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jozysuzy
post Feb 18 2009, 07:37 PM
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Hello, I'm new here, not sure how to call this topic and whether this is the right place. I do feel quite hopeless and have some questions regarding doctors and medications.

I live in London over a year, soon after my arrival had to start again with antidepressant (I used to see a psychiatrist and take antidepressant earlier, before arriving to UK).

I went to the medical practice where I am registered, expecting to be referred to a psychiatrist, but was prescribed my medication by the GP. When I needed to change the medication I didn't even get to see the same GP, as it's hard to get ANY appointment, let alone choosing which GP of the practice (there's about 7 GPs there). Recently I needed to change my medication as the one I was taking stopped working, got to see another GP of the practice and got a new medication. She basically gave me the choice whether I want to increase the dosage or change for a new med.

My question is whether this is a standard way of treating depression? Not being referred to a psychiatrist? Who gets to see a psychiatrist then?

I guess I'd be happy with this if all went well, but it didn't. After several days with my new med (Mirtazapine) I feel like this medication is just very wrong for me, but, what is worse, I don't think that the GP knew much about this medication, it seems as if it was chosen randomly. As I found out, Mirtazapine is suitable for people with insomnia, as it is sedating. I have the opposite problem though-one of my symptoms is that I tend to sleep too much, have troubles to wake up, and I did tell this to the GP. Now with Mirtazapine I find it almost impossible to get up, and once I do, I seem to be even more depressed than before, I have thoughts that I just want to die too often now so that I don't have to experience what I'm experiencing (I mean feel what I'm feeling).

Here is my second question - I don't know if I should go and see the doctor again or whether I should wait for some time and if it still doesn't get better then see the doctor. I had my first dose on Saturday night. I know it's said it might take couple weeks till the meds start working, but I think I am quite sensitive to medication and react faster - for example Citalopram literally saved me within couple days. And I can't imagine having to survive another week like this.

I would be very grateful for your responses.

goodnight




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kirkwuk
post Mar 8 2009, 03:38 PM
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I'm in the UK. A GP will practice much like you've been treated. You will be asked to fill in a questionairre about how bad your depression is, if it's over a certain score the GP will refer you to a psychiatrist. The waiting list is very long. I had to wait four years exactly to get treatment for CBT. That's a long time, but you have to learn to be patient with these things. There's no quick fix and I had to learn to help myself.

As for the meds they can take an awful long time to work so I really wouldn't try and get anxious about them not working. What is so hard about the side effects of Mirtazepine? A headache or sedation really isn't so bad considering they will disappear in time.


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Kirk's diary of cascading emotions 31/10 Discharged, health very good 15/09 Feeling AWESOME 03/08 Ill but keeping strong 31/05 Feeling better than I ever have 02/05 Okay 26/04 Feeling VERY stressed and anxious about new flat 12/04 Not felt this bad for some time 11/03 Major personal breakthrough, feeling as good as ever 28/02 Not good at all 08/02 Feeling as good as good can be 05/02/09 Going strong as usual 27/12 Best night for a while 25/12 Best Xmas for years

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psychocandy
post Mar 17 2009, 04:48 AM
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QUOTE (kirkwuk @ Mar 8 2009, 08:38 PM) *
I'm in the UK. A GP will practice much like you've been treated. You will be asked to fill in a questionairre about how bad your depression is, if it's over a certain score the GP will refer you to a psychiatrist. The waiting list is very long. I had to wait four years exactly to get treatment for CBT. That's a long time, but you have to learn to be patient with these things. There's no quick fix and I had to learn to help myself.

As for the meds they can take an awful long time to work so I really wouldn't try and get anxious about them not working. What is so hard about the side effects of Mirtazepine? A headache or sedation really isn't so bad considering they will disappear in time.


Yeh. I agree. Sounds familiar to me.

My GPs is the same. Difficult to get an appt, even worse to get to see the same doctor. Different GPs seem to have different levels of knowledge. Sometimes I think I know more about it sometimes.

I did get eventually refered to a psychiatrist after badgering my GP. First I had to see a mental health nurse to assess, waited even longer, then eventually saw a pdoc.

He was very good and I saw him a few times. However, when I'd stabilised a bit it was time to be sent back to my GP.
Trouble is then the GP refused to prescribe what the pdoc recommended (seroquel because it was an off label use !!!). Nightmare or what?

Luckily, my pdoc had written the GP a letter advising him what to do next. Even though my GP still refused to prescribe seroquel, the pdoc had recommended clomipramine which is working out pretty well for me.

Trouble is if this hadnt worked it would have been wait for another pdoc referral again....

Wait for CBT was yonks but fortunately, my employers heatlh insurance paid for it privately. Lucky cos it was 8 sessions at £65 a throw - gulp !!!!

Not going to criticise the NHS because it is free for everyone and short of money, but I think sometimes the care providded can be a bit second classs compared to some countries (like the US).


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