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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Maxime on October 4, 2005, at 11:28:58
Hi,
I was wondering why meds are so difficult to obtain in the UK. I know it's hard to get an MAOI prescribe and benzos are out. Is there any literature/research that has come out of the UK that we should know about. I wonder how the British Journal of Psychiatry compares the American Journal of Psychiatry. I think a trip to the library is in order.
Maxime
Posted by denise1966 on October 4, 2005, at 13:01:45
In reply to Do the British know something we don't?, posted by Maxime on October 4, 2005, at 11:28:58
Hi Maxime,
I'm from the UK, It took me about 4 psychiatrists before I managed to find one to prescribe an MAOI. The problem is you can't find out what they will and won't prescribe until you've been for a consultation and then you have to go through the usual list of questions and everything before you even get to ask them.
I've always thought there should be a site where people can go and give their reviews of psychiatrists, like they do with plastic surgeons.
I've never managed to find a psychiatrist here to prescribe a benzo so I've never taken one but I must say they will prescribe Zyprexa quite happily and 10mg of Zyprexa always really helps me when I'm on the verge of throwing in the towel.
All the best....Denise
Posted by ed_uk on October 4, 2005, at 13:27:32
In reply to Do the British know something we don't?, posted by Maxime on October 4, 2005, at 11:28:58
>Do the British know something we don't?
No....... but the British are skeptical - of most things. It's a different culture.
Ed xx
Posted by xbunny on October 4, 2005, at 15:16:58
In reply to Do the British know something we don't?, posted by Maxime on October 4, 2005, at 11:28:58
> I was wondering why meds are so difficult to obtain in the UK. I know it's hard to get an MAOI prescribe and benzos are out.
Im in the UK and I have never had any problem getting prescribed a benzo from my GP nor from the psychiatrist.
Buns
Posted by ed_uk on October 4, 2005, at 15:26:04
In reply to Re: Do the British know something we don't?, posted by xbunny on October 4, 2005, at 15:16:58
Gosh Buns, you have an unusual GP! My GP wouldn't prescribe a benzo if I held a gun to his head. All my previous GPs have been the same.
~ed
Posted by Maxime on October 4, 2005, at 15:49:36
In reply to Re: Do the British know something we don't? » xbunny, posted by ed_uk on October 4, 2005, at 15:26:04
> Gosh Buns, you have an unusual GP! My GP wouldn't prescribe a benzo if I held a gun to his head. All my previous GPs have been the same.
>
> ~edYes, I distinctly remember reading an article saying that there was a crackdown on benzo in the UK and it was in the newspaper so it must have been big news. I think your experience is more the norm Ed.
xoxo
Maxie
Posted by Meri-Tuuli on October 4, 2005, at 16:09:08
In reply to Re: Do the British know something we don't? » ed_uk, posted by Maxime on October 4, 2005, at 15:49:36
I have a slight feeling that as usual we (the British) are very behind on current thinking etc although we don't realise that we are.
And I agree with Ed - the British are very skepical too.
I also wonder how having a state healthcare system factors into it -- I mean, aren't drug companies pushing docs in the US to prescribe more than is needed?? That sort of thing anyway.
I'm hating the UK system at the moment. My docs are clueless!!! (see my previous post regarding wellbutrin) Although they are only GPs so maybe its abit different from seeing a pdoc.
Posted by med_empowered on October 4, 2005, at 17:45:15
In reply to Re: Do the British know something we don't?, posted by Meri-Tuuli on October 4, 2005, at 16:09:08
well...speaking as a US citizen who has experienced the joys (lol) of being waaaay overmedicated in the name of "treatment" I gotta say...sometimes I think US docs could use a little healthy skepticism. Every new drug that comes out is somehow automatically better than the "old, dirty" drugs, and there's always this sense that one needs to "cover all the bases," etc. etc. The benzo situation in the US is kind of complicated...you have docs who RX them a good bit, docs who RX them but under-prescribe, so there's really no point in RXing them in the first place, and then you have docs (especially GPs) who freak out when you say the word "xanax." Sooo...I don't know what to say about that situation; I think it really depends on the doc, your condition, your age, and where you live. When docs RX benzos here (in my experience) they tend to be kind of bad about tapers...its like they'll RX something for a year, 2 years, 3 years, and then **BAM!!**--they decide its time for you to be benzo-free, and a quickie taper is done...it seems like a lot of shrinks have power issues, I think.
