Problems in getting medication

[MarcoM]

Hi,

I have just joined the forum.

I sought help from my GP regarding anxiety. I asked him if I could get a prescription for citalopram but he refused. He suggested CBT.
I have not got anything against CBT but my wish was to complement the therapy with some medication. I tried CBT briefly in 2007 and it did not work on its own.

In 2001 I was depressed and I was prescribed citalopram for six months and it worked. As a matter of fact I was able to complete an MSc degree that year. Had I not been prescribed the medication I would have not manage to finish my course.
I told my GP that in 2001 Citalopram helped me but he was dismissive of it. He did not even bother to check my medical history to validate my claim.

I would like to try CBT again but I do feel I need some help now. I feel really bad, exhausted all the time, worrying about everything, I have broken down and cried a few times in the past week or so.
Doing CBT on its own will not work. I do want it to work but I am convinced that on its own it will not.

I would not mind seeing a private GP if necessary but from what I have seen online they all seem to want to tie patients in to monthly fees.

Does anyone have experience of getting a prescription via private GP?

Thanks

[debs71]

Hi MarcoM,

My strong advice would be to change your GP if you possibly can, as they sound like an idiot.

A good GP should consider both what they think is a good treatment plan - and for the vast majority of decent GP's that should be both medicinal and therapeutic care to complement - and what you feel and need.

I find it amazing that you have been offered no medication. It is usually the case (and again UNFORTUNATELY) that GP's bung medication at you, and do not mention therapy, but it appears to be the other way around in your case, but that too in my opinion is not good care, as therapy is useless if when it is done, you are back at square one again without the safety net and support of good medication to address things.

I hate to say it, but I am cynical when it comes to health services, and wondering whether your GP is on a money saving mission by not prescribing meds first. Why else, unless he does not advocate meds, but then if that is the case, he shouldn't be a health professional in the community and bringing his own philosophy into the mix!

I guess there are two options. The first is to see your doctor again and strongly express how you feel, in no uncertain terms, and the CBT alone is not acceptable for you. The second is to try if you can to find another doctor, who will be receptive to what YOU feel and want, and not just what THEY want.

I promise they are out there!

I do wish you luck and best wishes.:hugs:

[Lisa.w1979]

Hi Marco.

Firstly :welcome: to nmp

My GP took 18 months of me begging for help to give me meds. We tried fluoxetine, which id had at the end of 2011 for depression and got on well with. This time it was a different kettle of fish. I had so many side effects that i had to stop after 10 days.

[aprilmoon]

Hi Marco.
I'm new too. Sorry to hear you're having to deal with this while you're not feeling so good.I would definitely try another doctor.One that you feel you can work with to get you well.You shouldn't have to go private to get what you need,there are good ones out there.Keep trying.good luck.

[xrachykinsx]

Agree with all the other posts. A GP should definitely not refuse to treat you for anxiety. I'm actually suprised they haven't given you medication before CBT. The doctors in my area would rather throw pills at you and send you on your way! lol I agree medication and CBT is a good treatment plan...it allows you to understand your anxiety and cope whilst you have a slight safety net to stop you going under xx

[teej]

There's a doctor at our surgery like that - I can kind of see where they're coming from. The first line treatment is SSRIs and for some people they're an absolute b**ch to get onto - often making you feel worse with the side effects so if someone has never been on the meds before maybe CBT *might* be a better option.

Another doctor at our surgery is very pro-citalopram and won't prescribe benzos in any shape or form for anxiety.

The other two doctors will happily give out sertraline and benzos.

So depends on the doc. I deliberately see the pro-sertraline, pro-benzo doctors now. Just gives you more options.

[Rennie1989]

I suggest seeing a different GP at the surgery. Some GPs are really adverse to prescribing antidepressants, some dish they out like sweets whilst the few prescribe them properly. NICE states that medication AND therapy work hand-in-hand very well and you can print this off and show it to your GP. I've tried having a look but can't find it but I will keep looking and when I do find it I'll post it here or PM it.

[MyNameIsTerry]

My GP has never followed NHS guidelines. Initially it was just anti depressants and check ups. Upon my later relapse it was medication with a referral for CBT.

I don't think GP's either understand or agree with the guidelines because their methods are so varied.

Medication is described as coming after such as self help therapy, awareness courses, etc. Many areas don't even have these options because of funding and the ones in my city are charities receiving NHS funding.

Could you see another doctor or be more assertive with the current one?

[MarcoM]

Hi,

Just an update.

I saw another gp in the same practice and I was given Citalopram.
I feel better even if a bit tired at times.

Now I would like to get onto the subject of therapy.
I was offered to see a counsellor who "does cbt" in the practice.
I am aware that there are proper CBT qualifications that can be obtained by practitioners and the ones used in the gp surgery are not qualified with the relevant association.

Of course with the NHS it would be free for me to attend sessions however I want to make this work this time. I saw a counsellor in 2006 at another surgery for cbt and that did not help. Not much was explained to me about my thought process but all that was done was to list the thoughts I had and think of the positive. The number of sessions offered was six.

I am prepared to go private if this means that I can get a better level of CBT training. Do you guys think this (going private) ould be better?

Thanks

[MyNameIsTerry]

Hi Marco,

How did you determine whether they are properly qualified? I ask because I know there are various membership bodies and more than one of them are highly respected.

For instance, the BACP is often seen as the place to go, but the NHS often quote BABCP on their websites, so it can be confusing.

There is a Bill of Parliament currently going through to regulate all of this. Regulation of the industry is not going to any of these other membership associations, it's going to be centralised with other medical professions such as paramedics. This is very confusing because some of the other associations are very closely linked with the NHS and don't show any sign of going anywhere.

If you can get it free, do it. You could always try them and ditch them in favour of private anyway. Before going to this referral though, suggest thinking about whether they are registered to a questionable body, no body or a highly respected one first.