Why won't you prescribe me the medicine that I need?

Hi, my name's Jay. I've been seen by multiple psychiatrist, and they all refuse to treat me for ADHD because I have Schizophrenia. Apparently stimulants cause some schizophrenics to have more problems with their schizophrenia. I know they don't cause me any problems because I've been on stimulants in the past. When I don't have a stimulant I sleep 20 hours a day, and when I'm awake I forget everything. My life is a mess without a stimulant. I don’t use stimulants to get high. I use them in moderation to help me live a happy and functional life. Without my medicine I forget to put in the laundry when my wife asks, I start doing the dishes and get distracted with something else. And I am completely miserable. I find no joy in life. I’m not sad or depressed, I just see the world as blah. I really need medicine to live a normal happy life.

I'm among the many schizophrenics who are not affected by stimulants. But because you, the psychiatric community, think my schizophrenia *might* get worse, I am set to live a miserable useless existence. Why are you unwilling to help me? Why won't you let me just try the prescribed medicine and then if it makes things worse then I can stop using it? Why am I not being treated for ADHD just because some other people have problems with the meds? It's not fair. I find this to be prejudice.

My psychiatrists say they are making their decisions based on standards set by the Psychiatric Association. So because some psychiatrists who are high up there on the totem pole have opinions on how to treat some people, I then also get treated as “some people.” I’m not treated as an individual. We are not all the same. Some of us actually need ADHD meds, and whose schizophrenia is not affected by stimulants. So I need to talk to you about this issue. Why am I being denied a normal existence?

I take dextromethorphan, which is an over the counter cough medicine. It acts as a stimulant, since I am unable to get a psychiatrist to prescribe me with a stimulant. But the cough medicine has other side effects which are not good. And I want to stop using it so that I can live a healthier and happier life. But I need another ADHD med to take it’s place. Why won’t you people allow me to take an ADHD med that I need to live a normal coherent functional life? Why do you force me to rely on cough medicine, without which I would be unable to function properly?

When I was debating this with the supervisor of my psychiatrist, he eventually stated that the reason I can’t be prescribed ADHD meds is because they would make me happy. I asked him if being happy is a bad thing, and he said yes. I then asked him if up is down, and if slavery is freedom. And he said yes. Then I asked if he was just saying that, or does he actually believe what he just said. He told me that he thinks that he’s telling me the truth. Are you psychiatrists trying to mess with my head? I need help, and nobody is willing to help me.

It's a pretty straightforward violation of the Hippocratic Oath to prescribe a medicine that you think is likely to do more harm than good. I know it can be very frustrating, but you just can't expect a doctor to prescribe a treatment that they're uncomfortable with, even if you're comfortable with it. All the more so if it violates an established standard of care.

If you've tried multiple psychiatrists and gotten nowhere with stimulants, ask about alternative treatments. Have you tried Strattera? It's a non-stimulant ADHD med that works for some people. There are types of therapy that work on building skills for dealing with ADHD as well. Also, the hypersomnia (oversleeping) you're describing is not a symptom of ADHD that I know of, but it could be related to antipsychotic medication if you're taking those - have you asked about switching or trying a lower dose if you're currently stable? Forgetfulness and oversleeping can also be symptoms of depression (which a stimulant would temporarily "help.") Have you been evaluated for that? It may also be that the cough medicine you're taking is having effects on your sleeping and cognition that are making them worse.

You're certainly not the first person to feel hopeless because they can't take stimulants. But there really are other options to explore before you come to the conclusion that you can't live a functional life without them.

They won't prescribe me anything, stimulant or not. I've tried, but they refuse. Regardless, I don't think it's right that you people deny people medicine that they need.

The standards that they are following are wrong. Who do I talk to, to get the standards changed? This isn't right. You people shouldn't have the right to deny somebody medicine.

Before we start with the blame and pointing fingers at people on this forum, please remember that no one here is in a professional capacity. This is a peer support forum. We are not the doctors that are denying you this medication.

I'm sorry that you're struggling so much right now with the hypersomnia and following through with tasks. I have struggled with those things myself in the past. It's definitely frustrating when your doctor isn't hearing what you're trying to say, or they are hearing it, but believe their method is the right way to go. Remember that you do have a right to change doctors.

As an FYI, many doctors are being pushed not to prescribe stimulants as many people abuse them. I know that you said that you don't abuse them, but in my experience when a doctor hears someone demanding a certain kind of medication, they automatically think abuse/addiction and will refuse to prescribe them. You stated that you were on them before and they were helpful. Why did you stop taking them?

[mod edit] stimulants are absolutely contraindicated for schizophrenia... and the molecular bio supports this, the epidemiology doed, the behavioural genetics does, ###$ even the clinical non structured assesments, as whimsical and subjective as they can be, make it pretty obvious... i have a rare genetic sex linked mutation, the women in my family get schizophrenia, the men severe adhd... its literally a 2 amino acid mutation on one enzyme, multiplied by another two amino acids,so 11 12 21 and 22 times 11 12 21 and 22, make 16 outcomes... all with direct effects on dopamine binding... well lucky for me... i got the 1 in 16 that literally makes my binding sensitivity on key receptors next to nil... translation... i get like no dopamine... unless i run 3 hours a day and do 10 things at a time... i have no ability to focus... its a sensory thing... its latent inhibition... i have no sensory auditory filtering prior to higher cognitive interpretation of raw auditory info... schizophrenics, by literally an almost antithetical mechanicsm have insane gating... so similarly to sensory deprivation... u get complex higher cognitive extrapolations from little raw input... which creates auditory hallucinations... your brain tries to make sense of something... even when there isnt enough info there... sensory gating has a lot to do with 5ht2a, which because i have poor enzyme efficiency in comt... creating serotonergic breakdown products from my dopamine catabolism... is grossly downreulgated... this actually upregs 5ht3c... which is what changes d2... critical receptor for adhd... so it literally binds nothing and doesnt have proper feedback to habituate you to stimulant tolerance... you know what else does this... aripiprazole... abilify... it skips the dopamine blocakde to hit the peripheral 5ht2a and 5ht3c... thus minimizing side effect profile... so in a way... my brain is naturally, sort of on minimal side effect antipsychotics... the last thing someone with schizophrenia needs... is to further mess with sensory gating via stimulants... the results are bad, almost every time... like literally

