Comments for The Sidewalk Psychiatrist http://thesidewalkpsychiatrist.wordpress.com Practical answers to mental health questions Sun, 15 Nov 2009 13:58:33 +0000 http://wordpress.com/ hourly 1 Comment on Getting past the urine drug screen while taking Vyvanse by doctordan http://thesidewalkpsychiatrist.wordpress.com/2008/11/02/getting-past-the-urine-drug-screen-while-taking-vyvanse/#comment-3415 doctordan Sun, 15 Nov 2009 13:58:33 +0000 http://thesidewalkpsychiatrist.wordpress.com/?p=226#comment-3415 Yes it is. Yes it is.

]]> Comment on Vyvanse–new way to deliver an old drug (this one is ok!!!) by doctordan http://thesidewalkpsychiatrist.wordpress.com/2007/09/22/vyvanse-new-way-to-deliver-an-old-drug-this-one-is-ok/#comment-3414 doctordan Sun, 15 Nov 2009 13:54:56 +0000 http://thesidewalkpsychiatrist.wordpress.com/2007/09/22/vyvanse-new-way-to-deliver-an-old-drug-this-one-is-ok/#comment-3414 DUPOS--Perhaps you need to re-read my comments. I do not make judgements about what people choose to do with their lives. I am actually fairly liberal about those sorts of things. I am a stickler for respect. The entry you are referring to (I think) talked about doing what you want to do but being respectful to those around you. My job is to help people with their real-life psychiatric issues and medicine is just one of the tools that can be used. It should never be the only tool used. My work with patients is predicated on a certain degree of trust and accountability. I will do my best as I make decisions that impact on people's lives . . . they follow through on my recommendations or, at least, be straight forward and honest if they do not. I don't lie to them or deceive them . . . they don't lie to me or deceive me. It is a relationship like every other relationship. And, by the way, your knowledge of psychopharmacology, developmental neurochemistry and the practice of clinical psychiatry is cursory at best. I suggest you stick to expressing your experiences with medicine and doctors and don't make generalizations based on limited knowledge and experience. --DH MD DUPOS–Perhaps you need to re-read my comments. I do not make judgements about what people choose to do with their lives. I am actually fairly liberal about those sorts of things. I am a stickler for respect. The entry you are referring to (I think) talked about doing what you want to do but being respectful to those around you. My job is to help people with their real-life psychiatric issues and medicine is just one of the tools that can be used. It should never be the only tool used. My work with patients is predicated on a certain degree of trust and accountability. I will do my best as I make decisions that impact on people’s lives . . . they follow through on my recommendations or, at least, be straight forward and honest if they do not. I don’t lie to them or deceive them . . . they don’t lie to me or deceive me. It is a relationship like every other relationship.

And, by the way, your knowledge of psychopharmacology, developmental neurochemistry and the practice of clinical psychiatry is cursory at best. I suggest you stick to expressing your experiences with medicine and doctors and don’t make generalizations based on limited knowledge and experience.

–DH MD

]]> Comment on Getting past the urine drug screen while taking Vyvanse by doctordan http://thesidewalkpsychiatrist.wordpress.com/2008/11/02/getting-past-the-urine-drug-screen-while-taking-vyvanse/#comment-3413 doctordan Sun, 15 Nov 2009 13:41:56 +0000 http://thesidewalkpsychiatrist.wordpress.com/?p=226#comment-3413 I would just be consistently honest with your doctor and call him/her on their accusations of your non-compliance. If you really are taking it (I believe you), they should believe you. If you don't have a relationship with them that allows that degree of trust, then the trust becomes the issue between you two. So, anyway, how can it be that you are coming up negative on your screens? It could be that you metabolize the medicine so quickly that there is really not that much in your system. Remember, the assays that are used for the drug test don't test for ANY amphetamine. There is a threshold amount that must be present for the test to be "positive". You can get a quantitative assay (that is, one that gives a specific number rather than a positive or negative) but even then, I have seen cases where the level is "zero" even when the medicine is taken. Be straight forward and up front with your doc. If you suspect the doc of not believing you, call them on it--you can't get good treatment unless you have a good relationship with your doc and a good relationship is based on a certain degree of trust. --DH MD I would just be consistently honest with your doctor and call him/her on their accusations of your non-compliance. If you really are taking it (I believe you), they should believe you. If you don’t have a relationship with them that allows that degree of trust, then the trust becomes the issue between you two. So, anyway, how can it be that you are coming up negative on your screens? It could be that you metabolize the medicine so quickly that there is really not that much in your system. Remember, the assays that are used for the drug test don’t test for ANY amphetamine. There is a threshold amount that must be present for the test to be “positive”. You can get a quantitative assay (that is, one that gives a specific number rather than a positive or negative) but even then, I have seen cases where the level is “zero” even when the medicine is taken. Be straight forward and up front with your doc. If you suspect the doc of not believing you, call them on it–you can’t get good treatment unless you have a good relationship with your doc and a good relationship is based on a certain degree of trust.
–DH MD

