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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 36. This is the beginning of the thread.
Posted by gadchik on November 16, 2011, at 12:28:17
Just curious, has anyone been to a psychopharmacologist? There are none where I live.What was your experience?Do they have more understanding of psych meds than pdocs? Are their fees similar?
Posted by jono_in_adelaide on November 16, 2011, at 17:31:20
In reply to psychopharmacologist vs psychaitrist, posted by gadchik on November 16, 2011, at 12:28:17
I dont think psychopharmacology is a recognised specialty outside of psychiatry - its basicly the drug side of psychiatry, without the psychotherapy side..... psychiatrists who call them selves psychopharmacologists are just psychiatrists who focus on drug treatment.
I tend to think a mixed aproach is better, drugs have a big place, but therapy still has a role in many disorders
Posted by Christ_empowered on November 16, 2011, at 18:00:54
In reply to Re: psychopharmacologist vs psychaitrist, posted by jono_in_adelaide on November 16, 2011, at 17:31:20
Here where I live, all shrinks do is drugs. I mean, yes, they might talk to you briefly about your personal life, your past, etc. (more the older ones), but they're really about writing prescriptions. I can't imagine what a psychopharmacologist could do that would be that much different. All I can think is that they'd be even more into biological reductionism, which is a scary thought.
Posted by sigismund on November 16, 2011, at 22:33:23
In reply to Re: psychopharmacologist vs psychaitrist, posted by Christ_empowered on November 16, 2011, at 18:00:54
I was hoping they might know more, at the biological level.
Posted by Phillipa on November 17, 2011, at 10:30:20
In reply to Re: psychopharmacologist vs psychaitrist » Christ_empowered, posted by sigismund on November 16, 2011, at 22:33:23
I heard they delt more with things like neurological illnesses seizures as an example. Phillipa
Posted by ed_uk2010 on November 17, 2011, at 11:59:19
In reply to Re: psychopharmacologist vs psychaitrist, posted by Phillipa on November 17, 2011, at 10:30:20
> I heard they delt more with things like neurological illnesses seizures as an example. Phillipa
Not really, neurologists deal with epilepsy, at least in difficult cases. Most routine cases of epilepsy might be managed predominantly by general physicians. Here in the UK we do not seem to have a lot of neurologists.
Posted by ed_uk2010 on November 17, 2011, at 12:06:32
In reply to Re: psychopharmacologist vs psychaitrist, posted by Christ_empowered on November 16, 2011, at 18:00:54
>Here where I live, all shrinks do is drugs. I mean, yes, they might talk to you briefly about your personal life, your past, etc. (more the older ones), but they're really about writing prescriptions.
Here, patients with severe psychiatric illness often see a team of workers. There may be a community psychiatric nurse (CPN), social worker, psychologist and a psychiatrist. The psychiatrist is in charge. Unfortunately, it doesn't always work very well because patients do not get to see these people very often. Psychiatry does not appear to receive a lot of funding. Patients will less severe psychiatric illness will not get to see all these different people. They will be treated by a psychiatrist and GP, or just their GP. In the UK, you cannot normally go straight to a specialist like in some countries, you have to go via your GP.
Posted by Christ_empowered on November 17, 2011, at 15:56:52
In reply to Re: psychopharmacologist vs psychaitrist » Christ_empowered, posted by ed_uk2010 on November 17, 2011, at 12:06:32
On the one hand, I think its unfortunate that psychiatrists don't get more funding in the UK. On the other hand, it sounds as if lower-cost, but probably very important, services are emphasized. Look at the US. Shrinks here have adopted the bio-bio-bio model of mental illness, although they often refer people for therapy (especially if there are some therapists/counselors in their practice). Is there any evidence that people with mental illness of any sort--especially the more severe disorders--do better over here than in the UK?
Given psychiatry's track record and the limited tools they bring to the table, maybe limited funding is appropriate.
