Need advice - Will Travel!!

[Kobayashi]

Hi All,

Well, I'm back on the forums again after a two month vacation from the worst parts of my OCD. (Its always been there, just lurking under the surface).

Lately, I've been feeling awful. My regimen of Luvox and Risperdal doesn't seem to have been doing much. Feels like I've been taking a sugar pill. I'd hate to think what I'd be like without the meds right now. Ativan is keeping me afloat, but I know I can't rely on it forever.

Things are getting kind of serious. Work is getting tough and my wife is at the end of her rope with me. Being around my kids is tough...I think depression may be lurking because of all of this.

The CBT and mindfulness I've been practicing help somewhat, but what I'm going through now is something on the chemical side. I definitely need a change in meds. (Again).

My GP is at a loss and doesn't know where to direct me. She is openly concerned about sending me to one of the Psych's at the hospital. She refers to that place as the "chop Shop". I do have some experience with that place and I don't want to go back - it literally is like an assembly line there where you get 3 minutes with a doc and thats it.

Its a scary place to be when your Dr. is baffled by your condition.

Can anyone recommend a good Psych in the GTA area? My GP doesn't know anyone. The two people she wanted me to see locally here in Barrie are not taking new patients.

Any advice would be greatly appreciated.

Kob

 

[Daniel E.]

Living in Florida, I don't have any personal recommendations.

But there are some listed here, and (according to the directory) most of them are taking new patients and do not have a wait list:

The Ontario Obsessive Compulsive Disorder Network

For example, in Barrie (which you may already know about):

DR. JONATHAN DOUGLAS, PH.D.
Psychologist
P.O. Box 428
Unit 5
Barrie, ON L4N 8J8
Office phone: 705-735-4776
Fax: 705-733-9431


- I have 10 years of experience treating OCD, and between 5% and 20% of my practice is related to OCD.

DR. B. ANAM KHAN, PH.D.
Psychologist
Dr. K Anam & Associates
Downtown Medical Place
201A - 49 High Street
Barrie, ON L4N 5J4
Office phone: 705-721-8490
Fax: 705-721-1797

- I have 20 years of experience treating OCD, and between 5% and 20% of my practice is related to OCD.

- The typical wait length is 4 weeks.

In Toronto, just a small sampling:

I have 10 years of experience treating OCD, and more than 20% of my practice is related to OCD.

DR. DEBORAH AFFLECK, PH.D.
Psychologist
1200 Bay Street
Suite 302
Toronto, ON M5R 2A5
Office phone: 416-921-7469

DR. ANDREE LIDDELL, PH.D.
Psychologist
Ruth Berman Consultants
730 Yonge Street
Suite 226
Toronto, ON M4Y 2B7
Office phone: 416-961-0487
Fax: 416-961-5516

- I have 30 years of experience treating OCD, and between 5% and 20% of my practice is related to OCD.

(Some of the ones above also list their e-mail address, which I removed to reduce their chances of getting spam.)

 

[Kobayashi]

Thanks for the info.

Unfortunately, psychologists can't prescribe meds in Canada. I need a full blown psychiatrist. They are few and far between up here. Looks like there are some in Toronto that I can look into.

Florida? Nice! I was in clearwater 2 weeks ago. :2thumbs:

 

[Daniel E.]

Yeah, I now see the 3 psychiatrists listed for Toronto all have had waiting lists of 24 weeks.


BTW, regarding meds: OCD Treatment

It appears as though BT/CBT [behavior therapy / cognitive behavior therapy] is as effective as the combination of treatments, which is better than serotonin reuptake inhibitors...

Which SSRI works the best? Facetiously answered: YES. That is to say, one doesn’t know until one tries (outside of a previous personal response to one agent and/or a family member who responded well to a particular agent). No prescriber can determine what SSRI will work until it’s tried...

SSRIs sometimes take longer to “kick in” (latency of onset of action) in OCD as compared to MDD [major depressive disorder] (typically 2 months instead of 1 month). Most patients presenting to us have not had an adequate trial of previous SSRIs either due to dose, duration of dose, or side-effects limiting upward titration.

Algorithm for the Integrative Treatment of OCD

 

[Retired]

Kob,

I am puzzled by why your GP is unable to refer you to a psychiatrist. Although I understand there are wait times for a referreal to specialists in Ontario, that does not preclude a GP from at least trying to find a specialist to whom you can be referred.

Your options could include:

• Calling the offices of psychiatrists listed in the phone book and asking for an appointment, specifying you would bring a referral from your GP (if your GP is agreeable to do so)
• Calling the departments of psychiatry in the teaching hospitals in your area and asking to be seen either by one of the staff, a resident or in their outpatient clinic.
• Calling psychiatrists in neighboring towns and cities where there might be less demand, if you are willing to travel.

Each of these options requires considerable work on your part, but I believe can pay off if you are persistent. In each of these calls, tell the person who answers you would like to be put on a waiting list.

Use the doctor search utility on the College of Physicians of Ontario site as well

If you are willing to travel as far as Montreal, I can give you the name of a psychiatrist you could call. This person is retired but maintains a practice and accepts OHIP. If you're interested, send me a PM and I'll send you the contact info.

 

[Daniel E.]

My regimen of Luvox and Risperdal doesn't seem to have been doing much. Feels like I've been taking a sugar pill.

Are you still on 250 mg/day of Luvox?

For reference:

Guide to Neuropsychiatric Therapeutics - Google Books

 

[Kobayashi]

No - down to 150/day. I got very depressed at the higher levels...200+.

I react very strangely to all ssris. The only one that did good things for me was cipralex. Felt fantastic on that for 6 months...then it just stopped working. I managed to cram in a whole load of CBT during that 6 months tho.