Posted by tecknohed on October 4, 2005, at 19:25:47
In reply to Re: Do the British know something we don't?, posted by med_empowered on October 4, 2005, at 17:45:15
I've had lots of trouble getting what I need from UK docs. Try mentioning Parnate to a UK pdoc and then wait to be laughed at!
It seems especially hard for Social Phobics who have limited choice already. Yet for some reason Seroxat or Moclobemide are 'highly' recommended for it. Uh, why?
I was very lucky to get on an MAOI but it was no UK doc who put me on it. This pdoc was from Australia doing a study on Social Anxiety here. Very good Doctor, admitted Nardil was "Gold Standard". I'll be forever gratefull. In case anyone out there's interested:
http://www.psychiatry.uwa.edu.au/people/staff.cfm/STID/158
Best things about Britain? Devon/Cornwall and the weather (LOL) - but certainly not the health system.
Posted by jclint on October 4, 2005, at 20:01:37
In reply to Re: Do the British know something we don't?, posted by tecknohed on October 4, 2005, at 19:25:47
Some seem to be okay. I've found a fairly open minded private one, and although benzos & stims are off limits, there isn't much else that is.
She's into antipsychotics and polypharmacy. I'm just about to start low dose amisulpride... looking forward to it, fingers crossed.
Posted by Phillipa on October 4, 2005, at 21:02:45
In reply to Re: Do the British know something we don't?, posted by jclint on October 4, 2005, at 20:01:37
Same thing is happening in the US. The docs are all becoming benzophobic. They would rather rx an antipsychotic and an SSRI. Fondly, Phillipa
Posted by tizza on October 5, 2005, at 0:59:45
In reply to Re: Do the British know something we don't?, posted by Phillipa on October 4, 2005, at 21:02:45
I'm in Australia and I think that we get the best of both worlds. Not too much is over prescribed or under prescribed but it has started getting pretty hard to get benzo's off a GP but a pdoc will give you almost anything, within limits of course. But anti psych's and ssri rx's are being prescribed at amazing rates. With my personal experience it has been easier to get off benzo's compared to bloody SSRI's. It will probably take them years to discover that they have fried our brains. I'm coming off effexor xr at the moment and I'm tapering it very slowly and things are going well but once I'm off them, and I have tried loads of them, I'm never going to touch them ever again. I'll just demand benzo's because they alone seem to work much better for me. Reguards Paul. P.S. I think the British realise the addiction of benzo's, the aussies of both benzo's and SSRI's and the U.S. FDA, just likes playing monkies with us, remiss of their actions. Sorry I hope I didn't offend anyone I'm just a little testy today and needed to vent.
Posted by xbunny on October 5, 2005, at 5:35:01
In reply to Re: Do the British know something we don't? » xbunny, posted by ed_uk on October 4, 2005, at 15:26:04
> Gosh Buns, you have an unusual GP! My GP wouldn't prescribe a benzo if I held a gun to his head. All my previous GPs have been the same.
My dad who sees a different GP has no problem getting prescribed benzo sleeping tablets on a regular basis either. I would say that whenever I have asked the GP for a benzo I have stressed it was for very short term anxiety management only, maybe this is a factor. Coversely he always prescribes me far more than I need anyways, ie I ask for 4 tablets he gives me 28, I guess he thinks it will last me!
Buns
Posted by ed_uk on October 5, 2005, at 13:51:35
In reply to Re: Do the British know something we don't?, posted by med_empowered on October 4, 2005, at 17:45:15
Hiya Med!
>Every new drug that comes out is somehow automatically better than the "old, dirty" drugs.......
That doesn't really happen in the UK as much. Cymbalta isn't popular here.