Posted by gadchik on November 17, 2011, at 16:50:15
In reply to Re: psychopharmacologist vs psychaitrist, posted by Christ_empowered on November 17, 2011, at 15:56:52
My pdoc was originally to only prescribe the meds,and I had a therapist for talking.But now,Im out of therapy,and I talk more to the pdoc.She charges me more the longer i stay,which is understandable.Im private pay though and sometimes wish to get the rx and leave.When I visited my mom,she lives in bigger city,I noticed there were several psychopharmacologists listed in phone book,and I got curious about seeing one.
Posted by ed_uk2010 on November 17, 2011, at 17:19:26
In reply to Re: psychopharmacologist vs psychaitrist, posted by Christ_empowered on November 17, 2011, at 15:56:52
>On the one hand, I think its unfortunate that psychiatrists don't get more funding in the UK. On the other hand, it sounds as if lower-cost, but probably very important, services are emphasized.
There's been quite a bit of 'hot air' over here about how patients ought to be able to access 'talking treatments'. In practice, they aren't always available due to long waiting lists or lack of appropriate therapists. The result of this is that most people with moderate mental health problems get most of their treatment from the GP - which usually consists of occasional brief chats and repeat prescriptions for SSRIs or similar.
>Look at the US. Shrinks here have adopted the bio-bio-bio model of mental illness....
When it comes to moderate mental illness, I think there's much less of a bio emphasis here. There's still a strong bio emphasis for psychotic disorders, severe chronic depression and the more classic presentations of bipolar disorder (bipolar I).
>Is there any evidence that people with mental illness of any sort--especially the more severe disorders--do better over here than in the UK?
I don't know, but you guys certainly like prescribing the latest meds. I'm not saying that's a bad thing, but it's a major difference. When a new med gets launched here, it doesn't always get used much at first. Psychiatrists normally use the meds that they are familiar with and there is strong pressure from the NHS to avoid spending money on new products unless there is a clear advantage. This is not good for the pharma industry! It can sometimes be a good thing though... except when patients are denied access to new treatments even when the standard meds haven't helped.
You have a greater range of psych meds in the US. We do not have Latuda, Geodon or Fanapt. Saphris is not widely available but I think it may be supplied to hospitals. I'm not sure how much we are missing. We do have a few meds that you don't have, after all.
Posted by ed_uk2010 on November 17, 2011, at 17:21:39
In reply to Re: psychopharmacologist vs psychaitrist, posted by gadchik on November 17, 2011, at 16:50:15
>I noticed there were several psychopharmacologists listed in phone book,and I got curious about seeing one.
I suppose I'd want to know, are they just pdocs who don't want to talk much or do they have special knowledge of meds? I'm sure they vary a lot.
Posted by emmanuel98 on November 17, 2011, at 18:04:27
In reply to Re: psychopharmacologist vs psychaitrist » gadchik, posted by ed_uk2010 on November 17, 2011, at 17:21:39
My p-doc (who is in his early 70s and does and likes to do therapy) says all psych residents learn today is meds. So I don't know what the difference is between a psychiatrist and a psychpharmacologist. There is no licensing exam in psycopharm. The licensing exams are still in psychiatry and neurology, which most psychiatrists take.
Posted by gadchik on November 17, 2011, at 18:38:43
In reply to Re: psychopharmacologist vs psychaitrist, posted by emmanuel98 on November 17, 2011, at 18:04:27
I remembered reading once that a pdoc may consult w/or send a pt to see a psychopharmacologist if the pt is not responding to any meds that have been prescribed,and they may need a more complicated regimen
Posted by Phillipa on November 17, 2011, at 21:12:02
In reply to Re: psychopharmacologist vs psychaitrist, posted by gadchik on November 17, 2011, at 18:38:43
Might google difference between them if I get done with ebay posting I will. Phillipa
Posted by Raisinb on November 17, 2011, at 21:20:14
In reply to Re: psychopharmacologist vs psychaitrist, posted by gadchik on November 17, 2011, at 18:38:43
My impression was always that a Psychopharmacologist knows more about neuroscience and medications than a pdoc--sort of a very expert pdoc
Posted by Solstice on November 17, 2011, at 22:31:12
In reply to Re: psychopharmacologist vs psychaitrist » Phillipa, posted by ed_uk2010 on November 17, 2011, at 11:59:19
> > I heard they delt more with things like neurological illnesses seizures as an example. Phillipa
>
> Not really, neurologists deal with epilepsy, at least in difficult cases. Most routine cases of epilepsy might be managed predominantly by general physicians. Here in the UK we do not seem to have a lot of neurologists.
