new doctor taking me off my medicatio ..help

[gregcool]

hi guys.so iv been in my new flat for nearly three weeks now and have changed my doctors to my new area.as soon as he saw what meds i was on he made a coment on how excpenceve that my trazadone costs each month and said it was a very high dose..so i agread to cut down from 200mg per nigh to 150mg....this allways helped me to sleep and didnt realyhelp with my depression.but since cutting down over a week ago i am starting to wake early in the morning and through the day and night my anxiety is creeping up.not sure if its the change in meds or just the fact im now living on my own and just feel bored...any advice

[SarahH]

Sorry to hear that Greg. Sounds like another case of different NHS trusts having different budgets again!!!! It could be withdrawal symptoms from the Traz making you more anxious. You could just ride it out for a week or so and if it does not get better go back to your GP and ask to go back up. As far as I aware its not the "dose" that costs more but the number of meds you get prescribed.

Sarah

[MrAndy]

Hi Greg hope the flats going ok
It will take a while for you to settle on then new dose,I would guess at least three weeks
Why's the doctor concerned about cost,if it helps you need it no matter what

[gregcool]

Hi guys.andy flst going ok thanks mate.getting there bit lonely tho..i dont think the trazadone was helping much in the first place but i supose iv just got use to being on it now,i dont think now while im at home all day and bored and lonely that its the right time for me to come down and off any meds,i need to be working so im busy all day and dont think about things,he is my new doctor and just said to me that im on a high dose and then worked out how much it costs each month and said to bring me down in my meds,im going to continue to tske my regular dose and tell him im not ready yet and want to wait till im working

[Magic]

Hi Greg,
My husband had something like this happen to him. The cost.

He went to another GP in the same practice and was prescribed what he needed.

My sister had the same trouble with tubes of arthritis cream .Won't prescribe it.
She has to buy her own.

Do you get out much Greg? fresh air if possible will help you sleep better.
I know lots who cannot leave their house, so it is difficult for them.xx

[MrAndy]

Glad you've settled in ok and stick to your guns regarding the meds
Take care mate

[MyNameIsTerry]

Hi Greg,
My husband had something like this happen to him. The cost.

He went to another GP in the same practice and was prescribed what he needed.

My sister had the same trouble with tubes of arthritis cream .Won't prescribe it.
She has to buy her own.

Do you get out much Greg? fresh air if possible will help you sleep better.
I know lots who cannot leave their house, so it is difficult for them.xx

My mum had the same Magic. She has a lot of trouble with her skin, something which only came along after being 'guinea-pigged' on various blood pressure treatments, and they will only give her one bottle of the cream she needs so she has to buy a second one herself.

---------- Post added at 04:01 ---------- Previous post was at 03:55 ----------


he is my new doctor and just said to me that im on a high dose and then worked out how much it costs each month and said to bring me down in my meds,

Sounds like he would have been better becoming an accountant Greg because as a GP his first action should have been to determine whether you need or not before. His actions seem purely financial, not considering the needs of the patient at all, and if it weren't for the level of negative publicity it would cause them, I'm sure GP's like this would turn people away due to cost.

---------- Post added at 04:29 ---------- Previous post was at 04:01 ----------

Something I find interesting here is the cost.

If you look at this cost analysis per tablet by North Essex, Mid Essex, North East Essex and West Essex PCT's, Trazodone is cheaper than many mainstream SSRI/SNRI's:

https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=11&cad=rja&uact=8&ved=0CCAQFjAAOAo&url=http%3A%2F%2Fwww.midessexccg.nhs.uk%2Fabout-us%2Fccg-board-meetings%2Fboard-papers%2Fdoc_download%2F167-depression-medicines-guidance&ei=_n9lVMb9MtOvafiMgZAB&usg=AFQjCNGOuZYySoUEyxbd0mm0HFg4jcCw6Q&sig2=s6URYmKyXe3-9repZTBohw

If you compare the price per tablet at the same PCT's in the previous review period it shows that the 100mg was actually more expensive:

http://www.westessexccg.nhs.uk/Downloads/Your%20NHS/Medicines%20optimisation/Prescribing%20guidance/Guidance%20for%20use%20of%20medicines%20for%20depr ession.pdf

So, the cost was going down. The 150mg dose in the later review is a typo as it shows as 15mg but with a higher cost than 100mg and its in the same place as the previous review, so they missed off the zero. Common SSRI's such as Citalopram show as increasing.

