Mental Health

[Jim MAC]

I went for a follow up vist with my primary care physcian as we were talking he said i sounded a little depressed. We were talking about problems on my job due to SC disablties. He gave me some pills I thought nothing of it now today I get a letter in the mail for a appt at mental health. I am not rated for mental health reason I never claimned any mental condtions. What happens if I no show? Do I have to go

Thanks all

Jim

[Berta]

Jim-I actually believe this VA doctor was perceptive enough to do a good thing-it won't hurt to go to the MH doctor and you might be glad you did.

A few years ago I got a call from a VA supervisor who worked at local VA and had given my husaband and the other PTSD vets a lot of Hell when they worked under him.he was a tyrant who seemed to put more stress on them in one of the most stressful jobs at this VAMC.He said terrible things in some EEOC testimony when my husband filed an EEOC case against the VA.

Why did he call me? of all people to call knowing I had prepared Rods EEOC case myself (actually we had been sort of farm friends at one point before all that and his Male goat fertilized my Nanny goat every year so I could milk her -goat's milk is excellent to dink and for making cheese and even ice cream.

He apologised that he had been so rough on Rod and gave his condolensces over Rod's death. A little late but

he immediately was in a state of anxiety-telling me that the VA had put him on a leave due to his anger on the job and a shrionk had just diagnosed him with PTSD.

He had suffered from depression and took it out on VA employees and his wife as anger.

he was horrified to learn he had PTSD (he had put down the 'crazy's lots of times -as the VA PTSD vets called themselves- since some of the VAMC seemed to think they were nuts)

He was also a little relieved after we had a long talk.

He said maybe now he had an answer for the many problems he had on the job and the internal things he had told himself. He said he NEVER ever attributed any of this to Vietnam where things got bad- he had thought PTSD was a nut case thing-

I assured him (I used to work in a PTSD group)

it is far from nuts at all-

my long point is that he now had a condition he could try to understand-and could better understand the other PTSD vets he worked with.

He ad no insight at all for decades into his p[roblems until the VA put him on leave and gave him the diagnpsis and a treatment program.

Last I heard he had prostate cancer too but VA caught that in time.

I dont know about you at all- but this vet almost lots his wife and many friends stopped coming around his house because of PTSD which he didnt realise he had.

SC problems on the job can ultimately lead to TDIU ( and SSA)

I commend this VA doctor for considering the emotional impact of yur SC -it could be depression instead of PTSD-whatever it is VA has to treat it- and compensate it.

Maybe time to think of retirement?

[JON]

You are lucky to have a primary care doc that 1) even noticed you sounded depressed, and 2) cared enough to get you help for it. My advise to you is that if the VA schedules you for some kind of followup appointment, at least go. If, down the road, you file compensation for mental or related and they see you refused an appointment they will say, " Gee you refused an appointment to look into this and now you want compensation?" That makes your claim a whole lot tougher.

I would give one of my organs to have a primary care even remember my name, let alone know me enough to say I sounded depressed.

[Philip Rogers]

If it were me. I'd go. jmo

pr

[Jim MAC]

Thabks All

Guess I take my coca pops and go, Got to laugh at myself. I always said as far as medical care my DR at the VAMC beats the health care I had for 24 years in USAF hands down. The pills he has put me on is paroxetine. anybody know anything about them, Berta can't afford to retire right now child support to high

jim

[purple]

From rxlist.com:

PAROXETINE - ORAL

(pair-OX-eh-teen)

COMMON BRAND NAME(S): Paxil

WARNING: Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor immediately if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

USES: Paroxetine is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, panic attacks, obsessive-compulsive disorder (OCD), anxiety disorders, post-traumatic stress disorder, and a severe form of premenstrual syndrome (premenstrual dysphoric disorder).

SSRIs work by helping to restore the balance of certain natural substances in the brain (neurotransmitters such as serotonin). Paroxetine may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. It may decrease anxiety/unreasonable fears, persistent/troubling thoughts (obsessions), and unwanted urges that keep returning (compulsions). It may decrease the number and severity of panic attacks. Paroxetine may lessen premenstrual symptoms such as irritability, increased appetite, and depression.

HOW TO USE: Read the Medication Guide provided by your pharmacist before you start using paroxetine and each time you get a refill. If you have any questions, consult your doctor or pharmacist.

Take this medication by mouth with or without food, usually once daily or as directed by your doctor. Taking this medication with food may decrease nausea. This medication may make you either sleepy or wakeful. Therefore, depending on how this medication affects you, your doctor may direct you to take the entire dose once daily in either the morning or evening.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may start you at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Do not take more or less medication or take it more frequently than prescribed. Your condition will not improve any faster and your risk of side effects will increase. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time each day.

If you are taking paroxetine for premenstrual problems, your doctor may direct you to take it every day of the month or just for the 2 weeks before your period through the first full day of your period.

It is important to continue taking this medication as prescribed even if you feel well. Do not stop taking this medication without first consulting your doctor.

