Psycho-Babble Medication Thread 2037

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Re: Meds and such

Posted by Shirley on January 6, 1999, at 23:12:42

In reply to Re: Meds and such, posted by Toby on January 6, 1999, at 16:22:42

> You have to request an appeal from your doctor to the insurance company stating that other medications do not work for you and that they cause intolerable side effects. It has to state that Remeron is effective for you with few to no side effects and that it is your doctor's medical opinion that Remeron is medically necessary to treat your depression and he requests that the insurance company cover the cost of the medication, less the usual and customary copay for other medications. (And you are correct about the cost. Remeron is $77 per month for #30 30 mg tablets and Prozac is $84 per month for #30 20 mg capsules.)


I lucked out with my Internist who now prescribes my Effexor. When my therapist prescribed it, I was in for quite a shock when the pharmacy informed that my Qual Med insurance wouldn't cover it. It would run me well over $125 per month, so I asked my internist to do as you have suggested, and make a case to my ins. co. justifying it. He said that was way too much trouble, and filled up a bag with samples for me. I would come back for more when I got close to running out, and he'd fill another bag. Those "free" samples have kept me going for over two months now!

We just switched to another insurance (Regence), so now I have a real prescription to have filled (I think they cover it--details like this are overwhelming to me!) I don't care about the copay. I just want to be a regular kind of human again!

Insurance companies have too much control over our health care, IMHO.
Shirley

 

Disappointment

Posted by DL on January 7, 1999, at 21:06:00

In reply to Re: Meds and such, posted by Toby on January 6, 1999, at 16:22:42

I stopped the Remeron increase after those 2 nights and sleep is returning to previous Remeron status.....I was just too afraid of the unknown results with no one for support at home.

Disappointment: I had my med check appt. today. The Dr. said:
1. Increase in Remeron won't affect the appetite. He would not increase script.
2. Nixed Cylert or Fastin etc.
3. I explained the Remeron problem and asked if he would call the ins. co. or write an appeal. He just said it wouldn't do any good. He said I could write them a letter and complain. When I pressed him he said he would call if I find out the proper person to talk to and call it in to him. so far I have had little luck even trying to find out my ID #!
4. He asked how my life was going, if I still had the job. He then said to come back in 3 months and gave me a script for 30mg Remeron since the other had no refils.

I felt like the $50 per med check (perhaps 10 min) could have been saved and I could have skipped it and called the secretary for a script......

I alternate between feeling insensed that this doctor just does not consider my less earth shaking problems on par with the dramatic intensive care cases he may see.......and wondering if I am just a complainer who should grit my teeth and bare it, or wait it out or just accept what life is giving me now and be satisfied.--after all, that's what I have done most of my life and perhaps that is the ceiling of living for me.......

I want to stand on a chair in the waiting room and yell.......why won't you listen? I'm important too! Can't you just interview me carefully and sit down and figure out the mystery here?
And I want to stomp on the phone when the ins. co. puts me on hold for 15 min. while I'm at work. And I can't call from home since they close down at 4PM. Then they can't find my info and I'm not sure if I'm covered at all. If they all have samples, how come I never was offered any even when I tried all those meds? Or when the Remeron problem came up? Am I just too acquiescent? Too passive? Low self esteem? I don't know. I think you once said everyone deserves a listener...........

I am just so tired of calling and writing. With the divorce, house sale, new life, new job, new med, and a cold look at no retirement funds and no emergency funds and etc. I am so tired. I am in the middle of trying to get a QDRO written (divides a small retirement fund I had through husband pre-divorce). He refuses to help in any way and is putting up road blocks...So tired.

> You might want to call Dr. Longpre and get a feel for him and whether you feel comfortable talking to him before deciding between him and Dr. Altman. , but you are wanting, I think, to kind of go ahead and get it over with).

Yes, I would. But I am still afraid of ending up with someone who will not be helpful and not know it till too late....I feel like I am dragging under.
I will try to find a private time to call. Dr. Longpre and Poire's office called and left me a message at work today asking if I was still interested. But, of the people I have asked who have therapy, no one has heard of their practice. (not that i asked all that many..). Only comment I have heard about the other one (Altman) is that he is kindly and gentle (not necessarily a testimonial to his expertise)

Boy, what a pain I am, huh? Why am I not content to just hang on, like I always was before during the battering, tossing, drowning storm of my life? It's like a tug o war--I want more but I can't get there.