>
>Really!? Wow. Here (the US), epilepsy is treated by neurologists, and more specifically by 'Epileptologists'(a sub-speciality of neurology.
Solstice
Posted by Phillipa on November 18, 2011, at 0:03:31
In reply to Re: psychopharmacologist vs psychaitrist, posted by Solstice on November 17, 2011, at 22:31:12
Google search. But first yes we have lots of neurologists here. Phillipa, now the google diffence between psychiatrist and psychopharmacologist.
http://www.wisegeek.com/what-is-clinical-psychopharmacology.htm
Posted by sigismund on November 18, 2011, at 1:04:15
In reply to Re: psychopharmacologist vs psychaitrist, posted by Solstice on November 17, 2011, at 22:31:12
>Really!? Wow. Here (the US), epilepsy is treated by neurologists, and more specifically by 'Epileptologists'(a sub-speciality of neurology.
If you can afford it (US) or socialised medicine (UK) , according to your preference.
Posted by jane d on November 18, 2011, at 4:44:18
In reply to Re: psychopharmacologist vs psychaitrist, posted by Phillipa on November 18, 2011, at 0:03:31
> Google search. But first yes we have lots of neurologists here. Phillipa, now the google diffence between psychiatrist and psychopharmacologist.
>
> http://www.wisegeek.com/what-is-clinical-psychopharmacology.htmThis is misleading if not actually wrong. Psychologists cannot prescribe in my state and and I believe there are only a few where they can. Further the word has been around long before they could prescribe in ANY state and it has always referred to psychiatrists. If psychologists really have appropriated this term I imagine the MDs are spitting nails.
Back when psychiatrists were shifting from therapy to meds it distinguished those who used meds. Now they are all trained with an emphasis in medication. I'm fairly sure any psychiatrist can choose to use the term for themself and it doesn't guarantee any special expertise.
Posted by Emme-V2 on November 18, 2011, at 6:05:34
In reply to psychopharmacologist vs psychaitrist, posted by gadchik on November 16, 2011, at 12:28:17
> Just curious, has anyone been to a psychopharmacologist? There are none where I live.What was your experience?Do they have more understanding of psych meds than pdocs? Are their fees similar?
The psychopharmacologists I've seen are very sophisticated in their understanding of psych meds and are comfortable with both old and new meds, more comfortable with off-label prescribing when they feel it's appropriate for the patient, and remain very up to date on research. The one I saw for the longest time is also board certified in neurology. That doctor thought very holistically about checking for other medical conditions that can mimic depression (e.g., Lyme disease) and was also open to non-prescription options such as fish oil, Sam-E, etc. So yeah, I think it's ultra specialization in the pharmacopia. There is an American Society of Clinical Psychopharmacology.
Posted by 10derheart on November 18, 2011, at 12:03:02
In reply to Re: psychopharmacologist vs psychiatrist » Phillipa, posted by jane d on November 18, 2011, at 4:44:18
Great points, janed. I'd agree you have to take info on Wise Geek with a bit of a grain of salt....I'm unsure of its sources...?
In this case, though, it might be the difference between **clinical** psychopharmocology and use of the term without the clinical modifier. Maybe there are more psychologists doing this than we think....I dunno.
I just clicked over to the plain definition here:
http://topics.wisegeek.com/topics/psychopharmacology.htm#
...and it seems more like what I understood it to mean. If I had a psychiatrist, I'd ask how they understood its use....but I don't. My own therapist,(MA in counseling/social work) who chose not to get her doctorate, wants to go back to school to become a nurse practitioner so she can more comprehensively treat clients.
