New Diagnosis - Treatment

[UnknownUser]

Hello All,

I have been a trawler of this forum for quite a while now and this is my first post.

I have recently been diagnosed with ADHD-PI after being treated for depression/anxiety for the past 3 years without success. I proposed after doing some self searching into where the root of my anxiety and depression came from to my GP that I think I may have ADHD, I explained why and the GP said they would like a second opinion first from a psychciatrist. That was 8 weeks back now. I went and saw a psychiatrist who told me that they think that I may just have visual memory as opposed to audial memory. This was after 30 minutes of talking. I then went further into my thought process and how I was quite sure that I had ADHD in regards to what I had read. I walked out with a Strattera script for ADHD.

I started on 50mg a day of Strattera, 25 in the morning, 25 in the afternoon. 4-5 days in I was unable to get out of bed and was sleeping 18 hours a day, I missed 3 days of work in the week I was on it. I stopped that dose plan. He then gave a new script for 10mg, 1 a day.

I got home and didn't have the money for the new script and had a stockpile of 25mg pills still. I decided to continue after 2 days off them back on the 25's but only one 25 a day. 2 weeks later (Yesterday) I went and saw my psychiatrist again and told him what I was doing and that I have started getting very aggressive thoughts which is very much unlike myself and I have been very fatigued again and it only feels like it is building up. I had to take today off work as I was unable to get out of bed again and I slept 13 hours.

Yesterday at my session I asked my psychiatrist if there are any alternative treatment routes which I would be able to try hopefully with less side effects. He said the others have much worse side effects and he would not even consider them. After being told it was my only option I was asked if I wanted to continue the Strattera, I said well yes? I guess?

After my session I went home and did a bit of research into the other options, the only ones in my area being Ritalin and Dexedrine. It is said that the only reason these would not be prescribed over Straterra is the abuse potential.

Does this mean that I shouldn't have told my psychiatrist that I have self medicated previously in the workplace when things were very busy and I was unable to focus on a single task and was working on every project at the same time and making many mistakes?

My ultimate question is this, should I go and see another psychiatrist? Have I blown my chances with this one? I note good benefit from Strattera but I would rather not lose my job while waiting for it to work!

Sorry about the long post and thanks for any replies.

[Verile]

You should never mention self-medication with illicit drugs. That's a red flag for drug seeking behavior. If at all possible see someone in your area who has ADHD experience even if that means someone who specializes with children. If not maybe try asking about Vyvanse because it can't be crushed or snorted; not exactly the drug seeker's brand of choice.

Also, your psych sounds like an uneducated *******. I'd actually switch right away if you can. If anti-depressants haven't been working for you it's not that uncommon to prescribe a stimulant for treatment resistant depression.

[purpleToes]

Really depends on the doctor and the rapport you have together. Some will read it as an abuse risk, others will see it in the context of an impaired person trying whatever they can to function normally and not necssarily an abuse risk.

It should depend also on the doctor's assessment of the self-medicating patterns as to whether they were addictive in nature, but unfortunately it seems many doctors take a rather punitive view of it. They decide that past self-medication with legal or illicit substances, even if taken therapeutically and in moderation, means the patient is automatically an abuse risk with legally prescribed c-IIs. Which to me is a sign of dull or rigid thinking, where the doctor is unable to separate in their mind the two different ideas of illegal and abuse, and also that self-medication is not a euphemism for getting high recreationally, nor is addiction necessarily a component of it.

There could be a valid concern that a past self-medicator might have some problems taking c-II medication as directed, and as directed only; but I think this concern can be addressed by assessing the patient's attitudes and educating him on the reasons that compliance is important.

In most contexts, all illegal drug use is justifiably considered abuse if we take the view that healthy people do not need drugs and should not be using them recreationally. But self-medication is a different context. The word "medication" in self-medication already admits a certain rationality to its use, toward relief from a presumed ailment. It has a specific meaning and is not a euphemism for recreational use. That's not to say that self-medicating isnt often maladaptive, but it isn't always, either. Likewise, a drug being illegal should not automatically make its use abuse from a medical perpective, which is what I think doctors should primarily concern themselves with.

Conclusion, I think some doctors are withholding c-II medications for moral, not medical/therapeutic reasons, although I'm sure they believe it's for therapeutic reasons.

[sarahsweets]

Im sorry,regardless of past abuse, you deserve treatment. With the right meds nkww.tell him to go F**K himself and try hard to a. New one. Any doctor that know
Knows anytime about adhd knows that we are the most prone to drugs and alcohol addiction. Without treatment it becomes its even harder

[UnknownUser]

Thank you all very much for your responses. I explained my use as during work for a period of 2-4 weeks and I was measuring my dose to some degree. I think that I may have given the wrong impression.

The NRI, SSRI, SNRI all just turn me into a zombie. I stayed on the SNRI and SSRI for longer then 6 months. I might ring up my psychiatrist and ask him to send back a report to my GP so that I can ask my GP for another referral with someone who is experienced in ADHD treatment. Being told that one medication is my only solution when I know that there are other possibilities is the last thing I want to hear for my mental well being.

[sarahsweets]

Time for a new doctor, preferably a good psychiatirst...once you find one, waltz into the old one and tell him to take the strattera and shove it up hi a**, then tell him to f**K off. You'll feel wonderful and as long as youre other doc is set up you have nothing to lose.