No, it is not pretense. You cannot fake the way my p-doc reacted to the fact that I have no orgasms. He started problem solving on the spot. The on-call doctor who wrote his very first prescription for Elavil in ten years to help me sleep also genuinely cared. He was surprised that a tiny dose of Elavil helps me sleep, but since it does, he did not mind doing something he does not normally do. He was also 100% for going off Geodon because of unorgasmia which affects quality of life no less than food that does not have a taste, even though Geodon is 100% effective in controlling mania - I am absolutely stable and have not had mania for a year since the dose of Geodon was increased to the FDA max (so yes, APs do control moods). No mania for a year is clear success, but - diminished quality of life so we will look for something else. You absolutely have to have a doctor who prioritizes quality of life in a real way, without "pretense". It is easy to say when they do, and easy to spot when they do not. If a doctor feels that he is the one who decides how bad a certain side effect is over what you feel about it, that doctor is clearly out. For Littlebutt, the order of the day now is to compile a list of questions and statements to present during your first appointment with a new p-doc in order to determine if he/she is right for you. You do not want to a replay of the same "allow" and "insist" attitude. In particular, prepare a list of side effects that you are not willing to live with. For instance, I would not live with any degree of akathisia, Parkinson-like side effects, visible tremor, constipation, unorgasmia, and weight gain, but I can or think I can manage dizziness, some decrease in memory, slight tremor, acne, thyroid dysfunction - the latter two because I can take drugs against them to remedy the situation 100% and these drugs cause no side effects of their own. Then, prepare a list of goals.