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Huge question... - 3/21/2013 3:16:17 PM   
breagha


Posts: 380
Joined: 7/29/2012
Status: offline 		this has nothing to do with BDSM or the lifestyle.

i have a friend who is going through some tough times. she went to a therapist, and as protocol requires, did an evaluation with a psychiatrist to discuss meds. she does not want medication and told him so. when she left the office she was handed two scripts. Once for a sleep aid ( which she asked for ) and one for Neurontin. When she asked what the Neurontin was for she was told " the doctor said you are bi polar and he is prescribing you this for your condition"

Neurontin is a drug that is used to control and prevent seizures. Considered and anticonvulsant ( or antiepileptic ) drug. it is also used to relieve nerve pain in adults. Side effects include Drowsiness, Dizziness, Loss of Coordination, Blurred or Double Vision, Unusual Eye Movements, Tremors, Depression, Suicidal Thoughts/Tendencies, or other Mental/Mood problems. ( this is the list from the pharmacy paperwork )

my question is... why would a doctor give this drug to someone he felt was bi polar? Particularly because of the bold side effects.

my friend is fairly certain she isn't bi polar. she is experiencing depression and anxiety and wanted to simply go to therapy to help her through it.

confused.

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RE: Huge question... - 3/21/2013 3:32:11 PM   
LafayetteLady


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From: Northern New Jersey
Status: offline 		Well, I think she should consult with another psychiatrist, pronto. Many drugs are used "off label" because they have benefits for illnesses that the FDA didn't necessarily approve them for. It doesn't mean they are inappropriate.

However, the reason that I said she should consult another psychiatrist is because she told him specifically she didn't want medication, and it was prescribed anyway. That is a doctor not listening to what the patient says, and I would be concerned.

On the other hand, your friend didn't want psychiatric drugs to help her through this tough time, but she was ok with a sleeping pill which can have just as serious side effects, and be addicting.

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RE: Huge question... - 3/21/2013 3:38:11 PM   
breagha


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Status: offline 		i didn't think about the sleeping pill being addictive. he said she can take that on certain nights and doesn't have to take it every day. i wonder if that would make a difference?

i agree with you about getting another opinion. from the other things she told me about her evaluation session, i question the credibility of this doctor.

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RE: Huge question... - 3/21/2013 3:39:42 PM   
itsapixie


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Status: offline 		So, did the Dr prescribe her a medication for a condition without actually discussing the diagnosis with her? AND he failed to explain the major side effects? That is...not good. Is she able to see a different doctor who might actually discuss her diagnoses and her medications?

I'd suggest your friend to seek out a therapist that will really help her and not just shuffle her out the door with a list of medications that he didn't really discuss with her. Too many Dr's today will shuffle you out the door after a three minute appointment with a list of medications and not much more. It's sad, really.

On a different note, a lot of antidepressants and such will list "depression, suicidal thoughts, etc" as side effects. No medication is 100% effective for 100% of people who take it.

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RE: Huge question... - 3/21/2013 3:43:17 PM   
breagha


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quote:

ORIGINAL: itsapixie

So, did the Dr prescribe her a medication for a condition without actually discussing the diagnosis with her? AND he failed to explain the major side effects? That is...not good. Is she able to see a different doctor who might actually discuss her diagnoses and her medications?

I'd suggest your friend to seek out a therapist that will really help her and not just shuffle her out the door with a list of medications that he didn't really discuss with her. Too many Dr's today will shuffle you out the door after a three minute appointment with a list of medications and not much more. It's sad, really.

On a different note, a lot of antidepressants and such will list "depression, suicidal thoughts, etc" as side effects. No medication is 100% effective for 100% of people who take it.


i know that antidepressants have those listed as side effects. what worried me was the drug he prescribed isn't an antidepressant. not to mention that he prescribed them anyway when she said she didn't want them. i'm just worried for her. Luckily the therapist isn't the Doctor. i'm hoping that actual therapy will help her and she doesn't feel pressured to fill and take the meds.

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RE: Huge question... - 3/21/2013 3:54:47 PM   
angelikaJ


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Status: offline 		Nearly all of the anti-seizure drugs are used to treat bi-polar disorder.

However, he should have discussed the diagnosis with her and explained why he felt she likely has that condition.

I have been prescribed Neurontin before for shingles pain.
It worked very well, and for me, I had few side effects (besides it making me ravenously hungry).



