Will a PCP prescibe ADHD meds?

In My Humble Opinion
1

Right off the bat, I assume the answer is going to be YMMV.

But here’s the deal anyways. Back when I was in college I was seing a psychiatrist for ADHD. The meds she was giving me made a world of difference, I’m not going to get into it here, but for those of you with ADD/ADHD, you know what I’m talking about.

Well, she over prescribed the meds like you wouldn’t beleive and as a result, umpteen years later I still have some left. And, yes, they do still work, they work just fine (can we just let that go). Since I stopped seeing her, I’d take one here and there, but lately I’ve been taking them more regularly. I’d forgotten how nice it is to be able to go into work and not spend 8-10 hours day dreaming or forgetting what I need to do or just plain putting it off for another time. I’ve gotten ridiculously more productive. Yes, I know it’s a stimulant and that’s part of it, but I very much had ADD/ADHD all my life. In fact, I figured it out on my own long before it was a buzzword. (I remember going to my mom, showing her a book and saying ‘I think I have this thing called Attention Deficit Disorder, it makes so much sense’).

Anyways, I bumped into my neurologist’s nurse (for migraines) and asked if they would write a script for it and she said they don’t touch that stuff but if I just called my original psych and had the records transferred over to my family doctor, he’ll probably write it without thinking too much of it. The reason being that he’s not diagnosing anything, just writing me a script for something that I’ve already had.

My question is because of a few things:
1)I was diagnosed and saw this psych 15ish years ago. He may want me re-diagnosed. He is a bit of a pill pusher (which I have no problem with) so he might not have a problem with it, but still.
2)I’m not even sure if it’s possible to still get the records or even who to call. My psych still practices but not at the same place (and possibly not in the same group). I assume the obvious answer is to call the place where she works now and start there, but I’m guessing 15 years later those records might be gone.

So, any thoughts on this? It really is nice being back on the meds (even if I’m doing it myself), but if I continue, I’ll run out eventually. My old psych is a bit of a drive and working at a psychiatric hospital (while I’m sure they see people on an outpatient basis, this is a “real” psych hospital, they actually have people living there (to detox, I think)). I’d rather just handle this through my PCP if possible. Sure, I can just make an appointment and see what happens, but I figure I’d see if anyone has any experience first before I spend $100 for him to say ‘nah, go see a psych to take care of this’ and then spend $200 on them.

One of these days, if I remember, I’ll just give her new office a call and see if I can track down the old records. Since I’m thinking about it now, I’d send an email, but it doesn’t look like there’s a way for me to do that on their website.

2

PCPs can prescribe anything they want. Will they is another question.

Do you take any other medications regularly? Aside from children with AD(H)D, many adults take Ritalin, dextroamphetamine, or Adderall, because they enhance antidepressants, especially in people who are already taking the maximum safe dose of something like Wellbutrin, where more than 400mg/day carries a rick of seizures, or SSRIs, where more than whatever the max dose is carries a risk seratonin storm. I don’t think these adults are necessarily taking as much of these medications as someone with AD(H)D would, but taking them nonetheless.

You don’t happen to take antidepressants, do you? that would make it easier for doctor to justify giving you the stimulants.

3

That’s the answer I keep finding on the internet and the answer I assume is probably the only one I’m going to get until I actually talk to my current or past doc.

The only med I take regularly (as opposed to ‘as needed’ (for pain, usually)’ is Topamax/Topiramate. It’s given to me by my neuro. It’s an anti-seizure med that’s used very regularly to control chronic migraines (and I’ve been on it for, I don’t know, well over 5 years). I’m not sure if it helps or hurts my case, but some of the side effects are “ADD like”, confusion, memory issues etc. as well as being generally tired. From that perspective, he could say that a prior DX of ADD AND being on this med…yup, you need [ADD meds] to help’ or he could tell me that I need to start by working with my neuro to find another option since the Topamax might be the problem.

Again, I understand my mileage can and will very, I’m just asking.

Just to be clear, Topamax (sometimes called Dope-amax because of it’s side effects) is an anti-epileptic and not an anti depressant. I’m not on any anti-depressants, the only other regular meds I take (now that I think of it) are all allergy and GI related. Nothing that should/would come into play here.

4

I’d start with the group your psychiatrist used to work with and find out where the records are. At the same time, if you have the option to ask what your PCP would like you to do (get records, transferred, see someone else, etc), take that. I can send an email to my PCP for questions like this.

Once you know where the records are and whether your PCP will help you out, you’ll be most of the way to solving this.

Having taken Topamax for migraine (and transitioning off) and having recently started ADD medication, I can say that my experience was the “Dope-a-max” effects for me did not really resemble the ADD ones.

5

No, FTR, mine don’t either, I was just putting it out there.

I was just thinking, I do a lot of work with the group she’s in, I’m pretty sure I can guess her email. I think I’ll email (with my guess at her address) her directly, but under the premise of 'it’s Saturday night/Sunday Morning and I don’t want to forget, I’m happy to call the office, I just wanted to do this while I was thinking about it (because otherwise I’ll forget durrr)".
I mean, even if she gets the email, she’s perfectly within her rights to just ignore it, but hopefully, I’ll just get a ‘call my office’ or even a ‘call my old office, the number is…’. Even a ‘we discard the records after x years, those are gone’ would save me a few days of hunting them down.