we have psych down to a ###$ science... even the psychology crap, cognitive behavioural, existential, developmental, social, cultural, behavioural psych... we can now unify with a lot of heavy bio... in 5-7 years the technology already available will become cost effective that it will be readily used... which tangentally, will make the license comment i made in the begining of this post no longer necessary... you wont be able to bs being a psychiatrist anymore... so the old guys, and the people who think that a license is, well a license to sell their bs incompetance because they meet a minimum benchmark of well... literally just barely passing your usmle... sort of think twice...

the whole point of this whole post... dopaminergic stimulants are contraindicated in every, every way with schizophrenia... even with sever adhd

now.. heres an interesting cabeat though... bipolar disorder is actually not dopaminergic at all, and owing that 28 percent of adhd people are bipolar... enough research has well, shed light on the fact that low dose stimulants are often no problem with bipolar... weird eh... lesson... most things which seem intuitive either are... or arent, for reasons usually hard to know based solely on not having the available info, or because theyre not immediately evident... or are an oxymoron to the overlying social classifications we use... i.e. mania being similar to doing cocaine etc... being manic isnt always euphorics... can manifest in anxiety... all sorts of things... its a serotonergic thing... hence why ssris.. complete contraindication in type 1 bp... but moderate dose stimulants... not really anymore (so long as you use a mood stabilizer for a few months prior to starting stimulant treatment... stimulants alone are kind of dicey... so u just start with lithium, lamictal, valproate, carbemazapine, oxycarb... then usually like super low dose, typically long acting stimulant (bipolar people are way more likely to abuse meds... not judging.. lol, but yeah)

-- Sat Jul 05, 2014 8:45 pm --

btw... dextromethorphane is a dissociative, mildly serotonergic drug that actually is a glutaminergic antagonist mostly... it cuts of your somatosensory cortex... you get an almost like ketamine type feeling... but way worse for you and way shittier... the chiral enantiomer (like dextroamphetamine and levoamphetamine u could think of) levomethorphane actually crosses the blood brain barrier... unlike dxm... weirder thing... its a ######6 opiate... dxm is a weird drug... but yeah... youre way off... im not being preachy...

also, if u take antipsychotics... and my mom has schizo... so believe me... im more than empathetic... focus, staying awake... all this stuff will be extremely hard... im not licensed doc or anything... but one suggestion... to talk to your doctor about... is modafinil... it works on histamine system to promote wakefullness without inducing amphetamine like side effects... which in me, means reading a book... relaxing, going on a picnic... but well... from experience... for my close friend whose last semster i payed for... laying in a ditch, spending a year in a mental hospital, and a week ago, having me walk him 2 miles to the hospital because he was homeless, talking to himself, and threatening people... his mom is schizo... and he was fine until 3 years of daily coke use... im just saying

Jay NotApplicable wrote:Hi, my name's Jay. I've been seen by multiple psychiatrist, and they all refuse to treat me for ADHD because I have Schizophrenia. Apparently stimulants cause some schizophrenics to have more problems with their schizophrenia. I know they don't cause me any problems because I've been on stimulants in the past. When I don't have a stimulant I sleep 20 hours a day, and when I'm awake I forget everything. My life is a mess without a stimulant. I don’t use stimulants to get high. I use them in moderation to help me live a happy and functional life. Without my medicine I forget to put in the laundry when my wife asks, I start doing the dishes and get distracted with something else. And I am completely miserable. I find no joy in life. I’m not sad or depressed, I just see the world as blah. I really need medicine to live a normal happy life.

I'm among the many schizophrenics who are not affected by stimulants. But because you, the psychiatric community, think my schizophrenia *might* get worse, I am set to live a miserable useless existence. Why are you unwilling to help me? Why won't you let me just try the prescribed medicine and then if it makes things worse then I can stop using it? Why am I not being treated for ADHD just because some other people have problems with the meds? It's not fair. I find this to be prejudice.

My psychiatrists say they are making their decisions based on standards set by the Psychiatric Association. So because some psychiatrists who are high up there on the totem pole have opinions on how to treat some people, I then also get treated as “some people.” I’m not treated as an individual. We are not all the same. Some of us actually need ADHD meds, and whose schizophrenia is not affected by stimulants. So I need to talk to you about this issue. Why am I being denied a normal existence?

I take dextromethorphan, which is an over the counter cough medicine. It acts as a stimulant, since I am unable to get a psychiatrist to prescribe me with a stimulant. But the cough medicine has other side effects which are not good. And I want to stop using it so that I can live a healthier and happier life. But I need another ADHD med to take it’s place. Why won’t you people allow me to take an ADHD med that I need to live a normal coherent functional life? Why do you force me to rely on cough medicine, without which I would be unable to function properly?

When I was debating this with the supervisor of my psychiatrist, he eventually stated that the reason I can’t be prescribed ADHD meds is because they would make me happy. I asked him if being happy is a bad thing, and he said yes. I then asked him if up is down, and if slavery is freedom. And he said yes. Then I asked if he was just saying that, or does he actually believe what he just said. He told me that he thinks that he’s telling me the truth. Are you psychiatrists trying to mess with my head? I need help, and nobody is willing to help me.