To lie to a private GP to get a prescription?

[AintNoThing]

I’ve been on a lot of Anti-Ds and none of them have done the job for various reasons.

I have recurrent depression and ASD.

I am not in a great place rn, I’ve arranged counselling but really do need extra support in an urgent-ish way.

I’ve done a lot of research over the past year and feel that I would like to try Wellbutrin/Bupropion.

I know on the NHS it’s only available for smoking cessation.

If I booked and paid for a private GP appointment would they only prescribe if I said I wanted to stop smoking or would they consider prescribing for mental health?

Yeah did OoH go ok ?

Hello, thanks so much for asking.

I got a prescription for Duloxetine 30mgs. He said he didn’t really know how the other agmelotine or the vortioxone worked so was reluctant to prescribe.
Thanks again so much.

A GP won’t prescribe off label for MH/specialist drugs whether private or not. Wellbutrin is not approved for MH in this country. Specialist MH services may prescribe it and your GP will probably be happy to keep prescribing off the back of this (although they don’t have to actually, as it becomes their liability - have had this conversation with my GP as I’m currently on an off-label MH prescription).

There are no magic drugs that private doctors can prescribe that NHS can’t (or very few...), drugs are either licensed or they aren’t and that’s it.

Refer yourself to the specialist services, you might find you’re bumped up the list if your GP supports you and you’re suffering.

It might be worth paying to see a psychiatrist. They will know what can be prescribed. I get the impression you’ve tried everything your GP can prescribe, but that isn’t the whole list of MH meds available. There are plenty of others that can’t be prescribed in primary care.

Glad you got something.

That’s great, @AintNoThing - the best combo for me has been Duloxetine AND counselling, so do think about self referring for that too.

I know GPs have prescribed it 'off label', like they do with other treatments - could be worth an ask.

I'm glad you've been prescribed something that will hopefully help!

From your more recent posts, I understand that the more 'mainstream' (not the right term but I can't think of an alternative) counselling services may not be appropriate because of your ASD.

In this case it may be worth saving to see a private psychiatrist or psychologist if you have to wait a substantial amount of time for your assessment, or of you don't feel the assessment helps.

They're expensive (~£400 for a psychiatrist and ~£200 for a psychologist) but it might help you to know that you have a safety net of sorts that means you can access that care if you need to. They will usually, afaik, write a letter for you to present to your GP which may help you to see a psychiatrist on the NHS if you struggle to see one through your GP.

A psychologist can't prescribe medicatoon but they may be able to provide a more specific form of therapy for you that takes into account your ASD.

Just remember that help is out there, and you will find something that works, it may just take some time.

Thanks everyone I am really grateful for your help.

Nautilus, thanks for letting me know about 111, I wouldn’t have thought of it otherwise.

I really appreciate that Uncle Jamie, I’ll definitely follow counselling through.

Thanks hedge,
That’s really really helpful, Clearly I have no idea how the system works.
I may ask the private counsellor about referring to a NHS Pysch.
Really appreciate it.

Thanks tallgreenbottles, I’ve always been confused about what “off-label” is, not sure my GP would go for it on my word alone. Maybe a Psych ref though.

Thanks so so much JellyB. That’s incredibly helpful as I was wondering about private Pysch costs. That’s a whole lot of cheddar but I’ll definitely start saving as, all your points are really valuable.

I really appreciate everyone’s time and support it means a lot to me.

No worries. Definitely get the NHS referral for the assessment going. It's there as a backup then. I've been on anti depressants for many years and have now found one that works for me after much trial and error. I have meant to phone our counselling service for years too, but put it off due to the long wait because I only ever thought to ring when I felt I couldn't cope a moment longer. I did ring a few weeks ago, was lucky enough to get a cancellation for a telephone assessment quickly. The assessment actually did seem to unstick some of the obsessive thoughts I was having and they emailed me resources to get me going until the first appointment, which was 8-10 weeks.
Three of those weeks have passed now and when I feel really crap I do feel there's light at the end of the tunnel.
The thing with engaging with that service, too, is that if you follow their process, they can either help you, or if they feel you need a psych referral, they will write to your GP stating this, and that carries a huge amount of weight. Xxx

Had a big think and realised my GP has been treating me for over 15 years isn’t very good...

Just been on the phone to the GP surgery, new Dr. has made an urgent referral to an NHS Psychiatrist, but obviously that may take some time.

He also advised me not to take the Duloxetine until I’d seen the Psychiatrist as he said that the specialist has access to ‘red something’ drugs including agomelatine that only they can prescribe.

He said it would be best for the Psychiatrist to prescribe from base level and that they have in-depth knowledge of prescribing and mixing drugs.

I do agree with him and need to just focus on that.

@AintNoThing - I have fibromyalgia and depression is a part of the package, including intrusive thoughts. My coping mechanisms seem to be working for now but TBH, I'd give a very wide berth to any medication that has suicidal thoughts as a side effect even it was supposed to make me a mixture of Einstein, Wonder Woman and get a 95 years old billionaire for a spouse.

Thanks Eerie, I think proceeding with caution is really important to me right now, sticking plasters and powering through has just sped up the spiral.

Oh I'm so glad you got a referral.

Thanks Nautiloid, I’m surprised how amenable he was to it as my long term GP wasn’t.

He did see me repeat a terrible crash and burn cycle for 15 years.

So I’m feeling emotional about that, as it could possibly have saved me years of real trauma and burnt bridges as well as feeling like I’m moving forward.

Do you know how long am urgent referral takes, Googling says 2 weeks, but that feels optimistic?

So glad you've got a referral, that's really good news!

I had a referral for a metal health assessment and I was seen within a week.

I imagine it's probably longer for a psychiatrist but as it's urgent I would asume you would be seen within a few weeks at most (more likely a couple weeks, but prep yourself for longer).

Even if it takes a while, keep holding onto the fact that this may well be the turning point.

*Mental health assessment 😂

That timing sounds about right for an urgent one.

Are you currently taking an anti depressant?

With this new one, keep a casual journal of how you go with it so you can chat on your next appointment.

Wellbutrin isn't prescribed here but my GP said I could try it either alone or in addition to the one I was taking.

He suggested an SNRI to try and I did and find they work better for me.

Are you getting at least 30 minutes of exercise daily? My GP stressed how important it was to exercise every day and be sure to get enough sleep.

Thanks JellyB, I appreciate that. I’ll just keep focusing on that, I’m really hopeful about this.

Thanks Ranty, I am not on anything atm, as Dr. who made the referral to the Psych said to wait until the Psych prescribed.

I am finding it difficult to leave the house unless for a reason such as work or Dr. appointment so no, exercise has fallen by the wayside I’m afraid. Although very good advice, thank you.

Thanks Nautilus!

One reason the NHS won't provide it is that if you have bipolar manifesting as unipolar depression, it can cause severe rapid cycling. That's how I was diagnosed with bipolar disorder and ended up in an inpatient unit 15 years ago. Also, the side effects are not great. You have a terrible dry mouth and bitter taste for the entire time you take it.

Sounds like a good result for your OP - hope you don't have to wait too long to get the help you need.

That’s interesting Confront thank you. I’m sorry you went through that, hope you’re doing well now.

Thanks hedge, it feels right to wait, as you say, just hope not too long.