thinking about dropping my p-doc

and seeing my regular so I can self-medicate. My md is very lenient and will let me take whatever I want to. My p-doc is way too conservative. I tell him all my problems and the only thing he does is increase the lexapro by 10mg each visit. I tell him the risperdal is making me lethargic and he still keeps me on it. I tell him i'm not stable enough and have mood swings and he won't put me on lithium. It's sickening to think If I would have been self-medicating then I would have been alot better months ago. I'm currently on 2mg risperdal, 400mg lamictal, and 40 mg lexapro. What I have in mind is dropping the risperdal, adding lithium, adding wellbutrin, and increasing the lexapro to 50mg

You are a survival. Second opinion is always good.

Personally I would just find a new Pdoc, one that will work with you to find whats going to work for you. Your idea of a med combo that is going to help you may work, who knows, or maybe the dosages will be to high.

Oh yeah, I am sorry I can't remember if you are seeing a T , They are really helpful, especially while trying to find the right med combo.

Be safe,just find a new Pdoc, Most really care and listen.

I agree with morethingswrong. Try to find a new pdoc would be s good idea. Self medicating can be a problem. Good luck!!!

I agree with Christina.

My MD prescribed the Celexa that threw me into my most recent episode of hypomania, which started me down the path of getting in trouble at work, taking short-term disability to work through the meds when I started back to a pdoc, etc.

Not that all MDs would do this. Once I went back to my MD to have her fill out the papers for my FMLA leave and short-term disability insurance for my employer and filled her in on how my pdoc and T were working with me, she apologized and said she doesn't feel comfortable doing anything in the mental health area.

Yeah find a new pdoc yours seems to not listen to well. So go for it.

Purple celexa throws me into hypomania too.

This is probably a really bad idea. There is a lot of merit in approaching mental illness treatment conservatively (I think.)

However, as morethingswrong explained, you need to find a Pdoc who will allow you to self advocate but you can't be playing with your meds unsupervised.

Also, your Md could eventually become uncomfortable with prescribing you just anything and request records/confirmation from a psychiatrist.

I would suggest finding a new pdoc. Maybe asking your MD for recommendations. I don't think that your MD is just going to let you dictate all your medications and changes. It's one thing for a doctor to listen to you and for you to advocate for yourself and another for a doctor to just write prescriptions because that's what you want. I'm sure there are ethical guidelines prohibiting that and there are probably legal ones as well.

My pdoc listens to me and gives me options/choices but he's conservative when it comes to changing and adding medicine. He'll only change one medication at a time or a dosage at a time. Taking your example, if I was taking lexapro and my pdoc wanted me on 50 mgs, but felt it was better to only increase by 10 mg, then we'd increase by 10 mgs until I got to 50 mgs, then wait and see what my reaction was before adding or changing anything else. Because if you start changing multiple medications and stuff happens (bad reaction or good reaction) you can't tell what it's from.

I'll chime in to say what everyone else has said. Find a new pdoc. I have replaced two pdoc's for not listening to my concerns and input. It has worked out well. In fact, the pdoc I switched to came up with a great suggestion that I had not thought of in spite of being educated on meds and reading here a lot.

There are good ones out there.

Good luck!
EJ

Some pdocs don't understand they're suppose to have a working relationship with us. Pdocs are not just suppose to call the shots. A good pdoc listens and then made discussion.

I echo the others: Please find a new pdoc. Internal med and family practice doctors just don't have the knowledge base to manage a problem as complex as bipolar disorder. Mine sent me to a psychiatrist for that same reason, and even though I was pissed when he did it, I'm glad now that he did.

Smart docs realize when they're in over their heads. I'm not sure your primary care provider does, if he's willing to prescribe for your bipolar.

And believe me, a conservative pdoc can be your best friend. Self-medication is almost never a good idea for us BPers. Even as a registered nurse, I know my condition is too complicated for me to be running around treating myself, because like everyone else I lack insight when I'm in the middle of a mood episode.

My pdoc is quite conservative---we never change more than one thing at a time, and he researches everything very carefully before he prescribes for me. He listens to me and takes me seriously, both as a patient and as an RN; but his is the final word when it comes to my medications. (He wouldn't even let me increase my Celexa dose back in December when I was depressed....dammit, I like my hypomanias and he knows it, which is why he only lets me have 15 tablets at a time that I have to cut in half. The man is entirely TOO good at his job.)

You seriously need a pdoc who keeps your best interests in mind when s/he treats you, not a PCP who has no real idea of what they're doing or why. I wish you luck.

Before I was diagnosed with bipolar my MD prescribed me an antidepressant. After I was diagnosed, she referred me to a pdoc because psychiatric meds (except basic antidepressants) were out of her area of expertise (don't get me wrong, she's a great doctor, but only practices family medicine).

Anyway, I second what everyone else is saying. Find a good pdoc. If you don't like the one you're with, find another one. A good pdoc will listen and work with you to find the best way to make you feel better. Never be afraid to ask for a second opinion. Any doctor worth his/her salt will have no problems with this (my MD encourages it!).

My old pdoc was good, but I just didn't feel comfortable with her. I'm not sure why I stayed with her as long as I did. When she left the practice I found another one who is awesome.