Who can prescribe ADs aside from GP? Can't get appt!

[itsthemenopausenotme]

I've been off ADs for half a year or longer but I'm really struggling at the moment. I can't get an appointment with my gp - the only one who doesn't tell me to go exercise or find a job I love - because she's gone on holiday today and when she gets back I'll have to call for one in two weeks from then. The only other reasonable gp is on holiday too!

I've tried a lot of ADs over the last 20 years so don't want someone telling me to take something I know won't agree with me or causes problems or doesn't help.

Is there anyone else who can prescribe them? I have a support worker but she's just said I either wait or see a different doctor. I've seen the local MH team but all they've done is refer me for the support worker and signed me up for a mindfulness course (which I already practice at home).

I barely sleep because of anxiety. I don't know what to do. It just gets worse and I feel it's all hopeless. I can't go out due to anxiety. I managed to get to the gp yesterday with my partner because my gp was the emergency doctor but she'd been on a house visit so the waiting room was full of children and babies and stank of soiled nappies. After an hour I had a panic attack and had to leave. I can't face that again.

At the moment I wish they'd just admit me to a psychiatric ward and drug me up. Not an option obviously, my dd needs me for a start.

Sorry to ramble on. Does anyone know what I can do?

Only a medical doctor can prescribe so either your GP or your Psychiatrist if you have one. You either see a different doctor or wait, those are the only options. If you have a history of being prescribed a specific AD then they will reissue it, if they try and get you onto something else then just say "No, I don't get on with a lot of ADs, this one worked and caused the least trouble." They WILL issue it. Present it as a relapse rather than just feeling a bit down.

I take a very unusual choice of AD. It's hardly ever prescribed for depression anymore although it is a common painkiller in lower dosages. Even the pharmacists do a double take when they see the dosage and one even rang my GP to check, rather than take my word that it was correct. But they DO prescribe it and they will take your word if you say one specific one works better.

Our old surgery had a dedicated mental health nurse who would see people to refer upwards and (signed off by a doctor who would just pop their head in the room) prescribe ADs if needed. I assume someone would have mentioned this option to you if it was available at your surgery, but could be worth checking other surgeries nearby?

Otherwise could your partner go with you to one of the unhelpful doctors and be prepared to be firm? There's no real excuse for them to be difficult about prescribing something that's worked for you before.

I'm so sorry you're in this position. GPs who don't take MH seriously shouldn't be allowed to practice IMO, and the mental health system shouldn't be something you need to be in good mental health to navigate effectively.

Private psychiatrist can do, but you'll pay through the nose for an appointment and to the best of my knowledge the prescription would be private, not nhs, so could be costly.

Ok, thanks, nothing I can do then

The last one I took was helpful but stopped me sleeping, so I need to discuss if theres anything they can do about that.

I don't have a psychiatrist, I consider myself lucky to finally get a referral to the MH team ... After suffering depression on and off for over twenty years! It's so difficult to get any help.

Push doctor
What ones do u want ?

If they are sedatives might be hard to get them to prescribe but push doctor should be able to help

what about the online doctor services e.g. pushdoctor

if you have a history, then they might be able to prescribe something to tide you over

I also have A&D and I just stay on meds - tried coming off three times and now just accept I have to keep on.

Duloxetine helped the most but I couldn't sleep on it. I'd like something added on to help me sleep but unsure what.

I've tried Pushdoctor once a while ago for a migraine and was told I'd need to see my gp so I'm reluctant to waste more money. Plus I'd have to pay an admin charge, a prescription charge (I'm in Wales so usually don't pay) and pay for the medication, heaven knows how much it is. I'm off sick so have no money at present and can't afford it. And what happens next month? Will my gp prescribe it then or do I need to keep going back to Pushdoctor?

Have you tried a Tricyclic? They do have a lot of side effects and are rarely prescribed these days but they do tend to have quite the sedating effect. I have to set an alarm even when I don't have to go to work as I sleep 16 hour stretches otherwise. You might be one of the lucky minority that tolerates them well.

I'd like duloxetine because it helped with my hot flushes and chronic pain. Do they prescribe tricyclic ADs alongside SNRIs? What are the side effects?

In the past I have rung the Dr and left a message with reception to ask the Dr to ring me or arrange a phone call. Then pick up your script later?

I tried that but they won't do it.

Some surgeries have practice pharmacists who can prescribe. We have one at our surgery who is really helpful for sorting out prescriptions and things like this. Have you checked if that is an option?

If not you may have to compromise and see a different GP

Have you tried Tricyclics OP? I can’t take SSRIs They really make me unwell. the side effects I get are dehydration which causes constipation. Exercise, water and a herbal laxative help. Hope you get something soon and feel better

I take Cymbalta in the morning and mirtizipine at night, I'm also currently prescribed Depakote although this is being phased out as its fallen out of favour so replacing with carbmazapine and to help sleep and other symptoms I take serequel as it knocks me out.

smurfy I did wonder if that would work, I've taken Mirtazapine in the past and got on ok with it apart from weight gain, which I'd gladly take now compared to how I'm feeling. Do you sleep well?

I haven't taken tricyclics but I can't risk constipation because I struggle with that already and it makes me really unwell and causes me great pain.

I don't think my surgery has a practice pharmacist, it's not been mentioned as an option. To be honest if I ask anything I get shot down straight away, I've never met anything as unfriendly and arrogant as the receptionists.

Unfortunately you're just going to have to see a GP and be firm.

And to be honest if you want something more than the current "in fashion" antidepressants (seems to be citalopram and fluoxetine) then they are likely to just refer you onto a psychiatrist. The vast majority of GPs won't (and to be fair shouldnt) be prescribing complex regimes of neuroleptic medication or even prescribing some of the older or rarer ones without consulting someone with more specialist knowledge. The side effects and interactions are just too complex. Hell even the consultant psychiatrists I work with seek advice from our pharmacists before prescribing sometimes.

And this is the nature of the beast, most GPs cant/won't touch it. Yet MH services have been cut to the bones of wait times are huge and people such as yourself aren't getting the help they need.

Sorry for not being much help.

Perhaps your support worker could help you with the GP.

I managed to go down this morning and see a doctor, he was ok, listened and prescribed the antidepressants I was last on Duloxetine which seemed ok apart from that I struggled to sleep on them, but has said he will look at prescribing a low dose of mirtazapine to help me sleep. He did say I may need to be on them for the rest of my life.

Not usually, it's one or the other. Side effects are mostly dizziness and dry mouth.