Unhappy with how doc. has treated my anxiety

Hi Everyone,

I recently signed up to this forum, as I need some info. on xanax prescriptions. For just under 3 years, I have been taking, on average, a .5 mg xanax tablet each night to help with insomnia. On my prescription it said

"14 x Xanax tab. 0.5mg. Take one every 8 hours or as required. Repeat by 2"

My interpretation of the above was that it was to supply me with 6 week's supply of Xanax (ie 42 .5mg tablets), thus I phoned my doc's office every 6 weeks to ask for a repeat prescription which I obtained without any hassle. However, last month the doc realised that I was taking more xanax than I should have been (after I asked for a repeat prescription after just two weeks since the previous one) and he asked me to come into his office. Prior to this, it was at least one year since my last visit as I just needed to phone his secretary and then collect a prescription. However, when I came to his office, he ordered me to come off it as he did not realise that I had been using it on an ongoing basis for a couple of years. He said that the prescription above should have been for 3 months. However, this was not clear to me as prior to this, I had no problem obtaining a new repeat prescription every 6 weeks.

I told him about my confusion re the above prescription and asked why it was not brought to my attention earlier that I was taking too much. My doctor did not answer the question but told me that it was crucial to come off it, as xanax is not meant for long-term use, and should not be used as an ongoing sleeping aid. Initially, he prescribed xanax for panick attacks but because he did not monitor my use of the drug, he did not realise that I was using it as a sleeping aid.

For the past 2 weeks, I've pretty much stopped using it and have been suffering from sleepless nights. I feel annoyed with my doctor because he should have asked me to call into his office sooner, rather than just issuing prescriptions every 6 weeks without giving clear directions on how to use it, and without properly monitoring my progress.

When I expressed my frustration with my doc., he didn't really pay attention.

Any advice on how I should pursue this matter would be much appreciated. Over the years, in general, my doctor has been a good practitioner, however, this episode has annoyed me somewhat. Should I contact the medical council or is there any point?

Thanks in advance.

[68suezq]

i would make an apointment with a differnt doctor.just in case you have worse problems.some one needs to be monitering you sue

[greenlydia]

Welcome to the forum!

I'm a little confused because you first say the Xanax was perscribed for insomnia
but later you say it was initially perscribed for panic attacks.
So which was it..........because I need that answer to make sense of your perscription, which in either case, doesn't make sense at all. (To me)

If he wrote it for help with insomnia, it should have read something like this:

".5mg X30 to be taken at h.s." (h.s. meaning "hours of sleep" or more simply...... BEDTIME)

If this was written for insomnia, why would he tell you to take it every 8 hours? I would have questioned him about THAT as soon as I saw it. ("Repeat by 2" obviously means how many times the script could be refilled, but it's written differently up here)

I am having difficulty trying to figure out YOUR interpretation of this script. How did you come up with the #42? I freely admit I'm a moron when it comes to math, but no matter how I crunch the numbers, I can't come up with 42. What am I missing? Virtually ALL Schedule IV meds are only scripted for 30 pills with limited refills. But if you were taking this every night and only needed a refill every 6 weeks, then you were, obviously, getting 42 tablets.

You then write that last month.....................

"the doc realised that I was taking more xanax than I should have been............."
and once again I find myself confused by this. If you were receiving 42 tablets of .5mg Xanax which he had written you for insomnia, then that would indeed work out to exactly one tablet per night for 6 weeks.

If he had meant for you to take this for panic, then taking .5mg q8h (every 8 hours)  as was written in the perscription, would require 45 tablets for a one month supply. 42 tablets would leave you short.........

But you also wrote:

"(after I asked for a repeat prescription after just two weeks since the previous one)"
HUH? Why were you asking for a refill just two weeks later?

So, he called you into his office and told you that you had to quit the Xanax because it was not meant for long-term use, and should not be used as an ongoing sleeping aid. Initially, he prescribed xanax for panic attacks but "because he did not monitor my use of the drug, he did not realise that I was using it as a sleeping aid."

Which brings me back to the chicken or the egg question. When you first went to this doctor, what did you tell him your problem was? Panic attacks or insomnia? You're saying that because he did not monitor you, he didn't know you were using it as a sleep aid. If he perscribed it to you for panic attacks and you changed your own DX to insomnia, did YOU let HIM know?
I'm not usually a big defender of doctors, but when placed on any medication, one really should be a bit pro-active keeping in touch with the doctor. Three YEARS is a pretty longish time to take something without checking back with your doctor. I think there may have been some miscommunication at work here.

Well, either way, he is absolutely correct in telling you that you need to come off this medication. I will hope that he devised a slow taper program for you. One should not just cold turkey Xanax, but it sounds like that's what you've more or less done. I am really quite amazed that some sleepless nights are the only w/d symptoms you are ecperiencing. Consider yourself very lucky.

