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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Else on July 20, 2001, at 18:53:16
Last summer I was on Parnate for about three weeks and felt great but my doctor took me off it when I casually happenned to mention I had done cocaine in the past (NOT while on Parnate, of course). Since then, it's been NO but I am left with the frustrating sense that this might have been the magig pill had I kept my big mouth shut. (Please, I don't want to hear about how cocaine is bad for me, I already know).
Posted by SalArmy4me on July 20, 2001, at 21:30:31
In reply to How effective are MAOIs?, posted by Else on July 20, 2001, at 18:53:16
Get another doctor.
> Last summer I was on Parnate for about three weeks and felt great but my doctor took me off it when I casually happenned to mention I had done cocaine in the past (NOT while on Parnate, of course). Since then, it's been NO but I am left with the frustrating sense that this might have been the magig pill had I kept my big mouth shut. (Please, I don't want to hear about how cocaine is bad for me, I already know).
Posted by Lorraine on July 20, 2001, at 23:03:31
In reply to Re: How effective are MAOIs? » Else, posted by SalArmy4me on July 20, 2001, at 21:30:31
> Get another doctor.
>
I'm afraid I have to second this advice. What arrogance. It's bad enough to be depressed, but then to have to weed through pdoc h***
Posted by JohnL on July 21, 2001, at 4:29:20
In reply to How effective are MAOIs?, posted by Else on July 20, 2001, at 18:53:16
> Last summer I was on Parnate for about three weeks and felt great but my doctor took me off it when I casually happenned to mention I had done cocaine in the past (NOT while on Parnate, of course). Since then, it's been NO but I am left with the frustrating sense that this might have been the magig pill had I kept my big mouth shut. (Please, I don't want to hear about how cocaine is bad for me, I already know).
If I were you I would simply see another doctor who will prescribe Parnate for you. You could even ask up front if they will. If they won't, call another doctor. Someone will be willing to help you out, but you might have to do a little hunting to find them.
If you want to stay with your current doctor, here is a strategy that can work. It's called incrementalism. Do whatever you have to do, beg, plead, get on your knees, whatever, to get a two week supply of Parnate for trial. You'll have to go overboard to sell the doc on the fact that you will not do cocaine. Only ask for two weeks and agree to see the doc in two weeks. In a worst case scenario, bargain for just a one week supply instead. At that point, if all is well, ask for another two week supply. And set another appointment. The whole idea here is to slowly build trust with the doc and ease into the situation without any longterm commitments. Keep in mind the doc is protecting himself/herself from a lawsuit, and that is likely the main reason he/she is reluctant. If he/she prescribes Parnate, and then you do cocaine, and something bad happens, the doc could be in trouble.
Some doctors are in the business because they have a passion for it. But for most, it is their profession, it is the money that brings them into the office each day. By asking for only a small supply and rescheduling frequent visits, the doc will silently know he/she will be making easy money.
Anyway, assuming all goes well, over time you will earn the doc's trust. And, once the doc sees how well you are doing (assuming Parnate does work well), then both of you will have carefully eased into a more committed situation. Then longterm Parnate use won't be such a reluctant issue. The whole idea is to ease into it very gradually and incrementally. This often helps overcome any reluctance on the doc's part.
Hope something here helps.
John
Posted by Else on July 21, 2001, at 8:05:44
In reply to Re: How effective are MAOIs?, posted by JohnL on July 21, 2001, at 4:29:20
Hello again John,
> Incrementalism has been my technique for years. In Canada, the health care system is different. There is a shortage of specialists so even if my doctor wanted to schedule me in more often to make more money he couldn't. And he gets paid by the state. Changing doctors is DIFFICULT here and having seen others I think I should consider myself lucky. GPs would never prescribe something like Parnate and the waiting list for psychiatrists (in non-emergency situations of course) can go from months to years. I am behaving right now. I work, I haven't done anything self-destructive in a year, I'm no longer truly depressed. Maybe he'll give me a chance. Of course, it's unlikely that he could see me every week but arrangements could be made with a GP or something. But I wont push my luck just yet. He's just agreed to prescribe Klonopin which he would never have considered months ago. I do trust him and I'm willing to wait a while for the good stuff. Anyway, thanks again. BTW, I don't hear much about you.
> If I were you I would simply see another doctor who will prescribe Parnate for you. You could even ask up front if they will. If they won't, call another doctor. Someone will be willing to help you out, but you might have to do a little hunting to find them.
