View Full Version : Psychiatrist won't treat previously diagnosed ADHD, ok to ask Primary Doctor?


BricksAreHeavy
05-30-17, 06:15 PM
I'm going to my Primary Doctor tomorrow, so any sort of feedback would be very helpful. My ADHD is not being treated by my Psychiatrist, she won't continue my previous treatment, even after being diagnosed twice by other Psychiatrists. If you've seen some of my older posts, I've explained how I would like to go back on vyvanse and use it as an add on to my current treatment (SSRIs).

Is it okay to bring in my paperwork (I'm bringing in the actual prescriptions, my pharmacy printed out my history) and ask to be put back on my ADHD treatment? I am waiting on my medical history (the diagnostic paperwork) as it is taking a bit of time for the paperwork to get to me, and I won't have it by tomorrow.

I am currently seeing a therapist on a weekly basis, so I'm getting adequate talk therapy, however, the difficulties with my current Psychiatrist is giving me the idea that consulting my Primary Doctor about this would be a good idea.

Is this a good idea or a bad idea? Anyone else done this in the past?

someothertime
05-30-17, 07:42 PM
The issue you have here is like asking an experienced driver to accelerate with the brakes on.

Determine why this is so and you will be better placed in making some inroads.....

In short....

-the adhd would have to be as of not more debilitating to whatever the ssri's are for
-an alternative to ssri's would need to be sought ( alternative treatment / identification of the underlying issues ) if you were ever to be placed back on stimulant medication.

l_ruth_
05-30-17, 07:55 PM
in principle I think it is always a good idea to keep your primary doctor informed about your concerns with getting adequate support. I have done this only recently - having confidence with my GP (I think that is the equivalent term we have in Australia) has been a really good step for me. She knows I am considering pursuing a diagnosis for ADD

ToneTone
05-30-17, 09:38 PM
Totally fine.

There is a shortage of psychiatrists in my area ... psychiatrists who take insurance ... a buddy of mine gets his meds from his general practitioner. You may encounter some reluctance, but yes, that works.

Do try to find another psychiatrist as soon as you can (even after the gp hopefully prescribes for you).

Tone

dvdnvwls
05-30-17, 11:58 PM
As long as you're not going to that psychiatrist again, it's technically possible to do what you're proposing. It would be a problem to have two different doctors prescribing psych medications to you concurrently.

But there's a larger issue going on, that the psychiatrist who you're presumably not going to see anymore had decided that stimulant medication was going to hamper your ongoing treatment for borderline personality disorder. You are of course free to disagree with that analysis, but it seems just a little too convenient a time to switch doctors. Be wary of accidentally disrupting your current treatment - BPD and sabotaging treatment unfortunately tend to happen together.

sarahsweets
05-31-17, 04:34 AM
As long as you are done with the current psyche and get your meds only from your primary I see no issue with it.

Little Missy
05-31-17, 08:16 AM
As long as you are done with the current psyche and get your meds only from your primary I see no issue with it.

Exactly. Otherwise, your psychiatrist supersedes over all.

aur462
05-31-17, 04:25 PM
It's funny, you seem like the paragon of civility and balanced temperament online and when you post about some of your (anger,etc.) issues it just comes across as (humorously) dichotomous; this is meant as a compliment/good natured FWIW ;)

If you have a good relationship with your primary doc - how long have they been your GP? This could be a good idea. A consideration is to open the conversation and see where it leads. Comorbidity is German for "cluster (fudge)". If you have long standing relationship and trust built, you have one important aspect in your favor. The hard part, perhaps, is a GP that feels comfortable treating you for psychiatric issues, particularly ones that delightfully and confusingly interplay with each other. Most mental health care ends up in the hands of GP's, however, favoring you, but many/most, particularly if not intimately familiar and trusting of a patient, are not privy enough/if at all to the nuances of things that delve too much outside garden variety depression, anxiety and ADHD. The bottom line but not necessarily enough, is their trust in you and the extent they know you "inside and out".

Your pdoc's methodology is a paradigm that, on paper (notwithstanding "contraindications" of your Rx's with each other), is probably "good", but if you can prove (or something close) that your behavior on Vyvanse wasn't worsened, you may be "good to go" with your GP with a med you indicate HELPED you; to the extent that flooding your system with serotonin hasn't been as helpful and/or undesirable to functioning as stims, you have argument, collectively, that Vyvanse makes sense - "collectively" includes behavior during time you were on Vyvanse. Vyvanse is a good choice in this situation, relatively, since "abuse potential" is attenuated by it's metabolism.

Frankly, I've never had a GP for a particularly extended period of time, but my wife was able to circumvent seeing a shrink after we moved back to her hometown, in favor of her former, long-standing GP; she has comorbid BP2 and ADHD. He was comfortable enough prescribing what many docs wouldn't. However, she originally WAS prescribed these drugs from a pdoc before we moved. Incidentally, finding a good GP seems DAMN hard IME.