Stimulants Being prescribed a stimulant after being prescribed an anti-depressant?

[pandaman92]

Hi all,
Somewhat unique situation here - a family member diagnosed me with depression and prescribed me an antidepressant around a year and a half ago. The drug has been fantastic in many ways, and I rarely feel anxious or that I'm a burden to other people.
So, with that being said, I'm tired now most of the day. I was hoping that this would eventually pass, but I haven't been able to shake it. I informed my family member who prescribed me with the anti-depressant, and after asking her if a stimulant would could relieve me of the fatigue, she very hesitantly prescribed me the drug (vyvanse) a month ago.
The combination of the antidepressant and the stimulant have been life-changing. I no longer am anxious and I'm not tired either! But at the same time, I am not comfortable asking my family member to prescribe me again the stimulant medication, it was just too awkward last time and I feel will impact our relationship (this is a very close family member). Instead of asking her, I've scheduled an appointment with a psychiatrist. My plan is to be completely honest, telling him or her that I have suffered from fatigue after being prescribed an anti-depressant, and have recently been prescribed a stimulant from a family-member, which has proved to be very beneficial. My fear is that the psychiatrist will look up who the family member is who prescribed me the medicine for further information. If that is the case, then I would rather deal with the fatigue than have a close relationship negatively impacted.
Does anyone have any experience with this, or can anyone offer advice or suggestions? Thank you all for your help.

 

[Scrofula]

I think you'll be just fine. If this family member prescribed these drugs to you, and it was all legitimate (Vyvanse is controlled, but its not exactly "five pounds of hydromorphone, tid") I don't see what the worry is. I'm curious why you wouldn't want your psychiatrist to talk to this family member?

In any case, the only information you need to share with your shrink is dosage instructions and time you've been on it (an actual psychiatrist won't even bother asking you about your mother or what you see in the ink blots). She can't compel you to say who your prescriber is. You've hired her, like a lawyer, you can just walk out the door at any point.

The trick is your insurance. If the shrink and your family member are in the "same network" or whatever yours is called, she may be able to just punch your name in her laptop and call up the family member's name.

But keep in mind that people are lazy. If there's something vaguely unethical about your family member prescribing you this med, your shrink doesn't have any obligation to report it, and would really rather not have to figure out how she's supposed to do it, and then actually do the paperwork to do it.

I have been honest with a psychiatrist and said, "yes I've tried Zoloft before, my mother just gave me half her prescription." The guy doesn't blink at that stuff. If these two doctors are in the same network, it might be as simple as politely asking your shrink not to look up the prescriber.

Now, if it's because the "family member" is your now ex-wife, and the shrink is your new one or something, you're on the wrong board.

 

[pandaman92]

Thank you for the response! The family member is my mother, and she NEVER prescribes stimulants to anyone. Ironically, she is on the same anti-depressant as myself and also suffers the same symptoms, especially fatigue, but basically just deals with the fatigue and is a zombie on her off-days. Don't ask me why, I don't know. But for this reason it makes me think she'll see me as weak, and has already hinted that, so I'd rather see someone else instead. Hope that makes sense.

Also, how would I approach the subject that I've already been prescribed medicine by another doctor? Wouldn't they be curious to why I am continuing to be prescribed by the other doctor?

 

[Slow_Mobius]

Just FYI, questions about getting medications from doctors are against the rules. It sounds like you're mainly interested in how to preserve your relationship with your family member, which is okay, but this is riding a very fine line

 

[Scrofula]

Hmm. And keep in mind that Bluelight can't give advice on what to tell your doctor so as to get a certain drug. That's sometimes a good question, and not always even unethical, but it's a blanket non-starter for discussion. And now that shrinks and mothers are involved, I wonder if you're a candidate for our Dark Side forum.

Not quite yet though.

Ok, I'm still a little confused, because it sounds like you don't want your mother to know you're seeing a shrink to get stimulants, which she judges harshly (from your admittedly biased perspective). Well then, what's the problem with your shrink knowing it was your mother that provided the sampler? Or are you concerned that the shrink, in looking up your prior provider, will call up your mother, thus revealing your subversive scheming, or maybe for a chat about that time you pooped your pants at summer camp?

