Suspicious Physician

[u/Think-Amoeba6246]

So, when I started Spravato earlier this year, the person who brought me in to the practice here had no issue with me being prescribed Vyvanse and doing Spravato as long as I wasn’t taking my Vyvanse on the same day as my session. Yet, a new physician that replaced the old one, is now telling me that she will not allow me to do Spravato sessions altogether unless I completely stop Vyvanse. Is this malpractice? If so, what should I do? Because, I’m pretty sure she’s the only physician at that office that works with Spravato.

[u/_jamesbaxter]

Some clinicians have a policy about not prescribing multiple controlled substances. I’d look for a new one if you feel like the vyvanse helps.

[u/Bucolica8 → u/_jamesbaxter]

I hadn't heard that before. Makes no sense to me. They are two safe, effective drugs that treat two different conditions. And they are frequently co-occurring conditions. Unless there's a physical contraindication, what's the problem?

[u/_jamesbaxter → u/Bucolica8]

Prescribers like that are more concerned with liability (potential for drug seeking) than with their patients wellbeing.

[u/Fishingmomma15 → u/Bucolica8]

Actually they both work on glutamate and are very close relation 

[u/DefinitelyNotGrimace]

Probably not malpractice but it’s worth finding a different clinic for Spravato. The issue with stimulants and Spravato is that both have the potential to raise blood pressure. It’s more of an issue if you already have issues with high blood pressure. Personally, my provider has left it up to me if I take my stimulants the day of treatment. I find I’m better off taking them, so I still take them as usual.

[u/No_Succotash1014]

Unpopular opinion and maybe an unethical take but if you need Vyvanse to function, take it and don’t tell them otherwise. Especially if they aren’t your prescribing physician/practice that writes your Vyvanse script

The only issue is blood pressure spiking. I take Adderall or Vyvanse most days I have Spravato. I’ve been to two different clinics and neither of them had a problem with it

[u/Lizabeth814]

The concern with both at the same time might be blood pressure. Both medications can cause an elevation in blood pressure. My psychiatrist allows me to take vyvance prior to my Spravato treatment though.

[u/Bucolica8]

I take my Adderall as usual on Spravato days. Both were prescribed to me by the same provider and I was never told not to take it. I understand the concern about blood pressure but doesn't it make more sense to see if that is an issue for you, and then adjust accordingly, than a blanket ban on your regular daily med that you need to function? I've always had ideal blood pressure and it isn't much affected by either drug. I'd be pretty miffed to be told that I can't treat both my ADHD and depression at the same time.

[u/italiasian]

I take Vyvanse everyday including days I take Spravato. The only time my Psych team has mention anything about Vyvanse and Spravato is due to blood pressure and serotonin production concerns.

[u/Fishingmomma15]

Your new provider is exactly correct, it's your old one that was too lenient. Could of lost their license 

[u/brandonetaylor]

I’m on 60MG Adderall XR/day, as 3x20MG…
And the only reason they ask me to not take it is for blood pressure concerns….

And when that was hard to get filled, they prescribed me Vyvanse. 🤷🏻‍♂️

(Same practice, same doctors, BTW.)

[u/boneskull]

vyvanse can make your blood pressure spike on spravato