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After the rotten mess with Strattera, I decided to quit the most recent psychiatrist. This leaves me searching for a new psychiatrist. The third in a year.

Let me be absolutely clear: I don’t really want a psychiatrist at all. I’m thoroughly sick of them. I do, however, need someone knowledgeable about psychoactive medications who can prescribe appropriately for my disorders – meds management, in other words. And I want to be treated like the incredibly intelligent, responsible adult that I am.

Dr. Suspicioustwit's former patients.

It’s not like I really want to change psychiatrists. I’ve resisted it as long as I possibly could each time. Unfortunately, neither finances nor quality of care are always in alignment. When I started going to Dr. Suspicioustwit’s office, I just needed someone to get me on mood stabilizers as soon as possible. They did that for me. When it came to helping me manage ADD as well, they totally failed. Despite dealing with one of the world’s most screwed up health care systems, I still have some choice as a consumer.

Two referrals already failed to come through. Yesterday my therapist gave me 8 more based on a long list of names I printed off from my insurance website. He also crossed out the ones I should avoid at all costs – bible-thumpers, psychiatrists who don’t believe in psychoactive meds, and someone who’s under investigation. Not only do I need someone who will treat me decently, they have to take both my current and future health insurance. Details, details.

I also got a referral for a DBT group. I did ask about it, so it’s not like he was saying, “you need more head-shrinking, crazy girl.” Several members of my university NAMI group have given rave reviews about DBT, so it seems worth checking out. It’s focused more on developing coping skills than fixing the way I think, which appeals to me. There’s a group run by the same agency that Hippie Dude works for, so I have to call for an interview.

I hate seeking out health care providers. It’s like begging for rejection, and I already really hate making phone calls. I’ll start making the calls today, but it can also take ages to get going with a new doc. I have 56 days of the crucial “don’t go postal” meds left – lamotrigine and bupropion – but under 2 weeks of the “contributing member of society” meds remaining (methylphenidate and amphetamine salts). With my careful hoarding of ADD meds I’m just barely able to appear functional, but the dosage is so low I’m only operational for 3 hours a day. I’m doubling up for the rest of this week to try to get through my remaining dissertation edits.

If I’m lucky, one of these next 8 psychiatrists will work out. All I need is one.

In other news…

I just learned that Adderall is one of many drugs affected by consumption of ascorbic acid, which can lower the blood levels and efficacy of amphetamines. I’ve been taking Vitamin C supplements. That would lead to a much faster rate of drug clearance in urine, and the negative result for amphetamines on the drug test that got my ADD meds yanked. This effect doesn’t occur with methylphenidate, so at least I’m not screwing myself on the Concerta that I’m currently taking.

So the negative test result was mostly my fault:

  • I didn’t check interactions thoroughly enough because at the time, I didn’t realize that I a) could check vitamin interactions, and b) should check vitamin interactions.
  • I didn’t read the drug info sheet closely enough, because ADD makes it hard for me to read content in visually dense formats like those used in drug info sheets.
  • I didn’t tell the doctors I was taking Vitamin C because who would think that matters, and they do check urine pH with drug tests.
  • It didn’t occur to me that they were drug testing to ensure that I wasn’t selling my meds because no had ever treated me like an unreliable addict before.

Despite my own errors, I stand by my decision to quit the psychiatrist. They should have told me about the ascorbic acid interaction since orange and grapefruit juice are so commonly consumed. They should have told me more about Strattera side effects than “it’s probably like what you already experienced with stimulants,” which was completely incorrect from a pharmacological standpoint because of the difference in neurochemical action. They treated me poorly and everyone knows that Dr. Suspicioustwit runs a lousy crank-em-out pill mill. My therapist said that Dr. Suspicioustwit’s only advice to a severely bipolar patient was to move to San Diego where it’s sunnier. Because apparently sunny weather cures bipolar? OMG.