Well I have good news, young pandaman (I'm guessing 26yo, but that's younger than me by a stretch): none of this is really an issue.

Because, if what you are trying to do, is keep the script going from your mother, and get an additional one from a new shrink, and thus wish neither side to know of the other, it won't work. You haven't named the stimulant, but I don't know of many Rx stims that aren't also controlled.

Now, I'm sure that wasn't your intent, but just answering your question, you would simply tell your shrink you are currently prescribed 30mg Adderall IR tid or whatever, and you like it. You will then be surprised when she doesn't immediately pull out the pad, but talks to you for an hour. About your mother.

But lets say she writes you the max, a one month supply. You go to fill it. Maybe, just maybe, you pull off getting double prescribed the first time. Then whatever state you live in's Prescription Monitoring Program notices the double dip and bells and sirens and the DEA and ATF and Janet Reno come galloping in, and calmly alert the pharmacists. Who will blacklist you.

And then it's back to your mother v. the shrink, except the shrink won't see you anymore because you put her license on the line, so it's just you and your pissed off mother. Most people who get a new script from a new doctor take it to the same pharmacy they used before, where it just replaces the old one in their files. You wouldn't even discuss the old script with your new doctor. He simply writes a new script, and you fill just that one.

Controlled drugs are controlled. By databases and pharm techs eager to find you (I myself was trained to spot shifty-eyed Adderall junkies, which was easy because I was on meth and suspicious of everyone). The controls even have a bunch (relatively) of funding cause people are dying, from other things, but also pills. So it won't work.

 

[pandaman92]

Thank you again for the response. Yeah, two scripts certainly isn't my intention and I didn't realize that telling the other doctor NOT to contact my other doctor (who is, honestly, my mom) could possibly lead the doctor into thinking I'm scheming for two scripts. So I won't be doing that...

Now, to answer your question - yes, absolutely, I do not want her to know that I went to the other doctor because I don't want her to know that I am continuing the medication, plain and simple. If there is even a chance that the new doctor I am seeing will contact my past provider (mom) then I would rather not see him or her, it isn't worth it to me.

I am not asking if the doctor I would see will provide me with drugs; rather, I am asking if the doctor is going to write me a script, would contact my past provider. Putting this into context I completely see how this can be seen as a drug-seeker looking for advice on how to get two scripts, but that's not what I'm going for nor is it the direction that I wish for this topic to take.

 

[Lorne???]

I think you'll be just fine. If this family member prescribed these drugs to you, and it was all legitimate (Vyvanse is controlled, but its not exactly "five pounds of hydromorphone, tid") I don't see what the worry is. I'm curious why you wouldn't want your psychiatrist to talk to this family member?

In any case, the only information you need to share with your shrink is dosage instructions and time you've been on it (an actual psychiatrist won't even bother asking you about your mother or what you see in the ink blots). She can't compel you to say who your prescriber is. You've hired her, like a lawyer, you can just walk out the door at any point.

The trick is your insurance. If the shrink and your family member are in the "same network" or whatever yours is called, she may be able to just punch your name in her laptop and call up the family member's name.

But keep in mind that people are lazy. If there's something vaguely unethical about your family member prescribing you this med, your shrink doesn't have any obligation to report it, and would really rather not have to figure out how she's supposed to do it, and then actually do the paperwork to do it.

I have been honest with a psychiatrist and said, "yes I've tried Zoloft before, my mother just gave me half her prescription." The guy doesn't blink at that stuff. If these two doctors are in the same network, it might be as simple as politely asking your shrink not to look up the prescriber.

Now, if it's because the "family member" is your now ex-wife, and the shrink is your new one or something, you're on the wrong board.

What if it were a mistress or what not?

 

[Scrofula]

EDIT:
Pandaman, sorry to sound accusatory. Prescription fraud is a hobby for some addicts, and like I said, I enjoy frequent bouts of deep suspicion of everyone. Totally unrelated to my drug of choice, I'm sure.

All you have to do is be upfront with the new doctor. If she's a psychiatrist, this is actually relevant to your treatment. Psychiatrists are less prone to ask about your mother than therapists, but it's still in their purview. If nothing else it speaks to genetics for a differential diagnosis.

Or, you can simply omit the prescriber info and I'd bet my last gram there won't be any contact.

