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Med advice please


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Hi all,

Some advice please on meds. I went to my GP this week and saw the doctor who always seems to have appointments, all the others are normally fully booked. I saw him once before a year ago about a throat problem and he ended up being my patient. I would not have gone to see him this time round but I forgot what his name is and took that appointment. He was going to put my on an increased dose of my current drug, which I know is against the guidelines of the medical board and appeared surprised when I told him this. He then told me to take 20mg daily for 2 weeks and then 10mg for 2 weeks of my current drug before changing to the new drug. Today I counted up the pills he assigned to me and ... they are not enough for the course he assigned! I dont trust what he is telling me at all after these two experiences.

My question is thus: when changing meds, is it normal to half the dose for 2 weeks and half the dose again for a further 2 weeks? this sounds like a long time to me and like I say, I dont trust the guy; especially after my appointment with him last year!

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Hi machiato,

I think all drugs are probably different and in how they affect us too, but I don't think the reduction is unreasonable - if you reduce the dose too quickly then the danger is that things will get worse. I would however hope that he has advised you on what to look out for in terms of withdrawal effects and has also advised you to contact them again if things deteriorate?

Re there not being enough of the tablets he has given you, could you give them surgery a ring about this and ask them?

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Thanks for the reply NS. There certainly wasnt a shortage and I dont pick them up from the surgery anyway, its a prescription. Did he tell me what to look out for? Nope. Did he tell me to visit them again? Nope. I am also a very infrequent visitor to my surgery, so he has no reason to believe I am taking up a lot of their time. I just dont trust this particular doctor and have very little experience with meds, as I have only ever had Citalopram. Been on that since late August. It has helped with the depressive episodes but not with the anxiety. This week I had a real freak out, which ended with me doing something pretty silly and I decided I needed to try something else to help me with the anxiety to make sure it doesnt happen again, hence my visit.

To be honest, I still have some Citalopram left over, so I can just cut the 40mg ones in half, but he didnt know that and still miss-calculated. I dont mind mistakes, it happens, but my faith in this guy was really shaken last year when I when to see him over a horrible throat/ear problem and all he did was moan about 'the life of a GP'!!!

If you think a month scale down from 40mg to 0mg and then another month to build up to 50mg of setraline, then thats cool with me.

Thanks for your advice.

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I'm no expert! But I'm disappointed that he has not seen fit to keep an eye on you. Could you try to get an appointment with one of the others at the practice? I know sometimes I have to phone up first thing in the morning to get an appointment for that day but usually if I say that it is urgent then they manage to fit me in somewhere, even if it's turning up at the end of the day and waiting for one of the doctors to finish first. It can't hurt to get a second opinion on the timescale for the meds change, especially since this guy hasn't advised you on anything to look out for or asked to see you again.

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Hi all,

Some advice please on meds. I went to my GP this week and saw the doctor who always seems to have appointments, all the others are normally fully booked. I saw him once before a year ago about a throat problem and he ended up being my patient. I would not have gone to see him this time round but I forgot what his name is and took that appointment. He was going to put my on an increased dose of my current drug, which I know is against the guidelines of the medical board and appeared surprised when I told him this. He then told me to take 20mg daily for 2 weeks and then 10mg for 2 weeks of my current drug before changing to the new drug. Today I counted up the pills he assigned to me and ... they are not enough for the course he assigned! I dont trust what he is telling me at all after these two experiences.

My question is thus: when changing meds, is it normal to half the dose for 2 weeks and half the dose again for a further 2 weeks? this sounds like a long time to me and like I say, I dont trust the guy; especially after my appointment with him last year!

Hey Mach, what do you mean he ended up being your patient! I'm not surprised you don't feel you can trust him and are asking q's because it all seems a little bit suspect huh? Bloomin' GPs. It sounds like a long time to me, what if your withdrawal symptoms are too bad - 2 weeks is quite a long time without proper meds isn't it? i looked for the notes on my Prozac but couldn't find them. maybe your old meds would say something in the notes that come with. Or a knowledgeable pharmacist if you have one may know. i'm prob not helping much, :original: but you need to find out for sure.

I think i changed meds once a long time ago and i don't remember it taking 2 weeks before i started new ones, but that could be wrong or different meds so irrelevant. :sleep: BL

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Good advice from you both. Thanks! I will probably go back I just dont trust the guy.

I say he was my patient, because I sat there listening to him moan about his working life, how pointless it is and that GPs dont do anything useful or worthy (speak for yourself pal)... So, I guess I was his counsellor and he my client! lol... or not lol.

He gave me a naisal spray, which I had a feeling would do nothing for me.... and it didnt. What was it in the end? An ear problem, which I diagnosed myself through studying on the internet and buying a DIY kit to clear out my ears. Since he doesnt find his job useful, he could do something useful for us and give up!

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Absolutely! Our health is too important and GPs are in too powerful a position in my opinion for there to be second rate ones or ones that dont want to do a good job. Unfortunately, this doesn't seem to be an uncommon occurance and we have to be vigilant. BL

Edited by bendylouise
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Well thats good, reassuring i suppose! Does seem a long time tho, especially as the new ones prob wont kick in for at least a week? Still important to be careful with drugs. Hope it goes well for you and is worth the effort. Wishing you good luck , BL ps hope this doesnt sound sceptical, its not meant to be. x night night all

Edited by bendylouise
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Guest faithless

Hey Machiato. Meds such as Citalopram and Setraline are Selective Serotonin Reuptake Inhibitors (SSRIs) which are usually recommended to be gradually reduced rather than abruptly discontinued/changed. SSRIs are cumulative drugs meaning they take time to build up in your system and also to leave it - stopping abruptly can cause withdrawals such as nausea, tremors, confusion and loss of balance so a reduction for two weeks with a further reduction thereafter to wean you off sounds about right.

However, if you lack faith in your doctor then ask at your surgery if you can switch to another one. You shouldn't have to give a reason or even tell your doctor you wish to change - just ask at reception and they should assign another one for you (that's what I did when I was unhappy with my doctor). They shouldn't refuse your request and if they do then you are within your rights as a patient to make a formal complaint (something they'd rather not have to deal with so kick up a fuss if they try fobbing you off). Hope that helps mate and good luck with your med change.

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Thanks. Really helpful advice.... I think i will go with the program he has given me, as it doesnt break guidelines. When he suggested i take 60mg of citalopram, without even checking if i can tolerate it, i was fuming. I have low blood pressure and get dizzy spells from it. Yet citalopram affects the heart but he didnt bother asking or knowing. So i asked a friend of mine who is a cardiologist and he told me the doctor doesnt know his stuff... I agree. Too many bad things with this guy to put it down to a hiccup.

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Guest faithless

As you already get dizzy spells then I definitely recommend you gradually cut down as some of the main reactions to withdrawal are dizziness/vertigo (difficulty walking/standing etc) which could exasperate your condition. I know it's a Wiki article (hope it's okay to link it) but you might find this helpful - http://en.wikipedia.org/wiki/SSRI_discontinuation_syndrome'>SSRI discontinuation syndrome.

Your doctor sounds like a quack. Before prescribing any meds, it's common practice (and common sense) to ask about current conditions/allergies etc, so I can understand your distrust in this guy. I'd give the surgery a call right now and request a change of doctor - when it comes to your health you need somebody you trust. Give them a call mate, if only for peace of mind - you don't want the OCD latching onto yet another worry.

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