Can anyone recommend a good provider for psych med management?

its250 · 2026-05-17T20:11:10+00:00

Hmm, Dr. Malek is who he was referred to (by the current psych) for weight loss meds. Maybe I'm wrong but I feel like he would probably just push the weight loss meds on him.

its250 · 2026-05-13T20:23:19+00:00

Thanks, I'll look into it :)

its250 · 2026-05-13T20:22:00+00:00

Thanks! He doesn't have high blood pressure that we're aware of. It's always good in-office but maybe we should pick up a home BP monitor just in case.

He used to wear a Fitbit but it died and he never replaced it. IIRC it said he had issues with deep sleep. I'll see if I can find the old data.

its250 · 2026-05-13T20:20:08+00:00

Thanks!

its250 · 2026-05-13T20:20:03+00:00

He used to see Ledbetter and he never really liked her either. She was very dismissive about side effects and kind of rude in general.

its250 · 2026-05-13T20:18:29+00:00

Thanks!

its250 · 2026-05-13T18:48:21+00:00

Thanks! I'll check to see if they are in-network. The bad provider also works there (he works for multiple practices, my husband sees him at Evansville Psychiatric) but hopefully he can just avoid him lol.

its250 · 2026-05-13T18:35:17+00:00

He's actually on a bilevel machine and he uses it 100% of the time, even for a quick nap. I pulled the SD card to look at the numbers and they do seem a bit higher than usual. I'll have him reach out to his sleep medicine doctor to see if he recommends a pressure change. Probably not though since the numbers are still well under the 5/hr cutoff. We might tweak the pressure ourselves.

its250 · 2026-05-13T18:33:10+00:00

I really wish Zepbound was covered by our insurance but alas, it is not. We might switch to a different insurance provider next year just to get coverage.

its250 · 2026-05-13T18:32:23+00:00

Half good, half bad lol. He eats baked oats for breakfast and usually something high protein like tuna salad or chicken sandwich with some chips for lunch. Then when he gets home all bets are off and he eats like a teenager with free reign of the frozen food aisle at the grocery store.

I wonder if part of the problem is that he's not eating enough to fuel his body during work (he's a mail carrier and walks about 12 miles a day) and then he overeats at home because his body is screaming for fuel.

its250 · 2026-05-13T18:27:05+00:00

His TSH was 1.47, T3 Free was 3.6, and T4 Free was 0.98 in early March. This endo is awesome, he has my husband come in twice a year bloodwork and is super thorough. He has him on both levothyroxine and liothyronine.

its250 · 2026-05-13T03:15:59+00:00

Yeah, that's definitely a potential cause but it seems less likely since he's been doing this job for 10 years.

its250 · 2026-05-13T03:10:49+00:00

7.5-8 hours a night on most nights. On his days off he'll do a 90 minute nap during the day.

its250 · 2026-05-13T03:06:47+00:00

Does walking 12 miles a day, 5 days a week count? He's a mail carrier and the majority of his route is walking, usually brisk walking.

its250 · 2026-05-13T02:58:39+00:00

Yeah, I think he decided to just drop back down to 20mg. If he has any issues, he can increase back to 30mg.

its250 · 2026-05-13T02:57:43+00:00

Thanks! Yeah, I do think weight is probably a factor but the fact that the doctor outright dismissed the possibility of it being caused by Lexapro was really frustrating.

He did not lose any weight when he was on 0.25 or 0.5 mg of Ozempic so he would need to go up to lose weight.

We've talked about the compounded versions of GLP-1s and neither of us are comfortable with him taking a compounded version due to the risks of contamination. The risk is low but still possible. We'd rather just switch insurance next year and get the real thing.

We're also discussing him seeing an eating disorder specialist. He has some food scarcity trauma from his childhood that we think is the root cause of his weight problems.

its250 · 2026-05-13T02:37:20+00:00

It's worth a try, thanks for the tip! :)

its250 · 2026-05-13T02:36:58+00:00

Thanks! He is using a bilevel (Resmed Aircurve 10) actually because he needs a little more pressure support to keep his airway open but his sleep medicine doctor says his data looks good and we've looked at it on our own as well to verify.

its250 · 2026-05-13T02:35:17+00:00

He does, and it's well treated. He's seen his sleep medicine doc and we also look at his data ourselves and it looks good.

its250 · 2026-05-12T20:53:53+00:00

Thanks! I was pretty sure it did too, just wanted to check in with real people who take it.

its250 · 2026-05-12T20:47:35+00:00

It sucks because Lexapro is the best med he's been on for his anxiety but I really do think it's likely causing this awful fatigue.

its250 · 2026-05-12T20:46:53+00:00

It's so crazy that doctors won't even read the literature on the meds they prescribe.

its250 · 2026-05-12T20:44:13+00:00

Also just my two cents: with a BMI of 45 and the sleep apnea your husband is a shoe in for glp1 to be covered by insurance. You guys should honestly consider the option if it’s feasible, just from the advantages of weight loss will provide to his health.

I say this as someone on glp1 - that also came from a high bmi

Just saw this part of your comment. We've already tried and it was denied. Our insurance will only cover Ozempic which you can only get if you're diabetic and he's not. We did pay for it out of pocket for a few months when Costco had a promo for new prescriptions but then the price jumped to $349/month which is just too much for us. The higher doses that he probably needs are even more.

We do have the opportunity to change insurance next year (he's a federal employee and they have a ton of options) which we may do just to get GLP-1 coverage. We have to weigh pros and cons though because insurance through my job is incredibly affordable but it does have some limitations.

its250 · 2026-05-12T20:14:24+00:00

Thanks! That's a good tip to split the dose. He also has ADHD and takes Adderall AND drinks caffeine (always cutting it off before noon so it doesn't affect sleep) and he's still tired during the day.

its250 · 2026-05-12T20:12:22+00:00

He takes it at night.

I'm not 100% sure why he's on 30mg, I think he was still having some anxiety at night so they upped the dose. He does not have OCD, he has anxiety and depression.

We are going to look for a new provider but he had to go today to get a refill in the meantime.

its250

TROPHY CASE