>
> If you want to stay with your current doctor, here is a strategy that can work. It's called incrementalism. Do whatever you have to do, beg, plead, get on your knees, whatever, to get a two week supply of Parnate for trial. You'll have to go overboard to sell the doc on the fact that you will not do cocaine. Only ask for two weeks and agree to see the doc in two weeks. In a worst case scenario, bargain for just a one week supply instead. At that point, if all is well, ask for another two week supply. And set another appointment. The whole idea here is to slowly build trust with the doc and ease into the situation without any longterm commitments. Keep in mind the doc is protecting himself/herself from a lawsuit, and that is likely the main reason he/she is reluctant. If he/she prescribes Parnate, and then you do cocaine, and something bad happens, the doc could be in trouble.
>
> Some doctors are in the business because they have a passion for it. But for most, it is their profession, it is the money that brings them into the office each day. By asking for only a small supply and rescheduling frequent visits, the doc will silently know he/she will be making easy money.
>
> Anyway, assuming all goes well, over time you will earn the doc's trust. And, once the doc sees how well you are doing (assuming Parnate does work well), then both of you will have carefully eased into a more committed situation. Then longterm Parnate use won't be such a reluctant issue. The whole idea is to ease into it very gradually and incrementally. This often helps overcome any reluctance on the doc's part.
>
> Hope something here helps.
> John
Posted by Else on July 21, 2001, at 20:17:16
In reply to Re: How effective are MAOIs? » Else, posted by SalArmy4me on July 20, 2001, at 21:30:31
Sorry about repeating myself but I always forget to add the name of the previous poster.
I do have another doctor but since then there's been a fairly serious suicide attempt involving pills and I'm not sure he trusts me entirely yet. I've been good recently though. He may reconsider enventually. I guess I did not express myself clearly. My doctor is actually pretty nice and fairly open to my ideas. He just doesn't want me to kill myself with pills he has prescribed. I suppose I can't blame him but I am recovered to a large extent. I"m very stuborn. I always get my way even if it takes years. Plus the Parnate would be for SP (more effective than anything else I've tried) rather than for depression although it wouldn't hurt.
> Get another doctor.
>
> > Last summer I was on Parnate for about three weeks and felt great but my doctor took me off it when I casually happenned to mention I had done cocaine in the past (NOT while on Parnate, of course). Since then, it's been NO but I am left with the frustrating sense that this might have been the magig pill had I kept my big mouth shut. (Please, I don't want to hear about how cocaine is bad for me, I already know).
Posted by Elizabeth on July 21, 2001, at 22:37:23
In reply to How effective are MAOIs?, posted by Else on July 20, 2001, at 18:53:16
> Last summer I was on Parnate for about three weeks and felt great but my doctor took me off it when I casually happenned to mention I had done cocaine in the past (NOT while on Parnate, of course).
That was a silly thing for him to do. If he refuses to prescribe Parnate, I would find a new doctor and ask for some.
(BTW, the answer to your question: "very.")
-elizabeth
Posted by v on July 22, 2001, at 5:12:15
In reply to Re: How effective are MAOIs?, posted by Else on July 21, 2001, at 7:55:31
else... you might mention to your pdoc that the parnate alleviated your suicidal impulses...( i'm assuming, of course & that's dangerous i know) that this was true for you, yes?
if this guy is fairly open and you are convincing, you should be able to make him see your point of view... offer him a pact as well..." if you trust me and give me the parnate, i will honor that trust and not do anything to damage it"
and of course you have to mean it...just my 2¢ from one stubborn to another... :)
good luck
v
> I do have another doctor but since then there's been a fairly serious suicide attempt involving pills and I'm not sure he trusts me entirely yet. I've been good recently though. He may reconsider enventually. I guess I did not express myself clearly. My doctor is actually pretty nice and fairly open to my ideas. He just doesn't want me to kill myself with pills he has prescribed. I suppose I can't blame him but I am recovered to a large extent. I"m very stuborn. I always get my way even if it takes years. Plus the Parnate would be for SP (more effective than anything else I've tried) rather than for depression although it wouldn't hurt.
>
>
>
> > > Get another doctor.
> > >
> >
> >
> > I'm afraid I have to second this advice. What arrogance. It's bad enough to be depressed, but then to have to weed through pdoc h***
Posted by Else on July 22, 2001, at 10:53:29
In reply to Re: How effective are MAOIs? » Else, posted by v on July 22, 2001, at 5:12:15
Yeah I tried the honour thing already. Maybe I'll just let time work its magic. Changing doctors is not an option. There are about 25 pdoc in my (bureaucratic) sector and most of them are much worse. I know, I've met them.
