Too many Rxs?: My depression & anxiety from RA are... - NRAS

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Too many Rxs?

Hisue profile image
35 Replies

My depression & anxiety from RA are overwhelming. Feel like my skin & muscles hurt, burn, prickle. Psych prescribed cocktail of 3 antidepressants, anti-anxiety med, & sleeping pill. That is 6 new meds at once, on top of my RA meds & pain meds.

How can I know if I am having side effects from one or another? Dr gets mad if I question; but this makes no sense to me?

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Hisue profile image
Hisue
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35 Replies
TPaine profile image
TPaine

Hiya, maybe to help reassure you a little talk to the dispensing pharmacist about your medicines and ask for guidance on side effects to observe for and maybe best ways to take all meds to minimise issues where you can? I feel for you having these additional problems as it sounds like you are having a really rough time. I am fortunate currently as only on 4 different meds for RA which can be challenging so I can appreciate your worries with so many. Take care.

Tracy.

Jillyanne profile image
Jillyanne

I would definitely go and speak to a pharmacist, they have more time than doctors . I think you can make an appointment with them .

chubby2x22 profile image
chubby2x22

It's not an ease ride with all the meds. I have various things going on but yesterday my rheumy stopped beni pali as the pain and muscle spasm has not improved and these days I am almost housebound. I find gentle tai chi and breathing excercise help. Not for everyone but try something you like, good luck stay positive. Jane

Carol41 profile image
Carol41

Hi Hisue in the boxes of pills there are information leaflets which give you information on what the drugs are, how to take them and possible side effects . If you think that you are experiencing any side effects you should tell the person who prescribed them. Don't be fobbed off asking for help medical professionals are there to help you. I do know how you are feeling as I've been in that situation on a few occasions and know that there are alternative drugs/treatments if the first lot don't suit you Wishing you well Carol.

Hisue my local Doc always laughs at me as he knows if I hit 5 major pills in any one session I start moaning as I cant get my head round how your body will like that many. so he sends me to the pharmacy for a chatso I can talk it out.

Talk about it to someone so you feel informed.

PFKAAde profile image
PFKAAde

Hi Hisue

Others may disagree, and I’m not a doctor. But for me adding in 3 separate antidepressants in one go along with anti-anxiety (benzodiazepines?) and sleeping pills (zopiclone or similar?) is absolutely ridiculous.

Each one of those could potentially be a total nightmare when you are either on them, or possibly more likely when you are trying to get off them.

From my own experience of all of those drugs were (for me) an absolute nightmare to get off. Sertraline (SSRI) took me 4 attempts over >8 years to actually get off, and it wasn’t pretty for me or my family. If anyone ever offers you Gabapentinoids think long and hard.

The combination of them all added in one go is downright irresponsible (borderline incompetent), and is definitely not something that anyone who had experienced being on those types of medication would even consider.

In my opinion you are totally within your rights to question it, and any doctor that doesn’t like those questions should be instantly dismissed (by you, from your care).

A doctor should listen to their patients, not dismiss their concerns. Particularly when they are prescribing not one, but 6 (!!) potentially addictive and definitely dependence causing drugs — simultaneously!

Second opinion required in my opinion. If you can find another doctor that prescribes the same quantity and combination of drugs i would eat my hat.

And I don’t really care if people think I shouldn’t say this after what I’ve been through with those exact types of drugs, and I’ve never once been prescribed more than one at a time.

If you have an adverse reaction to even one of those drugs, who knows which one it was? So what do you do, stop all of them? It’s almost criminal.

And I totally get your anxiety and depression and your RA because I’ve had all of them in spades. And after being on all of the above I’d never take benzodiazepines or antidepressants ever again. That’s not to say they don’t have a place, but 6 in one go?!

All just my opinion of course.

🙏🏻

Hisue profile image
Hisue in reply to PFKAAde

Yes, this is exactly my concern. I was always taught that meds should be introduced one at a time, in case of allergy or side effects. Starting 3 different antidepressants & 2 benzodiazepines (ativan & temazepam) all at once, per day, seemed crazy to me. Plus monitoring or adjusting dosage properly? This dr is the dept head of large, local hospital.

I’ve had such bad experiences with drs and dentists that I am freaking out at the thought of seeing a doctor. I really appreciate your help and everyone’s suggestions. Very kind. TY.

PFKAAde profile image
PFKAAde in reply to Hisue

A senior doctor too! Wow.

Could you go to a different doctor to discuss your concerns before you start that cocktail of drugs?

