Scared of meds, even more scared to not take meds...has anyone had this combination of medications?

[joeylittle]

Some observations.

Patients call and address us if there are any concerns with medications.

Yes, and sometimes it takes up to 48 hours to get an answer. This is why it's sometimes useful to ask the pharmacist. It's their job to make sure they don't consult beyond their purview.

Truly, this is not an either/or situation.

The notion that physicians are insensitive and ignorant, while pharmacists is the empathic and rigorous cavalry that comes to the rescue, has unfortunately become an ingrained "factoid" for many.

Thats just cognitive distortion at work. I think it would be more productive for you to consider how that notion (doc unknowable, pharma tech accessible) plays into your own black/white thinking.

The truth is, doc and pharmacist (and nurse should be included) all have useful roles to play, when it comes to patient care. One is not 'more right' than the other. Understanding their relational roles is what matters.

 

[Sideways]

The truth is, doc and pharmacist (and nurse should be included) all have useful roles to play,

This!

I've had good GPs and production line GPs. The difference in their knowledge of medications, interactions and side-effects is huge. I've had a pdoc who was very actively involved in my physiological meds as well as my psychotropics, whereas my current pdoc refers me back to my GP for physical-issue meds.

Finally, I've had crappy pharmacists, totally brilliant pharmacists (like, remembered not just what I'm taking, but what I've previously tried and why I came off it...phwoar!!) and quite a few in between.

They all have their place. If they're good? They'll at least be able to draw your attention to possible interactions, and talk to you about things like side effects, and know when there's an issue that warrants checking with the prescribing doctor (which some will do for you).

One thing to keep in mind is that psychiatry is a specialty. So you'd expect your psychiatrist to have the inside scoop on your psychotropic meds. General physicians are a different specialty, and have the inside scoop on different issues - issues that your pdoc may not be fully abreast of.

once you're seeing a specialist and taking psychotropic, as well as physiological, meds? You're probably considered a fairly 'complex' case, at least as far as medications go. Your medications won't necessarily be unusual, but mixing psychotropics with other meds becomes fairly complex.

So it's very likely that your GP and pdoc will periodically come up against prescrition issues that they don't have the latest and greatest knowledge about. The pharmacist, in that case, is kind of like your last line of defence, and it's both normal and reasonable to check with them when you have questions about interactions.

 

[EmmaOwl]

I must still wonder:

Why do you go to "your pharmacist" if you are concerned about medications prescribed you?

I don't go to "my pharmacist" if I am concerned about medications prescribed me. I DO go to my pharmacist for some other reasons, like when my insurance company decides to stop paying for a particular medication.

Furthermore, do you really think they know your medications (and the effects upon you) better than your prescribing physician?

Yes. Absolutely.

I have so much on my plate, different specialists and meds in flux... say I'm looking to start a new med or change an old one, it is easier to get computer printouts of your medication history at the pharmacy. Someone who will call my insurance and stay on hold and coordinate and communicating with a variety of physicians and a number of different conditions.

I cannot recall many episodes when a pharmacist came and "saved the day"

As someone else said, it's not an "either/or" thing. I was just thinking of people who take *many* meds, a pharmacist may be able to help you. A pharmacist also may understand why you're anxious, when your stabilizing medications from your psychiatrist don't go through, or if you're anxious b/c the antibiotic you are on is not approved. Etc. A pharmacist who owns his own pharmacy who may open the store for you on a Sunday if you have an emergency.

I've had doctors prescribe me medications that are no longer being manufactured/no longer available. A pharmacist helped me with that once.
Of course my doctor goes first. I was talking about a very specific situation, here where the person has extra concerns. A pharmacist is potentially putting together a huge variety of medications from different healthcare providers.

I do my own research on my own medications and it's rather insulting that you think, from what I said, that I do NOT personally pay attention to what I am prescribed and for which condition(s).

 

[ParalyzedMind]

Some observations.

Yes, and sometimes it takes up to 48 hours to get an answer. This is why it's...

Pharmacists are not on call. They are not available 24/7. If it takes you 48 hours to get answers from your doctor and you are not happy with that, then I suggest you find another one.

 

[joeylittle]

If it takes you 48 hours to get answers from your doctor and you are not happy with that, then I suggest you find another one.

Not really my point, but yes, of course.

 

[EveHarrington]

A pharmacist knows the facts about medications, but they are not capable of reading your clinical...

Are you speaking in strictly a professional capacity?

This is how I read it.

Just wondering as I'm extremely wary of interacting with professionals on a forum such as this.

Thanks.

 

[ParalyzedMind]

Some observations.

Yes, and sometimes it takes up to 48 hours to get an answer. This is why it's...

I guess you are talking about cognitive dissonance and not distortion, but anyways.

Some observations.

Yes, and sometimes it takes up to 48 hours to get an answer. This is why it's...

I guess you are talking about dissonance, not distortion?

Anyways, I pushed back on the notion that a pharmacist knows your medications better than your doctor. If a pharmacist talks my patients into stopping their meds due to my lack of knowledge, I would have seriously questioned my capability to promote both healing and medicine.