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RE: Huge question... - 3/21/2013 5:18:41 PM   
SacredDepravity


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Status: offline 		Two things immediately:

1. Many drugs that are routinely used in managing bipolar are anti-seizure/convulsant meds. The way it was explained during one of my psychopharmacology (can't spell today so hope it's right) is that the mood swing that occurs with bipolar comes from basically the areas of the brain controlling emotions begin rapid firing left, right, or both based on the type of episode similarly to how the somatic nerves rapid fire in a person with a more typical body muscle seizure disorder. The meds work by restoring normal firing patterns basically and keeping them normal. It works for some kinds of pain disorders because they are also a rapid firing area of the brain where pain is processed. This is not a traditional anti-depressant medication therapy. It is very specific to the type of firing patterns that are often responsible for bipolar mood shift. That's a waaaaay simplified version, but hopeful it paints the basic picture.

2. ANY drug that changes the way a brain is currently functions tends to have a risk of increasing symptoms depression, etc. Brain chemistry is tricky and dosage and types of drugs as well as when they are taken and how faithfully can have a huge impact on these types of side effects. Also, there is this window that I call the "danger zone" when talking to people who have recently started on a new med where the medication is not a full effect, but is having just enough effect to feel a little more energy. I call it the danger zone because that slight increase in energy combine with still feeling hopeless and all around crappy is prime breeding grounds for a suicide attempt. It means the medication is actually working, but they haven't reached the light at the end of the tunnel. A few more days to a couple weeks later, the person is usually feeling much better and this issue goes away. It can resurface with weaning off of a medication, dosage changes, or missing a dose or several doses.

While I am glad your friend is getting help, I am concerned that the Dr. did not respect her wishes to deal with her condition without drugs. She has every right to not have treatments forced upon her unless she becomes a danger to herself or others. She needs to enforce her rights as a patient and her boundaries in care sooner rather than later or a pattern will be established that she can be bullied into accepting treatments she does not want and may have any number of valid objections to receiving. This is a relationship too and it is time for some communication. I wish her the best in her recovery.

SD

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RE: Huge question... - 3/21/2013 5:48:22 PM   
breagha


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quote:

ORIGINAL: SacredDepravity

Two things immediately:

1. Many drugs that are routinely used in managing bipolar are anti-seizure/convulsant meds. The way it was explained during one of my psychopharmacology (can't spell today so hope it's right) is that the mood swing that occurs with bipolar comes from basically the areas of the brain controlling emotions begin rapid firing left, right, or both based on the type of episode similarly to how the somatic nerves rapid fire in a person with a more typical body muscle seizure disorder. The meds work by restoring normal firing patterns basically and keeping them normal. It works for some kinds of pain disorders because they are also a rapid firing area of the brain where pain is processed. This is not a traditional anti-depressant medication therapy. It is very specific to the type of firing patterns that are often responsible for bipolar mood shift. That's a waaaaay simplified version, but hopeful it paints the basic picture.

my main concern is that she is a good friend of mine and i have not ever seen her have mood swings. i have seen bi polar disorder up close and i don't see the traces of that in her behaviour. if she is not bi polar and were to take these meds... would there be a bad reaction do you think?


While I am glad your friend is getting help, I am concerned that the Dr. did not respect her wishes to deal with her condition without drugs. She has every right to not have treatments forced upon her unless she becomes a danger to herself or others. She needs to enforce her rights as a patient and her boundaries in care sooner rather than later or a pattern will be established that she can be bullied into accepting treatments she does not want and may have any number of valid objections to receiving. This is a relationship too and it is time for some communication. I wish her the best in her recovery.

thank you for your info and well wishes for my friend. i know she plans on continuing therapy without the medication. she also plans on going to her therapist and seeing if she can give insight on why of it all.
SD



< Message edited by breagha -- 3/21/2013 5:49:30 PM >

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RE: Huge question... - 3/21/2013 6:01:39 PM   
SacredDepravity


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Joined: 8/6/2012
Status: offline 		Very possibly. Then again, it may help with her sleep. I was prescribed Neurontin alongside Ametryptaline (again, can't spell tonight, sorry) for sleep issues and it helped a great deal. Generally treating a non existent at all or the wrong mood disorder with medications for a different one doesn't bode well. We are facing that with a family member right now. The person has a definite mood disorder, but exactly which is still up for debate. Until things clarify more, the doctor doesn't want to treat the actual mood disorder, so the person is in talk therapy and we are medicating some particularly difficult symptoms such as the sleep piece. Good luck to everyone involved. Pm if there is anything more I can do.