Hisue profile image
Hisue in reply to PFKAAde

Thx. Yes, doctor-shopping seems necessary nowadays. Cymbalta , mirtzapine, & bupropion seems like a weird combo of antidepressants!

Mmrr profile image
Mmrr in reply to Hisue

A senior doctor often means nothing. Don't be fooled by titles 😉

PFKAAde profile image
PFKAAde in reply to Mmrr

True. The Peter principal in effect...

Mmrr profile image
Mmrr in reply to PFKAAde

Yup and usually older and , out of date, and often with a degree of arrogance. Not always of course.

Zatty profile image
Zatty in reply to Hisue

I was told by a rheumatologist to go and see my GP for antidepressants as he said from what I was telling him that I was clearly depressed (I had in fact tried to speak to my GP before as I was suffering from panic attacks and crying all the time but she just fobbed me off) and I was not keen to go onto that kind of medication, because of the dependencies/chemical/side-effects that you allude to.

I decided to go on a week-long yoga retreat to see if that made any difference and to go to see her if afterwards I still felt as bad. Not only was I able to do more yoga than I had envisaged (result! I did speak to the organisers to see if it would be suitable for someone with my condition/limitations) but I made sure I got outside and went and stood by the sea every day (a very mini walk as my mobility was limited and almost always on my own) and the retreat made ALL the difference. So much so that my (then!) boyfriend said that I looked healthy for the first time in six months when I walked through the door on my return.

I share this as a possible different approach/something to try before getting prescribed up to the hilt on drugs that may not end up doing you much good and perhaps the opposite… Might be worth a go if you’re open to that sort of thing and have the means to do it?

Whatever path you choose, I wish you the very best. It can be very tough times suffering from this condition and you can end up feeling quite isolated and at your wits end. Good luck with everything! With love and a big hug xx

PFKAAde profile image
PFKAAde in reply to Zatty

What a great reply.

❤️

in reply to PFKAAde

I totally agree with you on this. Psychotropic drugs are a living nightmare. Took me six years to recover from the side effects and withdrawals from a cocktail of drugs prescribed by a psychiatrist.

I do get very angry when doctors dismiss the seriousness of poly drug use, and don't listen to patients legitimate concerns.

PFKAAde profile image
PFKAAde in reply to

I hear you.

Hisue profile image
Hisue

My primary told me he never goes against recommendation of another doctor. I find that scarey. Why then have a second opinion? All this upset with doctors when I have severe RA, too, is causing me terror!

Mmrr profile image
Mmrr

You really do need to ask and be answered by the prescribing Dr. Take no tantrums from them they are just people doing a job, paid for by taxes from the general public. They are in these positions to serve your needs.

You could contact the department asking for advice. Be direct, but polite, give them a chance to answer, if they don't you can inform them you will be writing and wish your concerns entered into your notes. If you don't have success, go can through PALS.

In the meantime your pharmacist or GP might be able to help in the short term. It's your body don't take medicines that you don't want.

PFKAAde profile image
PFKAAde in reply to Mmrr

I get the feeling Hisue May be in the US(?), which makes the process somewhat different and I’m not going to pretend to understand how it works over there!

Over here, if it was me I would firstly go back to my GP and explain the situation (nicely). If that didn’t result in a second referral to a different consultant I’d then go down your path and ultimately get PALS involved.

No idea how that translates to the US system.

Hisue profile image
Hisue in reply to PFKAAde

Yes, I am in the USA. With RA and psych issues there are so many possible drug protocols; trial & error, much of the time.

So, if you complain or question a dr; he/she can “fire” a patient or malign a patient as “uncooperative or non-compliant” in medical records. I told my GP I felt over medicated and awful; she ran a Rxs/blood concentration test w/out telling me-refused to give me my med records and then called the rheumy to “bad mouth” me w/out my permission. I paid $ for this abuse & have no more strength.

So I am afraid to complain or press for answers; I am polite not rude. Very intimidating.... This is making me sicker.

Mmrr profile image
Mmrr in reply to Hisue

But you do not need to take the drugs, try to get some advice on what might be appropriate for you from another Dr ?

You can also fire your Dr, don't be intimated. Do you have a friend or family member who can accompany your at your appointments ?

Hisue profile image
Hisue in reply to Mmrr

Good idea, I am learning the “ropes”. It really hurts me that I am paying for tests, meds, & visits w/out informed consent and getting sicker & sicker. Plus, you are charged w/out knowing cost upfront.

I read that drs are also suing patients for giving bad reviews on the internet. I realize there are some creepy patients, but this is awful.

