Sorry this is so long...
So I have been diagnosed with Major Depression and Anxiety NOS (plus OCD). My pdoc has tried 15 plus meds on me, some to help with my sleep, but mostly these were antidepressents. All the antidepressents have made me sick in some way...I am the 1% who get the weird, intolerable side effects, and he would always tell me to stop taking them (not like I really had much of a choice with the side effects I was having). I have tried like 4 SSRIs and CANNOT tolerate them...prozac was one of the worst.
I am also an insomniac with the same bad dreams over and over again, so I take Klonopin to keep the dreams away when I am able to actually sleep. It's the only psych med I am on.
So I have been trusting my pdoc, and I REALLY didn't trust pdocs up until this guy...except until recently when I have not liked some of the ways he has moved into the realm of psychotherapy with me (he is certified to do psychotherapy, but said he could not be my T when I asked several months ago...he is too booked), so therefore I don't want 5-10 minutes of "pop" psychology when I am there for a med check and have not seen him for 4 months...he has missed a ton of my life (sorry dude, but YOU DON'T KNOW ME), and his advice was soo off-base this last time. I already have 2 Ts I see, I don't need more "help" in that way, and he really just pissed me off.
Anyway, he just recently prescribed Luvox and when I went to get it, the pharmacist mentioned it was an SSRI. So I called him and asked him WHY he thought this one would work (over the others) and basically he said he didn't think it really would (awesome!) but he was out of options (which we had discussed, but I feel better depressed then sick on the meds I have tried).
Then he said he wanted me to "stay his patient" but get a second opinion. I then actually mentioned another pdoc I know one of my Ts refers people too that is in his current office, and my current pdoc agreed and said he would talk to him about seeing me for an appt. and get back to me.
Ok, they are in the same office. Why can't my current pdoc just show the second opinion pdoc my folder and notes from our sessions and ask for his advice? I feel like I am going to be a lab rat under a microscope and that something else is going on here.
My pdoc is quite young (early 30s) and the 2nd opinion pdoc is in his 60s, so I get the idea (sort of...but how many more meds can I try and get sick on??), but why do I need to be there? I feel like he wants to see if he is missing a diagnosis but not telling me, and I also don't believe he wants me to stay his patient for a second. If it weren't that I need him in my corner as I am applying for disability, I would have stopped seeing him and found someone else I trusted in another office who left the pop psychology alone anyway and stuck with the damn 20-minute med appt. Any thoughts before my head explodes? Thanks.

A second opinion pretty much always involves an interview with the patient. Different docs may see different things based on the information they get directly from you. Looking only at your records gives him no more information than what is on the paper. The hope in a 2nd opinion of this nature is to get fresh eyes on the patient and hopefully come up with suggestions to your benefit.

Originally Posted by 1914sierra

A second opinion pretty much always involves an interview with the patient. Different docs may see different things based on the information they get directly from you. Looking only at your records gives him no more information than what is on the paper. The hope in a 2nd opinion of this nature is to get fresh eyes on the patient and hopefully come up with suggestions to your benefit.

Thanks.
I plan to give him not much more than is on the paper. I gave the other one more and he uses it against me in his "pop" psychology lectures. 2nd opinion guy is getting facts and that's it.

[content30]

Have you ever tried taking St. John's Wort? Depending on how severe your depression is, it may be effective. It has been shown to have lower rates of side effects and is all natural. In Germany, it is prescribed for depression. I'd consult a pdoc like 2nd opinion pdoc for dosage.

Anyway, 2nd opinions are like always in person. This guy is older...so, maybe he has some other ideas.... I hope he can be helpful to you!

I react terribly to psych meds. They made me more depressed. I'm off of all prescription medicine...except I'm taking Mobic as I just broke my arm--eek!

Originally Posted by content30

Have you ever tried taking St. John's Wort? Depending on how severe your depression is, it may be effective. It has been shown to have lower rates of side effects and is all natural. In Germany, it is prescribed for depression. I'd consult a pdoc like 2nd opinion pdoc for dosage.

Anyway, 2nd opinions are like always in person. This guy is older...so, maybe he has some other ideas.... I hope he can be helpful to you!

I react terribly to psych meds. They made me more depressed. I'm off of all prescription medicine...except I'm taking Mobic as I just broke my arm--eek!

Yikes, I am sorry about your arm. I hope you heal quickly!

Yes, these drugs suck for some of us, I guess. In my case, Lamictal made me extremely suicidal and I can already head that way on my own anyway. Cymbalta killed my short term memory. And Prozac made me think I had awful food poisoning; I probably should have gone to the hospital.

My depression is quite severe (thus the applying for disability soon), so I don't think St. John's Wort would do much for me, although I know it works great for some people. I will ask about it though. Thanks.

And yes this guy def. is older...my childhoood therapist took me to see him when I was 9 and he tried to give me Paxil, which is seriously off-label for that age and should never be done. I was thinking that blast from the past might be a nice ice breaker when we meet again??

[nicoleb2]

I've been on around 35 meds/med combos, sometimes it just really can take time to find a med that works. Have you tried any of the older antidepressants?

Originally Posted by nicoleb2

I've been on around 35 meds/med combos, sometimes it just really can take time to find a med that works. Have you tried any of the older antidepressants?

Yes I believe he has gone old school on me...Remeron was one of my meds (awful); I think that is older? I think there was more than one older med. I know what I have tried, but not which would be considered older?
I have also tried a few atypical antipsychotics and a few tricyclics...and Cymbalta and Lamictal were AWFUL...Geodon was crap...it all starts to sound the same.

And wow you must be patient. I hope you finally found the right thing for you.

[WikidPissah]

I think it's cool 2nd opinion doc would rather meet you than read about you.

Originally Posted by WikidPissah

I think it's cool 2nd opinion doc would rather meet you than read about you.

Its not about what he wants, it's about what my pdoc wants. And I don't trust him now anyway.

[Hope-Full]

I'd go for the second opinion in person. Without hesitation, actually. A lot has changed since you were 9, and now this pdoc is a seasoned 60 year old doctor.

As far as meds go, I've been on dozens of them with rotten results - everything from rashes to suicidal thoughts to living in the toilet. my pdoc continues to plug away at things with me, and we take things one day at a time. Currently we're trying tenex, which is generally for high blood pressure but some off use might help me he said, so I'm giving it a go. Patience is the only choice I have when it comes to meds, as like you, I'm that 1 in 100,000 side effects!

Good luck!

[ultramar]

I really don't believe a psychiatrist can do a thorough and accurate evaluation without meeting with the patient in person. At the end of the day, the notes reflect the interpretations/assessment of your issues by another person, none of it comes directly from you. I think it's actually a good sign that he wants to see you in person; a lazy/not very competent psychiatrist would just flip through the notes and come up with diagnoses. You're more than notes on a paper, and I think it would be a good idea for the psychiatrist to get to know you somewhat by talking to you.

Since meds haven't worked so far, it seems to me you don't have much to lose by getting another evaluation. Plus you don't seem to like or trust your pdoc much, maybe this one will prove to be more trustworthy, or even more skilled.