What a bad day. My therapist ended up being no good.

[Tony Ramirez]

My mother is going to take me to my sister's doctor in Queens on Monday and then I will get a refill.

I am done with this clinic. The bad doctor called me yesterday to try to force me back but he is scared of my mother. He wanted to put me back on Seroquel. That medicine was not bad except for the constant hunger. That is why I wanted off. But then I found out that Prozac did the same thing.

I talked to my yoga teacher who sounded like my mother. My friend had to cancel because of work. At life group we broke up into prayer groups again men and women and went into rooms, once again understanding why we do separate gender hangs now. I of course broke down. I told them all that happened. I was very supportive and loved. I felt much better.

When I got home I once again talked to my mother for nearly two hours. I did sleep better. I do feel better. I am resting this weekend until church on Sunday where I will see more of my friends but I know I won't break down emotionally anymore.

 

[tree]

I did notice, there are extreme drug shortages this year. I wonder if that's why they decided no refiills.

In my experience, a prescription isn't infinite.
Medication is prescribed for a set length of time, then
I have to go in and see the doctor so they can determine
if an extension is necessary.

It's quite routine to see "No Refills" on the bottle.

 

[Aspychata]

But still, procedurely, you just don't stop a client cold turkey, it's tapered off. It's the responsibility of the prescriber to prevent adverse affects.

 

[tree]

That's why an appointment with medical provider is the usual
step when the label says "No Refills." Consultation required
to determine what treatment to pursue.

 

[thejuice]

I can see why they do that bureaucratically but what I don't understand is stopping something that they have someone chemically reliant on. Sometimes a patient cannot come in to see anyone if they're ill and the system should be more flexible.

 

[Aspychata]

The therapist didn't prescribe the medication, and l didn't see the rx, so l don't know what to assume. The therapist may have overstepped the protocols regarding medication. The prescriptions always will say no refills after some point, because the patient has to be re-evaluated. Most medications for psychological issues, never have infinite refills until you fall over dead. Lol. Only psychiatrists or MD's can prescribe, so the therapist consults with their MD that oversees the clientele for that agency. From what the OP is saying, l don't think the therapist even consulted with the MD. I think they were on a control trip. When the therapist perceived the OP as stressed out, they should have immediately gone into crisis assessment and consulted with their supervisor for the next steps needed. This doesn't sound like it was handled correctly.

 

[Judge]

Legal issues can be complex when it comes to the distribution of anti-psychotic drugs. It's the one type of medication where your physician might get the upper hand with a patient having to comply with their observations and recommendations approved by the court in some cases. When patients' rights go only so far. Whether or not they are considered a danger to themselves or others.

No refill recommendations reflects a method of control in terms of keeping a patient in a state of being periodically monitored relative to whatever medication is being prescribed and taken in real time. Quite a deliberate process in determining which medications work and which ones don't.

In essence a patient's right to refuse medications can be mitigated by their doctor over the prescribed anti-psychotic drugs through various court precedents. IMO, tread lightly with your physician over such matters. You don't want your physician to petition a court to get involved.

Examples:

https://slate.com/technology/2022/0...endant-mental-illness-supreme-court-sell.html
https://psychnews.psychiatryonline.org/doi/full/10.1176/pn.2001.36.1.8
Just "google" in any search engine subjects like "can a doctor force a patient to take antipsychotic medications?" Scary stuff...

 

[Aspychata]

Also, limiting refills helps with liability issues, because patients can suffer severe side effects from any type of medication due to the chemical composition.

 

[Judge]

Also, limiting refills helps with liability issues, because patients can suffer severe side effects from any type of medication due to the chemical composition.

Not only with physicians, but also the professional liability of the pharmacists who actually distribute such medications to patients. There's a whole lot of oversight when it comes to the legal aspect of it all. Much worse still, if and when it involves controlled substances.

 

[Hypnalis]

There are gaps in the story. But Tony has a temporary solution, and hence the time he needs to get this sorted out, so it's not immediately important.

As for what should be happening: It seems Tony and his medical provider don't agree on the correct treatment.
And the level of stress reported here isn't appropriate, and was displayed before the Prozac ran out.

That combination isn't going to encourage a new medical provider to casually agree to a patients request for a drug that wikipedia says isn't usually indicated for SAD or ASD.

@Tony Ramirez
You waited too long to deal with this. Start work on resolving it as soon as you've secured your next "no refill" prescription. Next time be calm when you talk to the MD, especially when stating a preference for a particular drug. Displaying a high level of stress in that situation is likely to be counter-productive.

You can't quickly learn to regulate emotions or stress, but you can and should learn to limit how much you display those states to other people.

 

[Mary Terry]

But still, procedurely, you just don't stop a client cold turkey, it's tapered off. It's the responsibility of the prescriber to prevent adverse affects.

Well, sort of. In the US, it's the patient's responsibility to know how much of a medicine they have on hand and to follow up with their prescribing physician to ensure they don't run out of an essential medication. Prescribing physicians and drug manufacturers have no liability for adverse reactions if the patient has been warned about potential adverse reactions. See the lengthy list of potential reactions, contraindications, warnings, and other information included in every drug package insert, for both prescription and over-the-counter medications. If the patient has notified the prescriber of a drug allergy but the doctor prescribes it anyway, then the doctor may be liable for adverse reactions in that situation.

 

[Aspychata]

In the state of Florda, doctors are not required to carry malpractice insurance, but they have to have a sign in their office stating this. Something l just learned.

 

[Judge]

In the state of Florda, doctors are not required to carry malpractice insurance, but they have to have a sign in their office stating this. Something l just learned.

There's a bit more to it. Though I suppose the bottom line is what happens if one litigates against a doctor who can't financially account for their letter of credit or estimated cash on hand? Even then that may well amount to liquid assets far less than what a malpractice policy might cover.

Seems this present environment resulted from major tort reform legislation circa 2003.

"Florida law requires doctors to obtain an irrevocable letter of credit or have money set aside in an escrow account to pay out medical claims if they don’t have insurance, but there is no system by which authorities ensure the doctor has insurance. For instance, if your car insurance lapses, your license can be immediately suspended. But doctors are held to a lower standard than the general public.

Typically, doctors who practice medicine in hospitals carry insurance policies, as do the hospitals themselves. However, private practitioners, and especially those who offer discounted cosmetic surgery, frequently do not carry medical malpractice insurance.

Technically, if a doctor does not carry medical malpractice insurance, they are required by law to make patients aware of that fact. However, they can fulfill this requirement by simply posting a notice in their office, which often goes unnoticed by many patients."

https://www.palmerinjurylaw.com/injury-guide/malpractice-insurance/
https://www.gallaghermalpractice.com/state-resources/florida-medical-malpractice-insurance/

 

[Aspychata]

@Judge , now l ask. It's scary to think my doctor isn't insured.

 

[Gerald Wilgus]

That was a caring therapist. But l have ran into several bad ones that give me the stupidest advice. And l think just why? Just why are you in this profession?

I am lucky with my therapist taking me through Cognitive Processing Therapy. She work with autistic individuals. Right now in my therapy I am working on what forgiving that younger me for my confusions that led to my isolation would feel like.

 

[Aspychata]

That's great progress. You are a success story. And l am so appreciative that you share your success story here with us.

 

[Tony Ramirez]

I got my medication from my sister's doctor yesterday who is now got be my primary medical doctor. I am going to see a separate therapist which my mother is looking for.

 

[Aspychata]

Alright, you kept searching. That's a success story.