DE, I'm sorry that you too are not being listened to by your pdoc. It's so frustrating.

I've tried changing pdocs. I don't live in the US so I guess things work differently here. They have a *system* that you can not get around. Believe me, I have tried and tried until it almost killed me, pardon the pun. It is so damn frustrating. First problem is that you must go to a pdoc that works out of the hospital closest to where you live. Another problem is they don't like you 'doctor shopping'. Once you've been to one and left for whatever reason, the next one is more leary about taking you on. I'm already on the 2nd one in my area. The 3rd problem is there is an extreme shortage of doctors here because they are paid by the government and our government doesn't pay them as much as they would like, so they get their training here and then high-tail it across the border and practice in the US. I've approached my t on my situation. She works in an office, affiliated with the hospital, that contains several therapists and pdocs. I used to go to one from that office before but we parted ways on not so good terms. The pdoc I currently go to and have been for about 2 yrs now, works out of the same hospital but has her own private office. Anyway, when talking with my t, I explained my situation and gave her a list of my meds with each of their dosages. My dosage level on my Effexor XR is substantially higher than what most ppl need BUT at the same time quite a bit lower than what it used to be before. However; I have had a 2nd AD introduced, Wellbutrin SR but at a low dosage. I've been on Effexor XR for 4 years. Initially it worked great once up to a substantially high dose and my suicidal ideation and urges disappeared. Unfortunately, they are back with a vengenance now and have been for several months. I'm not sure if that means that the ADs are not working as well, need to be increased or my BP is worsening. Maybe all of the above? When I gave my med list to my t, she was surprised at the dosage of Effexor XR I was taking and promptly said that nobody takes that much, btw, I take 225mg/day. I know that is a high amount and that many ppl can get along on 75mg/daily but we are all different to how we react to different meds. I also know from a previous board that I frequented that there were some ppl there who were taking more than 400mg/day, albeit if few. Anyway, she said that any of the pdocs in that office would take all my meds and slice the dosages in 1/2 of each one of them. Well, that certainly isn't going to help me. She did say she would talk to my old pdoc and see if he would take me back. I have a t appt today and I'll ask her if she has talked with him. As I said, we did not part on good terms but when I saw him, I was taking 375mg/daily of my Effexor XR, so I know he wouldn't have a problem with increasing it. But at the time I saw him, I was not taking Wellbutrin, so maybe that might influence his decision, should he be willing to pick me back up as a patient.

Also, as I said, my pdoc, t and GP want me to control my depression on my own and all feel that I should be able to do that. I've yet to be successful, unless to force myself to sleep off the entire depressive cycle each time that hits, which is extremely frequently. My t is not happy with that method, she would like me to find something positive to control my depression. I don't know, maybe I should be able to control my depression and I'm not doing a good enough job of trying to. That's what they all think. I'm at a loss. Unless I can find a way to control the depression on my own, we're playing Russian Roulette and one of these times I'm going to lose, I know that. It's just a matter of time.