Update

Oh Cash this sucks. Do you really have choices in this moment? It seems like all you can do is wait and see what the new Pdoc says in September if you can't see another one before. What are your thoughts?

Can I just say again what a tough cookie you are? Because you are.

Reckless. Yup, that's the word. On a previous thread on this, I was reading and basically flipping out (yeah, exclaiming incredulity and outrage at the screen with gusto! ) and refrained from writing, because afterwards, I usually regret what I said (or how I said it) when all worked up. But time has passed, and I feel the same, so here goes:

That man is a lawsuit waiting to happen.

Ditch him.

Now, I understand that you are in a spot in being able to secure another provider for awhile. In the meantime, question the hell out of his judgment (using the term loosely there, as he seems to lack it altogether...) And don't just leave it at that if he gives an answer that is a crap answer. You don't have to take crazy high doses just because he's reckless enough to prescribe them at levels that fly in the face of scientific knowledge.

I'll leave it at that, lest my rabid wolverine come out. Because I'd really like to meet this guy in person, shake him and yell, well...Many Vigorous Things Not Fit For Print.

Btw ...Did he learn how to subtract at school, or only how to add?

(Not to just go for the jugular, but I can get very protective and it really fries my bacon that he's doing this to you!)

"WE", huh?
Hmmmm. That might give him a reality check right quick...

Yes what Innerzone said !

I understand how hard it can be to get a new pdoc in some areas, so I guess you just have to deal with this one. I would tell him I am confused and I would like to see some documentation concerning dossing. Remember, the dose is agreed to by you and the pdoc, not forced upon you.

My pdoc writes with a very heavy hand and I have disputes over doses all the time with her. On lamictal she has me at 400, but has mentioned I could go to 500. When I told her I thought 400 was the limit she said she knows of cases that are at 500, even 600. Remember as I said she is very heavy on doses, but even she never said that she has heard of 800.

I wanted to be sure what I was advising you before I did, so I looked at Lamictal Dosage - Drugs.com it is a very informative piece and says NOTHING about a 800mg dose. It looked to me like an optimum dose is between 200 and 400, depending what other drugs you take.

Since you cant get a new doc, and you have to work with this one, do some research you can quote and then be firm, he can't force you to take that large a dose.

I really hope you get things worked out on this, nothing worse then a pdoc pushing drugs on you that you don't want or need.

It's not very realistic because of my kiddos. I'm hoping in Sept I will really like this new pdoc and he will be a fresh pair of eyes. I will be prepared with questions like "how do you feel about dosing: high vs avg?" and "will you increase meds and then add new ones (same cycle, etc) or will you wean from non working meds and introduce new ones?". Hopefully I can get honest answers.

I have no choices at this moment; I have no choice until Sept.

My thoughts flip-flop. I really LIKE my current pdoc and I know how much he cares for me. Like I mentioned, I have seen him on and off since I was 15. However, I both hear what all of you are saying and cannot ignore what Dr. G had to say. I am dispirited.

Thank you for calling me tough...if I wasn't so depressed, I might believe you.

This is what helps me sometimes....

You don't have to make a decision today sweetie. You don't have to make a decision this week. Give yourself a break from thinking about this, from trying to figure it out and decide. Just release and relax a little bit.

I know your status quo right now sucks but it can't be helping to have the stress of this internal confliction on top of it. Unless I am missing something something it seems like you have no choice but to maintain status quo until you see the new guy in sept. Unless you were going to wean off your stuff by yourself (which is bad right.) or try to go inpatient and detox as people talked about in previous threads but you have been clear about how that isn't a choice for you.

I know you can't believe it right now but I know that it still helps to hear people say it. You are so strong. You have been dealing with this for so long. keep on keeping on Chica!

Thank you for sharing this! I looked at the chart and the highest dosage mentioned, for either bipolar or epilepsy, is 500 MG. Obviously this exceeds that.

Since he's going to be your T can you ask him to start reducing your medications. That it scares you that your above 400 mg.That optimally you want to get down to 1 ms, 1 ap, 1 AD, and 1 prn at a level you can increase during episode. This may not be possible I'm on 3 AD each for different reasons, and no PRN.

Hey hey, cashart!
With the embedded responses, I couldn't figure how to bring them onto here, so will kind of be winging it...

Interesting on the grapevine thing. I wouldn't be at all surprised if it were so. Less accountability...

On the "SO non confrontational"... I am too most of the time (except when Rabid Wolverine comes out! ). But remember, there are ways to question and hold someone accountable without being overtly confrontational. Here is one from personal experience...

First, a little backstory. When I was first correctly dx'd, the first med to try was Lamictal. Though I'd been dx'd by a psychiatrist, I had this kooky idea that I'd have my GP do the actual prescribing, probably trying to avoid the expense of appointments with the Pdoc. (Ironically enough, we're talking the GP that had previously mis-dx'd me, bringing on the hell that is ADs alone.) In what should not have been a surprise, GP's psych ineptitude was still intact. She wanted to titrate me up at a ridiculously fast rate! I'd done enough reading to know that this was not only out of line, but increased the likelihood of side effects.

Why risk this on a med that was a solid choice for me? So I said something along the lines of, "From everything I've read, that is a very fast titration." She said something about that I shouldn't worry, it was just fine. I asked her for the source she based this on.
See? I didn't have to "get into it" with her, but let her know she had to show accountability.

She did give me a source (can't remember what). I'm not even sure if I checked it out, because my Do You Never Learn?! bell was already going off, and I knew psych had to handle it. The GP's prescribing attitude was not as egregious as your Pdoc's, but still, I wanted to stay solidly mainstream, where the scientific consensus was.