]]> Comment on Getting past the urine drug screen while taking Vyvanse by Lena http://thesidewalkpsychiatrist.wordpress.com/2008/11/02/getting-past-the-urine-drug-screen-while-taking-vyvanse/#comment-3411 Lena Fri, 13 Nov 2009 21:37:27 +0000 http://thesidewalkpsychiatrist.wordpress.com/?p=226#comment-3411 I have been taking Vyvanse 50 mg- 1 capsule a day for almost a year now... I have to do random drug screenings and they're telling me I don't have the amfetamine in my system. I'm not sure what test their using, but how can this be happening? I take this and my birth control every morning religously with a glass of milk and a pb & J sandwich. I feel like I'm being accused by my dr of being unresponsible with a controlled substance... Any suggestions? I have been taking Vyvanse 50 mg- 1 capsule a day for almost a year now… I have to do random drug screenings and they’re telling me I don’t have the amfetamine in my system. I’m not sure what test their using, but how can this be happening? I take this and my birth control every morning religously with a glass of milk and a pb & J sandwich. I feel like I’m being accused by my dr of being unresponsible with a controlled substance… Any suggestions?

]]> Comment on Vyvanse–new way to deliver an old drug (this one is ok!!!) by DrugUsingPOS http://thesidewalkpsychiatrist.wordpress.com/2007/09/22/vyvanse-new-way-to-deliver-an-old-drug-this-one-is-ok/#comment-3402 DrugUsingPOS Wed, 04 Nov 2009 02:28:21 +0000 http://thesidewalkpsychiatrist.wordpress.com/2007/09/22/vyvanse-new-way-to-deliver-an-old-drug-this-one-is-ok/#comment-3402 Ripping apart a person for using vyvanse recreationally is a bit hypocritical in my opinion. Apparently there are people that 'need' vyvanse but those people are typically looking for a shortcut to solving their adhd problems, no matter how unhealthy it is to give amphetamines to 10 year old kids despite the overlooked neurotoxicity of it, why don't you toss in some oxycontin for social anxiety. I was prescribed amphetamines and taking over 130mg of adderall a day until I realized i could overcome my adhd with much healthier means, but that is the heart of america, gratification now for the expense of tommorow. It is a lot safer to use it recreationally as opposed to getting continually dosing children with amphetamines, destroying dopamine receptor sites and leaving them dependent on a medicine to keep them feeling normal. I'm a recreational user, though i much prefer psychedelics to amphetamines. Just because someone uses drugs does not make them a degenerate slob who is uncapable of helping society. Ripping apart a person for using vyvanse recreationally is a bit hypocritical in my opinion. Apparently there are people that ‘need’ vyvanse but those people are typically looking for a shortcut to solving their adhd problems, no matter how unhealthy it is to give amphetamines to 10 year old kids despite the overlooked neurotoxicity of it, why don’t you toss in some oxycontin for social anxiety. I was prescribed amphetamines and taking over 130mg of adderall a day until I realized i could overcome my adhd with much healthier means, but that is the heart of america, gratification now for the expense of tommorow. It is a lot safer to use it recreationally as opposed to getting continually dosing children with amphetamines, destroying dopamine receptor sites and leaving them dependent on a medicine to keep them feeling normal. I’m a recreational user, though i much prefer psychedelics to amphetamines. Just because someone uses drugs does not make them a degenerate slob who is uncapable of helping society.

]]> Comment on Getting past the urine drug screen while taking Vyvanse by Dustin http://thesidewalkpsychiatrist.wordpress.com/2008/11/02/getting-past-the-urine-drug-screen-while-taking-vyvanse/#comment-3401 Dustin Tue, 03 Nov 2009 19:32:59 +0000 http://thesidewalkpsychiatrist.wordpress.com/?p=226#comment-3401 Vyvanse is not dexedrine. Vyvanse is not dexedrine.

]]> Comment on Tapering Lamictal by Sara http://thesidewalkpsychiatrist.wordpress.com/2007/07/15/tapering-lamictal/#comment-3400 Sara Tue, 03 Nov 2009 17:24:56 +0000 http://thesidewalkpsychiatrist.wordpress.com/2007/07/15/tapering-lamictal/#comment-3400 Hey, how is it going? I am in the same boat and would like to know how the yaz is helping with Lamictal acne. It can be hard to find people on the same meds as you when there are so many combinations. I'm not on lexapro though, but close enough. Hey, how is it going? I am in the same boat and would like to know how the yaz is helping with Lamictal acne. It can be hard to find people on the same meds as you when there are so many combinations. I’m not on lexapro though, but close enough.

