Is it unreasonable to ask my doctor to tell my doctor to rule out physical causes first?

Question

I have taken various psych drugs in the past but never stayed on them. Because I am very bothered about the idea of them being perscribed without any real tests being preformed. I think it is wrong for someone be giving me these drugs after only having spoken to me. And every doctor I see comes up with a new diagnosis, new list of drugs and says they other doctor was all wrong. It makes it hard to trust their jugement. And it's not like I'm getting lousy doctors. They're all very qualified from good schools etc. It's just that no one really seems to know what's wrong with me.

I keep reading things online about people having taken psych drugs for years only to discover later that it was not from a "chemical imbalance" at all it was something else like a tumor etc.
So I feel like this time I should rule out other things before trying a new drug


Has anyone made this sort of request?
What was your doctor's reaction?
What sort of tests would the be likly to preform?

I typoed the question
Should read:
"Is it unreasonable to tell my doctor to rule out physical causes first?"

Answer 1

Not at all. I am bipolar, and before my doctor would prescribe medication (I was diagnosed prior to seeing him) He ran a test to make sure my thyroid was working correctly as my symptoms could have been caused by a malfunctioning thyroid. You should always received any mental health diagnosis from a psychiatrist and any other medical diagnosis from your regular doctor. They specialize for a reason.

Answer 2

Nothing is unreasonable when it comes to your better health.

And a solid approach to this is, "Doctor, just to get us all on the same page, so I'm not guessing what the problem is and you aren't either, let's rule out a physical issue before looking at psychotropic medications."

The reaction I'd expect, from a good doctor, is a serious consultation with you to help him determine what can be ruled out without tests, and a firm committment to getting the necessary tests scheduled as soon as possible.

I'd expect, at very least, for him to do a complete blood count (CBC) to make sure you have a good electrolyte balance and that that the blood gases are in balance, and a complete physical exam to include the major body systems. At your request, he might also do an image analysis of your brain.

By the way, this is YOUR life...live it in a way that's comfortable for you. Ask for the medical treatment you deserve.

Good luck.

Answer 3

Absolutely not. The first thing a good doctor should do is rule out any physical illnesses that could be causing the symptoms. For example, hypothyroidism commonly causes depression. If you go in complaining of depressive symptoms and the doctor fails to do a thyroid test I'd find another doctor. Don't worry about the doctor's reaction. You're paying him to treat you. If you request that he tests for physical conditions and he gets mad then piss on him and find someone else.

Answer 4

Always rule out underlying medical causes before accepting a psychiatric diagnosis. I worked in emergency psychiatry for many, many years. Before we were called in to see a patient our first question to the ER doc was ALWAYS, "Is this patient medically cleared?" (ie have medical possiblities been ruled out.) In some busy, inner city ER's docs. are quick to call in Psych. if a person presents with altered cognitive functioning or just weird behaviors. I can't tell you how many times we, in the Psych. Dept., would refuse to see the patient until certain test results were back, and low and behold, once the test results were back the patient had a medical and not psych. problem. Again I say to you, always rule out a medical problem before you jump to determining that the behaviors, etc. are stemming from a psychiatric problem.

Answer 5

The nature of your question makes me think that someone has given you a diagnosis that implies that your symptoms are not real, but rather somatic.

I do not think it is unreasonable to have medical tests run to determine if there is a physical cause for your symptoms. For example, depression is common in people with thyroid problems.

However, I will also say that physical symptoms at times may have a psychological cause. Anxiety can cause chest pains or breathing difficulties. Some individuals may even go blind and there is nothing physically wrong with them!

It would depend on what your symptoms are-if you could clarify, then you might get some more specific responses.

Answer 6

No, but your insurance company might not pay for what they might consider unnecessary testings. Be prepared to pay.
They can run blood tests to check your endocrine system, hormones, thyroid, glucose/insulin levels, etc. for a start
That said:
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Answer 7

No, it's not unreasonable. It sounds like your doctor might be in too much of a hurry to do a proper examination and order tests. However, if he/she prescribes a new drug, he/she should tell you how long it should take to see relief of your symptoms - one week, two weeks, etc. You should stay on the drug for at least that long to give it a fair chance, and then you should go back to review the results. If you and your doc are to solve your problem, you have to do your part as well.

Answer 8

sorry, i don't have any experience in this area, but i have a few comments. good for you for taking a proactive approach, rather than blindly following your doctor's suggestions. i don't think it is unreasonable, and it can't hurt to ask.. what's he gonna do, drop you as a patient for asking? also, don't be too hard on the docs. there's a reason it's called "practicing" medicine...nobody has it down to an exact science.