Help finding Psych who’ll prescribe

[SkbOH]

Hi folks:

I have/had been seeing a psychiatrist for about 3 years. He took over my case after my original doc (who diagnosed the ADD back in 1998) died. This was all at the the same outpatient clinic, which was very close to my home.

The first doc was great. He had a lot of experience and used a lot of common sense, never had a problem increasing my meds (mix of Adderall IR And XR), stuff like that.

The new doc seemed at first to be pretty good. Because of life long clinical depression as well as some physical disorders I had to go on Medicaid in 2011.

Anyway, the new doc was kind enough to work out a sliding scale fee with me. I finally got SSI benefits in Oct last year, so things were looking up.

Then I was informed via phone that my current psychiatrist would no longer be able to see me because I had changed my appt too many times last year. I was never informed there was a limit, and I never cancelled any appointment with less than a week notice. What had changed last year was that my Mom, who I live with, started needing more care (she is 85). The other thing that changed was that the clinic increased their rates to $300 per 15 minutes and stopped any sliding fees.

So I was kicked to the curb. My doc gave me one referral to a place that is about 7miles from my home, and neither I nor my my Mom can drive.

How many of you have found yourselves in this type of situation? How did you handle it? Right now I’m so depressed that I feel like I have no real options. I’m agoraphobic and also have insomnia, neither of which help me locate someone who will help. When I tried in the past I was told that I was on waaaay too much Adderall-60mg XR and 20 mg ir or that the doctor didn’t believe in stimulates, etc.

I don’t want to face stuff like that again because it makes both my depression and agoraphobia worse. But I have to do something soon because I only have about a months worth of my other psych meds (Effexor, and diazepam for panic attacks/restless leg/insomnia) left.

Any advice would be welcome.

[Lovinit]

Go see the doctor 7mile away, take an Uber taxi and in the front desk about your top 2concerns then go from there. You won’t know until you try. Good luck. Hope the next doc is who you’re looking for

[Hidden]

7 miles is not as far as it feels to you. I agree with Lovinit, take an Uber. I have to drive 50 miles to get to my psychiatrist and when I get to the clinic I see her via Skype. It’s good to ask oneself if it’s worth it. In my case, YES. The world is pretty messed up and everything seems to be getting harder to maintain, but we definitely want to do everything in our power to be mentally capable as we can. It can take a lot of compromises.

[HadEnuf]

First, the “way too much” reaction is typical of those accustomed to prescribing only for a child's body mass: in other words, they don't know what they're doing with adult ADHD—and possibly not with medication dosage in general.

Unfortunately, we live in a world where prescribing for ADHD has repercussions in the form of government scrutiny, often by ill-informed investigators, so many practitioners are unwilling to deal with it. I choose primary care physicians based on their willingness to handle the prescribing, since I have been titrated to a stable dose for years—a nuisance, to be sure, when one has moved as many times as I have, the last few years: going through all the shame-inducing “drug seeker shunning” every time has been a tough obstacle.

If the end of your own profile name is any indication, being in a state adjacent to ground zero of the “oxycodone explosion” isn't going to help, either: my experience was that prescribers in that part of the country are particularly nervous—it took moving to Texas to finally get my dose titrated properly for a man of my physical size, which made a substantial difference.

That said, I certainly want to wish you well: I know this isn't easy, especially with agoraphobia in the mix and either no car or no driver's license. Hopefully, you can find both a well-versed, affordable practitioner and a ride that won't put the cost out of reach (given your income constraints) before you're forced to go too long without proper medication.

[SkbOH]

Yes, I do live in central Ohio and, in fact, my hometown-and current town-is Worthington, which was featured in a national CBS (or NBC) news story about the morphia based drug use epidemic. The main freeway from Michigan straight to Florida runs right past us so almost every pharmacy, doctor, etc., are hyper suspicious, always on the lookout for “doc shopping”, and other forms of behavior that are supposedly signs of opioid abusers.

Another factor I have to keep to myself is that I have over 20 years of medical experience: first as a policy researcher for an med insurance company, and the rest as the Chief Medical Underwriter & assistant med director. My past experience has taught me that a lot of docs don’t like patients who have such a background, so I learned to keep my mouth shut-for the most part.

And finally, if you are on Medicaid a lot of PCP’s think you are scum.

Like you all said, I’ll just have to try as hard as I am able to locate someone new.

Wheee.

Thanks Much,

Scott B

[Bynddrvn]

Honestly have lost count of the number of medical professionals who have refused to prescribe stimulant medication to treat my ADHD - Inattentive type. They don't seem to care at all that the medication works for me. Right now I have been off my medication for about three months and when I could get my medication the local medical office required that I call in the prescription, then they would usually pee test me to make sure I was taking my meds, then I would return and pick up the prescription, walk it over to the pharmacy, come back in about an hour to see if they filled it or if I needed to head across town to get my meds as they didn't have enough on hand to fill the prescription, and then once I had the medication show my driver's ID to prove that I am who I say I am. One day it literally took me from 8am till 2pm to get my meds. So frustrating to spend so much time getting my medication each month. Then my doctor left and the new one won't prescribe stimulant medication. Arrrgggh! Good luck!

[SkbOH]

I’ve had experiences so similar it’s spooky! I’ve found so many docs have no idea how Adderall XR works. These people are supposed to be experts but clearly they are not. They usually think that if you take 2 30mg caps that you’ll be on 60mg all day long. I used to take the time to explain that only half of each capsule is active at any one time, showing them in the PDR where it explains all that, etc.

Now I just sigh heavily and (I hope) glare with disgust, get up and say something about the idiot needing to go back to med school, or that I am going to file complaints with the state board, stuff like that. I know it doesn’t help my cause but I’m so sick of the routine that I don’t care.

Besides, it feels soooo good to see their shocked face! I’ve found once I hit the big 55 mark that my mouth has a mind of it’s own.

;-[}]

[Halem1982]

$300 for refills? That’s insane. Mine is $90. Maybe try the Dr. On Demand App. I had a migraine recently and I was able to see a dr within 7 minutes of signing on and she gave me a prescription for it. The appt was like $79 or something. I noticed they have a mental health section so maybe that would be a better option? I don’t see ADHD as one of the things they treat but it does say they treat “focus and concentration” which could be a lot of things. I just checked for you and for psychiatry, the initial visit it $225 and follow ups are $99. I hate my psychiatrist so I might try this next time I need my meds filled.

[SkbOH]

Hi Harlem:

Sorry for taking so long to follow up, I had an appt with a new internist who was recommended to me as one who would be happy to work with kooks such as myself AND had no problem prescribing class ll meds.

Turned out to be completely wrong. Just lovely, wasted an entire afternoon just to be told I needed to loose some weight. I SOOO wanted to smack him very hard and very many times but I controlled myself.

Anyway, I’m going to check out your suggestion. I am also going to contact my sort of current PCP to see if he can refer me to someone, with the secret hope that he’ll just prescribe himself until I can find one on my own.

Thanks for your help,

Scott

[MatureCreativeL]

Low magnesium is tied to panic attacks. It sounds like you may need a "medical ride" under medicaid insurance to get to this new Psych. Sometimes Primary Caregiver Or Family Physicians may help with anxiety med prescriptions. If you have any nerve/body pain diagnosed, you could try gabapentin. The advantage is that it has been used "off lable" by Psychs for anxiety too. It has really help me in both ways for years now.