PFKAAde profile image
PFKAAde in reply to Hisue

The more I hear of the US healthcare system the more unbelievable I find it that ‘social health care’ (as it seems to be referred to) is so maligned over there. Medical bankruptcies, getting ‘fired’ by a doctor (wtf?), $10k to have a baby etc etc.

The most expensive system in the world by some margin and one of the least effective of any rich nation by virtually any metric you care to use. But at least you don’t pay for some ‘freeloader’s’ care, right?

The idea of taking someone with you is a good one in any system. They might think twice about what they put on your record if you have a witness!

Depending on what state you are in you may be able to record your appointment without the consent of the doctor. According to this article (which quotes from JAMA) you can ‘covertly’ record an appointment in 39 states (in 2017 anyway), although it says the laws are a bit murky and you should clarify your state’s laws first. If not in one of those states you need the permission of everyone in the room, but you could always say you get confused and forget what was said so you’d like to record it (which is totally understandable when they prescribe 6 drugs in one go). No guarantees, but worth a go maybe.

Not sure what else to suggest apart from changing doctors and finding a PCP / GP with a good reputation for being on the patient’s side, so to speak. There must be some!

🙏🏻

Mmrr profile image
Mmrr in reply to Hisue

This is why I love our NHS.

I expect you would be entitled to an itemised bill ? Same as anything you are paying for ?

Hisue profile image
Hisue in reply to Mmrr

Yes , the NHS sounds highly superior to me.

In the USA, patient is responsible for all charges, is billed after the fact, bills are in medical code w/out translation. You don’t know what you are paying for unless you know coding. My treatment has been horrible.

PFKAAde profile image
PFKAAde in reply to Hisue

Not superior in every way for sure, but free at point of delivery makes a huge difference. Like all large organisations there are both good and bad aspects. Needs more funding urgently.

in reply to Hisue

Hisue I am a Brit married to an American and we are constantly comparing how US just issues scripts and in the UK slightly more control is done. So yes check check check as that is why so many Americans are addicted to prescription drugs. And remember you are paying for the treatments so you have a right to question it all.

Hisue profile image
Hisue in reply to

In the US, many doctors choose to receive “rewards” from pharma companies and are offered “incentives” by sales reps -so the more scripts an md writes, the more financial or other perks rec’d.

The FDA has tried to regulate & cap this activity -not easy to do. Why so many scripts written? It is lucrative.

Also.it is quicker and more legally safe to write scripts & order bldwork, than to do a physical exam & consult w/patient.

We in the US are told about “patient rights”- a false notion if you are sick, old, a woman, uneducated, etc. and not a lawyer, or relative of lawyer or dr.

Is this good medicine? I have no power other than to leave.

Hisue profile image
Hisue

Yes, wealthy Americans get very good care here, Socialized med is generally maligned in the US, but I have learned that the average US Joe is at the mercy of things. No one even told me RA must be treated aggressively at the onset!

Can I get a decent RA treatment plan & bloodwork explained to me? Not yet. I have RA & new rheumy does not even look at my joints or touch me. The med ass’t asked me what my height & weight were! There is no nurse to answer questions. If you ask dr about something you read: disdain!

I had no idea of what a mess things can be. When so sick & vulnerable; it is a shame. If the DMARD can cause blindness, pls tell me so I can have my eyes checked!

Drs worry they will be sued or patients complain if they have to wait. I am seen by med ass’t, NP, & then MD - have to repeat myself 3x.

I will try to take someone with me. I have no tears left...

KittyJ profile image
KittyJ

Wow Hisue this sounds really disgraceful and very stressful. I’m so sorry you are being treated like this and seem to have your hands tied behind your back with regards being seen by someone else. I hope you get better treatment soon. Keep talking to us for support x

Hisue profile image
Hisue

I really appreciate this forum & thank you all. Sorry for the rant, but I feel I am being slowly undone.

in reply to Hisue

stick with us we will back you like a support wall till you get yourself sorted.

Hisue profile image
Hisue

Thx, I feel like I am dying. I have significant joint damage from lack of proper timely treatment.

Hobbledehoy profile image
Hobbledehoy

I am so sorry that you're suffering... Would it help if you consider which is the lesser evil, your poor feelings or the meds?

Good 🍀 luck and God bless, sweetheart. May better days ahead come sooner than later x

Carol41 profile image
Carol41

Dear Hisue we are ALL dying in different ways, what choice do we have? I just hope you will be able to overcome the misery of the moment and have better days ahead. Wishing you well Carol xxx

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