View Full Version : Psychiatrist Frustrations!


psychological1
04-11-14, 10:25 AM
I've been diagnosed over a year ago, and I'm still working to find the correct med. I'm currently on Vyvanse, and while it's slightly working, it just isn't managing all my symptoms. I saw a psychiatrist for the first time recently, expecting to finally be able to have an intelligent discussion with someone about the different medication options, as I've been seeing family docs that, for obvious reason, have less experience.

So I finally get in to see him, and I explain to him that Vyvanse wears me down physically and makes me zone out, all the while procrastinating and not thinking about anything relevant at all. He then tries to explain what Vyvanse is, and just got it completely wrong. He got the "lisdexamfetamine" part right, but said the lysine group made it an isomer, which is mostly correct, but not exactly.

So I suggested that I'd like to try Adderall, and I explained how it has both enantiomers present, one of which is known to help motivation and initiation. So he interrupts and explains in a really roundabout way that Adderall is a mixture of a bunch of different salts (I'm thinking "four, to be exact") and this is right after we talked about how Concerta was ineffective for me. So... he then says that Adderall often is beneficial because it's a mixture of Concerta and Amphetamine, but that he wanted me to try Vyvanse for a little while, and upped my dose from 50 to 60. He also prescribed lexapro for my anxiety, which I was happy about.

Anyway, I could not believe what I'd heard about his explanation of Adderall. He clearly did not know what he was talking about, and I have to play it off so I don't sound like a pompous a******. This is the fourth doctor I've seen in a year, and I'm beginning to lose hope of finding someone who can both get me in, and also know what they are talking about.

tryn-optmsm
04-11-14, 10:40 AM
sorry to hear you've been having 'shrink-related' challenges......
(((psychological1))) -- WALL*E-type e-hug

Personally, all I can say is hang in there... Med's can't fix everything - though they make life a hey of a lot easier (for me it was Adderall XR + Lorezepam to knock me out at night; Vyv' had the same really icky effect on me too)

psychological1
04-11-14, 10:49 AM
sorry to hear you've been having 'shrink-related' challenges......
(((psychological1))) -- WALL*E-type e-hug

Personally, all I can say is hang in there... Med's can't fix everything - though they make life a hey of a lot easier (for me it was Adderall XR + Lorezepam to knock me out at night; Vyv' had the same really icky effect on me too)
Thank you! It's been frustrating, but I'm hanging in there. What has helped the most, as you have said, is not medication but the therapy. I've been seeing a great psychologist and he just understands everything. Too bad he isn't trained in dealing with medications too!

You may have explained this already, but why were you taken off Adderall if it helped so much?

Fuzzy12
04-11-14, 10:57 AM
I think, it's the 25% levoamphetamine in Adderall that are supposed to give you that kick and might help with motivation and energy.

So... he then says that Adderall often is beneficial because it's a mixture of Concerta and Amphetamine, but that he wanted me to try Vyvanse for a little while, and upped my dose from 50 to 60. He also prescribed lexapro for my anxiety, which I was happy about..

???????? :eek::faint:


Anyway, I could not believe what I'd heard about his explanation of Adderall. He clearly did not know what he was talking about, and I have to play it off so I don't sound like a pompous a******. This is the fourth doctor I've seen in a year, and I'm beginning to lose hope of finding someone who can both get me in, and also know what they are talking about.

Based on the above I would have suggested that you find a new psychiatrist but it looks like you might be running out of psychiatrists to try.. :scratch:

It sucks of course to be treated by someone who has obviously got some gaps in his knowledge but otherwise is he ok? Irrespective of what he thinks, is he cooperative and willing to take your concerns and suggestions into account?

If you haven't been taking vyvanse for long it makes sense to try it out for a bit longer, a few weeks at least and at different doses. I haven't tried Adderall but I'm not sure any stimulant really helps much with procrastination.

tryn-optmsm
04-11-14, 11:16 AM
Off add' -- self-destructive freakout --> too poor for addy' :( but workin' on it ...

