Panicked And Walked Out On Psychiatrist

[Lady of Longbourn]

Have you read the HIPPA (if you are in the US)?

http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/

 

[anonymous12345!]

Have you read the HIPPA (if you are in the US)?

Thanks for the link. I'm aware of HIPPA, but I have not read it. I might well do so after yesterday's circus.

I met with my therapist today and gave her the play the play. She was appalled and flat out stated that this psychiatrist was non-HIPPA compliant, both based on the type of computer program they are using and the fact that patient info was left unprotected. While I do have the option to report, I have to weigh whether or not that's the best choice for me. I am, however, planning to send a letter that states my belief that they are non-HIPPA compliant and requiring that they respond within X number of days with the steps they have taken to remove all of my personal information from both their electronic and manual filing systems.

My therapist gave me two additional psychiatrists that I can call whom she knows take my insurance. She didn't initially refer me to them because we were trying to find someone who I could actually build a relationship with etc. and apparently both of these psychiatrists either lack in personality or approach. However, I told her I didn't much care at this point. I just need someone educated enough to write a prescription that will help alleviate some of my symptoms.

 

[blue moon]

Privacy is very important and they should respect your privacy , no matter what. I also have not had so many great experiences with my latest psychiatrist.

 

[anonymous12345!]

OP here. I finally saw one of the psychiatrists who my therapist recommended and he prescribed two different medications. Paxil to help with the PTSD symptoms and Trazodone to help with the insomnia. I had been taking Citalopram (Celexa) and Zolpidem (Ambien) for the same reasons, but in the case of Citalopram, it was ineffective, and in the case of Ambien, I was trying to move off it because I've been it for way too long and I'm not getting a good REM sleep while on it. I haven't been on the new meds for very long, but I am concerned that I'm having a reaction/bad side effects and I'm confused about what to do for a variety of reasons.

First and foremost, I have contacted the psychiatrist several times between yesterday and today and have yet to hear back (in fact, yesterday his phone just kept ringing and didn't even go to voicemail, so I couldn't leave a message). I did speak to my therapist about it and she's been very supportive (as usual), but she of course cannot give medical advice. Question: is it normal for psychiatrists to not return calls such as this? Aren't they legally obligated to call you back or something?

Second, I find it extremely hard to distinguish between my PTSD symptoms and medication side effects (there is a lot of overlap), and I don't want to give up on something if I should just give it more time. Has anyone else experienced this confusion and what have you done to sort things out? I've been trying to pay close attention to what is a "new" symptom (i.e. stiff/jelly legs), a possibly "new/increased" symptom (i.e. dizzyness/lightheaded/lack of coordination/unsteady), and what is an "old" symptom (i.e. breathing issues).

I'm really at a loss on what to do. A big part of me wants to just to take these experiences with both of the psychiatrists as a big fcking flashy red sign that I should just stay away from doctors/meds altogether, but the other part of me knows that I need some help to manage my symptoms (and to sleep!). Any suggestions appreciated.

 

[joeylittle]

Does this psychiatrist have a nurse? Make sure you are leaving your messages in the right place.

It's scary when you are out there on a limb with a new med and aren't sure what's happening, side-effect wise. But if you are relatively new to them, or in the switching period, you really need to give it at least two weeks and generally four. Aggressive side effects should quiet down after a full week on something, but you still may have ongoing side effects, and you decide if the benefits outweigh the annoyance.

I'm not a doctor: here's what I know about those. You should google "serotonin syndrome", because it's one of the most serious side effects you could be vulnerable to. If you have signs of it, go to the hospital. (It's relatively rare; I asked my psych how I'd know if I had it, really, because I can be a worrier - and she said "don't worry. You'd know". If that helps at all)

If you have feelings of suicide, leave that message for the doctor. If you feel manic, or "up", tell the doctor.

Don't drink grapefruit juice, trazadone changes its bioavailability in reaction to it.

And otherwise, keep a journal and wait it out til your next appointment. It can take awhile to sort out what is causing what.

 

[ms spock]

I take a long time to settle on a medication. I have an increase of certain types of symptoms. It can be rugged and rough going. It also takes me a lot of time to wean off them as well. It takes a lot for me to manage it.

The thing each body deals with medication differently and that changes over time. I used to be on the highest dose and doctors who didn't know me would be worried it was too tired and make me sleep all the time, but no.

Don't go up or down on your dose unless you you speak to your psychiatrist.

I would hope the psychiatrist would get back to you so you could run by what is happening to you.

Do you live alone? I would humbly suggest that people on medication changeovers shouldn't be on their own.

 

[joeylittle]

Do you live alone? I would humbly suggest that people on medication changeovers shouldn't be on their own.

