Consultant vs GP

[ruthandsam]

Who has the overall say on what medication you are prescribed? I'm under a consultant following a 2 week stay in hospital in June, however, I have not had my medication reviewed and my appointment is not until end of September.

I believe my meds needs either the dose changing or another introducing asap, however, the GP will not prescribe me anything as he said that it is for the consultant to decide. I have had my appointment cancelled twice and am not due to see the consultant until end of Sept as no other appts are available what the hell do I do? I want to get back to work but do not feel able because of the medication.

I have an appt to see the GP tomorrow but I am wondering if I am wasting my time - it is so frustrating as my work are ringing me asking when I am going to go back to work.

[scotman]

Can you write to the consultant?

[Mamyalynne]

Contact your Consultants secretary by telephone and ask advice, which I am sure they will pass on to your GP.

[Sqad]

Your GP sends you to a consultant for his OPINION......your GP doesn't have to take it.

I have no idea of your disease process or your medication, but if the Consultant discharges you from hospital on a medication regime and unless he writes to your GP with further instructions, then he would expect you to continue until he, the Consultant sees you again.

You may feel that you need a change of medication, but your GP clearly doesn't.

[ruthandsam]

Good old 'Seroquel' 25 mg x 3 per day. GP reluctant to change dosage or add new drug as I've not seen Consultant P since being in hospital. GP doesn't want to change regime as she says that she may choose medication that may not be the choice of the Consultant P. I feel like I'm going round in circles because I am unable to get an appt before end of Sept with the C.

[saxy_jag]

It's the GP who has the overall say on my OH's medication. The consultant prescribed it originally and it's been very successful but it's off-licence and the GP won't prescribe it on repeat, despite several long letters having gone back and forth between him and the consultant.

[ruthandsam]

Now that makes sense saxy_jag, so to speak. I remember the Consult P saying that he prescribed my medication off label for me which would make sense why the GP is reluctant to change the regime. I will go to my GP tomorrow as planned and talk through the options.

Thank you everyone for your input!

[wolf63]

Do YOU think that you need another anti-d or a stabiliser? Do you feel in any way better than upon your discharge from hospital? Do you have someone who can gauge whether there is an improvement in your mood?

I wish that I could be of more help but my current medications seem to have fried my brains and turned me into a Zombie.

Do you have a CPN?

[ruthandsam]

Thank you wolf63 for your input as I know it is quite 'difficult' to put these things into words.

I know what you mean by 'fried my brain'!! It's hard work just doing everyday things with this stuff and yes, I feel I need an anti d in addition to the current med. I feel a lot better since hosp but just have't got my usual spring in my step or enthusiasm for life as soooooo drained of energy. I'm having to plan my life around the bloody tablets as 1.5 hours after taking them I'm zombified. Ha Ha!

[ruthandsam]

I have a care co-ordinator who actually was the one who said that it would be unwise to go back to work until I have had my medication reviewed as she does not think the dose/med is fully suitable. See my problem - need to see the Consult P as soon as possible but no appts available

[wolf63]

I am on Lithium and Setraline just now - feel 'okay' but brain is dead. Since 1997 I have had many combinations of drugs - none have really helped a great deal. During this period I have had the same GP and a handful of consultants - never too sure if this is good or bad.

I gave up (thrown out) work when I was 40 and it helps that I don't have to worry about taking days/weeks/months off sick. I live on my own with two moronic moggies for company.

Talk to your GP and tell him/her how you feel - I know that explaining it is really difficult.

Some days it is so hard to keep going with the knowledge that it isn't going to go away. It is a continual cycle of despair.

Good luck tomorrow - I am away to hide under the duvet with my little boy cat Frankie.

Susan

[boxtops]

The consultant can instruct the GP to prescribe a certain medication, but there is such a constraint on the prescribing budgets these days, it's not always possible. Think of your consultant as the specialist expert - whilst many GPs specialise, many are generalists and don't have the in-depth subject expert of the consultants. I'd do as mamya suggests - ring up your consultant's secretary and explain your position.

By the way, why was your appointment cancelled? Appointments cancelled by the consultant should be given priority for rebooking.

[ruthandsam]

Bless you Susan - thank you!

