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Update, answers to questions, medication cocktail
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<blockquote data-quote="mindinggaps" data-source="post: 763964" data-attributes="member: 29823"><p>Dear [USER=18958]@Copabanana[/USER] - Today I had my regular psychiatry and medication appointment. Since we have been discussing medication management and compliance, in case it is of interest to you or others, I thought I would share a bit about this process.</p><p></p><p>My appointments take place every 1 to 6 months depending on circumstances and adjustments. My last appointment was 3 months ago and today we reviewed the outcomes of the latest changes and made some minor tweaks to the cocktail. The primary concern is typically Intermittent Explosive Disorder (IED) symptoms - we always begin by reviewing if there have been any breakthrough events of rage. Fortunately, I have been symptom free for some time now. Side effects are discussed and I have the opportunity to raise concerns here. After this, further probing questions are asked to evaluate the situation and I also have the ability to express any thoughts or concerns about behavior. </p><p></p><p>Lately our primary focus has been managing compliance. At this point it is well known that with appropriate medications, I am able to do well. However, we know that I have aburtly stopped medication with disasterous results - this is viewed as symptom and we work to have treatments which will prevent this from happening again. One thing the psychiatrist monitors is any urges to skip doses and what the underlying reasons are. For the most part there have not been significant issues here, although urges to skip medication or thoughts of enjoying symptoms have not been totally absent. After discussing options we decided to slightly increase the medications specifically targeting compliance and also to boost support for mood control. To accomodate for this without risk of side effects, we lowered some impulse control medication since it is clear this is well managed. The results is a slight increase to Abilify and Lamictal with a lowering of Vyvanse. We will follow-up in 1 month to observe for side effects or adverse events.</p><p></p><p>One issue which I am sure you can see is that success in this process does require input from the patient, trust between the physician and patient and also some self-awareness and desire to get better from the patient. With my input into the process, there are limitations to what can be achieved.</p></blockquote><p></p>
[QUOTE="mindinggaps, post: 763964, member: 29823"] Dear [USER=18958]@Copabanana[/USER] - Today I had my regular psychiatry and medication appointment. Since we have been discussing medication management and compliance, in case it is of interest to you or others, I thought I would share a bit about this process. My appointments take place every 1 to 6 months depending on circumstances and adjustments. My last appointment was 3 months ago and today we reviewed the outcomes of the latest changes and made some minor tweaks to the cocktail. The primary concern is typically Intermittent Explosive Disorder (IED) symptoms - we always begin by reviewing if there have been any breakthrough events of rage. Fortunately, I have been symptom free for some time now. Side effects are discussed and I have the opportunity to raise concerns here. After this, further probing questions are asked to evaluate the situation and I also have the ability to express any thoughts or concerns about behavior. Lately our primary focus has been managing compliance. At this point it is well known that with appropriate medications, I am able to do well. However, we know that I have aburtly stopped medication with disasterous results - this is viewed as symptom and we work to have treatments which will prevent this from happening again. One thing the psychiatrist monitors is any urges to skip doses and what the underlying reasons are. For the most part there have not been significant issues here, although urges to skip medication or thoughts of enjoying symptoms have not been totally absent. After discussing options we decided to slightly increase the medications specifically targeting compliance and also to boost support for mood control. To accomodate for this without risk of side effects, we lowered some impulse control medication since it is clear this is well managed. The results is a slight increase to Abilify and Lamictal with a lowering of Vyvanse. We will follow-up in 1 month to observe for side effects or adverse events. One issue which I am sure you can see is that success in this process does require input from the patient, trust between the physician and patient and also some self-awareness and desire to get better from the patient. With my input into the process, there are limitations to what can be achieved. [/QUOTE]
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