Does anyone have the PCP prescribe psych meds?

I did when I first moved here back to my small hometown. There was one pdoc for four counties and he was full. So my primary doc just kept me on the same meds that I had been on. Then they got two more pdocs and I saw one of those. He kept me on the same meds until recently when I wanted to go off of a few because of my age. My primary doc was awesome.

Great! I will m primary doc tomorrow for an unrelated somatic issue (post-viral complications) and I will run it by her, as something I might need in 2028.

At one point, my previous pcp sent me to the pdoc (university depression center) to get evaluated for an official maintenance prescription. My current pcp has continued that without another evaluation for 4 or so years now. So i would say that yes, as long as you are stable on your meds and a pdoc will tell your pcp its okay.

I've had PCPs fill in gaps for prescriptions if I'm between providers but they wouldn't make any changes.

That makes total sense. Continue what a pdoc prescribed before, for maintenance, without additional evaluation, without making any changes.

Yes my gp prescribes all my psych meds and I touch base with my pdoc once a year

Are you able to remain a patient of your pdoc so that if anything changes and you need an adjustment you can get in for that? Even if you have to see him annually to stay on his list it might be worth the money.

He is in private practice, all on his own, no bureaucracy, so I am sure he will be open yo that. Good suggestion!

I saw my PCP. She cannot prescribe Zyprexa, as this medication is outside the scope of her competency. However, the clinic (not one clinic, really, but a large network of clinics, with one being in my town) has psychiatrists; they just rarely take new patients, and there is a long wait. I said that that was fine, I would not face this issue until my COBRA coverage ran out, so we have plenty of time. She said it was good that I was so proactive, and gave me two questionnaires to fill out, about things in the past two weeks. I asked if it was OK to be referred to psychiatry while not being symptomatic. She said it was not only OK, it was actually better. I filled out the mood questionnaire and attached an explanation that where I had non-zero scores, in the sleep and fatigue departments, the issues I reported were due to my hypersomnia and the recent post-viral exacerbation of Long Covid. So even though my total score was 5, it was due to non-psychiatric concerns. In the GAD questionnaire, my score was 0. These questionnaires are necessary to accompany a referral from the PCP.

There was a resident I really liked during my inpatient stays in 2016 and 2017 and I knew that she later started practicing in that clinic in my town. I looked her up, and she is no longer there. She is now in private practice on her own in a posh town closer to the hills. Other than her, I do not know any psychiatrists and I am fine being referred to anyone, the first available one. I noticed that most of them do not take new patients; I mean, MDs do not. But there are NPs who take new patients. I messaged my PCP, saying that I can go see an NP—really, anyone who will be open to taking a new patient. I just want to establish myself as a patient, convey my long and complicated historically, but straightforward recently, story, and have that prescriber on board if and when I go on Medicare. So we have a plan and I will wait for the referral.

I know I promised I'd stay away from the subforum but I'm breaking that promise. Just this once
My PCP has been prescribing my meds (Effexor & clonazepam) for years. When I first became caregiver to my mom I was an MHMRA client and one of their doctors prescribed my meds. Then my state cut funding and MHMRA cut patients. I was one of those cut. I couldn't handle withdrawal symptoms and caregiving at the same time so I asked my mom's doc if he'd see me. I explained the situation and he became my doctor and prescribed the meds. He saved (prolonged at least) two lives. He's still my PCP.
I hope everything works out for you.

Quote:

Originally Posted by Tart Cherry Jam I have a great pdoc, but at the end of my COBRA enrollment next year, I woke be able to afford him. Hopefully, I will have Medicare by then (hopefully I get approved for SSDI for a neurological, not psychiatric, disability, and then after a while on SSDI, I will become eligible for Medicare). My pdoc doesn't take Medicare. I have a very simple regimen-- Zyorexs monotherapy. I actually have lots of Zyprexa in my stash, and right now I am getting more, covered by COBRA, so I can see myself having enough and not needing a prescriber for a long time after COBRA enrollment ends. But eventually I will need a refill. I know that most pdocs in the area don't take Medicare, but my internist at a large clinic certainly will take Medicare. I have known her for over a decade and she knows that I am vigilant and skillful in managing my care. So maybe the simplest thing will be to ask her to prescribe a little Zyprexa, reminding her that I have been stable on it and out of psych hospitals since 2018. It is not about managing a complex and shifting medication cocktail; it is simple, stable monotherapy. Does anyhave have a PCP manage psych refills?

Wow, what a story—saved, or at least prolonged, two lives!

I wonder if there is a difference between classes of drugs. Your PCP prescribed an antidepressant and a benzo, and my PCP cannot prescribe an antipsychotic. I wonder if antipsychotics are out of bounds for an internist while antidepressants and anxiolytics are not. Could be also differences between the states, as physicians are licensed by the state, or maybe this particular clinic's stringent rules for its physicians.

My internist had no problem writing the antipsychotic script. What he had a problem with was my sleep meds, because I took twice the normal amount. He arranged for me to be seen by the overworked single pdoc and when that specialist said yes, she’s bipolar it’s ok. He after that had no problem with it.

I hadn't even considered those aspects. FWIW when my doc initially prescribed them he had a private practice. He has since joined a healthcare corporation and he still prescribes them.
It would seem odd if an internist could prescribe benzos but not be allowed to prescribe antipsychotics. I do live in Texas though. It's sort of a mashup between the worst aspects of the Wild West, Tammany Hall and the Dark Ages...
And yes I do give him credit for that. I wouldn't have survived coming off Effexor and a benzo in one month while trying to take care of my mom.
Good luck getting your med situation sorted!

Quote:

Originally Posted by Tart Cherry Jam Wow, what a story—saved, or at least prolonged, two lives! I wonder if there is a difference between classes of drugs. Your PCP prescribed an antidepressant and a benzo, and my PCP cannot prescribe an antipsychotic. I wonder if antipsychotics are out of bounds for an internist while antidepressants and anxiolytics are not. Could be also differences between the states, as physicians are licensed by the state, or maybe this particular clinic's stringent rules for its physicians.