Independent medical expert answers
on psychiatry and psychology

Switching to Different Prescription Drugs, New Medicines; Choosing a Doctor

Written by: Fabio Piccini, doctor and Jungian psychotherapist, in charge of the "Centre for Eating Disorders Therapy" at "Malatesta Novello" nursing home in Cesena. Works privately in Rimini and Chiavari. E-mail:
First version: 22 Jul 2008. Latest version: 29 Aug 2008.

Abstract:

Switching from one psychothropic drug to another can cause many problems and should be done under the supervision of a psychiatrist.

Question:

For more than 4 years I have suffered from anxiety attacks and sometimes depression. I have been taking Tropium for the last two years and this seems to work most of the time. However I am feeling increasingly depressed and am not happy that Tropium is the only solution being offered by my GP ( he did ask me 3 weeks ago to switch prescription drugs and try Lustral instead - I stopped taking Tropium and started Lustral - within 24 hours I was suffering severe anxiety and hallucinations so I immediately reverted to Tropium. I take up to 40/50mg per day and do not feel that this is sustainable. I want to find a long term solution to these problems and am increasingly dis-satisfied with my GP's advice. Should I switch to new medicines? Can you help?

Answer:

Changing from one psychotropic drug to another, particularly after having taken one medication for a long time is rarely an easy job.

Sometimes one can experience symptoms of abstinence from the old drug, sometimes one can experience the side effects from the new drug. Sometimes, one can also experience a rebound effect of the symptoms of the earlier disease.

For these reasons, this kind of interventions would better be supervised by an expert psychiatrist rather than a G.P.

As a matter of fact only a psychiatrist has enough experience about psychotropic drugs to know what is he best thing to do in any given case.

Thus I would suggest you ask your G.P. to refer you to a good psychiatrist to revise your drug therapy.

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