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Jan 04, 2023, 11:34 AM
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Member Since: Jul 2019
Location: Downtown Vibes, California
Posts: 15,701
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I have to stop the Topmax (AD) Because of the "lights" I'm seeing, which indicate potential retina problems (tears, detachment). Serious issues - a frighteningly not uncommon effect of the medication. It has been pulled from the market a couple of times, not sure why it's still available, at all.
Saw med dude yesterday, he denied the optical issue  , despite my far more experienced GP/gyn/OB connecting the dots immediately & putting in an urgent referral to ophthalmology clinic. I was floored by the denial. This is my vision. My eyesight. The info is all over the internet on reputable medical sites.
@BeyondtheRainbow, I spoke with med dude very openly, persistently, but without being pushy, about Emsam. He said "I can't prescribe a med I'm not familiar with" and "An AD can cause hypomania" and "That's a really new MAOI...they cause all sorts of side effects and can be dangerous because of the potential issues MAOI's can cause." Later in the appointment he did say he'd "do some reading about that medication Emsam."
As for the enormous research medical univ psych near me (Univ of Calif, Davis School of Medicine)- they are "full to capacity and not taking new patients at this time." (I'm sure they take new patients who are of particular interest to them, referred by so-and-so, just not off the street people.) But, thank you again so much for your support 
My next suggestion to med dude was Symbyx (Prozax/Zyprexa combo that is being used specifically for BD). From the research I've done it has very high ratings from patients. However, Symbyx is a weight gainer.
His reply was that "These things are all off label, but you seem to want to try them."  Symbyx is NOT off label!
Med dude remains very calm, patient, and sympthetic. I don't mean to say he isn't. He simply cannot put the patient's needs over his young, inexperienced ego, and that is a huge problem. That I have 4 decades of experience with psych meds doesn't seem to count for anything with him. Clearly other medical professional's opinions or experiences do not mean a damned thing to him.
He finally agreed to prescribe a very low dose of Symbyx, but said, "I mean, do you want to gain weight?" 
I would feel sad to leave him, like I'm hurting his feelings. I wish I could find him years from now. But I keep looking into other options. I have to. That said- I have yet to find another option.
btw, @Random 503, I made a point of asking med dude *the question*. What is the big concern if I become hypomanic, or even slightly manic? Because I have never had a true full-on manic episode. His answer was, "Mania can result in having to go into the hospital, or jail, or even death!"
I acknowledged that with an "Okay," then told him I'm far more concerned about these severe depressions I've been experiencing in the past several years than I am about a hypomanic episode. He replied with something vague, while scrolling on his phone, an mmm.....hmm...
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