The guinea pig and poorly planned experiments

[anonymous]

This post began as a response to

How do you know your medication is working?

but I did not want to hijack the thread and go off on a tangent. I have had similar concerns to that poster.

I had a discussion with my doctor about meds at my last appointment.

I explained that I was having a difficult time knowing what the baseline is from which we are working. When he switches from med to med to med, and all of them have side effects, it is not clear to me if I am dealing with a baseline issue or if I am dealing with a medication side effect. If something changes, was it simply because I was going on or off of a medication (a purely physiological reason) or is it because the new med is actually helping or hurting the baseline mental issue?

I asked if I should not allow the previous drug to work its way out of my system before adding something new. As I see this, it is like a poorly planned scientific experiment with no control group.

He said no, I should not wait before starting the new medication (the old one was likely helping, but with some bad side effects). He asked me to go back to my symptoms before the last drug and use that as a baseline. When my original symptoms have improved, then we are onto something.

This still seems like a haphazard approach, at best; however I dont know what a good approach would look like.

What is the baseline? When is it time to say, "No more"? At what point should a person back off of all medication for a period of time and re-establish what the "real baseline" looks like? Maybe therapy has helped enough that further trial and error is no longer necessary.

 

[Justmehere]

It's really common that once a medication starts working, someone will figure ah, no more of the original symptoms, no more need for the medication... they stop it and then experience big relapses of symptoms.

That being said, if you are able to remain safe to yourself and others,,and stay functional, and you would like to try to see what it's like without medications, that is an option open to you. You can tell the doctor you are declining to stay on meds at this time, and would like to taper off. Depending on what medications someone has been on and for how long, it may take some time to get through that process and experience a new baseline. This is why most doctors don't wait for it to be completely back to baseline again.

It is common for a doctor to add a new medication while someone tapers off another.

But if you want to wait before adding another and see how you do, that's totally an option. You can also ask to take a smaller dose, and see what symptoms change and not.

I'd advise checking in with your therapist before making the decision about medications and get their feedback about how well things are going on and off different medications.

 

[Deleted member 37474]

You are taking a very scientific-thought process approach to your medications and I think you are valid in these concerns. So the question is, do you trust the doctor? Does he/she have the qualifications to understand your medications and how to prescribe them?

I sometimes request a student to switch to a mouthpiece or reed strength that he/she will grow into. When he/she develops the muscles that were almost there in his/her embochure it is clear that I knew what I was doing. I don't question my decisions but the student or parents might, as the kid sounds a little bit worse before sounding better. I could take an extremely gradual approach and shave their reeds right where they need to be each moment they play, but that wastes time and money getting to the better outcome. I want them there asap.

 

[The Albatross]

It is key to know you're crisis point before backing off on meds. It is key to have a good therapeutic relationship. Rational and reasonable decisions can't really be made otherwise.

Personally I'm not an advocate of Rx meds... but I had no issue with doing the harder work with my shrink and being challenged by peers.