Posted by ed_uk2010 on November 18, 2011, at 12:32:04
In reply to Re: psychopharmacologist vs psychaitrist, posted by Solstice on November 17, 2011, at 22:31:12
>Really!? Wow. Here (the US), epilepsy is treated by neurologists, and more specifically by 'Epileptologists'(a sub-speciality of neurology.)
I don't think I explained it well at all. A specialist will be involved with the initial diagnosis but the specialist might not be a neurologist. For example, children may be referred to a hospital paediatrician. The specialist will decide on the treatment and titrate the dose but the medication will then be continued by the GP. They call this 'shared care', and it happens with most long term conditions here. Do your GPs only treat minor conditions?
A large proportion of epilepsy cases are not severe. Patients may have occasional seizures which are well controlled by a single medication. In these cases, there is not much for the specialist to do. Less often, epilepsy is extremely difficult to control and patients have multiple problems. A specialist will then be involved over a long period.
I didn't mean to give the impression that GPs diagnose and treat epilepsy without hospital intervention. It's just that mild/routine cases do not always need a great deal of specialist intervention beyond the initial diagnosis. That's not to say they won't have occasional follow ups at the hospital.
Posted by jane d on November 18, 2011, at 18:41:51
In reply to Re: psychopharmacologist vs psychiatrist » jane d, posted by 10derheart on November 18, 2011, at 12:03:02
> Great points, janed. I'd agree you have to take info on Wise Geek with a bit of a grain of salt....I'm unsure of its sources...?
>
> In this case, though, it might be the difference between **clinical** psychopharmocology and use of the term without the clinical modifier. Maybe there are more psychologists doing this than we think....I dunno.According to this AMA article it was still just New Mexico, Louisiana and the military as of last March with legislation introduced in New Jersey, Tennesee, Arizona, Hawaii, Montana and Oregon.
http://www.ama-assn.org/amednews/2011/03/07/prl20307.htmI couldn't find any evidence that it had yet passed in any of those places. So not that common yet. But comimg soon it seems.
> I just clicked over to the plain definition here:
>
> http://topics.wisegeek.com/topics/psychopharmacology.htm#
>
> ...and it seems more like what I understood it to mean. If I had a psychiatrist, I'd ask how they understood its use....but I don't. My own therapist,(MA in counseling/social work) who chose not to get her doctorate, wants to go back to school to become a nurse practitioner so she can more comprehensively treat clients.Ah. I'd missed that distinction when I read it the first time. Thanks for pointing it out. But I still think there's currently a distinction between psychopharmacology and psychopharmacologist in actual usage. But that may just be an accident of who can prescribe and may disappear. I've never heard of a psychiatric NP referred to that way even though that is in fact what they study and what they do. I'm a big fan of NPs.
I haven't used wisegeek before. Do you find it generally useful? There are so many phony "answer" sites around now that I tend to ignore any that I'm not familiar with. And there's a whole bunch I wish could block from all future search results.
Posted by Phillipa on November 18, 2011, at 19:05:14
In reply to Re: psychopharmacologist vs psychiatrist » jane d, posted by 10derheart on November 18, 2011, at 12:03:02
When my pdoc got in a really bad car accident she had a RN practioneer fill in for over a year. She prescribed all my meds for me including benzos. Then at some time the charts were sent to another psychiatrist to sign off on them. I think kind of like when RN if the Lpn (phasing out) gave a controlled med or did an admission the RN had to review material and sign her or his signature to indicate they agreed with what the LPN did. Phillipa
Posted by Phillipa on November 18, 2011, at 19:11:52
In reply to Re: psychopharmacologist vs psychaitrist » Solstice, posted by ed_uk2010 on November 18, 2011, at 12:32:04
Short and to the point I feel. 10der same place you got yours!!! Phillipa
http://www.wisegeek.com/what-is-clinical-psychopharmacology.htm
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