You could, no doubt, file a complaint against your doctor. Because this involves a Schedule IV medication some action may be taken. If you hope to get any satisfaction by filing a complaint that states "my doctor didn't give a rats rear about me," save your ink.
You could call the State Medical Board and ask about porcedures. If you believe this doctor was truly negligent, then you have every right to file a complaint. Will it do any good? That I can't tell you. But I can tell you it's a very large "good ole boys" club.

For your sake, I hope someone else takes a crack at your post. I fear my confusion about certain things may have skewed my answer.
I do wish you luck, however you decide to handle this.
Peace
Greenlydia




    

[gumbygumby]

Mental doctors dont care about thier patients. To almost all of them(100% of government docs) we are less than human. They wont trust us more than a zookeeper trusts animals`.

I need psychiatric help desperately, but have only been able to have one appointment so far. The dr didnt even look me in the eye. He ended up giving me a prescription for a depression medication. Depression medication for my severe anxiety and to top it off, he gave me a medication extremely dangerous for people with diabetes, like me. Two months before they would give me another appointment so i get to be unmedicated for a long time`before i go to another severely disappointing appointment.

The most sad part is that i know, unless a full on government destroying revolution occurs in my lifetime, I am going to die knowing everything i know is doomed. Unfortunately, as revolutionaries now belong to psychiatrists and prisons, it's going to be a long time.

In a world that isn't complete garbage, he would be held responsible for his actions, but psychiatrists are held responsible for thier actions for so rarely that they seem mentally incapable of feeling wrong. They can get away with even more torture if the patient is a child. God bless america?

[gumbygumby]

I cant afford a private anything.


As for your other stuff you wrote to me....what?

But seriously, either i need to look into this heath care bill some more, or you're a republican.  

Honestly, I dont believe at all that the soulless drones on fox can get anything right other than manipulating people like you.

A revolution WILL happen, we just probably wont be around to enjoy it.

[PeterBrown]

Thanks for the replies everyone!

Greenlydia, you are right to be confused. The xanax was initially prescribed for panic attacks. However, I subsequently started to use it for insomnia. During my few appointments with my doctor during the 3 year period, I did mention that I used xanax when I had difficulty falling asleep. On one occasion, I also mentioned that the xanax was not particularly effective in preventing me from having panic attacks and asked for beta blockers which he prescribed. I found that the beta blockers were A LOT more effective in stopping the physical symptoms of the panic attacks. Consequently, for 2.5 years, I've been given repeat prescriptions for Xanax and Beta blockers.

42  Xanax tablets is the correct number. On each prescription, he prescribed 14 x .5mg tablet. When you multiply 14 by the two repeats, you get 42. However, for the beta blocker section, it said 90 tablets, and "take 1 daily as required." Perhaps, I should have noticed the discrepancy(between the prescriptions for both drugs) here and realised that the prescription was for 3 months, and not 6 months. However, as I do not come from a medical background, this did not occur to me.

I asked for another repeat prescription just two weeks after receiving the previous one as I was going travelling. It was on this occasion that my doctor saw a red flag as I'm sure he went back over his records and saw that I was getting a new repeat prescription every 6 weeks, and not every 3 months which is what he intended. However, he only mentioned this to me for the first time after properly looking at my dosage and usage of the drug.

You are totally correct when you say that there was mis-communication, however, isn't it the doc's responsibility to ensure that he is prescribing the correct amount of Xanax, and to also continue to monitor how the patient is responding to the medication? If I hadn't asked for the repeat prescription after just 2 weeks, I'm sure that I would still have no problem getting a new repeat prescription every 6 weeks without having to go for a consultation every few months.

Ryan, your analogy is completely correct - my doctor intended 14 tablets to last for 1 month. However, how on earth was I to know this when it did not mention anything about 1 month on the xanax section of the prescription?  Also, "take every 8 hours as required" is also not clear. To me, this implied that if I really needed to, I could take one every 8 hours each day and if I needed to, I could ask for an increased dosage. However, for me, 1 tablet/day was sufficient ie 42 tablets/6 weeks.

On the last prescription, the doctor removed the two repeats and just gave me a prescription for 14 tablets and, this time, he clearly wrote "TAKE AS DIRECTED." I just wish that his instructions had been so clear from the outset!

I do indeed feel like raising some hell but part of me is asking will it really achieve anything at all?

Thanks again for any advice.

[PeterBrown]

Hi, I just noticed a significant mistake in the second paragraph, it should say 6 WEEKS and NOT 6 months!!