What helped me.. as an addition to med's (still workin' on it, faaaaarrr from there yet)
1) Accountability Group
2) Reading, learning, finding workarounds (there are TONs for Adult ADHD'ers -- my fave today is FAST Minds)
3) awesome forum ppl who sometimes actually have really good ideas
4) Lots of ppl say mindfulness....

Tangent? Me? couldn't be?


Fuzziness, you know I <3 you so I can say this: Adderall REALLY helped put my ducks in a row (they were actually disciplined) it was OMG so this is what it's like to be 'norm', so it was sooooooo MUCH easier to be motivated to do stuff (Concerta, helps my ducks from jumping up n' down... in a row... not so much ) if it makes sense --- still had issues ofc -- though life was hey of a lot easier

Stevuke79
04-11-14, 11:17 AM
Unbelievable. I would say that unless you're actually running out of options, you can't work with that guy. I don't require that a pdoc knows all the chemistry. But he has to know whether or not he knows it.

psychological1
04-11-14, 11:18 AM
I think, it's the 25% levoamphetamine in Adderall that are supposed to give you that kick and might help with motivation and energy.



???????? :eek::faint:



Based on the above I would have suggested that you find a new psychiatrist but it looks like you might be running out of psychiatrists to try.. :scratch:

It sucks of course to be treated by someone who has obviously got some gaps in his knowledge but otherwise is he ok? Irrespective of what he thinks, is he cooperative and willing to take your concerns and suggestions into account?

If you haven't been taking vyvanse for long it makes sense to try it out for a bit longer, a few weeks at least and at different doses. I haven't tried Adderall but I'm not sure any stimulant really helps much with procrastination.
You are correct. Stimulants do not help with procrastination; therapy and techniques are needed for that. Overall, he is a nice guy, but that doesn't mean I get the best treatment.

He did say that he would be willing to try Adderall in a month if it still doesn't work, but I've been on Vyvanse already for 2 months, at 40 mg then 50 mg. Now I'm at 60. 60 has been better, but I think that it's due to the Lexapro now potentiating it. I'll just have to wait it out, and see how this month goes.

psychological1
04-11-14, 12:03 PM
Unbelievable. I would say that unless you're actually running out of options, you can't work with that guy. I don't require that a pdoc knows all the chemistry. But he has to know whether or not he knows it.
Very good point. I'll give him one more chance, but this is only because I feel like I have researched enough to know what is best for me. If he wants to be stubborn, then I'll have to switch yet again. There is one psychiatrist that I want to see, but he was booked for ages.

This guy also said that Vyvanse comes in 80mg capsules, and it only goes to 70. A tiny meaningless detail, but I just expected better from a specialist.

sarahsweets
04-11-14, 12:07 PM
What a f**king tool. He must have gotten his degree by mailing in that form on the back of comic books. It came with free bazooka bubble gum.

psychological1
04-11-14, 12:13 PM
Off add' -- self-destructive freakout --> too poor for addy' :( but workin' on it ...

What helped me.. as an addition to med's (still workin' on it, faaaaarrr from there yet)
1) Accountability Group
2) Reading, learning, finding workarounds (there are TONs for Adult ADHD'ers -- my fave today is FAST Minds)
3) awesome forum ppl who sometimes actually have really good ideas
4) Lots of ppl say mindfulness....

Tangent? Me? couldn't be?


Fuzziness, you know I <3 you so I can say this: Adderall REALLY helped put my ducks in a row (they were actually disciplined) it was OMG so this is what it's like to be 'norm', so it was sooooooo MUCH easier to be motivated to do stuff (Concerta, helps my ducks from jumping up n' down... in a row... not so much ) if it makes sense --- still had issues ofc -- though life was hey of a lot easier
You mentioned that you liked Adderall XR, but have you tried IR? It's pretty cheap and most people prefer it. I can't imagine Concerta actually costing less than Adderall. Goodrx has 60 tabs adderall IR at 42$, 30 capsules of XR at 73, and 30 Concerta tabs at 75$. Is it a matter of insurance doing what they do best?

