Psychiatrist for second opinion only?

[mermaidcafe.livejournal.com]

A couple weeks ago, I had a really strange reaction to a dosage change in an antidepressant, and I'm still suffering the effects of it. My doctor doesn't know why this happened or how to fix it. I don't know if this is something that a good doctor *should* know how to deal with or if I really am in a peculiar situation and my doctor's doing the right thing.

I'd like to find a psychiatrist/psychopharmacologist that will just listen to this particular situation and give a second opinion. I don't want to change doctors unless it turns out that another doctor is better equipped to deal with this situation, so, understandably, I'd rather avoid the intake process with another physician. I don't know if this conflicts with medical ethics or not, but I figured it was worth a try. Does anybody have ideas on how I can run what's happening by another pdoc? Even if somebody here happens to be one or be friends with one, that would be a huge help and for legal purposes, I would realize it's not actually medical advice.

Thanks for any ideas.

(btw--any chance of a mental health tag getting added?)

Comments

[anyee.livejournal.com]

First question: why did you up your Wellbutrin dosage? If you were having problems controlling your depression, you could be "crashing" because your disease is being poorly managed at the moment.

I can think of a few:
SR and XL have different release patterns. XL has a much slower release that is supposed to occur at a steady amount over the day. It's possible that your metabolism causes this release to "speed up". This isn't crap; liver enzymes do magic things. How were you taking the SR before this day? 2x100mg or 1x200mg?

Also, you went up 100mg in a single day, which is going to cause some side effects, especially the hyper-ness. This goes away after a few days for most people. Two days is not a good amount of time to determine the new effects of an antidepressant. Unless you had a serious reaction, ie suicidality, delusions, you may have wanted to tough it out for those few days to see if it resolved. As I said, for most people, it does. For me, it does, and I'm up to 400 a day as needed.

Changing both doses of medication near each other, plus changing formulations, will in my quasi-professional opinion explain most of the ups and downs you're dealing with. I think you really do need to wait this one out a little more. And again, if you're taking more medication because you're feeling more depressed, and you're still feeling more depressed, it could very likely be your brain and not the meds.

[mermaidcafe.livejournal.com]

Thanks!

I upped the Wellbutrin because I was having some mild to moderate depressive symptoms--but they've definitely been severe now.

Meds do need time to level out. I asked my doctor about seeing if the WB XL would smooth out and she said she'd never heard of anyone experiencing severe depression as a side effect and that's why she told me to change. The hyperness lasted just that one day, very briefly, but there was huge depression before and after. I don't know if the upped WB would've gotten better eventually or not.

[adrian-turtle.livejournal.com]

I consulted Dr. Popp a few years ago, and I also think well of her. I hope she has time to give you a second opinion about this problem. I know you're trying to avoid "the intake process," but a responsible doctor will need to know a lot of your medical history to investigate this kind of problem (drug reaction, or drug interaction, or new symptoms of a chronic problem, or some different issue.) So it might look a lot like an intake process from your side.