This medication may cause dependence, especially if it has been used regularly for an extended time or if it has been used in high doses. In such cases, withdrawal reactions (e.g., mood swings, headache, tiredness, sleep changes, "shock-like" feelings) may occur if you suddenly stop this drug. To prevent withdrawal when stopping extended/regular treatment with this drug, gradually reduce the dosage as directed. Consult your doctor or pharmacist for more details. Report any withdrawal reactions or worsening symptoms immediately.

You should see some improvement in 1 to 2 weeks. It may take several weeks before you feel the full benefit.

Tell your doctor if your condition does not improve or if it worsens.

SIDE EFFECTS: See also Warning section.

Nausea, drowsiness, dizziness, trouble sleeping, loss of appetite, weakness, tiredness, dry mouth, sweating, yawning, or headache may occur. If any of these effects persist or worsen, tell your doctor promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: unusual or severe mental/mood changes (e.g., agitation, thoughts of suicide), shakiness (tremor), restlessness, inability to keep still, decreased interest in sex, changes in sexual ability, blurred vision, numbness/tingling.

Tell your doctor immediately if any of these rare but very serious side effects occur: bloody/black/tarry stools, vomit that looks like coffee grounds, easy bruising/bleeding, fainting, fast/irregular heartbeat, muscle weakness/spasm, seizures, change in amount of urine.

This medication may rarely cause a very serious condition called serotonin syndrome. The risk increases when this medication is used with certain other drugs such as "triptans" used to treat migraine headaches (e.g., sumatriptan, eletriptan), certain antidepressants including other SSRIs (e.g., citalopram, fluoxetine) and SNRIs (e.g., duloxetine, venlafaxine), lithium, tramadol, tryptophan, or a certain drug to treat obesity (sibutramine). Before taking this drug, tell your doctor if you take any of these medications. Serotonin syndrome may be more likely when you start or increase the dose of any of these medications. Seek immediate medical attention if you develop some of the following symptoms: hallucinations, unusual restlessness, loss of coordination, fast heartbeat, severe dizziness, unexplained fever, severe nausea/vomiting/diarrhea, twitchy muscles.

For males, in the very unlikely event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and seek immediate medical attention, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching, swelling, severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Contact your doctor for medical advice about side effects. The following numbers do not provide medical advice, but in the US you may report side effects to the Food and Drug Administration (FDA) at 1-800-FDA-1088. In Canada, you may call Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking paroxetine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, personal or family history of suicide attempts, liver problems, kidney problems, low sodium in the blood, severe loss of body water (dehydration), seizures, stomach/intestinal ulcers, glaucoma (narrow-angle type).

This drug may make you dizzy or drowsy. Use caution while driving, using machinery, or doing any other activity that requires alertness. Avoid alcoholic beverages.

Caution is advised when using this product in the elderly because they may be more sensitive to its effects. The elderly are more likely to lose too much salt (hyponatremia), especially if they are also taking "water pills" (diuretics) with this medication.

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may infrequently develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

Since untreated depression can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor.

This drug passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

Certain medications taken with this product could result in serious (rarely fatal) drug interactions. Avoid taking sibutramine or MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) for 2 weeks before, during, or after treatment with this medication. Consult your doctor or pharmacist for additional information.

This drug should not be used with the following medications because very serious (possibly fatal) interactions may occur: pimozide, sibutramine, thioridazine.

If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting paroxetine.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: drugs removed from your body by certain liver enzymes (e.g., aripiprazole, atomoxetine, fluoxetine, phenothiazines, procyclidine, risperidone, tamoxifen, antiarrhythmics such as propafenone, flecainide, TCA antidepressants such as desipramine, amitriptyline), cimetidine, digoxin, fosamprenavir/ritonavir, metoprolol, quinidine, theophylline, tramadol, "water pills" (diuretics such as furosemide), drugs that can cause bleeding/bruising (e.g., aspirin, antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as heparin, warfarin).

Aspirin can increase the risk of bleeding when used with this medication (see above). If your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Discuss the risks and benefits with your doctor.

Also tell your doctor if you take any other drugs that increase serotonin, such as bromocriptine, buspirone, dextromethorphan, lithium, meperidine, propoxyphene, phentermine, SSRIs, SNRIs, tryptophan, St. John's wort, drugs used to treat migraines such as "triptans" and dihydroergotamine, street drugs such as MDMA/"ecstasy," amphetamine. (See also Side Effects section.)

Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, quetiapine, nortriptyline, trazodone).

Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Cimetidine is a nonprescription drug that is commonly used to treat extra stomach acid. Because it may cause undesirable interactions when used with paroxetine, ask your pharmacist about other products to treat stomach acid. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

[sharon]

It's the generic for Paxil.

Paroxetine tablets, suspension (liquid), and extended-release (long-acting) tablets are used to treat depression, panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks), and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). Paroxetine tablets and suspension are also used to treat obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), generalized anxiety disorder (GAD; excessive worrying that is difficult to control), and posttraumatic stress disorder (disturbing psychological symptoms that develop after a frightening experience). Paroxetine extended-release tablets are also used to treat premenstrual dysphoric disorder (PMDD, physical and psychological symptoms that occur before the onset of the menstrual period each month). Paroxetine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.