Effexor withdrawl

[Smilemaker100]

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[Smilemaker100]

Why would I disagree? Well....I fill on average 180 prescriptions per day - lots of those for a variety of antidepressants, mood altering, antianxiety, etc medications from any number of different medical specialties - FM & OB/GYN included. I also worked for 20 years in a hospital with an acute inpatient psych unit in which my responsibility was chart review & patient drug education. My PERSONAL relationship with these prescribers, especially in recent years, has been that patients get referred to the primary provider when the patient becomes stable or has circumstances which prevent the patient from utilizing a specified mental health provider. In addition, many of these medications are used by oncologists, pain management physicians & neurologists for treatment of depression (sorry - don't really know the diagnostic terminology) associated with an illness which they are managing. Physicians communicate with each other all the time - you may just not be aware of it.

The reality is some insurances do not provide for mental health benefits and most, if they do, place limits on how many times or how much money is spent on utilizing these services. For these patients, it is in their interest to have their continuing medical needs followed by their primary provider, who can consult with the psychiatrist, if access or plan limitations prevent continuing treatment. It is better they are followed by a physician rather than not being able to access anyone at all.

I will agree with your assessments with regard to dentists & mental health issues since you are a dentist & brought it up. I can only agree though based on my own limited experience with my husband and his colleagues, who are personal friends. Uniformly, they do not know these drugs side effects (but, my husband does not know what felodipine is used for either!), but they call the physician if it will impact treatment. Few root canals need to be deferred because the patient is tapering Effexor or starting on Wellbutrin, but you may have a different practice than that of my husband.

I'm not clear why you might want to limit prescribing authority. Take your area of expertise...you prescribe chlorhexidine as a mouth rinse - that is its only approved indication. However, dermatologists use it for some of the conditions they treat. Prescribers - all of them - take on the responsibilities of what they do seriously. I have never, on rounds, during my hours of chart review & in all the various ways I've had to contact them have ever not taken what they do seriously & in a considered manner. Sometimes, bad side effects happen and it takes more adjustments than some might want to find a stable therapeutic plan, and sometimes patients just dont click with providers...but that is not a reason, IMO to chastise the whole bunch of non-psychiatrists. That said....your personal experience may be far greater than mine.....

I was mostly referring to the ignorance/prejudice of general family practitioners in regards to psychiatric illnesses (ie. their inability to diagnose them accurately). From a pharmacological standpoint, I definitely can't argue that I have had as much experience as yourself. I was referring to the diagnosis and the understanding of the illnesses themselves.

I think if there is one thing which is lacking in undergraduate medical education today, it is in the field of psychiatry. I find it quite apalling as at any point in time, about 20% of the population has/will be afflicted by a psychiatric illness.

GPs from the "old school" tend to be the ones who are more ignorant. I have met a number of them. Alas, that has been my experience thus far. Perhaps I will meet more doctors in the future who will prove otherwise. It would be really enlightening if that happened. 👍

 

[Psyclops]

I was mostly referring to the ignorance/prejudice of general family practitioners in regards to psychiatric illnesses (ie. their inability to diagnose them accurately).

This does tend to be a problem.

 

[Doc Samson]

If you search the web, you will see this "surprise" among people when the withdrawal sx strike is indeed a very common problem. I don't understand why discussing the why's and wherefore's here provokes such jerking of knees.

The fact that withdrawal from Effexor is public knowledge is neither here nor there. There remains a significant difference between asking (or answering):

"What's usually done for Effexor withdrawal?"

and

"My room-mate is withdrawing from Effexor, what should she do?"

It's the same difference that we see in:

"Erotic transference... what's that all about?"

and

"I'm in love with my psychiatrist, what should I do?"

Which is the thread that linebored recently started, and was quickly closed.

 

[Psyclops]

You're right. After re-reading the OPs post it certainly seems over the line. Although I do think that sometimes replies could discuss things in a general sense without addressing the thinly veiled attempt at getting personal help.

 

[ORBITAL BEBOP]

I think the arrogance lies in assuming that you can offer a professional opinion outside of your area of training. Again, I would never presume to tell my patients that their dentist had misinformed them about oral hygiene.

Doc Samson is 100% correct. This applies to any field that a person is not an expert in. An expert, not a dabbler. You can't compete with the USMLE Step 1,2,3, medical school psychiatry, pharmacology, rotations in psychiatry and neurology, 4 years of residency dedicated to psychiatry, oral and written board exams plus the years of experience a psychiatrist has. This is not arrogance, as many overly defensive people think. "I think the arrogance lies in assuming that you can offer a professional opinion outside of your area of training". If I have any dental questions, I refer them to my husband, who is a dentist with 2 years of GPR under his belt.

And Smilemaker, you are the one who brings up your own degrees but won't back it up when asked directly. I doubt you are an oral surgery MD resident, most probably a GPR who gets called to take care of tooth pain in psych patients in addition to your own clinic patients.

omg, does this thread need to get any longer?

 

[Poety]

Doc Samson is 100% correct. This applies to any field that a person is not an expert in. An expert, not a dabbler. You can't compete with the USMLE Step 1,2,3, medical school psychiatry, pharmacology, rotations in psychiatry and neurology, 4 years of residency dedicated to psychiatry, oral and written board exams plus the years of experience a psychiatrist has. This is not arrogance, as many overly defensive people think. "I think the arrogance lies in assuming that you can offer a professional opinion outside of your area of training". If I have any dental questions, I refer them to my husband, who is a dentist with 2 years of GPR under his belt.

And Smilemaker, you are the one who brings up your own degrees but won't back it up when asked directly. I doubt you are an oral surgery MD resident, most probably a GPR who gets called to take care of tooth pain in psych patients in addition to your own clinic patients.

omg, does this thread need to get any longer?

I just want to add what burns my arse: When I did my family med rotation and I said "do you think we should refer out to a psychiatrist? I mean look at all these meds" I was told, OH WE CAN DO MED ADJUSTMENTS, ITS JUST DEPRESSION - I responded with, yeah, but shes not getting better and she seems to be crashing response: ITS ONLY SSRI'S I CAN HANDLE IT 😱

You don't see psychiatrists going around saying "OH its just a boil, let me get my scalpel out and drain it" 🙄 😱

 

[Solideliquid]

I just want to add what burns my arse: When I did my family med rotation and I said "do you think we should refer out to a psychiatrist? I mean look at all these meds" I was told, OH WE CAN DO MED ADJUSTMENTS, ITS JUST DEPRESSION - I responded with, yeah, but shes not getting better and she seems to be crashing response: ITS ONLY SSRI'S I CAN HANDLE IT 😱

You don't see psychiatrists going around saying "OH its just a boil, let me get my scalpel out and drain it" 🙄 😱

LOL

Or how about.."Oh it's only hyperthyroidism, here take this pill you'll be fine. What? You say it glows in the dark? Hey how about that?..."

 

[Anasazi23]

Sorry I'm late to the party. While the discussion is interesting, the thread and initial question constitutes soliciting medical advice, which is in violation of the TOS.

Closing.

 

[Anasazi23]

Sorry I'm late to the party. The initial question constitutes solicitation of medical advice and is in violation of the TOS.

Closing.