Ruth
x

[ruthandsam]

Thank you boxtops - I understand the constraints on GPs budgets and also their knowledge base. That is the frustrating thing about my appt which was cancelled by the consultant because she has had to retire on health grounds with immediate effect. I don't suppose they have been able to employ a replacement CP immediately. I fully understand the reasoning behind the late appt however I really need to get my life back on track asap, beginning with the medication.

I will give the secretary a ring tomorrow and also explain the problem to my GP and then perhaps inform work's Occupational Therapy dept. I am unable to return to work because of my current med regime but hopefully if I keep the communication lines open I will have support from both work and via the CP and also my Dr.

Thank you for your advice.

[lcg]

if your gp is reluctant to add an anti-d to 75mg of quetiapine a day, s/he really needs to get some cajones (so to speak). they usually prescribe things far worse and bugger things up royally, so i really can't see a problem. you can do one of several things...call your consultant and demand an earlier appointment; see the duty officer at you local cmht to prompt a change of meds/earlier cons app; scream at your care coordinator; see a different gp in your practice; or just make repeated appoinments until your gp gives in. one, a combination or all of these usually work - sometimes you just have to make a pain in the arse of yourself to make a point!

also - if you're zonked out on your meds, how on earth do i get through the day? i take 400mg quetiapine a day, 150mg venlafaxine, zopiclone, the odd 5mgs diazepam, up to 120mg codeine daily and have a morphine patch on. i thought i was a little dozy...but perhaps i am a little more drugged up than i thought!!! i work full-time (50+ hours a week), care for my hubby (who is also mad!), am doing a masters and everything else that comes with it. it's ok most of the time, but sometimes i just have to hibernate for a bit. my point is, though, that you will get used to your meds, feel a bit better and be able to tackle life again - but don't rush and maybe enjoy a bit more of a 'holiday' from work while you settle things down. stick up for yourself and be clear about what you want...they usually listen eventually! good luck x

[ruthandsam]

Icg76 you make me laugh - sorry. You have really put my situation in perspective and rightly so! You're mixture of meds is quite a concoction and I'm also familiar with Zopiclone and good old Lorazepam and pain killers but managed to wean myself off them whilst in hospital.

You could well be my Care Co-ordinator as her words were 'enjoy a bit more of a holiday from work' as well. I must say that I'm very eager to get back to work (ironically working for Psych Services, NHS) as I'm used to working many hours and being on call in the evening occasionally. I enjoy the buzz that comes with it.

Thanks for the 'kick up the butt' and all the best for your studies, work, home life, etc, etc. Now back to reality for me! xx

[lcg]

ruth - i also work in the nhs mental health services - who i have found (ironically) to be unsympathetic and hard-nosed. my post was not intended as a 'kick up the butt', but rather as a 'shout and scream', get yourself sorted and only then entertain the idea of going back to the grind. you have to be fighting fit before going back to work, otherwise you will end up having more time off in the long-run. it is possible to be medicated up to the eyeballs and be a productive member of society and i sometimes think consultants and gp's think after a period of mental illness that you can never be capable of anything - and your gp's attitude is most unhelpful. even if your consultant has moved on, your local services should be providing you with a suitable, accessible replacement. waiting until the end os sept. is simply unacceptable. thank you for your good wishes, and i again wish you the best of luck x

[ruthandsam]

Thanks Icg76 - Result! I went to see my usual GP this morning who prescribed me Citalopram 10 mg x 1 per day, to be increased as necessary. She understood the situation and is also writing to the Consult P to try to bring my appt forward. Also agreed with me that there is probably a hormonal element contributing to my symptoms because of my age but has advised that I speak to the CP re this. So I regard this all as a good result and will now 'watch and wait' and hopefully get my life back on track again sooner rather than later.

Many thanks x

[boxtops]

well done ruth - persistence pays off! - let us know how you get on.

[wolf63]

Good luck to you - it is a tough journey back to 'normality' but I am sure that you will make it.

[lcg]

hurrah! hope the introduction of the citalopram helps things out. it worked wonders for me...let us know how things progress and i'd like to say that i'm usually online and would be happy to chat again if you need clarification on anything in the future. well done for persevering x