]]> Comment on Klonopin withdrawal or re-emergence of anxiety??? by doctordan http://thesidewalkpsychiatrist.wordpress.com/2007/08/30/klonopin-withdrawal-or-re-emergence-of-anxiety/#comment-3396 doctordan Wed, 28 Oct 2009 10:52:08 +0000 http://thesidewalkpsychiatrist.wordpress.com/2007/08/30/klonopin-withdrawal-or-re-emergence-of-anxiety/#comment-3396 But, Theresa, where did you get the idea that it was OK to go cold turkey off your Klonopin. Is that what the doctor recommended? Did you do this on your own? Benzo withdrawal can be VERY uncomfortable and VERY dangerous. That does not make Benzos evil. It makes them an intervention that must be managed carefully . . . like most of the interventions that are prescribed by western medicine. --DH MD But, Theresa, where did you get the idea that it was OK to go cold turkey off your Klonopin. Is that what the doctor recommended? Did you do this on your own? Benzo withdrawal can be VERY uncomfortable and VERY dangerous. That does not make Benzos evil. It makes them an intervention that must be managed carefully . . . like most of the interventions that are prescribed by western medicine.

–DH MD

]]> Comment on Klonopin withdrawal or re-emergence of anxiety??? by teresa http://thesidewalkpsychiatrist.wordpress.com/2007/08/30/klonopin-withdrawal-or-re-emergence-of-anxiety/#comment-3395 teresa Wed, 28 Oct 2009 10:19:30 +0000 http://thesidewalkpsychiatrist.wordpress.com/2007/08/30/klonopin-withdrawal-or-re-emergence-of-anxiety/#comment-3395 Mark, you are so right. I have been on klonopin 3yrs. up to 2mg per day. Went off cold turked 12 days ago and have all the symptons and started having them long berfore I went off.But was too foggy too realize I was such a mess from this drug. Went to my docs on day 6. Gave me LIBRIUM. Cried becausse the withdrawal is so hard. Took the prescribed dosage and went to emergency the next day. All because I finally looked on the internet and found out what I had been prescribed, that was on day 5 of my withdrawal. Doc said it was psychological and if I didn't want to not to take anything else because I'm out of the woods as far as siezure goes and, fine. RIGHT. THIS IS CALLED BENZODIAZEPINE WITHDRAWAL. Maybe the docs are doing this in good faith but they need to educate the GP fully about side affects withdrawal before writing this out to patients. I found a site called the Road Back explaining the truths about benzos and regardless of my intelligence, had no idea what a benzo meant until I researched it after quiting myself. It's a rough road, anybody out there. RESEARCH THIS DRUG. YOU MAY NOT WANT TO GET ON IT. God Bless, Teresa Mark, you are so right. I have been on klonopin 3yrs. up to 2mg per day. Went off cold turked 12 days ago and have all the symptons and started having them long berfore I went off.But was too foggy too realize I was such a mess from this drug. Went to my docs on day 6. Gave me LIBRIUM. Cried becausse the withdrawal is so hard. Took the prescribed dosage and went to emergency the next day. All because I finally looked on the internet and found out what I had been prescribed, that was on day 5 of my withdrawal. Doc said it was psychological and if I didn’t want to not to take anything else because I’m out of the woods as far as siezure goes and, fine. RIGHT. THIS IS CALLED BENZODIAZEPINE WITHDRAWAL. Maybe the docs are doing this in good faith but they need to educate the GP fully about side affects withdrawal before writing this out to patients. I found a site called the Road Back explaining the truths about benzos and regardless of my intelligence, had no idea what a benzo meant until I researched it after quiting myself. It’s a rough road, anybody out there. RESEARCH THIS DRUG. YOU MAY NOT WANT TO GET ON IT. God Bless, Teresa

]]> Comment on Lamictal and acne by doctordan http://thesidewalkpsychiatrist.wordpress.com/2008/05/14/lamictal-and-acne/#comment-3394 doctordan Wed, 28 Oct 2009 02:39:49 +0000 http://thesidewalkpsychiatrist.wordpress.com/?p=100#comment-3394 Darlene-- HANDS DOWN!!! I would give it a try. I assume that the mood stabilizer you are referring to is Lamictal. Can Lamictal cause worsening of acne . . . yup. Can it provide for significant improvement in mood, overall improvement in feelings of well-being, happiness, contentment, relief from suicidal thoughts . . . yup. Do the math. You don't know what side effects it will cause. You don't know what the benefits will be. I suggest you do a benefit/risk analysis and decide for yourself. If it was up to me, I would choose the chance for happy over the risk of acne. If my acne got worse, I'd treat it or stop the Lamictal. What is relief from depression worth to you???? You decide. --DH MD Darlene–

HANDS DOWN!!! I would give it a try. I assume that the mood stabilizer you are referring to is Lamictal. Can Lamictal cause worsening of acne . . . yup. Can it provide for significant improvement in mood, overall improvement in feelings of well-being, happiness, contentment, relief from suicidal thoughts . . . yup.

Do the math.

You don’t know what side effects it will cause. You don’t know what the benefits will be. I suggest you do a benefit/risk analysis and decide for yourself. If it was up to me, I would choose the chance for happy over the risk of acne. If my acne got worse, I’d treat it or stop the Lamictal.

What is relief from depression worth to you????

You decide.

–DH MD

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