Physician-bashing is very real; accepted and probably also due to the fact that they are also care takers. This has nothing to do with me quitting to practice medicine, but such popular dogmas sure as He11 makes me realize at least something good has come out of it. I know very few physician friends of mine that doesn't see this as a ongoing problem and is a major drive for their unhappiness.

It takes a lot to step away from such a high-paying job, but such comments definitely makes me less likely to have regrets. I know at least 5 physicians that have left the field; one that has gotten shot; several that have been assaulted and threatened (including my wife for not prescribing Oxycodone) and several that opted to leave this earth.

You have had physicians prescribe you meds that no longer exist? What about maybe not on formulary or generic? I have no idea what you mean by this statement.

Anyways, this happens frequently. I know very few physicians that are even comfortable telling others/strangers what they do any more.

So a pharmacist owning own store "may" open up on a Sunday?! I am "impressed". If I don't answer my page within minutes on Sunday night at 3 AM, I will likely get reprimanded as a minimum and probably risk much worse long-term issues than that. Otherwise, the old medications are often he best ones. It is easy to save people thousands of bucks by choosing smart medication regimens. Then again, people still think physicians get kick back when they prescribe the newest and most expensive meds.

How you can be insulted when I spoke in general terms about my perceptions is up to you. I find it SUPER-INSULTING to be told I don't know the medications I prescribe my patients, but then again. I am no longer doing this, so I probably should not.

-Hands down one of the unhappiest jobs in the Western world and no amount of money can help that-

I think I am getting too sensitive here over my past job to be any more benefit or find support here. Better leave this place to the experts.

Next time you have a medical emergency, call your pharmacist, would be my suggestion.

Finally, wish you all well. It wasn't my intent to enter a fight, but I don't like to be stomped while lying down either.

 

[EmmaOwl]

You have had physicians prescribe you meds that no longer exist? What about maybe not on formulary or generic? I have no idea what you mean by this statement.

Really? You need an example? I mean exactly what I said. Yes, I had a physician prescribe a type of asthma inhaler that has not been on the market for some years now. He wrote down the name of it and voilà! I was prescribed a medicine that does not exist.

I'm not gonna give a speech on behalf of my local pharmacy, and the PIC ("Pharmacist in Charge") at my local chain place, but they both deserve one.

 

[EmmaOwl]

Finally, wish you all well. It wasn't my intent to enter a fight, but I don't like to be stomped while lying down either.

Don't blame you. Clearly a sore spot for you and I'm sorry to let it devolve into bickering on my part. I'm not taking any one particular side. I've had great care and I've had terrible care, by all different types of medical providers over the years.
Mostly, I like @Neverthesame 's "Layer" theory. The more people checking, including the patient him/herself, the better

 

[EveHarrington]

I guess you are talking about cognitive dissonance and not distortion, but anyways.

I guess you...

So......did you miss my quote?

Thanks!

 

[shatter eyes]

I am feeling this right now....
My seroquel is not working.
I question the valproic, prasozin, prozac, etc etc.

Pharmacist in past said i need med review by docs.
Diff doc diff meds all say its good for me like crutches until i recover. Old trusted lawyer says my meds all sound familiar in other client as "cocktail for disaster". I had to see him because when i snap or have an outburst humans are not humans and my adverse defensive mode becomes combative. I have assaulted strangers but cannot remember much. I confronted and itched to fight 3 goofs for spitting at the WW2 vet cynotaph. I wanted to fight. I wanted him to pick up what he spat and apologize to the memorial. His buddies surrounded me pointing out more spits. A lady jumped between us...then i broke down and cried. I have changed so much in 2 years. Sometimes i wonder if the lawyer is right.

Nobody is one the same page.
I just want to return to my natural being without trial error pills but i am even more scared to stop.

I feel like a dart board for docs throwing dope darts at me. Hit n miss. More darts hoping to land a bulleyes on me.

 

[BM2A]

I felt exactly the same. They kept telling me dont lose hope, if one anti depressant doesn't work, there are hundreds, we need the right one. I think maybe sometimes the prescriber doesn't realise its not just a case of trying a new one like a new pair shoes. Going with it, taking it everyday as prescribed for months and coping with certain effects can be an ordeal.

I decided some side effects were too much and asked my Dr to try something else. He did. I've had seroquel as an anti psychotic and mood stabilser for 2 years, its worked, and I'm gradually coming off it. I've had venlaflaxine as anti depressant and its working. I'm lucky.

But with the seroequel there was a month off work due to initial side effects they warned me would likely happen and I was prepared. The venlaflaxine nausea and low blood pressure for a couple of weeks. Plus going a little bit crazy initially.

Its a difficult process is what I'm saying and trial and error it is hard work. If it doesn't work it doesn't work. But I think as long as your following the medical advice on starting, taking them as prescribed and only stopping the meds gradually as medically advised then its your decision ultimately what you continue with.

Though I should point also that obviously if you are feeling unwell with any drug, possible side effect your worried about, then seek medical advise straight away