) they don't take my insurance. 3) they don't have any convenient hours--since I work FT, M-F, have 2 children and limited sick time, this poses a real problem. But I will keep up the search and ask my neuro for further suggestions for one. (thanks pennstater for that idea!)

                        One thing that has really bothered me about the reactions to this thread--I think it's the fear that a lot of people with MS may have felt at one time or another--the fear that when they finally reach out for help--that help won't be there. Or that they will be dismissed. Or they will be shamed or labeled drug-seekers. I will admit that I wasn't expecting such judgement when I initially posted and it really threw me for a loop. I know--welcome to the internet, but I thought I was in a safer place here.

                        As I said initially, it took me 3-4 years to ask for help in that area. And even then, it took a lot for me to do so. I was here asking a question, and was immediately questions regarding my motives for wanting to continue on a course of action that my trusted pcp and I had discussed at length to start on.

                        I know there is a lot of fear/unknown in my life right now. My whole medical support team has been turned upside down with the retirement of my NP and my neuro moving. I am a very strong advocate for people to search for health professionals who will work WITH them. And I had found that team, where we could have honest conversations about my health, their expectations and my needs. That is completely wiped out. And it will take time to build a rapport (aka trust) with new medical professionals. So while I am in the process of rebuilding my team, I asked the question so I would have a better idea of what others do since I had read about people having their neurologists prescribing them meds and wasn't sure if I was pursuing it through the correct source.

                        I'm also a firm believer that you should take an active role in your health. That includes reading warning labels and possible side effects of ANY thing that you are prescribed or take (even supplements).

                        Thanks to everyone else who has since responded. I appreciate the input.

                        Comment


                          #13
                          Hi Hsmaldo,

                          We're all concerned about each others welfare.

                          You received well thought out responses, knowledgeable (or in my case lack of knowledge) comments worthy of your sincere post.

                          I could have cobbled together better wording, maybe others too, but the entire thread displays what MSW is all about.

                          No one here can judge anyone here.

                          We're just concerned.

                          J

                          Comment


                            #14
                            hi again,
                            I am truly sorry if anything isaid was in any way judgemental.
                            I have experienced this feeling too at times but believe in most cases replies are formed with care and consideration to more than just what the poster is saying- people try to read between the lines and try to give support but also usually be cautious with advice- no one wants to be responsible for some ones bad decisions.

                            In aus we don't place as much emphasis on psychiatric medicine as in other places and we don't have much access to them. Though i did see one years ago when i was to i was making myself sick and all my ms symptoms were in my head.

                            I dont tend to agree that a psychiatrist would be the best person to prescribe meds.
                            Most of us are on multiple meds for a wide variety of symptoms to do with ms and or other things most psychiatrists would know very little about these symptoms/meds and or history and would tend to focus on the issue at hand ie anxiety, depression etc.

                            In aus a persons General Practitioner (GP) shares all history with neuro and viseversa.
                            Depression etc is one of an ms patients most common symptoms- we basically have brain damage in my opinion- with the list of all previous meds in front of them i have gotten scripts off which ever doc i'm seeing at the time.
                            Of course it is always a difficult road to travel if you are still at the trial and error stage of working out what treatments work for you. And IT IS TRIAL AND ERROR even with our dmts it remains a juggling act of symptoms,reactions, benefits,convenience etc etc. At the end of the day it is up to us to decide what is best for us.
                            Its good to be able to share our experiences on here though and possibly give others more info so they can make their choices.
                            hsmaldo you strike me as a sensible individual.
                            Good luck with your choices and i look forward to hearing from you again.
                            Caroline

                            Comment


                              #15
                              Ah sorry just wanted to add something i forgot
                              I have found the best person to discuss meds with is a qualified pharmacist.
                              They actually know more about medications than ANY doc.
                              In aus you can make a complimentary apt to discuss.
                              Caroline.

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