The least anxious route is to put that out front right away, though, including the part where you'd be hiding your medication use. And the hoped-for behavioral changes, from your mother, which I had the impression you live with. Ok, not as bad if you don't live with her, but you're still hiding it, it has shame attached to it, and already the stench of deceit. Will you overcompensate and be lethargic around her, to hide your new-found feelings of energy? So she gets concerned and thinks you're on "the pot" and acts weird, which you misinterpret and get anxious about, and become lazier in response? A vicious negative feed-back loop of distrust and depression.

All stuff a shrink would love to know, and a general practitioner could care less about--it's already been fifteen minutes.

And, like I said, be prepared for the doctor to disagree, and not write the script anyway.





---------------

Dude, it's his mother, FFS!

I was writing a big long sorry post, OP, don't worry, but it's late and I was losing the sharp edge that defines my eloquence, that our viewers have come to expect. So I returned to my cave, till Lornes's email alerts summon me.

I shall return.

 

[pandaman92]

Hi Scrofula,

Don't worry about it, I laughed.

Anyways, no, I don't live with my mom. Moved out of the house at 18 and took at job half-way across the country after undergrad. The awkwardness has nothing to do with how I am when I am on the stimulant, it's having her prescribe it when she's clearly against it, since we share the same symptoms, and she manages to cope with it. So, as I said before, I plan to be completely upfront with the psychiatrist in that I was prescribed the drug a month ago, I like it and it works, and I wish to continue taking it. The issue is that I don't know how to answer why, if I had already been prescribed by another provider, am I not asking that provider for a refill? As you have said, it doesn't add up and could turn on a red-light that I am potentially and wrongly seeking drugs.

I guess the way to move forward would be to tell the truth - I think it's weird and awkward - and hopefully the psych understands? And if they don't I'll just walk out? I have a hard time believing that I am the only person to have been in this situation before..

Interested to hear your thoughts.

 

[Scrofula]

You tell the psychiatrist the truth: your mother wrote the script, extremely reluctantly, and you don't think it's proper to be treated by your mother, and with therapy she disagrees with morally. Or whatever the details are. No ethical issues or worries on that.

(That doesn't break the rules here, putting words in your mouth for your shrink, when they're true.)

It's a psychiatrist, so she keeps a straight face when she hears the most sordid paraphilias, the ones so disturbing they were rejected from Law & Order: SVU. Ice-T would blush in embarrassment.

Saying your mother doesn't like your stimulant medication is nap time for a psychiatrist.

When I started Zoloft a thousand years ago in undergrad, I told the shrink that starting it felt like an LSD come-up, and he just nodded--a sensation consistent with the literature. When I explained an odd effect yawning, like a whole lot of really good muscle-relaxing, just had the best sleep-in ever yawns, he nodded (shrinks nod a lot) and related several case reports of Canadian women having spontaneous orgasms after yawning, while using sertraline. Dead pan, with details. That was him being funny (the stories were true, but I mean his sharing) I realized later. (And I absolutely bitched when I realized I couldn't jerk off on it. He explained the SSRI "treatment weekend", which is skip a dose come Friday night.)

You can tell your psychiatrist anything, absolutely anything. They won't share it with anyone except maybe their spouses as they get ready for bed. They'll leave your name out though.

And they would feel it unethical just from a treatment-standpoint to ever contact your mother.

 

[RDP89]

I don't see why you're worried about what this new psychiatrist would say about it, if he thinks something is off and refuses to prescribe it, you just go to another one. The only problem I could see is being labeled as a "drug seeker", but as far as I know that only happens in cases of opioids and such, not sure if psych doctors can even do that?

 

[RDP89]

When I started Zoloft a thousand years ago in undergrad, I told the shrink that starting it felt like an LSD come-up, and he just nodded--a sensation consistent with the literature. When I explained an odd effect yawning, like a whole lot of really good muscle-relaxing, just had the best sleep-in ever yawns, he nodded (shrinks nod a lot) and related several case reports of Canadian women having spontaneous orgasms after yawning, while using sertraline. Dead pan, with details. That was him being funny (the stories were true, but I mean his sharing) I realized later. (And I absolutely bitched when I realized I couldn't jerk off on it. He explained the SSRI "treatment weekend", which is skip a dose come Friday night.)

