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Is this normal treatment from a psychiatrist?

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Is this normal treatment from a psychiatrist?

Postby mansuperz » Tue Oct 07, 2014 4:16 am

Hi you,

I bolded my questions so it would be easier, since this is a pretty big post, but I wanted to be detailed.I am simply asking if this is normal or not, based on other peoples experiences or knowledge. I feel like I should see a new psychiatrist based on the reasons I have listed below.
So, I have just started seeing a new psychiatrist about 1-2 months ago. The reason I am doing so is because my old psychiatrist is about 1 hour away, harder to schedule, and costs money to see ($90, I don't have insurance).

I have been prescribed on sleeping medications for a decade or more. Every one I've been on had some side effects (I either oversleep, wake up in the night unable to fall asleep again, or wake up lethargic and tired for the entire day unable to focus), they simply did not affect me before (because I did not really care whether or not I overslept and such), now they do.

Just to clarify, I am a 25 year old undergraduate student at UCF who is obtaining his degree in a few months. I have no history of abusing medications.

I have asked my new psychiatrist (who is free to see at my school) to switch my sleeping medication, or at least for a solution to my insomnia, several times. He prescribed me to temazepam, I think 7.5 mg or 15 mg originally. I took it and fell asleep, but I kept waking up in the middle of the night and was unable to fall back asleep. This really hindered my abilities, as I have an early morning class.

I went back to him, instead of switching to a new medication, he simply doubled my dosage to 30 mg. I took that for about two weeks, still had the same issue. Went back to see him today. He was very reluctant about switching my sleeping medication, so he suggested bumping up the dosage to 45 mg at first. Then he couldn't find it so he switched me to trazadone 50 mg, which I have not taken yet tonight.

This is honestly really annoying and a big hassle. If a medication is not working, why would he simply up the dosage? Also, temazepam does not come in 45 mg doses, so he made up a dosage (unintentionally) in an attempt to avoid switching my sleeping medication.

I asked him about it, he said, "I can't keep switching your sleeping medications." Is this normal? This makes no sense, he has literally prescribed me to TWO sleeping medication (temazepam and trazadone) since I've seen him, aside from that, all he did was double my dose of the former one.

I don't want to keep switching either, I just want to find ONE medication that works without any significant side effects and stick to that. This is just a big hassle. Maybe he thinks I am going to abuse the new medications? This doesn't make sense to me though, don't drug addicts stick to one, rather than switch all over the place.

Seriously, is there an issue with switching to new sleeping medications, am I missing something here? All I want is to SWITCH to new medications UNTIL I find just ONE that works, that I will stick to it as long as it works. I don't want to keep switching, and if the medication is not working, then why would he even suggest continuing it or up the dosage, rather than switch. Also importantly, I have never asked for a specific sleeping medication, I have been completely open to his suggestions and have not argued with any of them once. I was ready to take the 45 mg dose of temazepam until he couldn't find it, and I looked it up later and I see now that it doesn't exist.

On another note, the first time I saw him, I asked him the same question 5 times and he either didn't hear me or misheard me. I asked him about light therapy, literally 5 separate times in our first appointment, light therapy is when you use a high powered lamp (usually 10,000 lux) which simulates sunlight, in order to fight depression in the winter months where people get less sunlight.

Obviously, he did not hear me correctly, because he directed me to the therapy center of my school because he thought I was asking about therapy. I was surprised and did not realize he misheard me until I asked him why he directed me to the therapy center, and he said that I asked about it. I did clarify myself, even mentioning a lamp and I used basically the same explanation that I just typed out above, he must not have heard it.

I also feel like he is condescending when he talks to me, and I have not felt this way with any doctor before, am I misinterpreting this situation? Even when I asked about light therapy and he directed me to the therapy center, I simply let it go and said I would look into it later, as I did not feel like correcting him after I already stated it 5 separate times. He repeated himself, I think twice, "Are you sure you do not want a referral to the therapy center? You asked for it." He looked at me like I was an idiot, and that I did not understand what he was saying.

On today's visit, and previous ones, he has asked me general questions that my old psychiatrist also asked me, like, "How is school?" etc., so I answer the question, but I expound on the answer, as I was used to doing. He stopped my explanation and just said, "Is it good or bad?" He asked me only in order to get a one word answer, and pretty much ignored my explanation, which was what I thought psychiatrists wanted to hear? Maybe he has a checklist given to him from my school that he has to fill out every time a patient sees him, and these questions are part of that checklist, and the answers he can fill out are "good" or "bad"?

The second time I saw him, I showed up late due to being unable to find parking. He had lunch scheduled near the time I showed up, I think I was there around 11:45 a.m. and his lunch was scheduled for noon. He literally rushed my appointment and ended it on the dot, I felt rushed too. I can understand him wanting to go to lunch, and it is not his fault I was late, but isn't psychiatry a more delicate field, and shouldn't there be more sensitivity around this situation?

I asked him a question towards the end of that rushed appointment, and he literally said, "We're out of time!" as he was scribbling my prescriptions out as quickly as possible. I was out of his office before the clock hit noon, just in time for his lunch.

With my old psychiatrist that I saw for over a decade, I literally NEVER felt rushed even once. He also had no qualms about prescribing me new sleeping medications if an old one didn't work. No questions asked. I guess you get what you pay for, and the free psychiatrists at my school make it appear that way...

Thanks in advance for any answers.
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Re: Is this normal treatment from a psychiatrist?

Postby angelina4 » Wed Oct 08, 2014 3:50 am

I'm no expert, but what the hell - I'll give you my uneducated impression. The sleep medication thing doesn't surprise me - it's sort of common for doctors to want to try increasing the dose of the medication you're on if you've had any response at all and no bad side effects. Before switching to a new one, that is. And you said you did have some response. So that sounds normal to me anyway.

The rest of it? Nothing you said raised any big red flags. I sympathize with him on the lunch issue - if you're late that's really on you. The light therapy issue sounds like a miscommunication. But maybe he's not a good listener or is distracted which wouldn't be a good thing.

But overall it sounds like you're not happy with him. And condescending isn't good either. Often it's a lot of little things that tell you about a person, none of which on their own are so terrible - and that may be what's going on here. That there are a lot of little signals that this isn't the psychiatrist for you. I'd follow your gut.
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