Interference From the College of Physicians & Surgeons

[honda]

I was taking Dexedrine for about a year, and never felt better. It really helped me a lot. Then out of the blue my doctor receives a letter from the College of Physicians & Surgeons stating that his prescribing practice falls out of the expected norms. The review was not about me the patient. It was about his prescribing. Why his prescribing of Dexedrine falls outside of the expected norms I have no idea. I have been properly diagnosed as having ADHD.

This is not the whole letter, but because of the above statements he immediately stopped prescribing Dexedrine.

Recently after many months I asked my doctor if I could go back on Dexedrine, and if he couldn’t do that could we try a different medication. His answer was no, because according to him I appeared to be more anxious than usual while I was on that medication. He also stated that I have a bad anxiety disorder, and the mix of a stimulant medication could cause serious anxiety complications. This is true I do have a bad anxiety disorder, but I certainly was not anxious when I was on Dexedrine. Actually I felt very much relaxed, alert, and at peace. I even asked my wife about it, and she agreed I was definitely not anxious. Wemen are really good at spotting mood changes, and if I was more anxious than usual she would have noticed.

As long as my doctor says that stimulant medication causes me to become anxious there is nothing I can do about it. It is his word against mine, and that gives him a good reason not to prescribe it. Also the College of Physicians and Surgeons has a big sway on how a doctor practices. It can stop them dead in their tracks.

What I would like to know is there anything I can effectively do about the situation I find myself in. Your suggestions and ideas would be much appreciated.

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[blackdog]

Hi @honda

I have never heard of such a thing. I honestly don’t know what to say about it. Very strange.

One thing I can say is that the fact that you felt calm when you were on the Dexedrine is pretty much definite proof you have ADHD. And, imho, you probably don’t have an anxiety disorder. But I’m not a doctor, so don’t quote me on that. It doesn’t add up though. A stimulant should not make you calmer if you have severe anxiety. I’m wondering of the anxiety is actually more a symptom of the ADHD rather than a separate disorder. (again, not a doctor, just speculating)

Maybe try asking your doctor to prescribe a non-stimulant medication? There are some that are used to treat ADHD. And if it’s not a stimulant, there shouldn’t be an issue. Other than that, all I can think is, find another doctor.

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[deebee]

Sorry, I responded to your “Request for Advice” post before reading this. Where are you located? I found the Ontario monitoring criteria, looking for myself on the Ministry of Health site.

You might have filled a prescription too soon, gotten a dose increase they don’t approve of etc. You might try asking for Vyvanse, because it is formulated to help forestall abuse. The amphetamine effect kicks in only after it is digested. Or atomoxetine, a non-stimulant. Or the antidepressant bupropion, which help many ADDers.

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[blackdog]

Ah ha! Thanks for bringing this thread up @deebee. I knew I’d seen something, somewhere… but that’s about all I ever know.

Okay, I think I do understand this now. The doctor probably went “off label”, prescribing more than the recommended maximum dose of Dex, or wrote the prescriptions too close together, or something. But I think he was overreacting when he refused to prescribe the Dex, or any other med. Unless this is not an isolated case and he has reason to be afraid of getting into trouble.

I just started on 10 mg of Dex, in addition to 80 mg of Vyvanse and 300 mg of Welbutrin. The pharmascist reacted predictably, giving me all kinds of unnecessary warnings and prattling on about how I am already taking “a very high dose of Vyvanse”. 🙄 But other than that, I have had no issues with getting my meds. So there is something fishy about this.

Vyvanse is schedule II and subject to all the same restrictions as the others, despite being theoretically abuse proof. In addition to that, the maximum dose was set ridiculously low by the FDA, so it might might not be helpfull to try switching to it in a case like this.

 

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[honda]

You are right there is something very fishy about my doctors behavior. He not only won’t prescribe Dexedrine or any other stimulant, but claims that it causes me to be anxious. And seeing that I have an anxiety disorder, it could cause serious complications. This is nonsense because first of all, if it made me anxious it would be out of my system within 6 hours. If I thought for a moment this medication was making me anxious I would stop it immediately. Why would I let myself suffer?
Secondly, all the while I was taking Dexedrine I never noticed an anxiety problem. Even my wife observed that I was more calm, and relaxed than usual. It made a big improvement in my life, and she told me so. So why is my doctor saying it causes me to be anxious? It doesn’t make sense. My guess he won’t prescribe is, because of the letter he got from the College of Physicians & Surgeons, and he is using the anxiety excuse as a false reason for not prescribing it to me. It is his word against my word. Who is going to believe me? He is the clear winner, and it seems that there is nothing I can do about it.

One other thing that I am confused about is why does the College of Physicians say that my doctors prescribing practice falls out of the expected norms? What does this actually mean?  The next time I see my doctor I will ask him.

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