View Full Version : Psychiatrist that is aggressive and refuses to titrate?


whoisinthere22
04-11-17, 10:06 AM
Hey, I am a long time diagnosed ADHD guy who only recently accepted to try any sort of medication to treat the disorder. I talked to my family doc and referred me to a psych that agreed to prescribe me vyvanse 30mg for 3 months! So I came in today after three months to talk about life and my progress, and I told him that the med makes me more concentrated and less anxious, but there is a lot of room to improve with titration (mind you, the first thing he did when I entered the room was to write a prescription for me while talking at the same time with me). Anyways, the psych immediately refused and said that he thinks that I am fine and that the current dose is the best for me. I started asking him questions about why he thinks so and if there are any other medications that won't interfere with titration. I could see that he got a little angry while saying that he is going to discharge me in two months (we scheduled an appointment in two months).

I am not sure, but is this kind of behavior normal?

aeon
04-11-17, 10:21 AM
Hey, I am a long time diagnosed ADHD guy who only recently accepted to try any sort of medication to treat the disorder. I talked to my family doc and referred me to a psych that agreed to prescribe me vyvanse 30mg for 3 months! So I came in today after three months to talk about life and my progress, and I told him that the med makes me more concentrated and less anxious, but there is a lot of room to improve with titration (mind you, the first thing he did when I entered the room was to write a prescription for me while talking at the same time with me). Anyways, the psych immediately refused and said that he thinks that I am fine and that the current dose is the best for me. I started asking him questions about why he thinks so and if there are any other medications that won't interfere with titration. I could see that he got a little angry while saying that he is going to discharge me in two months (we scheduled an appointment in two months).

I am not sure, but is this kind of behavior normal?

It might be normal for some, but not helpful.

Kick him to the curb. Find a new doctor, someone who will partner with you in your efforts to achieve well-being.


Cheers,
Ian

Bouncingoffwall
04-11-17, 11:12 AM
A lot of psychiatrists are jaded from years of dealing with drug-seeking behavior. So they assume all patients walking through their door, stating they have ADHD, are just seeking a fix.

It's unfortunate, but the few bad apples out there who take advantage de-legitimize the rest of us who genuinely need help. Doctors are always trying to control their level of liability, and don't like taking chances with controlled substances.

That's why it's best to find a doctor that specializes in treating ADHD. They will be a lot more reasonable when it comes to adjusting and prescribing meds.

OhLookABunny
04-11-17, 06:03 PM
There is the controlled substance angle to consider, of course - but there is also MDeity Syndrome.

Let me tell you a story of my mother's experience, and why it makes me so thankful my own psychiatrist suggests but doesn't force.

Bear in mind, the drug in question for Mom and me was an SSRI antidepressant, not a stimulant or tranquilizer. But conventional wisdom in the medical field seems to be to push the same dose of SSRI on all patients, and often to just start out with a dose that's already high for certain individuals and then increase it even more.

This is what happened to my mother: Six months after my dad died unexpectedly of a pulmonary embolism, and I was living with her trying to care for her own health needs - and because of my own psych and emotional issues and grief, will be the first one to admit I wasn't that great at it - but we were trying - Mom's health crashed. Her diabetes was way out of control, was the main thing. So she spent some time in the hospital. While there, the mental and emotional caught up with her, so off to the geriatric psych ward she went (and from there to the nursing home, another story).

While in the psych ward she was given an SSRI - Lexapro, I'm thinking it was. Having suffered from depression much of her life, she was no stranger to antidepressants. And - like me, I guess I inherited this - she was super-sensitive to meds. Well. The hospital insisted on the high doses, Mom was absolutely MISERABLE with the nausea and side effects of them, and I was so grieved and angry on her behalf :mad: it took all I had not to just open a can of you-know-what on the staff.

I did attempt to talk with them, but I didn't do much good. She survived that stay, but the thing that did the most good for her, I'm convinced, was the minstering of the deacon from my church who was also chaplain there and ran a grief group. He was so kind and just let her be herself and showed her compassion. It tore me up to see her suffer because of the inability of the doctors to think outside the box about medication dosages. :(

The connection I'm making to your situation is simply to demand to be treated with respect, and since you do have the power to fire that doctor if there's someone else available, keep that on the table as an option if he won't work with you. By titrating I'm assuming you mean adjusting the dosage either up or down to find an optimal fit, correct? To me this should be plain common sense. :rolleyes:

Joker_Girl
04-11-17, 07:08 PM
Tell your family doctor about it, and have him or her write your scripts.
Tell them what you thought of the Vyvanse. Yes, of course there are tons of add meds and dosages. No one, or almost no one, gets it exactly right, right off the bat.
I can understand being jaded because of people always trying to scam you, but you were referred to him for adhd specifically. What is his malfunction?
I would also tell the family doctor about what happened, so they know to quit referring to him. And cancel the next appointment. Obviously he is moody, lazy, and doesn't want to have to actually deal with patients. Giving him money for this behavior is ridiculous.

Pilgrim
04-11-17, 10:50 PM
Sounds like he prescribes but he doesn't really get ADD.