SD

< Message edited by SacredDepravity -- 3/21/2013 6:02:31 PM >

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RE: Huge question... - 3/21/2013 6:21:08 PM   
angelikaJ


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quote:

ORIGINAL: breagha



my main concern is that she is a good friend of mine and i have not ever seen her have mood swings. i have seen bi polar disorder up close and i don't see the traces of that in her behaviour. if she is not bi polar and were to take these meds... would there be a bad reaction do you think?



Bi-polar is not a simple one size fits all diagnosis: it can manifest itself in very different ways.
Bi-polar disorder does not always manifest itself with huge mood swings.

If she has periods of being very energetic and not sleeping that are followed by crashes of a prolonged period, that could be bi-polar disorder.

Bi-polar 2 does not have the mania: there are milder mood elevations along with severe depression.

She might have racing thoughts, which can be typical of bi-polar disorder.

Some people with bi-polar disorder over-spend when they are manic or fall into rages.

So, again, the question is: why did that psychiatrist see that in her?




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RE: Huge question... - 3/21/2013 6:24:06 PM   
LafayetteLady


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Joined: 5/2/2007
From: Northern New Jersey
Status: offline
quote:

ORIGINAL: breagha

my main concern is that she is a good friend of mine and i have not ever seen her have mood swings. i have seen bi polar disorder up close and i don't see the traces of that in her behaviour. if she is not bi polar and were to take these meds... would there be a bad reaction do you think?



Bi-Polar 2 doesn't have those radical mood swings.

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RE: Huge question... - 3/21/2013 6:39:08 PM   
breagha


Posts: 380
Joined: 7/29/2012
Status: offline 		wow. i didn't know there was a bi polar 2. when i was going through therapy it wasn't an issue so i didn't think to look into it like i did the diagnosis i was given. i'm learning a lot tonight. how many levels are there?

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RE: Huge question... - 3/21/2013 6:41:51 PM   
breagha


Posts: 380
Joined: 7/29/2012
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quote:

ORIGINAL: angelikaJ


quote:

ORIGINAL: breagha



my main concern is that she is a good friend of mine and i have not ever seen her have mood swings. i have seen bi polar disorder up close and i don't see the traces of that in her behaviour. if she is not bi polar and were to take these meds... would there be a bad reaction do you think?



Bi-polar is not a simple one size fits all diagnosis: it can manifest itself in very different ways.
Bi-polar disorder does not always manifest itself with huge mood swings.

If she has periods of being very energetic and not sleeping that are followed by crashes of a prolonged period, that could be bi-polar disorder.

Bi-polar 2 does not have the mania: there are milder mood elevations along with severe depression.

She might have racing thoughts, which can be typical of bi-polar disorder.

Some people with bi-polar disorder over-spend when they are manic or fall into rages.

So, again, the question is: why did that psychiatrist see that in her?





honestly i cannot answer that question as i was not in the room when the evaluation was being done. as i said in reply to LafayetteLady, i was unaware that there was a bi polar 2 until i read this post.

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RE: Huge question... - 3/21/2013 10:25:20 PM   
Winterapple


Posts: 1343
Joined: 8/19/2011
Status: offline 		A doctor once prescribed something off label for me to
use as a sleeping pill. I didn't take it because of the
possible side effects. But he was a reputable doctor and
I think it's a fairly common practice.

I think your friend should see another doctor. Bipolar is a
serious diagnosis and it doesn't sound like he made any
effort to talk to her about it and help her understand it or
why he thinks she has it. Medication is only part of the
treatment for bipolar disorder. As said by others it's not a
one size fits all thing. I was thinking there are three types
of bipolar. Rapid cycling bipolar being one type?

In any case she needs to learn as much about as she can
and needs a doctor who will answer all her questions instead
of just handing her prescriptions.

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RE: Huge question... - 3/22/2013 2:05:52 AM   
AthenaSurrenders


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Status: offline 		Fast reply

Like the others, I'd be much less concerned about WHAT he prescribed than the way it was done. I don't know this drug specifically but as has been pointed out, anti-seizure drugs are commonly used in the treatment of bipolar and a huge number of drugs have depression as a possible side effect - hell, even my birth control does.

