Private psychiatrist question

[MarmadukeM]

Hi i am being referred in to the community treatment team for ongoing support and hopefully a face to face psychiatrist medication review. I’ve had a rough 5 months and I’m now on a boat load of meds including meds to counteract side effects of other meds! My bipolar depression has improved to say 50% but I’m nowhere near my ‘normal’ self and my nurse and therapist think I’m over medicated. I’m struggling to function at work, my vision is blurred, I’m really clumsy and forgetful.
my worry is that if they accept my referral I am looking at maybe 4 to 5 months before I see a psychiatrist and I find the thought of that unbearable to be honest - I know that in particular one of the meds is just plain bad for me and I’ve persevered with it for almost 5 months but enough is enough! I do have the means to pay for a
private psychiatrist review and then maybe one follow up appt but I can’t commit to anything more than that.
Have anny of you done this? And how did it go/was the nhs able to pick you back up and act on the psychiatrist suggestions?
Any advice/experiences of the process would be great xxx

My private psychiatrist just sends an appointment review letter to my GP asking them to prescribe the medication he recommends and they have always done that without questioning it.
So, it should be fine for you to arrange a medication review with a private psychiatrist and for them to get your GP to prescribe the meds.
Same with requests for fit notes. I don’t think my GP has the bandwidth to question them so they just provide them despite never seeing or speaking to me about my MH at all.
Good luck

Just to add that I would recommend The Priory for private psychiatrists and I think alot of them offer online appointments so you wouldn’t even need to see them F2F unless you wanted to.

@Porchwouldbenice thanks ❤️
yeah I have been looking at the priory psychiatrists, just trying to find one that specialises in bipolar disorder. I think I’ve found one in Manchester, I’d be happy to travel as I like face to face. His sec isn’t in till next week. How long roughly has it been for you to be able to get an appointment? Just approx x

Please check with your GP surgery if they will prescribe meds the private psychiatrist prescribes. They may not and you will have to rely on private prescriptions which can be expensive. This happened to my DSis as the psychiatrist prescribed a specific slow release tablet with the local health board did not and so the GP wouldn’t prescribe.

Where are you? In the UK there are several research hospitals, e.g. Warneford Hospital in Oxford, which offer a NHS psychiatry appointment and assessment as part of their Bipolar Clinic. You don't have to live locally but you do have to be able to travel to the appointment. They will do the assessment and change any meds. They will also make you aware of any research studies they are recruiting for, but you can say not now if you are not interested.

Sorry, I’m not sure how long it would be for a new patient as I see mine every 2 to 3 weeks. I would have thought it would only be a few days rather than months but some of them only work part time privately so would have less available appointments. Good luck x

When my psychiatrist has prescribed privately for me (when trying different meds) I haven’t found them expensive at all. Often the same price or double that of an NHS prescription. Obviously, depends on the meds in question but not a reason to rule out a private meds review.

@FindingNemo123 I’m in newcastle upon Tyne - do you ask GP for referral?I think I have found a few options so hopefully someone will get back to me next week.
@Aligirlbear its not slow release quetiapine is it? I’m on that one already from NHS psychiatry but I know it’s not widely prescribed cos it’s a lot more expensive than the regular quetiapine.
@Porchwouldbenice thanks again for your advice - fingers crossed I can get an appt. I just heard back today that they have had to delay the triage of my nhs referral as they are too busy to look at its been put back to next week 🤦‍♀️

Could anyone suggest how much a private psychiatrist charges? I see eyewatering rates of around 800 per hour!

Don’t know if this is typical but mine charges £350 for initial assessment of up to an hour and then £170 for follow up appointments of up to 30 mins.

@fouroclockrock i agree with @Porchwouldbenice - I am looking at priory psychiatrist and they quote £350 for the initial assessment which I don’t think is too bad really x

Just one thought @MarmadukeM , if you are prescribed lithium, either your private psych will need to arrange regular blood tests and you'll have to pay, or your GP will need to agree to do this, fairly regularly at first. Whichever it is, it's important to get them done xx. Good luck.

@Ramblingaway cheers 😀 I think I be getting on less drugs so prob not be doing lithium but who knows?! X

Just an update for anyone interested in going down the private route -
I rang the priory Chelmsford on Monday just just gone and I was offered an appt the following day via zoom or a f2f this Monday coming, so just a one week wait even tho is Xmas which I think is really good (I chose f2f for my initial appt as I prefer this)
I am paying £360 for 50 mins. Any f/u will be £170 for 25 mins.
i also got an update on my NHS referral (for comparison). So they put my referral in a week ago approx and I have been given an appt for Jan 29th for an initial assessment which is with (I think) one of the nurses or similar. After that they would arrange my psych appt I think. So I’m glad I’ve decided to go private as otherwise, as suspected, I’d be waiting several months for the NHS to see me.
good luck to anyone interested similar situation xxx

Thanks for the update @MarmadukeM, I’m really glad you were able to get an appointment so quickly. Hope it goes well and you get the answers you are looking for xx

Best of luck with your appointment, it sounds like you're overmedicated and need fresh eyes which hopefully you'll get.

Thanks - yes I really hopeful this is the start of some progress towards feeling a bit more normal !

Hi OP. how was your appointment? I really hope it was helpful.

Hiya @Porchwouldbenice thanks for checking in :-)
It went well, she was really nice and supportive of stopping the Vortioxetine and also the trazodone. She went through slow tapering so I’m doing it super slowly over a few weeks or maybe months if needs be.
I feel like she gave me plenty of explanation of why they are probably causing more problems than they are solving. I would be lying if I said I wasn’t apprehensive and i know my husband is worried it will destabilise me but to be fair it wasn’t working particularly well hence the psychiatrist appt! X

That’s great news @MarmadukeM. Fingers crossed it works for you and you have the option of a follow up appointment if the meds need tweaking further.

Yeah @Porchwouldbenice im guessing she will write to my GP and send me a copy so they will know what’s going on. Is that what’s happened when you have seen you private psychiatrist? Also,have you tapered of meds before? X

Hi @MarmadukeM

Yes, they will keep your NHS GP informed. It is useful as they can ask your GP to prescribe the meds they recommend on an ongoing basis ( which can be cheaper than private prescriptions) and also, being cynical, The Priory like to cover their arses in case anything happens to you.

Yes, I have tapered off MH medication before and recently. My psychiatrist downplays the severity of withdrawal symptoms and prefers to say it is my depression that is making me feel so bloody dreadful but I’m not sure about that.

Don’t let that discourage you though as I have stopped all my meds whereas you are just consolidating yours. Best of luck x

@Porchwouldbenice im interested in what they got you to do - did they do tapering where you have to start crushing the lowest available dose and drop it even further till you are on practically nothing? And you mix it in water and take it through a syringe? X

I did it against the advice of my psychiatrist so I just reduced the dose until I got down to cutting the smallest tablet I had in half. He wasn’t very helpful with tapering down further from that as he said it wasn’t a therapeutic dose so it wasn’t doing anything. So I stopped completely and I’ve felt really grim after that.

It sounds like your psychiatrist has given you some specific tapering advice though so why are you worried about following that?

@Porchwouldbenice im not worried as such because she specialises in deprescribing and so I think im going to be doing it in as trouble free a way as possible. It’s probably just because I didn’t actually recover completely from my depressive episode so I’m a bit like ‘what if the antidepressants actually have been working and I stop them’. Do you not feel, from experience, that it varies so much from person to person and psychiatric treatment is very much trial and error (or probably more accurately ‘hit and miss’)
if you don’t mind me asking, what made you come off your meds? And what’s your plans now? X