Kind regards
~ed
Posted by ed_uk on October 5, 2005, at 13:55:36
In reply to Re: Do the British know something we don't?, posted by xbunny on October 5, 2005, at 5:35:01
Hi Buns,
Diazepam, nitrazepam and temazepam are still widely prescribed in the UK, but only to people who are already physically dependent on them. The large majority of benzo prescriptions are for middle aged/elderly women who've been taking them for years!
Kind regards
~Ed
Posted by Phillipa on October 5, 2005, at 17:43:13
In reply to Re: Do the British know something we don't? » xbunny, posted by ed_uk on October 5, 2005, at 13:55:36
Ed, like me! Fondly, PJ O
Posted by River1924 on October 6, 2005, at 22:18:34
In reply to Re: Do the British know something we don't?, posted by denise1966 on October 4, 2005, at 13:01:45
Maybe in the US, getting fat or (more probably fatter) is considered worse than any temporary addiction/withdrawal.
In the US, I don't know how doctors pick which benzo: I've tried several and had very different reactions or no reactions to drugs which are supposedly very similiar.
I think it is bizarre, docs would give zyprexa but not a benzo (at least temporarily.) But, in the US, the same situation exists for the elderly with dementia, parkinson's or sleep problems. Regs on the books from the late 70's and early 80's make benzo hard to prescribe.
Someone said something along the lines that science only really changes when a generation dies. I think when every pdoc who prescribed or taught during the 60's, 70's, or 80's dies, benzos will get a realistic evaluation.
I'd also guess that a state run medical system (as in Britain or the heavily regulated US nursing homes) makes drugs labelled bad by the establishment very hard to rehabilitate and actually prescribe.
Posted by Tom Twilight on October 7, 2005, at 16:29:12
In reply to Re: Do the British know something we don't?, posted by tecknohed on October 4, 2005, at 19:25:47
Glossary for none UK people:
NHS means "National Health Service"
Alternatively "No Hope Service" or "No Help Sorry"
;)Hey everyone
Unfortunately I've come into the discussion rather late, which is a very annoying because it’s such an interesting one!
Several things that were said in this thread really struck a cord with me.......I think part of problem with the UK is that the NHS is completely publicly funded; therefore there is not the same incentive to please patients as there is in a private system.
NHS docs get paid equally, whether they help patients or not.The UK system is, on the whole, unwieldy and conservative.
Most UK docs seems unwilling to experiment with med combos, and are also unwilling to treat disorders aggressively.
Also the vast majority of UK GPs and Psychiatrists seem to be quite benzo phobic.I work in Addenbrook’s Hospital Cambridge as a porter
Supposedly one of top UK NHS hospitals, as yet I haven’t had any involvement with the psychiatric side of things.
I will say that although it very impressive in some respects, it does seem to be lacking in others, the pain control particularly seems to be quite lackadaisical, and the lifts frequently brake downI'd also like to say that Tecknohead's post really struck a cord with me
> I've had lots of trouble getting what I need from UK docs. Try mentioning Parnate to a UK pdoc and then wait to be laughed at!
The very idea! An MAOI and a Stimulant!
> It seems especially hard for Social Phobics who have limited choice already. Yet for some reason Seroxat or Moclobemide are 'highly' recommended for it. Uh, why?
>
Moclobemide for serious mental illness, what a joke! Treating one the most stubborn disorders with one of the weakest drugs. To his credit my last UK Pdoc said it was useless
Having said that it probably works great for some people, but not very many, I daresay.Someone said that the Australian health system is best
Probably because it a mixture of public and private funding so you get the best of both worlds..........
Posted by Dr. Bob on October 8, 2005, at 19:01:24
In reply to The British Medical System-A few thoughts, posted by Tom Twilight on October 7, 2005, at 16:29:12
> Glossary for none UK people:
> NHS means "National Health Service"...Sorry to interrupt, but I'd like to redirect follow-ups regarding Medical Systems to Psycho-Babble Politics. Here's a link:
http://www.dr-bob.org/babble/poli/20050924/msgs/564641.html
Thanks,
Bob
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