But, I would be hugely alarmed that a doctor would make a serious long-term diagnosis without even explaining it to her. I would think as a minimum he should be telling her what to expect, different treatment options, long term prognosis, how they will monitor it and potential side effects of the drugs. If there were time limits he could've made a follow-up appointment and/or pointed her towards some reputable sources of information so she could learn. She should find another doctor. Even if this one is spot on in terms of diagnosis and prescription, he's let her down by not giving her the information she's going to need to make informed medical decisions.

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RE: Huge question... - 3/22/2013 11:37:05 AM   
SacredDepravity


Posts: 270
Joined: 8/6/2012
Status: offline 		Look up the DSM online and just look through the different mood disorders and the types of bipolar disorders. What seems to fit best? The doctor should have had a far more in depth conversation with her, I agree. She needs to fully understand her diagnosis as well as the benefits and risks of every last one of the medications her doctor asks her to take. I have serious issues with the ethical practices of this provider based off of the information provided here. That may be an unfair assessment, but I see no effort to give this patient complete information, no discussion of options in treatment, and a complete ignoring of her wishes to forego medication based treatment. I would get a second and maybe even a third opinion. This is serious stuff.

I had a doctor once diagnose bipolar with me. The medications led to a whole host of problems. The reality? I was grieving the loss of a close family member. After getting the drugs out of my system and cycling through my grief, life became much more stable. I was young with no insurance and no money and did not seek a second opinion. I always seek second opinions now when the diagnosis is much above the common cold. I will tell you the cost of these visits far outweigh the money blown in meds and the hospital stay that resulted from the whole screw up. I can't recommend a second opinion strongly enough.

SD

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RE: Huge question... - 3/22/2013 1:03:52 PM   
ShaharThorne


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From: Somewhere in TX
Status: offline 		I am a rapid cycling bipolar and there are about 3 or 4 bipolars, depending on the doctor a person sees. I take Depakote ER (1500mg) and Geodon (160mg). I also take Artane because the Geodon is known for causing the shakes (common side effect) and Restoril for sleeping. At times I can't sleep, at times, I do...right now I got a bad cold so I am taking several OTC drugs to combat it and staying in bed when I can.

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RE: Huge question... - 3/22/2013 6:45:45 PM   
littlewonder


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Status: offline 		meh....I was given a drug for my stomach problems. I also have sleeping problems. I've yet to have any sleeping pills help me....but amazingly the stomach drug puts me out like a light. I mentioned this to the doctor and she said if it works for the sleep too then just take it when you need to sleep and it will help your stomach also. So that's what I do.

Some drugs that are not for a certain condition can funny enough, work for other ailments as well.

I know a few people who use Neurontin for anxiety, depression and bi-polar. It's not prescribed as often anymore though with all the new drugs on the market. But for some people, Neurontin just works better for their body chemistry. No rhyme or reason. That's why people usually have to try different meds for a problem until they find the right one or the right dose that works for them.


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RE: Huge question... - 3/23/2013 12:25:32 AM   
jwl3948


Posts: 10
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Status: offline 		Bipolar is a catch all diagnoses that is loosely defined and also over used. When I lost my health coverage for about a year I had to go through the county mental health department. I had been with my other doctor for about 7 years. I had tried a number of drugs until we found a mix that worked well for me. When I went to the county mental health department the doctor tried to re-diagnose me to bipolar. I had to argue with hem why my symptoms did not fit a bipolar diagnosis until he agreed with me. What it came down to is he wanted to put me on less expensive drugs that the county had a large stock of but I could not get him to own up to it. Bipolar covers so many symptoms with its many forms of manifestation that a whole host of mental health problems can be lumped under the title. She may well be bipolar but I would go ask another doctor first.

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RE: Huge question... - 3/23/2013 4:32:53 PM   
DreamyLadySnow


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Status: offline 		breagha, the diagnosis of bi-polar can be hard to take. I was diagnosed in November of last year and am still getting used to the meds.
All meds have listed side effects. Very few people experience them or at least to a serious degree.
My doc told me that anti-depressants can make the manic episodes worse, and he's getting me off them.
My doc spent a lot of time explaining the diagnosis, the drug he was prescribing, and what to expect.
If your friend didn't get that I would agree with those who suggest a different psychiatrist

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