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I want to scream. I went to the psychiatrist’s office this morning and the results of all my tests from last month were normal. Except. The drug screen came back positive for cannabis, no shocker because it stays in fat cells, and I have plenty of those. But it came back negative for amphetamines, which ought to stay in my system long enough to still be showing for the drug screen.

So Dr. Suspicioustwit was “concerned” that I’m not taking my meds (read: selling them) and ordered a changeover to Strattera. Normally I go along with all this crap but right now is the worst time possible to rock the boat with a change to a drug cocktail that is really working for me. I’ve been told time and again by doctors, “let’s not rock the boat,” when contemplating potential medication changes, which is one reason that I settled for substandard treatment for years and years. I just didn’t know how much better things could get.

But here I am mostly functional, and the carpet’s being yanked out from under me. I have a month, to the day, to finish writing my dissertation manuscript and get it turned in. I desperately need my ADD meds to make that happen. Changing to Strattera, which might not work for me at all (or worse, could trigger mania) means a slow increase in dosage over several weeks, so I probably wouldn’t be feeling any improvement until the time when I’d need to be turning things in. It means I’d basically be without the medication that lets me do my work during the period of time when I need it most.

So I have an appointment with the psychiatrist proper in three weeks, instead of just the PA who has to carry out his wishes. The PA is sympathetic but can’t do anything in contradiction to the psych’s orders. I explained that not only am I on a low dose of Adderall in the first place (lower than the usual adult dose) but I’m a lot heavier than the guidelines for dosage and the efficacy for all these meds are dependent on body weight. The box for the Strattera starter pack specifies that it’s for people whose weight is 126-147 pounds. Last time I checked the scale, that’s nearly 70 pounds less than what I weigh (sad but true.) This suggests that the Strattera will do exactly jack shit for me – I weigh 50%-75% more than those dosage guidlines, for crying out loud! In addition, I metabolize stuff fast. Two hours after I stop drinking, I’m stone cold sober, and I never get hangovers. Never. In fact, if I skip even one day of Wellbutrin, I feel it with a vengeance, and a prior psych told me that’s very, very unusual. My body just seems to be particularly efficient at eliminating foreign substances from my system. It’s not at all surprising to me that I’d test negative for amphetamines given the low dosage and my body weight.

I told the PA that I’m not going to take the Strattera until I’ve exhausted all of my other options. I’m going to finish off the instant-release Adderall that I have on hand first. She said that’s what she’d do too, so at least we understand each other on that point. I may then switch over to a doubled-up dose of Concerta to get me through this deadline, and that should take me up to the next appointment date. The PA said she’d talk to Dr. Suspicioustwit about it and would call me this afternoon if there’s any change, but I’m not holding my breath. Let’s also add to the list of complaints that I’d need yet another insurance prior authorization (week delay) to get this filled, and my copay for Strattera would be double what I pay for Adderall. I can handle the expense, but I could really use that $23 for something else. Like my lamotrigine and Wellbutrin prescription copays – both of them put together.

I’m beyond angry about this. I’m utterly furious, and it’s also making me extremely anxious and upset to tears. It didn’t even occur to me that the doc must be thinking I’m selling my meds until I got home, and that makes me even more angry. Just because I’ve taken illegal drugs in the past does not mean I’d sell them. That’s just insulting. The part where it’s completely undermining my progress is more than just a little frustrating. I told the PA that it’s not just “being in school” but the biggest deadline of my life! These things are not in the same class at all. I have a good 40 pages to write in the next two weeks, and that’s when they’re going to take away the drugs I need to succeed? The stream of obscenities that I’m suppressing here would make a sailor blush.

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