There's one I hate particularly. I used to think maybe I had ADD (still not sure I don't). So the first thing I told him when I first saw him was: "I thight I might have ADD". He replied, very condescendingly, "ADD is something little kids have" dismissed the issue altoghether and then proceeded to make me talk about my mother and seemed intent on making me cry. I am not changing doctors, no way. My current pdoc is more of a scientist but he's very cautious. I think once he's certain I am stable he might reconsider. But the Parnate would be for SP. I am not suicidal. I think maybe he considers that Parnate is not worth the trouble for such a mild condition (mild meaning awful but not life-threatenning).> else... you might mention to your pdoc that the parnate alleviated your suicidal impulses...( i'm assuming, of course & that's dangerous i know) that this was true for you, yes?
>
> if this guy is fairly open and you are convincing, you should be able to make him see your point of view... offer him a pact as well..." if you trust me and give me the parnate, i will honor that trust and not do anything to damage it"
> and of course you have to mean it...
>
> just my 2¢ from one stubborn to another... :)
> good luck
> v
>
>
> > I do have another doctor but since then there's been a fairly serious suicide attempt involving pills and I'm not sure he trusts me entirely yet. I've been good recently though. He may reconsider enventually. I guess I did not express myself clearly. My doctor is actually pretty nice and fairly open to my ideas. He just doesn't want me to kill myself with pills he has prescribed. I suppose I can't blame him but I am recovered to a large extent. I"m very stuborn. I always get my way even if it takes years. Plus the Parnate would be for SP (more effective than anything else I've tried) rather than for depression although it wouldn't hurt.
> >
> >
> >
> > > > Get another doctor.
> > > >
> > >
> > >
> > > I'm afraid I have to second this advice. What arrogance. It's bad enough to be depressed, but then to have to weed through pdoc h***
Posted by Elizabeth on July 22, 2001, at 13:06:28
In reply to Re: How effective are MAOIs? » v, posted by Else on July 22, 2001, at 10:53:29
> Changing doctors is not an option.
In that case, I'd just keep working on this one. I think that he could probably be persuaded to come around. He might just need to get to know you better in order to feel that you're reliable and trustworthy.
It's a sad world where doctors punish their patients for being honest. I've never taken cocaine, but even if I had, I would be very hesitant to tell a doctor about it, at least until I'd gotten to know him.
-elizabeth
Posted by Else on July 22, 2001, at 16:18:17
In reply to Re: How effective are MAOIs? » Else, posted by Elizabeth on July 22, 2001, at 13:06:28
That's good advice really although I agree it's unfortunnate. But admission of drug use ends up on your file and sometimes even changing doctors doesn't make a difference. 6 or 7 years ago I had this deranged, bitchy psychiatrist who had like 5 Rottweilers protecting he office. She was of the type who never says a word to you. Anyway, she prescribed Prozac & Xanax for me for SP. I was about 18 years old and partied hard so one night I had a bit too much to drink and blacked out because of the Xanax. (She had never told me I couldn't drink while on these drugs, BTW). I naively reported this to her on our third appointment thinking this was worth mentionning. There was no fourth appointment (she dropped me), stopped all my prescriptions and told the GP who had reffered me to her I was an alcoholic. (I actually found this out years later when said GP asked me if I was still dependent on alcohol. I said WHAT!!!!!!!!. I've never been dependent on alcohol in my life. I can't even drink on two consecutive days, it makes me sick. To this day she's not convinced). I was 18, I drank like an 18-year-old. But to some doctors, any drug or alcohol use (or misuse, perhaps) means you are an incurable drunk or junkie and you'll never get anything other then Prozac. I'm warning you. Doctors are like the insurance company people : You've never had a drop of alcohol in your life and you favour the death penalty for pot smokers. That way, maybe you can have a medicine cabinet stocked with pharmaceutical speed and still look like a good upstanding citizen.
>
> In that case, I'd just keep working on this one. I think that he could probably be persuaded to come around. He might just need to get to know you better in order to feel that you're reliable and trustworthy.
>
> It's a sad world where doctors punish their patients for being honest. I've never taken cocaine, but even if I had, I would be very hesitant to tell a doctor about it, at least until I'd gotten to know him.
>
> -elizabeth
This is the end of the thread.
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