Given short shrift at visit to the doctor
August 11, 2010 4:59 AM Subscribe
My husband recently had an appointment with a new doctor, primarily to discuss issues of mild depression and a mystery nodule in his inguinal region. Depression is not chronic or severe, and husband has never sought treatment for it before, but doctor (a) prescribed Effexor + Xanax right off the bat; (b) did not discuss "discontinuation syndrome" or other potential side effects; (c) did not look at the nodule at all. What would you do?
posted by SomeTrickPony to health & fitness (16 answers total) 1 user marked this as a favorite
My husband was looking for a new GP, and recently made an appointment with my GP, whom I'm very happy with. She is part of a small practice with an out-patient surgeon on staff. Even though his appointment was with the GP, it was the surgeon he wound up seeing for the intake appointment.
The main motivation for going to the doctor was to seek treatment for mild depression, and to have the doctor take a look at a hard nodule that had recently appeared in his inguinal region. His depression is not severe, and he has never sought treatment for depression before.
The doctor prescribed Effexor + Xanax for depression, and did not discuss most side effects with him, or really offer any explanation for this choice, discuss alternatives, etc. etc. Basically said it would make him feel better. My understanding is that the Xanax was prescribed in the event that he experienced increased anxiety or agitation as a side effect of the Effexor.
In addition, the doctor did not look at the nodule that my husband mentioned at the beginning of the visit.
It may be relevant to mention that my husband has some issues with alcohol/borderline alcoholic. He is not a super heavy drinker, but tends to drink 3-4 units every night on weeknights and often more on the weekend, over time escalating to as much as 40-50 units a week, at which time he'll eventually attempt to cut back or quit. This is a cycle that repeats itself a few times a year. I don't know if Effexor is any better or worse a choice for someone who historically has a difficult time with maintaining light drinking or abstinence. This fact was mentioned to the doctor.
I feel like: (a) Effexor is not a good choice for a first-time trial of anti-depressants for a case of mild depression, and that it would have made more sense to start with an old stand-by like Zoloft or Lexapro with a less harsh side-effect profile; (c) side effects, and particularly "discontinuation syndrome", should have been discussed; and (b) the doctor should obviously have addressed the other medical concern that my husband was there to ask about.
Now, my husband is a passive person. If it were me, I would have not left the room without discussing the nodule thingie. But he's the type to just not say anything, despite the fact that he is really very concerned about it, and has been talking about it with me rather anxiously for the past several days.
What would you do in a situation like this? Am I right in thinking that the doctor provided inadequate service?
FWIW, he started taking the Effexor 2 days ago and is having a rough time with it. He feels so sick he's taking the day off work today, which is something I've seen him do exactly once before in the 6 years I've known him.