6

I wouldn’t send a professional email to someone’s personal email box.

My daughter takes ADHD meds - but they were only given to her with a full workup - which they want her to retake every couple of years. And her primary (pediatrician - she’s 16, but hasn’t switched over yet) can’t do ADHD, only about half the doctors in the group do it.

They keep a really tight lid on them because - like opiates - they are worth a lot recreationally.

7

I did end up sending the email last night but I started it off with something along the lines of “I do a lot of work with your medical group* so I guessed at your email address, blah blah blah, I’m more than happy to call, I just didn’t want to forget to take care of of this”

I won’t be insulted at all if she doesn’t respond or just asks me to call. In fact, I didn’t really ask her to do anything other than possibly point me in the right direction. I’ll probably just call her current office this week and start there. I sent the email hoping she might say 'oh, you’ll just need to call the old place, the number is…" or (I’ll admit, in a perfect world) “Hey, no big deal, give me your information, I’ll have them send the files over”.

Regarding doing a full workup, that’s the reason for the files. A nurse friend of mine suggested that if I can get the old diagnosis, my current doctor (that I’ve only been seeing for a few years) may very well just write me the script(s) with a lot less questions since he won’t have to make a diagnosis (or at least he’s not basing it on nothing).

Oh, and I just realized you said “I wouldn’t send a professional email to someone’s personal email box.”. I sent this to her work email. Yes, that would be weird if I went and found her personal email address and sent it there.
*It’s HUGE group with about 30,000 employees, it wasn’t exactly rocket science (if I’m right) to guess her address considering how many people I work with from that group.

8

I’ve dealt with several different PCP’s (several different patients) with ADHD meds and all doctors had no problem prescribing these.

Note that a psychiatrist may initiate and adjust the prescription, then the PCP takes it from there. Also say in the case of a kid doing poorly in school, this may be reported to the PCP and the PCP may up the dosage a bit. I suppose if the medication was too much, they would lower it as well. Just tell them what is up!

FYI - It is common for a specialist to diagnose a problem and start a regimen of drugs - get the dosage adjusted. Then the PCP to take over regular refills of those prescriptions.

9

I was going to pretty much say the same thing.

10

Update: My old doctor (that I wrote the email to) wrote back to me. She told me where I could most likely find the old records and told me that if I ran into any issues getting them I should I should let her know and she’ll see if she can help out. She also wrote a few sentences about taking some notes about my symptoms and how/where/when they impact my life etc and then, again, told me to let her know if I need anything else. (These symptoms are a pretty regular part of my life, as bad as my memory is, I wouldn’t have a hard time rattling off how they impact my life. ADHD is my life. It’s not like I just fidget too much on stressful days or day dream in the morning when I’m still tired, it’s something that’s with me nearly 24 hours a day. )

IOW, she not only seemed fine with me emailing her directly but was almost too happy to help.

I’ve contacted her old medical group to request the records. I called them first and asked what the chances are of them having 15 year old records, they said it could be hit or miss, so I submitted the form and we’ll see what happens.

Hopefully they’ll have them and hopefully they’ll say what I want them to say (I made a note that I’m just looking for the portion of the records with the diagnoses and the med management.
It dawned on me, as I was requesting these how I ended up seeing her. Back when I was in college my parents found some weed, decided that I was into all kinds of drugs and sent me to an AODA counselor*. If you’ll recall from my first post, I had told my mom when I was young that I thought I had ADD, but she never did anything about it (long story). Anyways, I made a deal with her, I’d go see the counselor*, but only if I could also see a psych to get treated for ADD. This doctor and the AODA guy worked together. I realized that it’s possible my records could reference the AODA guy.
Hopefully only the ADHD stuff is in there, if the AODA stuff is there, I’m not sure I want to give it to my current doctor.

Just to be clear I wasn’t (cough cough at the time cough cough) doing all kinds of other drugs. My UA’s showed only THC, I stopped smoking* to make him happy, a few weeks of sessions later my THC levels fell below the threshold and he was satisfied. Last time I saw him.

**It was funny how many of my friends needed to pass drug tests for one reason or another and came to me for advice on how I passed mine. They didn’t like my idea of just not getting high for a month or two. Sucks, but it works.
PS Something else I have to think about (whether I see my PCP or someone else about this) is if I bring up that I started taking the old meds again. I can even show them the old bottles so it’s not like I got them illegally, I legitimately have some left over. Again, I know this is a YMMV thing. I know some docs will say ‘You’re messing with these drugs on your own, nope, sorry’, but I also know that some docs are happy with the direct approach of “this is what works for me”.

11

On medical release of information forms, you can elect to not release information about drug use, mental health issues, etc.

On the other hand, IF you are currently using marijuana, alcohol, any illegal drugs, prescription drugs, or over-the-counter drugs, TELL YOUR PCP. Be honest. Drugs can have interactions with other drugs - even over-the-counter drugs.

Holding back information like this could cost you your life in some situations.

Also it is like taking your car to a mechanic and not telling him your trunk latch is not working. Then you get the car back and it is not fixed. Well duh! How can they fix something if they are not told all the information?