[greenlydia]

Rather than trying to "brain battle" my way through this again, I'm just going to assume that since you've seen your doctor about this "misunderstanding," then you are now on the correct dosage for the correct condition and that both you and your doctor are on the same page.
I would hope that while speaking with the doctor, you expressed, openly, your feelings of his lackadaisical approach to patient follow-ups.
How'd that work out for you?
I stated in my last post that I'm not normally much for defending doctors, but when you wrote above that:
"On the last prescription, the doctor removed the two repeats and just gave me a prescription for 14 tablets and, this time, he clearly wrote "TAKE AS DIRECTED." I just wish that his instructions had been so clear from the outset!"
While I agree wholeheartedly that the original perscription was rather cryptic, if you had questions about how you were meant to take this medication, it was YOUR job to contact the doctor for clarification. If you had done that, three years of misunderstanding would have been cleared up immediately.
And while I can totally understand and sympathize with your anger that this doctor did not follow up with you, you must realize that most doctors have a patient load that that is staggering and for him to follow up with each patient would find him working 24/7. I don't offer that as an excuse. Just a fact. The good old days of the family doctor calling you up and checking to see how you're doing went out when "Leave It To Beaver" went off the air a long time ago. What we, as patients, in this new age need to accept is that we are no longer merely the patient, but part of the team. And yes, it would have been nice for them to advise us of our new positions, and the rules that went along with it, but again, like the old "Ma Bell" monopoly of the phone symstem use to say "We don't care. We don't HAVE to!" I fear doctors feel pretty much the same way. It has become a "treat 'em and street 'em" society. So, unfortunately, it has fallen to us to do the follow up work.
A recent example of this happened to me. I was having some severe sinus issues which two doctors could not fix, so I was sent to a specialist. He sent me for an MRI. I was told nothing at his office about how long it would take to get the results, I wasn't told to call back in a week, I wasn't told that they would call me with the results. I was told nothing. But, like you, I just assumed (a big mistake) that since this guy was some big wig specialist, surely HE, or at least one of his minions, would call me  with the results.Three weeks later when I had heard nothing, I called and demanded to know my results. They had no doubt I was angry. Two DAYS later I received a letter telling me that the results were negative. That was all it said. One sentence.  Naturally I was relieved to  know that nothing was wrong, but I still had many questions I would have liked to ask the doctor. When I called his office and requested to speak with the great man, or even his PA, I was informed that I was welcome to make an appointment to discuss my results. Excuse me! I had to pay for ANOTHER office call to get my freaking questions answered! And the first opening he had was 5 weeks down the road.
While I realize these two cases are quite different..........it does go to show that "follow up" is obviously a thing of the past.      
I'm quite sure that if your request for a refill had not "red flagged" you, you're correct in thinking that your scripts would probably keep getting refilled every six weeks.
Miscommunication? Lousy doctoring? Negligence? A medical system that no longer works? Take your pick and pick your fight.
As you have been advised, I also would "raise some hell." I just wouldn't expect too much to come of it. On the other hand, if we all just keep our mouths shut, nothing will EVER change, so the ball IS in your court.
I wish you the best.
Peace
Greenlydia
    

[PeterBrown]

The prescriptions weren't faxed. I collected a hard copy from my doctor's reception every 6 weeks which was always signed by my doctor.

On the latest prescription, my doctor gave me 14 xanax and it states "TAKE AS DIRECTED." However, he did not provide any details on gradually decreasing my dosage as part of a discontinuation programme. He did say to come back, if I had any issues, but that was it. He also made it clear that he wants me to come off it completely.

[greenlydia]

Well, I can happily report that my confusion is down but my curiosity is up. When he gave you your most recent prescription for the 14 Xanax and it stated "TAKE AS DIRECTED," how have you been directed to take it?

Since he wants you off it, he should advise you to make an appointment to discuss a taper schedule with you. There is no "one size fits all" taper.

He also told you to come back if you had any issues.
I'm sure it must be me, but I find your doctor even more confusing than his script writing technique.
Did he tell you that he was not going to refill your script anymore? If so, then you better get with him ASAP and figure out a taper schedule.
It sounds to me like you still aren't both on the same page and if it was me, I would make an appointment to discuss this. I'd hate to see him just cut you off and expect you to cold turkey from Xanax. Dangerous and cruel practice if that's his plan.

[PeterBrown]

Hi Greenlydia,

He didn't give me clear directions at all on discontinuing it. He never warned me to gradually decrease my dosage. When I was leaving, I said that I'd come back in 3 months and he added to come back sooner if I had any issues.

Luckily the only side effect which I got from going cold turkey is difficulty sleeping.

I don't think that I'm going to pursue the matter with the medical council because ultimately, I can't see the case going anywhere.

With the 14 tablets that I have left, I'm going to keep them for a rainy day (e.g. if I have an important event in work the next day and need a good night's sleep)

Thanks for all the advice!