[Denman]

I see a Psychiatrist for medication management of my Depression.
I have to see him on a Monthly basis to get new prescriptions.
My Sister says that it is a scam, and I should ask my Primary Care
physician for the medications, and get Refills. She thinks I should not
have to see a Psychiatrist on a monthly basis to get my medications.
How does everyone else feel about this issue ?

[JustZeek]

I can see where monthly would be annoying but my primary care admittedly knows nothing about the way each depression med works or their side effects. So on one hand you have someone knowledgeable who knows the side effects and treatment aspects of the drugs and on the other you have someone who will give you a yearly prescription. Kinda up to you and your med situation.

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[Altered Moment]

I think you should see a psychiatrist unless you are on a med that is working really good for you then you could transfer to a GP just for refills. You stated that you are not doing good on meds so I think you should still see the psychiatrist. I keep a daily mood log and give it to him because I get nervous and I can't remember how I was last week. You may need to increase dose or change to another one and it should be a pdoc who makes those desicions. You should also advocate for yourself. I have often went it and said this just isn't working and I want to try out this drug. They usually go along with me.

[TheOriginalMe]

Here in the UK very few people would get meds if you had to see a psychiatrist. Probably 95% of prescribing is done in primary care. My meds have pooped and my GP has referred of to MH services but they've refused to take me on.

No one around where I live would get psych meds either if only a psychiatrist prescribed them. There are literally no psychiatrists for hours except a couple and they're not taking new patients.

[Altered Moment]

There is definitely a huge lack of them in the US. Even in a city where there are alot of them it can take months to get it.

MH services but they've refused to take me on.

That is just horrible.

If he is not watching your behavior with regard to the meds I don't know why you can't go every three months or whatever. I see a PA. Her knowledge is best described as a cross between a pdoc and a pharmacist. I am not all that confident in a gp if there is a reason to change meds and if you see both you miss consistency of care. If I want to look at diagnosis I would see a doc. Plus she texts me to check up from time to time. I can text her if I have a question. What pdoc does that?

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[healingme4me]

I see them as specialists, in their field. General Practitioners, practice general medicine, kinda like jack of all trades. My gp, is more an expert in the field of dermatology, um, I'll stick with my pdoc where psyche meds are concerned, just in case.

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[TheOriginalMe]

The advantage and disadvantage of gps managing meds is that they keep it simple. They don't chop and change meds when they're working but they can't prescribe off label if you need something unusual or different. It depends on the patient and their needs whether a gp or a pdoc is the best option for prescribing and monitoring meds. Actually my gp is a far better T than any T I've ever had so on that score I'd rather let my gp manage my depression but I do need my meds sorting too and I'm out of options on that one

[ToeJam]

Originally Posted by TheOriginalMe

Here in the UK very few people would get meds if you had to see a psychiatrist. Probably 95% of prescribing is done in primary care. My meds have pooped and my GP has referred of to MH services but they've refused to take me on.

Had the same situation... gives off the wrong message but at the same time I know that mh services are being cut left right and centre... so they only take on severe cases (I.e those who have taken the plunge). With that said, it was the crisis team who wrote to my gp saying that I should be on a different med and to see how that goes... so that little step did help.

[Anouk]

I think it differs for everyone depending on how well your meds are working and how stable you are.

Personally, I had one great psychiatrist and when he left -- the others were dickheads. One even said to me how he felt he had to change my meds all the time because otherwise he didnt feel like he was giving me value for money.

As my meds were working I was quite shocked to hear that point of view. I left that day and never went back.

My GP looks after my meds and is open to ideas and things that we then discuss. He also has said to me 'give me a day and I w2ill do some research and think about things'.

I am happy with that and since going solely under the care of my GP I have done a lot better overall, than I have for a long time.

It depends on you. Think about what you need. I hate to say it, but your sister doesnt live with your illness and therefore doesnt get to dictate how you treat your illness nor the choices you make in something about which she knows nothing.

[Auntie2014]

My GP took me off of paxil cold turkey which landed me in hospital. Condition of my release was that pdoc do meds. None were taking new patients in network for my insurance so an out of network pdoc that would take me as new patient was "by law approved" for out of network payment based on my DX. The only bad part was that it was 100+ mile round trip to see him. This was all handled through the patient advocate at the hospital that could quote chapter and verse on why my insurance was required to approve and pay out of network.

Because I crash quickly when changing meds my preference is to see someone that understands and deals with the kinds of meds I need and use.

[Rose76]

I agree with your sister. The only reason to be seeing the pdoc every month would be if you were unstable and experiencing a lot of distress, or having a lot of SI. If you have a history of serious self-harm, that might make the pdoc want to touch base with you, until it appears that you are pretty stable.

If you feel like you want to stay on the meds, as they are, and you feel that you are not in crisis, then I would consider thanking the pdoc and turning things over to your PCP. Going every 4 weeks to the pdoc is excessive, unless there is a reason. Your meds should come with refills. Except for narcotics, you should be able to get 90 days worth at a time.

There are doctors who will milk the system. Yours may be doing that. It would depend.

[LadyShadow]

It depends on the pdoc and the situation. I see mine every three months because I am pretty stable. It could be they are trying to milk the system or there is just more to the story. Its hard to say. Are you compliant? Or do you have a history of non-compliance? That could be why too.

[CaptainChaos79]

Personally I have bad horrible experiences with psychiatrists prescribing my meds. My primary is my primary, my neurologist, and my psychiatrist all rolled into one. He has a better knowledge of psych meds than any specialist I have ever seen, at least in my area. I guess it just depends on who is best qualified among those who are available to you.

[Espresso]

I prefer to stick with a psychiatrist. I like that they have more specialized knowledge and more experience with this type of thing.