Stevuke79
04-11-14, 12:19 PM
It's funny you mention that. I would like to try IR because of what I heard... but I think XR is good enough.. but I wonder if IR is better (vis a vis tics or "zombie focus").. Ya know what, I have a review with my shrink in a few months, I'm going to ask him if IR is worth trying for 2 weeks.

Wait, I wonder if it's really strange that I'm hypothesizing about my own medication.. like would I ever say this amoxicilin is fine, but should I try ampicilin and see if it's better? (I just googled names of popular bronchitis meds)

psychological1
04-11-14, 12:25 PM
It's funny you mention that. I would like to try IR because of what I heard... but I think XR is good enough.. but I wonder if IR is better (vis a vis tics or "zombie focus").. Ya know what, I have a review with my shrink in a few months, I'm going to ask him if IR is worth trying for 2 weeks.

Wait, I wonder if it's really strange that I'm hypothesizing about my own medication.. like would I ever say this amoxicilin is fine, but should I try ampicilin and see if it's better? (I just googled names of popular bronchitis meds)
I know what you mean. But these meds are quite different! With an infection, you take a med, don't feel its effects, then stop taking it. Whereas with any CNS drug, it directly affects our quality of day-to-day life, and we usually stay on it for extended periods of time. So it's important to get it exactly right!

Stevuke79
04-11-14, 12:28 PM
Right, .. and I mean this as nicely as possible, .. my doc would probably appreciate it. He has a very good grasp on the chemistry.

Like all that highly specific highly technical stuff I say on here.. I'll share that with him and he'll be like, "yeah,.. well that's it in very broad strokes,.." .. lol!

psychological1
04-11-14, 12:42 PM
Right, .. and I mean this as nicely as possible, .. my doc would probably appreciate it. He has a very good grasp on the chemistry.

Like all that highly specific highly technical stuff I say on here.. I'll share that with him and he'll be like, "yeah,.. well that's it in very broad strokes,.." .. lol!
That's exactly what I want from my doctor. I just want someone who understands the differences among the meds so he will understand what I'm talking about if I give a suggestion, instead of just assuming I'm some drug seeker who read up on Adderall and wants it.

psychological1
04-11-14, 12:43 PM
100th post!^

haha sorry I got excited

tryn-optmsm
04-11-14, 05:23 PM
You mentioned that you liked Adderall XR, but have you tried IR? It's pretty cheap and most people prefer it. I can't imagine Concerta actually costing less than Adderall. Goodrx has 60 tabs adderall IR at 42$, 30 capsules of XR at 73, and 30 Concerta tabs at 75$. Is it a matter of insurance doing what they do best?

Hmmmmmmmmmm I LOVE talking about how poor I am..... :rolleyes: though if it's helpful to others... who am I to deprive them ?

1) Adderall isn't the new thing -- Vyvanse is ---> Poor people receive Patience Assistance for Vyvanse, not Add'

2) Concerta -- different company --> Patience Assistance for brand name

*******Patience Assistance --- if you're UBER-poor (like me at the moment) --> your doc' fills out paperwork -- sends it to Patent-holder --> they give you a card that looks like an insurance card --- you get your med's for free




I am a CAPITALIST (with capital letters) though am grateful for the above programs (took JnJ 2 business days to approve me)





Ad' IR -- Couldn't live with the crashes -- MADE ME MISERABLE, omg I'm drowning in misery

tryn-optmsm
04-11-14, 05:26 PM
ooooooooooooohhh + Glad you got Excited -- fun hyper part =)

Stevuke79
04-12-14, 12:02 AM
Hmmmmmmmmmm I LOVE talking about how poor I am..... :rolleyes: though if it's helpful to others... who am I to deprive them ?

1) Adderall isn't the new thing -- Vyvanse is ---> Poor people receive Patience Assistance for Vyvanse, not Add'

2) Concerta -- different company --> Patience Assistance for brand name

*******Patience Assistance --- if you're UBER-poor (like me at the moment) --> your doc' fills out paperwork -- sends it to Patent-holder --> they give you a card that looks like an insurance card --- you get your med's for free

LOL!! Assistance for brand name. Great post overall as well.