I don't disagree that this would be ideal, @Ms Spock, but sometimes we don't have an option.

 

[ms spock]

@joeylittle I do unfortunately get that, I have done it on my own - in 2013.

 

[anonymous12345!]

Joeylittle, thank you for your response. Unfortunately, he does not have a nurse (in fact, he even does his own billing). I finally got a call back from him today and he explained that his office has been having "connectivity" issues all week. I guess I'll buy it, at least this time. We're currently playing phone tag, so I haven't yet been able to speak to him.

It's funny you mentioned serotonin syndrome, because that's exactly what my mind jumped to after doing a pretty thorough read of the possible side effects for these meds. I really appreciate your insight that I would KNOW if I had it. Definitely reassuring, although I still feel uneasy about all the serotonin pumping into my system. Also, thanks for reminding me that I may need wait out the symptoms until my body gets used to the new meds.

I forgot to mention in my previous post that because the trazodone has been ineffective at helping with the insomnia, I've been taking it AND ambien. Unless there's some sort of waiting period before trazodone becomes effective, then I definitely want off it (but I definitely don't want to continue using ambien).

Ms. Spok, thanks for reinforcing the bit about how your body needs time to handle new meds. As for my living arrangements, I don't feel comfortable answering, but appreciate your inputs and hearing about your own experience with meds.

 

[joeylittle]

because the trazodone has been ineffective at helping with the insomnia, I've been taking it AND ambien. Unless there's some sort of waiting period before trazodone becomes effective, then I definitely want off it

Does your doctor know this? If not, leave it on your next message.

I remember needing to adjust my trazodone up to the right dose for it to help me sleep - it turned out to not be the right med for me, but it took about 6 weeks to get it going properly. Ambien is notorious for being hard to wean off of, and it is likely that you will need to endure some restless nights (unfortunately). I'm curious if your doctor just told you to stop ambien or if he put you on a plan to decrease dose as the trazadone increases.

They can be really hard to reach, the psychs. But it does sound like you two will connect. Make a list of your questions and have it ready with you when you speak with him, so you can make sure you get everything answered in that phone call.

 

[anonymous12345!]

Joeylittle, my doctor does not know this. I thought about leaving it on his voicemail, but I'm concerned if we continue playing phone tag then he will just answer me back on that one thing and not on all of my questions if we somehow miss each other again (I do have them written down, I'd be screwed otherwise... memory is sh*t these days). Unfortunately, today was a particularly difficult day schedule-wise for me, but I tried telling him when I'd be available and he instead called when I wasn't. I don't know what to do and was hoping for clarity heading into the weekend.

Anyway, back to the trazodone. That's really good to know about the dosage issue. I'm currently on 50mg, maybe I need to bump it up. Regarding a "plan" for getting off ambien, no, he didn't. I felt as though the whole appointment was kind of like pulling teeth with him. He took a very thorough history (much to my disliking) and then spent much less time talking med options with me. After he handed me the prescriptions, I was the one who had to initiate ANY sort of discussion about what to do about my previous meds. With the citalopram, his answer was well, you could take both, referring to the paxil and citalopram, and then he finally decided on me taking half for about a week before I could stop it. With the ambien and diazepam, I believe he said it didn't matter (in terms of weaning off). Actually, now that I think about it, I may have asked about taking the trazodone with the ambien. I really can't remember, ugh.

I also had to ask about how I could contact him in case I ran into any issues with the meds. I thought it was odd that he didn't just provide all this info up-front to me. I mentioned it to my therapist and she didn't really comment on it, so I thought maybe it was standard practice. I'm wondering why you're saying psychiatrists are hard to reach. How is that possible? I mean, I definitely get it in terms of trying to set up an initial appointment with one (many, many calls to multiple doctors went unanswered), but I thought once you became a patient that were legally obligated to get back to you. They're playing with lives, aren't they.

My therapist does think I may be having a reaction of some sort (making clear that this is not her area of expertise etc) and that I need to speak to him. I'm considering stopping the meds cold turkey as of today, as I don't think I've been on them long enough for that to be a problem. That said, I'd hate to quit without giving them a chance to work (as mentioned above, sorry for the repeat). I would probably just go back to taking my normal dosage of citalopram until I can figure out something else (I've been taking citalopram for several months and probably shouldn't just stop it).

 

[Lady of Longbourn]

I take trazodone and know that 50mg is pretty low (lowest is 25mg), highest is in the 100's. Also, it wont put you out right away, it supposed to be a natural sleep. I would honestly give trazodone a chance if you can but ask your doctor. My understanding is that it's one of the safer medication to help you sleep out there. It's not addictive and it's not difficult to wake up with either.

Why not call, leave a message asking if you can increase just your trazodone? Make a direct request if you are playing phone tag.