When to go on medication?

[Chitoshi]

Hi everyone,

I'm about to start the "right medication for me" journey as it relates to my anxiety and what's going on at my internship site.

I'm not going into what's going on at internship, I'm just looking for advice on what I should be expecting.

My therapist said that he'd be willing to talk to my primary care doctor about this if she had any questions, but he suggested going back on Prozac, then going on a "mild sedative" such as diazapam(?) or alprazam(?) which will help me access my coping skills without turning into a panicky/jittery mess.

I mentioned had previously had panic attacks on the Prozac, but he said that combined with the sedative that I would see a difference?

What should I be looking out for in terms of side effects? Should I trial this during my upcoming 1 week off of work or is it best to start this figuring-out-ness as soon as possible?

I'm afraid the sedatives will turn me into a zombie at my internship and that the Prozac will cause the panic attacks again, and I have literally no room for error at my internship site right now, so this medication exploration journey is a bit scary at the moment.

 

[EveHarrington]

Number one......you need a psychiatrist and not a GP to manage your psych meds, especially when it comes to PTSD. This is not “straightforward” anxiety or depression. It’s a bit more complicated than that.

Number two.....you should NOT be listening to med advice from a therapist beyond “I think you should consider medication”. Nope. Nope. Nope! They are not trained in medication. They do not know what they are doing.

Number three......you don’t EVER want to have to take a second medication in order to combat the side effects of the first unless absolutely necessary. And in your case, it’s the last thing you should be doing. And with a benzo? A drug that has the potential to create dependency? Nope!

Number four......Prozac was a bomb. This means that you should be trying other medications. With so many other options out there, why would you want to go back on a medication that gives you panic attacks? (Prozac is known for making anxiety horrendous in certain people.)


A benzo MAY help you, but should only be used sparingly.......most definitely not regularly enough to counteract the effects of another medication.

 

[Chitoshi]

Thanks, I'm talking to my primary care doctor about getting referred to a psychiatrist, perhaps. I won't mention what my therapist suggested, just that maybe medications for anxiety may help. :)

 

[Chitoshi]

So I went in to advocate for a psychiatrist, and instead my primary care doctor gave me a beta-blocker and alprazolam. She didn't want to give out a referral for a psychiatrist yet. She said we need to manage my "symptoms of anxiety" first then we'll talk about medication management.

She also said that if I'm needing medication after 3 years of doing fine without medication, that my therapy isn't working and I "need to find someone who does different modalities" or "do different modalities" with the current therapist. We currently do CBT when I'm not in crisis mode, and it's generally been working pretty well for me, though, when I'm even-keel.

She also suggested yoga at a Hindu temple and dry needling from a physical therapist.

I'm really confused.

 

[EveHarrington]

Your GP doesn’t know the ins and outs of psychiatric medication or PTSD. Why is he/she saying you don’t need a psychiatrist?

Are you sure your insurance requires a referral? (Mine doesn’t.)

Are you sure you are “fine” after three years of no medication? I’d say maybe not if you are still in/out of crisis mode.

Her response is actually why you need a specialist and not a GP.

 

[Chitoshi]

@EveHarrington , she's saying I don't need a psychiatrist because my life circumstances are stressful (grandma dying, crap supervisor, and increased responsibility) and causing panic.

I have an HMO, I require a referral from the primary care doctor to get to a specialist. She actually suggested I need to give my supervisor a box of chocolates and tell my supervisor she's a good supervisor and maybe things will get better (seriously?). I think maybe I need to find a new GP in my network.

Honestly? I don't think I'm fine after three years of no medication, I agree with you. I guess by "fine" I meant "not hiding under a desk" and just "surviving," which I guess is much different from living my life. You're definitely right, there. :)

I've actually come very far with my current T, and my fiance has seen tremendous gains from where I was (couldn't even go to the grocery store by myself) to where I am now (I'll advocate for myself even though it's terrifying, and I'm much less likely to back down when met with resistance regarding myself).

My current T suggested the medication because it's seemed we've hit a plateau in my progress for the past 6 months, and I haven't really broken through that yet, so we were wondering if something else medically has happened.

 

[EveHarrington]

But at the end of the day, you still have PTSD, right?

I understand the HMO stuff. It can be quite frustrating!

I’d try to find another doctor if you can.