Goldfinch
04-20-2009, 10:56 AM
There have been a lot of questions about antidepressants recently and some cautionary remarks about who should prescribe them and monitor you when you start taking them. No one should feel bad about wanting to feel better; no one with a chronic condition such as IC doesn't get depressed or anxious about it at one time or another, and the right drug can enhance treatment by helping you get some perspective. But it's always wise to proceed with care and as much knowledge as possible.
As everyone probably knows, only an MD or a psychiatrist can prescribe drugs. Since there are many many antidepressants and anti-anxiety meds available, and since everyone reacts differently to them, it would be ideal to see a psychiatrist to help chose the right med and to monitor your progress; they have the most training and experience. Although gps and primary care docs prescribe psychotropic meds all the time, they aren't necessarily the best prepared to do so.
But sadly, one truth about medical care in this country is that most health plans lag behind when it comes to mental health coverage. My plan is decent when it comes to choice of doctors and the copays are very reasonable, especially for drugs, but there is virtually NO coverage for therapy or for psychiatry without a DSM diagnosis, and even then it's extremely limitied. So that puts most of us the position of asking our primary docs for help with antidepressants. Some have a better grip on these meds than others. Several years ago my then primary doc put me on celexa, but she put me on a dose far higher than the recommended starting dose and I became quite ill within a couple of days. Needless to say, she's not my doc any more.
I would say that anyone wishing to try an antidepressant or anti-anxiety drug should read as much as they can about them and ask lots of questions about different drugs when talking to the doctor about it. Be really clear in describing how you feel; if you are listless and can't get out of bed until noon you probably need a different drug than if you are jangly, can't calm down, have insomnia or panic attacks. Make sure your doctor is giving you the minimum dose to start. If they want to see you back in the office for a follow-up in two or three weeks that's a good sign, and remember that if you think you are having any side effects--physical or emotional--call your doctor right away!
As everyone probably knows, only an MD or a psychiatrist can prescribe drugs. Since there are many many antidepressants and anti-anxiety meds available, and since everyone reacts differently to them, it would be ideal to see a psychiatrist to help chose the right med and to monitor your progress; they have the most training and experience. Although gps and primary care docs prescribe psychotropic meds all the time, they aren't necessarily the best prepared to do so.
But sadly, one truth about medical care in this country is that most health plans lag behind when it comes to mental health coverage. My plan is decent when it comes to choice of doctors and the copays are very reasonable, especially for drugs, but there is virtually NO coverage for therapy or for psychiatry without a DSM diagnosis, and even then it's extremely limitied. So that puts most of us the position of asking our primary docs for help with antidepressants. Some have a better grip on these meds than others. Several years ago my then primary doc put me on celexa, but she put me on a dose far higher than the recommended starting dose and I became quite ill within a couple of days. Needless to say, she's not my doc any more.
I would say that anyone wishing to try an antidepressant or anti-anxiety drug should read as much as they can about them and ask lots of questions about different drugs when talking to the doctor about it. Be really clear in describing how you feel; if you are listless and can't get out of bed until noon you probably need a different drug than if you are jangly, can't calm down, have insomnia or panic attacks. Make sure your doctor is giving you the minimum dose to start. If they want to see you back in the office for a follow-up in two or three weeks that's a good sign, and remember that if you think you are having any side effects--physical or emotional--call your doctor right away!