Discussion: patient specific vs. Dx catigorization treatment

Opinion:  Lack of quantitative diagnostic studies makes diagnosis of mood disorders subjective.  Disagnosis is based upon tow elements with many variables, also mood disorder symptomatology is similar.   The fact is diagnostics are qualitative in nature and many variables affect the MD's diagnosis.  Science has not discovered how the brain actually assimilates information from sensory input to processing the information that determines behavior.

Tretment was sumptomatic until six months post partum.  6 months of consultyations and dignostic studies negaive and mental health referral made and 10 years of treament so far.  Mainly stable untill abuse became unmannageable.  Emotional shut down 1/07, and been disabled since.  At that time meds, Prozac 60, Welbutrin 300, Trazadone 50-200, 8 mg xanax on average daily, over 10 years this became a maintenance dose.  Meds not abused substances.  aciphex prn, Topomax (topamax) for migraines.  I started tx, underwent intensive dual dx outpt tx, med changes, 4in 2 years, current, prozac 40, cllonapin 1 mg/day ativan for breakthrough anxiety (affected by gastric bypass), amictal 200 mg/d. Aciphex prn.  Psycho therapy has droken delusions of perfect life remembering childhood and currenly remembering recurrent brutal rape with flash backs.

I think I my primary diagnosis is PTSD, with manifestations of the other dx.  Amphetamines are used to treat PTSD rarely.  I have used amphetamines did not manifest addition behavior and my stability and productivity increased.  Becasue they are illegal I only use them when I am having an exacerbation and the meds aren't working yet.  I think a trial of medical amphetamines should be explored but amnost no MD will do this.  My tx would be better becasue I could be honest with them.  How do I approach or find a competent psychiatris that will work with me?

[Roger Gould, M.D.]

The best way to find a highly qualified psychiatrist is to call your local medical school, department of psychiatry, and ask for a referral.