Serotonin Syndrome

[Grace11]

Yes, an APRN can. I don't know what qualification process they go through to do so. It's pretty difficult to see the actual doctor many times, and the APRNs are much more accessible. I know the health care system here is a nightmare, so it may sound bad. It may be bad. I don't know any different....I just miss having health insurance to even get in to see anyone.

 

[allitherapy]

When you are seeing a nurse practitioner or a physician's assistant, a doctor should be behind the scenes reviewing your file and the prescriptions that have been ordered for you. All APRNs and PAs must be supervised by a physician. They also are not allowed to prescribe controlled substances

Nurse practitioners (APRNs) have either master's or doctoral degrees in nursing, so their education is much beyond that of an RN. Physician's assistants also have master's degrees and some have doctorates.

A family practice APRN is required to have 500 hours of clinical experience before being able to work. A primary care physician must have 14,000 clinical hours before being able to work. There is a huge difference between the two.

I personally don't go to APRNs or PAs, but they are ok for minor illnesses, etc. I would definitely not go to them with anything serious. Nothing against them, but my preference is to go to an expert, and that's not going to be someone who has 2-3 years of education. It will be the doctor with 7-11 years of post-undergrad education. Maybe I'm biased because I'm in medical school, but just my opinion. ;)

 

[Grace11]

When you are seeing a nurse practitioner or a physician's assistant, a doctor should be behind the scenes reviewing your file and the prescriptions that have been ordered for you. All APRNs and PAs must be supervised by a physician. They also are not allowed to prescribe controlled substances
. ;)

Right, I did not clarify that about controlled substances. The doctor must do that. I have had great experiences with nurse practitioners, so I tend to feel comfortable in their care. However, they have never diagnosed anything with me before discussing it with the physician. So I assume there is a system in place by which the doctor must approve of treatment plans, etc. I like the personal attention I get from the APRNs I have encountered.

 

[allitherapy]

The reason why APRNs and PAs exist is because of the huge shortage of physicians in this country. It is much easier educationally and time wise to become an APRN or PA than it is to become a physician, so it's quicker to churn out new APRNs and PAs than doctors. The shortage is only going to become much, much worse in a few years when we add a few more million patients to the caseloads. I won't go off on a political tyrade here though.

 

[Grace11]

I won't go off on a political tyrade here though.

Nor will I, though I was tempted to do so in a different rant thread. Suffice it to say health care in the U.S. has major problems for many reasons and it's best to be armed with knowledge and use it to find the best physician you can, IF you can...

 

[Heather]

A nurse can prescribe medicatio.

Well, where I go for therapy the APRN is supervised by a Psychiatrist. So, everything she does has to be cleared by her. The Psychiatrist is supposedly a well known expert in PTSD. I've only met her a couple of times.

 

[Chaz Kindred]

If the meds listed above are all SSRI's, Why do I have to take others of those I/E Topirimate, Mirtazipine, Sertaline? I was told I needed all of these as SSRI boosters? My doc supplied by the VA, is basically running though a list to see "I'm trying to figure out what we can do next if this doesn't work for you, so we will give it 6 weeks"..........

OK I'm a test subject and my body is going to figure out what its not going to like or take in

 

[anthony]

There are only seven SSRI's: [DLMURL]http://www.ptsdforum.org/c/wiki/selective-serotonin-reuptake-inhibitor/[/DLMURL]

The brand names are really quite irrelevant, as the primary ingredient is one of the seven.

You then have a range of other drugs, not SSRI's, such as SNRI's, MAOI's, Tricyclics, etc, all of which contain further sub-groups of medications, and they do different things.

Drugs may simply do nothing for you... as they don't work for everyone. Physicians also have to play the trial and error game on a patient by patient basis, as they have no way to determine what medication will work for you, if any at all. They start with the safest usually, being SSRI's, then work their way outwards. Its not really that others aren't safe, but more they come with different side effects, and some are addictive, which create far worse issues all by itself, ie. Valium, Xanax, etc.

 

[justwannabeme]

A nurse can prescribe medication? Seriously! :eek: No disrespect to APRN's, but I can only see bad things coming from medication being prescribed outside of doctors. Doesn't the US have enough issues without adding more to the pharmaceutical industry?

Shocked a little...

Thanks for that LMFAO! Oh, so true.
We here in Canada are very much the same as Australia, no APRN's and the same with smokes..stores have to ID kids here under 16. It was easier for me to buy beer at 13 in Montreal at a corner store than it is for a kid to get cigarettes here now a days! About time!
Yes serotonin syndrome is very real, my pharamcist saved me from a real potential issue. I always go to the same one now. We don't advertise cigs, alcohol, drugs, the same as the US either, but we do get all the US stations here..

 

[Elektra]

I'm on 200mg of Zoloft and 100mg of Trazedone. I am still having trouble sleeping. I asked the APRN if I could increase the Trazedone but she said that both Zoloft and Trazedone are SSRI's and work on the same receptors in the brain.

There's no way to tell how much serontin a person has in their system. Which can lead to serotin syndrome which can be very dangerous i.e. unstable gait, coma, even death. So, I didn't want to risk it.

Anybody else on 2 SSRI's have any problems? Anyone have any thoughts?

Heather, I went through Serotonin Syndrome Twice, you can believe me when I say you NEVER want to go through that mishap. Something you might want to try, which people on here may freak out about, but it works for me. I take something called Seroquel, it is an anti-psychotic but in low doses it can help you sleep, and not interfere with any of the SSRI's you may be taking. I have taken it for 6 years now for Chronic Insomnia and it has helped so much. Start with 50 to 100mgs and you should be fine, it also gets rid of those terrible PTSD nightmares. I loved Trazedone, but it got to the point where I was taking it and on such high doses it was messing with my SSRI, so I just STOPPED sleeping. Please be safe whatever you decide to do.;)

 

[anthony]

Six years on sleeping tablets does not sound normal to me... sorry. That says you haven't dealt with your trauma correctly, if you are still having nightmares and taking sleeping tablets for six years.

The cause of the trauma is the cause of the nightmares, also combined with habitual poor sleeping habits after that duration.

 

[Heather]

No thanks. Seroquel makes you gain weight. I'm not interested in taking any meds. that do that. But thank you for the suggestion.