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Re: No insurance / No doctor / Need help - ANGRY

Posted by metric on March 13, 2009, at 18:51:18

In reply to Re: No insurance / No doctor / Need help - ANGRY » metric, posted by detroitpistons on March 13, 2009, at 16:35:21

> This is a new place, so they aren't cutting me off. It's a community mental health center, and it's free if you don't make much money, etc. I used to have insurance and see a private doctor until recently, so the meds I have now are still from the last 90 day prescription that I got from him. So basically, I'm going to this community place in order to continue to get my meds, because I can't just stop taking Effexor XR.
>
> They knew my financial situation and that I needed help getting meds. That's the whole reason I went there in the first place. Most people who go there are just getting out of the hospital or something. A lot of them have medicaid. For me, it was just for maintenance medication. They told me from the start that I was going to have to apply for patient assistance, so I knew that was going to be the case. BUT, I thought they would take care of me with samples or something until that point. The long and the short of it is that the guy I'm dealing with is basically a moron....He's supposed to find out about samples for me, but he hasn't called me back yet. He also mentioned something about the center actually paying for a couple week supply for me. If all else fails, they'll give me a script for the generic until I can get the stuff from patient assistance. I think I'll be fine, but at the time, I was scared and frustrated. I've got to stay on top of this guy and make sure he does what he says he's going to do.
>

I was referring to your former private doctor (about cutting you off). Can't he keep you tided over with prescriptions until you're in a more favorable situation?


> Before looking at the international route, I'm going to see if I get approved for patient assistance. If I don't get approved, I'm going to try and wean off of Effexor.
>

Try to get as many benzos as you can from the new doc. Ideally (IME) clonazepam (Klonopin) and/or alprazolam (Xanax), preferally the former (again, IME). Get the 2 mg tabs (of either), which you can split. Some people find benzodiazepines equally if not more efficacious than "antidepressants" for depression, with fewer side-effects, and they're very inexpensive. There's the issue of cognitive/memory impairments (though I'm not convinced that "antidepressants" fare any better in that respect), but they can be very helpful in a pinch. Try to time the doses so that peak concentrations don't aren't occur around the time you're planning to e.g., study. And stay away from lorazepam (yuck).

> I don't like this doctor, at all. I told him about the problem with Remeron, and instead of giving me something new, he gave me nothing at all!!! I figured the Remeron was better than nothing. I was walking out and looking at the scripts, and I didn't see one for Remeron. I said, "Hey, I don't have anything here for sleep," and he says, "Well I thought you said you didn't like the mirtazapine," to which I replied "I don't like it, but I need something."
>
> So just like that, he was going to have me walk out of there with nothing for sleep, without telling me!! We walked back into his office and he writes me a script for Remeron, even though I suggested that maybe we try something else. Is this guy that stupid? He doesn't know about any alternatives, like maybe Trazadone? This guy is a complete toolbox, and it's no wonder he's working for a community health center. He sucks. He refused to prescribe me adderall and didn't even explain why. People take the same drugs as I do with Adderall. It's not unprecedented.
>

He won't prescribe Adderall because it has high "abuse potential", not because he's concerned about potential drug interactions or your safety. I know, it sucks. BTW, if you can get amphetamines, I think dextroamphetamine (Dexedrine, DextroStat) is a better choice. Adderall is composed of a mixture of both dextro and racemic amphetamine salts. Since levo-amphetamine has more pressor and less central activity than its dextro counterpart, d-amphetamine has a more favorable ratio of CNS/ANS stimulation.

For sleep, there's always good old diphenhydramine (Benadryl), which is OTC and cheap -- about a penny per 25 mg tab at places like Costo or Walmart. But you probably already know about that, so I assume it doesn't work for you, or has intolerable side-effects.

> I've wanted to take a drug holiday, but I've had too many rough times in the past year. At the very least, I'd like to maybe get off of Effexor and stay on Lamictal. My hope is that Lamictal, as a mood stabilizer, will prevent me from sinking into depression. I don't like to be on meds, but I've had a few depressions. It keeps happening, and so of course, I'm scared that it will happen again. I hate being depressed. It robs me of my life. I've tried taking herbs, 5-HTP, SAMe, and none of that stuff works for me. Even some of the SSRI's didn't work for me. Effexor is powerful though.
>
>

I understand why you're pissed off. I think it's a shame that more people aren't outraged at the injustice of prohibition. I think all drugs should be sold over-the-counter. That would solve both the access and price problem. I can't believe so many adults actually *like* being treated like children.

Get whatever you need, somehow, and keep some around even you don't plan to use it, so you'll have some in case you find yourself spiraling downhill. Good luck.


> > A few thoughts...
> >
> > Did you explain your financial situation to whomever was originally prescribing you these substances? I can't imagine why he or she would cut you off from your medications as a result of your financial hardship. Doesn't sound very ethical to me. Can you think of any other branch of medicine -- excluding psychiatry -- wherein that would happen? Some people on medications only visit their doctor at intervals of several years. Frequent office visits are wasteful of the patient's time and money, especially if nothing is being changed.
> >
> > You can save a lot on the *uncontrolled* drugs you mention (Effexor and Remeron) by importing them from overseas. Also, immediate-release venlafaxine (Effexor) is available as a generic in the United States. Though it may be somewhat less convenient, it would be far less expensive.
> >
> > You mention being a student and studying for exams. You should be aware that mirtazapine (Remeron) is a very potent long-acting antihistamine. You might want to be careful with
> > that. (I found it very impairing)
> >
> > Finally -- although view is probably unpopular here -- you might find it very liberating to ditch the shrinks and your psych meds. You might feel a whole lot better (but be prepared to feel worse for a little while) in many respects. You don't sound like the type of person who will flip out and lose it unmedicated.
>
>


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