Martha listened quietly, letting John get the history out there without interruptions, her expression calm and neutral. Most of it coincided with what she had already read and been told. When he finished, she took a breath, considering everything carefully.
"Well," she started, looking thoughtful. "What concerns me is that you're coming to me for more medications when what I suspect might help you more is to come off the ones you're currently on and perhaps try something a little less drastic." There was a pause as she tried to read what his reaction was to that.
"Insomnia is one of the most common side effects of just about every medication there is for treating PTSD, and those medications can also be one of the biggest causes of tremors. It can become a very dangerous combination, to take medication to handle one problem and then a whole host of other ones to try to counter the side effects from the first one. That, combined with your alcohol intake, and yes, I know how much you've been drinking just by looking back on the message boards, can cause some serious damage to your liver." She nailed him with a look, the kind of look that said not to try to bullshit her, because she had heard it all before, from all kinds of patients, ranging from Friday night London A&E patients to veteran soldiers who battled alien invasions.
"You've been through a lot, John, and believe me, I understand it, but chemically suppressing emotions is a truly terrible idea in the long run." That way led to an inability to focus thoughts, chronic insomnia and permanent damage.
Martha sighed slightly and sat back in her chair. "Obviously, coming off these types of medication too abruptly can be very dangerous, so before changing anything to your prescription, I'm going to need to take a blood sample, run a liver function test and do a full blood count. Then, once we know what sort of state your internal organs are in, we can think about adjusting the meds. What do you think?"