Any Doctors around please, or others struggling with ADHD please?

[Squeaky2023]

Is this a reasonable e-mail to send? I am at a nadir here, absolutely desperate:

Dear Dr xxxx,

I am having serious difficulties with my current treatment and ADHD plan.

I was unable to obtain my medication as my name was misspelled on the latest prescription. There has been no one to help me in your absence, resulting in worsening anxiety and depression along with suicidal thoughts. I feel unsafe and unsupported by this treatment plan. This instability has resulted in my having time off work.

I had started treatment with you in the hope that my quality of life would improve. It has drastically worsened, with family conflict and my inability to cope with this alongside my job. The conflict in my family, with my eldest son (also being treated by you) is the worst it has ever been and is threatening my relationships with more than one family member. The living situation is not sustainable as it is. I have cried every day for several weeks.

This brings me on to the issue of my former use of Prozac. I was advised by Dr xxxx during initial assessment that 20 years on this medication was not not recommended, but with little suggestions for an alternative. My detailed diagnosis letter clearly recommended reducing my dose to 20mg every other day. I accept there may be a gap in communication, as I had interpreted this to mean with a view to stopping the Prozac entirely due to the caution advised when taking it with ADHD medications.

I am at a loss to what to do now. My GP tells me that this advice “was unfair” from your staff and that they expected you, as a specialist, to advise an alternative. I was disappointed in the lack of support from all parties and am in a precarious situation with little faith in either.

I do feel I am caught between the gap between the NHS and your treatment plan. Please advise on anti-depressant medication for me as a matter of urgency. My home life and career are now threatened.

This brings me onto the lack of availability of Elvanse, the drug recommended by you for my condition, hopefully to replace Medikinet that I was initially trialing.
My contract with you is for a year, with no further funds to extend this if this lack of availability continues. Please tell me your plans regarding this increasing possibility.

I cannot emphasise how much my situation has worsened. I do feel that I have been left high and dry, without access to an alternative, and a much reduced quality of life.

Yours sincerely,

Xxx

Why are you sending an email and not just having a further appointment (possibly with a GP referral saying what the problems have been)?

The psychiatrist schedules the appointments. I've paid £2.5k and don't feel like I can ask for an additional one. I'm just at a low ebb and wanted it written down as talking points so I don't forget anything where it comes to my next communication with him.
I'm not sure what I will get out of him, given the disaster it's been so far.

I think it is more effective for OP to put all her concerns in writing - it is always wise to have a paper trail and will effect change quicker.

And as well, the GP hasn't wanted to help me, just coming out with "it's not fair". I feel like I am living in an altered reality where everything I need to happen is not, with the opposite happening for the worst. I've got nowhere to go, have I?

I don't know whether I am going to survive this.

Honestly? I don't think you will get far sending a private consult an email and expecting an appointment type response. What is the reason your GP cannot prescribe an anti depressant?

It is much easier (for me) to put things like this on paper, helps organise my thoughts. So a letter is good, is this to the consultant?

You need proper support from a specialist adhd group, I think.

Adhd medication and anti depressants don’t work well together.
i think you need to be more specific about what you want and write that

1. i want a prescription in my name
2. i want an urgent appointment. I expect to hear from you by x date.

@Squeaky2023 I know it doesn’t feel like it, but I promise you do have options. Your GP has a duty of care to you so does this doctor.

Why I mention the GP referral is because if a GP writes to a specialist and says, “this is not working we need a different plan” - may have more weight then an email.

A lot of doctors will also want to see you before making any medication changes

I would remove the 5th paragraph (GP saying unfair, lack of faith) I don’t doubt any of it is true but may put noses out of joint, and you need people on your side. I think I would put something more neutral along the lines of GP needs your advice on alternatives.

i would also go back to your GP and ask them to write to specialist. They can’t just say “unfair” if they don’t think treatment is ok they have a duty of care to raise that with specialist.

Do you have anyone who could go with you to advocate for you? I know what it’s like when you are struggling. A friend/family who is claim, but assertive can be very helpful.

Thanks Bounty, that is helpful, and, yes, I definitely do need an advocate. My husband always seems to get excellent treatment from the GP, but I am often given a metaphorical shrug and the feeling that there is nothing more worthless than a middle aged woman. Husband will speak with me. I bet they'll love that; two people on the phone appointment to them.

There seem to be a few issues

• the prescription in the wrong name
• the shortage of ADHD meds
• you can’t afford to see the dr anymore
• changing your Prozac

The first the dr can help with.

Many people are struggling with the shortage of ADHD meds.

Have you been offered any that aren’t methylphenidate based?

Have you been referred to NHS services to help with ADHD? I assume the GP won’t agree to prescribe unless you are under the care of a consultant and often they won’t agree shared care with a private dr.

Can you ask your GP to refer you to a psychiatrist to help with your depression?

@Squeaky2023 men are taken more seriously then women - sadly.. I guarantee if your DH is on the appointment saying how concerned he is for you and an integrated plan of care you’ll get further than on your own.

I agree. Him being "Professor Squeaky" seems to help too.

Your symptoms sound more anxiety based. Could you try things like mindfulness groups or support groups?