.

It guess it must be my specific neurochemistry, but SSRI's make me extremely fucking irritable. No good feelings in any way with anyone of them I've ever tried. Never heard of this happening to anyone. Doesn't matter though, even if they worked the erectile dysfunction means I would never take them. Even if they worked amazing for me, I'd actually probably rather just off myself than not be able to use my dick. sorry didn't mean to get off topic my bad.

 

[Scrofula]

Doesn't matter though, even if they worked the erectile dysfunction means I would never take them. Even if they worked amazing for me, I'd actually probably rather just off myself than not be able to use my dick. sorry didn't mean to get off topic my bad.

Uh, excuse me, gotta break-in here. My dick worked just fine (still does too!). It rose to meet every mission with the firm yet slightly giving attention needed.

With SSRIs the issue is completing the mission. At first you can't. At all. Which has its benefits, but is intensely frustrating. That goes away with time and steady doses, but the mission completions just don't have the ticker-tape parade, hero's welcome they used to. Not even a 'nam kind of counter-reception, a cynical heroism. Just, more like a sneeze.

As for being irritable, I find they do make it easier to be rude to people. Blunting the negative aspects mean you don't feel as bad insulting or confronting someone.

 

[zephyr]

Uh, excuse me, gotta break-in here. My dick worked just fine (still does too!). It rose to meet every mission with the firm yet slightly giving attention needed.

This claim needs picture evidence or it did not happen.

 

[Scrofula]

I skipped a Zoloft and I'm full of meth; and spamming pharmacological stimulant info, and I'm the mod so I can keep going.

That means I offer the rigidity of skyscrapers, cantilevered spans to cross vast canyons, a pale and kinda pink Monolith to point the way to Jupiter.

It's also dark and I'll knock a bunch of shit over finding a light.

 

[zephyr]

^ Ok just pm it then

 

[pandaman92]

Hi Zephyr,

Getting hard shouldn't be the battle! It's blowing your load that's the hard part. Your girl will love it if you can control exactly when you're able to spill your man gravy. Like Scrofula said, the irritability might be due to your being more blunt and saying things that you normally wouldn't say that may lead to escalated levels of emotion.

Anyways, thank you all for the responses and advice. It is much appreciated!

 

[DayDreamBeliever]

I found this to be helpful. After feeling so sluggish for so long and getting on low anti depressants, and then taking a stimulant. That combination was great.

 

[Mmp85]

Most doctors just check your pharmacy records if they want to confirm you've been prescribed a drug in the past. I used the wrong generic name when listing my meds once and the doctor caught the mistake when they checked with the pharmacy.
I don't think the psychiatrist even needs to know the doctor involved is your mother. It really has no bearing on whether they feel comfortable prescribing the drug. I would just say your general practioner prescribed it which I assume is what she is for you.

 

[carkatz]

I have a very very similar experience in the sense that both of my parents are physicians and my dad has a history of prescribing me my medication regimen (adder all, ativan and zoloft) in some phases of my life (for good reason) i.e the beginning of 2016 I actually switched to a new psychiatrist when I transferred schools and before I saw this psych for the firs time my dad prescribed me my regimen for the time being until i found that new psych. When I had my first apt with him he spoke to my dad to get the background, etc. not an issue at all. now two years later the psychiatrist is actually retiring (he's almost 90) and upon agreement with my psychiatrist my dad helped me out until I found someone new in october. This psychiatrist I told who prescribed me what in the past, etc. and he actually didn't even ask to speak with any of my old docs, he just got my medication record which I know docs can do. and saw how long i've been on it and we went from there. and my PCP also whenever I see her if I tell her my dad is currently prescribing, doesn't give it a second thought. so three different doctors who didn't seem to think twice or have an issue as well as the 2 psychiatrists no problem continuing the meds. Now idk if my situation may be different since I have a long stable history of my medication regimen but in the end the psychiatrist, if he's a good one, will mainly care about how the meds worked for you to decide what to continue and not to. if they do speak to your mother it will likely be to gather more info on what the past issues were that lead to you being prescribed the vyvanse and SSRI and how she feels it worked for you. which i'm sure any psych would do that to a former doc whether it be the patents mother or not. your psych just wants to help you! don't be scared.