My friend’s daughter had a panic attack at work. She went to the emergency room. They prescribed Seroquel, which is an antipsychotic. They told her she was bi-polar and sent her home with a prescription.
Is this type of diagnosis usually made in a single ER visit?
Would they provide a referral to a shrink?
If not, should this be reported to someone?
This kid is a slacker extraordinaire. I think she might be depressed, but for the most part, I wouldn’t believe this at all if it weren’t for the fact that she got a script out of it.
Me too. I wanted to ask her mother if she actually saw the pills or the prescription, but I might be better off just nodding and saying, umm-hmm… This girl hasn’t held a job for more than 6 weeks in her entire life. I have a feeling she googled up some info to feed to the 'rents.
Don’t judge the diagnosis based nn the medication. It’s true Seroquel is an anti-psychotic, but it’s from a class of “atypical antipshycotics”, in smaller dosages it’s ALSO used to treat insomnia and anxiety disorders, not just psychotic stuff.
A roommate of mine in college took it because he used to get panic attacks.
ETA: And I agree with the above post about Googling the script and jumping to conclusions.
ERs always tell you to see your own doctor. As far as a bi-polar diagnosis at an ER, yeah that doesnt sound right. Her parents should take her to see a real psychiatrist ASAP. The ER isnt going to refill her prescription. They probably put her on Seroquel to calm her down so she can get out of there and see a regular non-ER doctor.
Agreed on the ER diagnosis of bipolar. Seroquel–and the other atypical antipsychotics–are pretty good at getting someone off of something bad. I’d wonder what kind of procedure they used for making the diagnosis; I mean, I wouldn’t think they’d go into something that involved in the ER. IME, there’s usually a battery of questions to answer, and sometimes, it takes more than one appointment to make the determination.
That being said, they absolutely should have given her a referral to a psychiatrist. Medicating any mental illness–and especially diseases on the bipolar spectrum–involves a certain amount of risk. The medication might not work. It might make things worse. Yeah, it might be perfect, too, but the downside of it not working or making things worse means that the initial use should be supervised.
That being said, Seroquel is used and indicated for treatment of bipolar disorder. This is heavily indicated in the Wikipedia article, and would be easy for her to gank (if, you know, you think she’d do that). WAG, but. . .with a 22 year-old coming in with an anxiety attack, they might have prescribed it because A.) it is sedating and B.) has less of an abuse potential than things like Valium and Xanax. When I was on Seroquel, it knocked me the heck out.
Anyway. If she really can’t hold a job or manage her life, it doesn’t much matter if she’s telling the truth or not. If the ER suspects she has bipolar disorder, that should be checked out. If she’s lying about this, has had panic attacks, and is also so non-functional that she “hasn’t held a job for more than 6 weeks in her entire life,” then there’s probably something going on up there. Either way, psychiatric help could be beneficial.
>They can’t even afford the Seroquel. She’s 22 years old and not covered on their insurance.
She should consult her state human health services to see if she qualifies for free/cost reduced care. Not to mention several drugs used to treat bipolar disease are now available as generics.
Also, many psychiatrists work on sliding scales dependent on the patients’s income and situation. Its not hopeless.
I agree, there are avenues she should try. Getting her to do so is part of the battle. The other part is that her parents are getting fed up with her not towing the line, and I think their sympathy is running a little thin right now. I will talk to her mom and suggest that this may be at the core of her slackerosity. I think they need to draw a line in the sand and tell her to comply or beat it. She’s a rather spoiled, whiney, pain in the ass most of the time. It’s becoming clear that she’s really out of control and needs to get some help.
Anxiety is a common presenting complaint in the ER, and also a common buckett discharge diagnosis (anxiety, hyperventilation, panic attack, not otherwise defined). That is not the same as a proper psych diagnosis of panic disorder, social phobia, etc. We usually treat acute symptoms with a benzodiazapine and refer out. I don’t think I’ve ever seen an ER doc give a psych diagnosis before. However, certain facilities, usu larger ones, will have psych available, or may have the county mental health unit attached to them. Your fiends daughter may be uncertain about who she saw in the ER (happens all the time), or she may have glossed over what happened before the trip to the ER. I know nothing about the specifics of this case.