Choosing a Mental Health Professional

Zoel

I recently moved to a new state where I have to obtain a new mental health professional in order to continue the medications that have been successful for me for a long time. The physicians I've met have recommended changing these medications completely, from generic mirtazapine and lamotrigine, to various other patented drugs. They have provided reasons, in first appointments mind you, that I don't find especially compelling, such as the notion that generics are "less potent" than name brand drugs. It's possible that this is my unreasonable but medicated paranoia talking, but I think they are lying.

I've spent roughly $800 on doctor appointments since I moved to Rhode Island trying to find the "right" one, that doesn't seem like a quack in this sort of way, and I am running low on said medications. In the interest of saving money and time, I would like opinions on how to find a physician whom I can trust to prescribe medications for the right reason. I haven't had to do this before, since I originally started seeing my first psychiatrist at the age of 12, and am now 30. Talking to offices over the phone hasn't really proven to be effective, because naturally people scheduling appointments cannot provide any real meaningful statement on the quality of the physician.

ceres

My experience with generics has been that they work, but.. sometimes differently or not as well. That's not a problem everyone has with every drug though, and if you are clearly doing fine on what you have there should be no reason to change things. It's really weird to me that you are having this problem, since it's like pulling teeth for me to get someone to check the little box that tells the pharmacist and insurance company "no generics, please."

Then again, I usually go to my PCP for my prescriptions at this point, because I've been on something that works, have a history with it, and see no reason to mess with it. I just moved as well, and went to my new PCP and said "give me this please, and only this, because this works for me and I'm comfortable with it." She has a neuro background, and she told me it's weird for me to have been given that medication for my diagnosis, that x and y medications might work better. I carefully explained to her that I give no shits about my diagnosis because I have something that works and am not interested in messing with that in any way, and it's right there in my history so please just write the prescription.

Is that an option for you? Cab you find your new PCP first, go in for a physical, bring your old prescriptions, and say "I'm shopping for a psychiatrist I feel comfortable with, but for now can you write these as a stopgap?" Or, if you don't need monitoring, maybe that doctor will just write them for you since you have such an extensive history.

Zoel

Either due to local laws or customs, primary care providers here seem reluctant to prescribe things outside their immediate knowledge. I had no prob bob getting my Synthroid refilled.

Shadowfire

generics are "less potent" than name brand drugs. It's possible that this is my unreasonable but medicated paranoia talking, but I think they are lying.

Yea, this right here? This is bullshit. Especially when you have a history with a particular medication that is positive, they should not be talking about switching you away.

If your primary has a problem filling a prescription for a medication you've been taking for years, find a new primary. They're not worth your time.

MegaMan001

First, I'd contact your previous physician and have them refer you specifically to someone to get the prescriptions filled as quickly as possible.

Second, now that you have more time, speak with your previous physician about a referral to something more permanent. Hopefully you'll find someone you trust and can develop a rapport with.

Third, as you've been on psychiatric medications for such a long time there is really no reason to switch from one medication to another if you are having success. In fact, you could do more harm than good. However, there is absolutely no difference in the chemical composition or structure of a generic versus brand name drug. They are identical. Now, there is certainly documented placebo effect with having a brand name, but as long as they are the generic versions of medications you are already on you shouldn't have any problems.

I want to make it clear, my advice is not to change medications - particularly psychiatric medications - because they are unique to the impact on the patient, but there is absolutely no difference between a generic and brand name version of the same drug. If you're having success on Mirtazapine and Lamotrigine you'll have the same success on Remeron and Lamictal.

Does that make sense? It looks like you have two issues, one is finding a provider you trust and two is to remain on the medications that work.