Now take a look at this one from Sussex Trust:

http://www.sussexpartnership.nhs.uk/component/jdownloads/finish/2029/2668?Itemid=0

Look at the low cost of Trazodone compared to Duloxetine. At the £0.99 shown in the above 2 reviews from the Essex trusts it works out the same as for Sussex at £27.72. I'm on Duloxetine, have been for about 3 years and my GP has never raised an issue with cost, he recommended going on it instead of Citalopram. I haven't even seen him in over 15 months (lost faith as unwilling to refer to any further therapy) so cost isn't an issue for his practice partners.

Even looking at other common SSRI's in the Sussex Trust document, we are only talking about a couple of pounds a month so its hardly significant...oh, and the prescription cost is more!

All I can see if that the oral solution is very expensive but the tablet versions are cost effective.

The rather amusing thing about your GP's change is that it shows as the same cost to supply 2 100mgs (£0.11 x 2) and 1 150mg (£0.22) so unless he plans on dropping you further, he has saved himself nothing by doing this based on the first period shown by the Essex trusts. The later period is 2 100mgs (£0.06 x 2) and 1 150mg (£0.12)

So, unless you are using the oral solution, I can't see this GP is doing his sums right. I also can't see why he trying to save a matter of pennies.

---------- Post added at 04:47 ---------- Previous post was at 04:29 ----------

If anyone would like to have a read of the GMC's view on things like this and why a GP, or any doctor registered with them, is personally accountable to them despite the relationship with trusts & the NHS, you can find a summary here:

http://www.patient.co.uk/doctor/Ideals-and-the-Hippocratic-Oath.htm

Sarah - I can see a few in that list that are getting breached on these threads where GP's are saying its all about cost or 'bluffing' about maximum dosages such as one on pregabalin recently. I think GP's think they are entitled to mislead because patients are not aware of the duties of their doctors.

[gregcool]

Guys thanks for the info,,thanks terry,,hes looking at the costs for sure,im going to stick to my guns and tell him im just not ready yet to reduce my meds,although i would love to come off them and try something eles to see if anything eles works,im all decorated in my flat now and spent three weeks solid doing it,but think i need to start getting out a bit now that its all finished..feels like a anti climax now its all done and i have nothing left to do when i get up in the morning,just sitting around watching tv day and night with no company,if the weather is dry ill have to start walking into town and have a coffie.just to break up my day and get some fresh air,,,cant stand the lonelyness

[MrAndy]

Walking will do you good Greg ,any wellness clubs or sometimes local churches put on day clubs you can attend ?

[chickpea]

Getting out and going for a coffee sounds like a good idea - go to the same place and you'll soon start to recognise the "regulars" and the staff and strike up conversation.
There is nothing worse for anxiety and depression than being alone with nothing to do - I've been at a loose end at home this week and my mood has plummeted and my anxiety has rocketed. Even picking up the kids from school has helped - a quick chat with the other mums, a bit of fresh air and change of scenery, it all helps.
I don't know whether this is something you'd even consider, but maybe a cat or a dog for company would help?
I have both, and chickens and just taking care of them means I'm not always lost in my own thoughts. A dog is a great excise for getting out every day, and you get to meet other dog walkers. I know you've said you're missing family in your life, and of course a dog wouldn't replace that but the unconditional love they give is amazing therapy.

[MyNameIsTerry]

Walking will do you good Greg ,any wellness clubs or sometimes local churches put on day clubs you can attend ?

Churches often put on coffee mornings as well that are pretty cheap. I lady who attended the anxiety walk-ins I went to used these as she was very isolated in the daytimes and she said they helped her break the day up until her husband came home from work. She had always worked before and like a lot of us, we end up with far too much time on our hands when we are not working making us worse.

[gregcool]

Thanks guys for your imput.ill have to venture out and see whats avalable im my local area,,got to find something to do with my days,i took a walk into town today which was nice to get out of my flat,just to break things up,

[SarahH]

Greg, just a thought but are you well enough to join a club? I sing in a community choir and go to Ceroc dancing once a week. (not as naff as it sounds)Both you can go to on your own and people are very friendly. It gets me out of the house and makes me talk to other people.

Sarah