[Suraya]

I went to my pdoc today, desperate because I've been having s*** thoughts and super depressed. I told him I had seen my regular doctor last week and she did a full blood panel because I've had extreme fatigue for several months, even with working out consistently four times a week. He asked me if she had any recommendations because he wasn't sure what to do with me. This made me feel really uneasy with his ability to help me and figure out a medication regimen that can help combat my depression and anxiety. Now I feel worse, like I'm going to be stuck feeling this bad and life is hopeless. I think he may have tried to say it in a joking way, but you shouldn't try to joke around with a depressed patient. I really like him and he's so kind, but what if he really doesn't know what he's doing?

[ruh roh]

So he had no recommendations or thoughts about meds?

[Suraya]

He increased my Zoloft. He said increasing it generally just works for anxiety and not depression, but it won't hurt. He also put me on a folic acid. I'm also on Latuda which I have been for a few months. I've tried a few other things in the past that didn't work. Now he seems out of ideas.

[LonesomeTonight]

Has the fatigue just been since you've been taking the Latuda? I don't know anything about that drug, but I know lots of psych drugs can cause sleepiness and/or contribute to depression. Or maybe it's the combo of that plus the Zoloft.
Did your doctor check your iron and B12 levels? (Iron should be in a regular blood panel--well, at least anemia would show up in the red blood cells part--but not B12).
There's a lot of drugs out there, and different people react differently, so unless you've tried most of them, your pdoc should at least be able to come up with something to try. Have you tried other SSRIs? Or SNRIs like Cymbalta?

[ruh roh]

Originally Posted by Suraya

He increased my Zoloft. He said increasing it generally just works for anxiety and not depression, but it won't hurt. He also put me on a folic acid. I'm also on Latuda which I have been for a few months. I've tried a few other things in the past that didn't work. Now he seems out of ideas.

Thanks for the clarification. It sounds to me like he's just being honest, which I think is better than someone who acts like he knows it all and won't listen. I agree that B-12 test would be a good idea and makes sense given that he's suggesting folic acid.

[msxyz]

He does sound a little incompetent if he can't think of anything else but up the dose for Zoloft thinking it will only help with anxiety and not the depression. Why not increase the dose for Latuda instead?

[ScarletPimpernel]

Latuda can cause sleepiness. I was taking it during the day, but I was so sleepy that it was too dangerous to drive. Now I take it at night.

Mental and physical health are very intertwined. Your Pdoc was probably just wondering if the GP had any insight on his/her end.

My Pdoc and GP work at the same clinic, so they get to read each other's notes. My Pdoc does all she can with psych meds. My GP makes sure my physical health isn't affecting my mental health. My GP referred me to an endocrinologist to test my hormones. Both my GP and endocrinologist are making sure that my hormones aren't too high/low and that my diabetes is being control. Both affect mental health.

So no, I don't think your Pdoc is incompetent. I think you should sign a release allowing the two to talk to each other so they're on the same page (just my personal opinion). You might also want to look into getting a DNA test that will show how each medication is processed through your liver. It will help when choosing which cocktail will help you the most.