 

Toby, legality of sharing unused meds

Posted by Susan on January 8, 1999, at 9:18:12

In reply to Disappointment, posted by DL on January 7, 1999, at 21:06:00

Toby, if someone has a 90 day supply of a medication that cannot be used because of adverse reactions should that med (ex. Remeron) be flushed down the toilet or can it be given to someone who has a real financial need? It seems like such a waste to flush it when someone who has the same prescription could use it. Wouldn't it be the same as receiving samples? Do medications lose therapeutic properties after a year? I know it is illegal to share meds but if someone already uses them what is the harm? Thanks for your input.

 

Re: Disappointment

Posted by Elizabeth on January 8, 1999, at 15:49:25

In reply to Disappointment, posted by DL on January 7, 1999, at 21:06:00

Hey DL, sorry I didn't respond earlier - been having computer troubles.

It's too bad your doctor didn't want to let you try Cylert; did he say why? I took 18.75mg (the lowest dose it comes in) for about 6 months and it actually improved my sleep (as long as I took it first thing in the morning). I have big problems maintaining a regular sleep schedule, even though I try to do all the "sleep hygeine" tricks. It didn't make me feel anxious or jittery, and I don't remember any appetite loss.

Also, where in NH are you exactly? I'm in Boston and know a few good doctors here, if it's not too far away. It does sound like your doctor isn't taking your problems seriously enough. :-(

 

Other options

Posted by Dr. Bob on January 9, 1999, at 12:25:49

In reply to Disappointment, posted by DL on January 7, 1999, at 21:06:00

> I want to stand on a chair in the waiting room and yell.......why won't you listen? I'm important too! Can't you just interview me carefully and sit down and figure out the mystery here?

> And I want to stomp on the phone when the ins. co. puts me on hold for 15 min. while I'm at work. And I can't call from home since they close down at 4PM. Then they can't find my info and I'm not sure if I'm covered at all.

Sometimes if you try working with a doctor, or an insurance company, and don't get anywhere, it's time to look for another.

I realize that unfortunately there aren't always other doctor options...

If there aren't other insurance options, it might not hurt to give your employer some feedback on this one and to lobby for either a different choice or more choices in the future.

Good luck,

Bob

 

Re: Other options

Posted by Toby on January 11, 1999, at 10:22:35

In reply to Other options, posted by Dr. Bob on January 9, 1999, at 12:25:49

Is the doc that you see in private practice or at a mental health center? You might get more help at a mental health center with the meds than with a doc in private practice. Sometimes they have programs where they can assist with part of the cost of medications. You probably don't qualify for the patient assistance program that the Remeron company has since you have a prescription program with your insurance, but maybe you could talk to your doc about getting a month's supply of samples every other month or something so that your $25 copay would stretch a little farther.

Regarding the EMDR therapists, do talk with them on the phone and then just pick one you feel reasonably comfortable talking to. If they've had the real training then you shouldn't have anything to fear about how "good" they are; remember, this is technique where you will be doing most of the work; the therapist is there just to make sure your brain is continuing to move along and to keep you safe.

Susan asked about returning meds to give to someone else. I checked with a pharmacy and they can't redistribute meds that have been removed from the original stock bottle. However, certain crisis offices that help indigent folks do collect unused meds and samples from the local neighborhood and use them. My clinic will reuse samples if inspection doesn't reveal tampering, but meds in a bottle can't be reused because you just can't ever be sure that tampering hasn't been done and also once the med is out of the stock bottle you don't know the true expiration date or stock number so that if a recall was made by the company because of a problem you wouldn't be able to properly identify the recalled meds.

 

Re: Other options

Posted by shelley on January 11, 1999, at 16:56:13

In reply to Re: Other options, posted by Toby on January 11, 1999, at 10:22:35

Interesting. Where can I send these unopened samples to? I hate to trash them if they could be of some use to some other financially unfortunate person like myself.

 

Reply to Elizabeth

Posted by DL on January 11, 1999, at 20:16:17

In reply to Re: Disappointment, posted by Elizabeth on January 8, 1999, at 15:49:25

> Hey DL, sorry I didn't respond earlier - been having computer troubles.

Thanks for the response. Things have been tumbling in on me lately. I seem to be able to bumble along ok until too many things pile up..then I'm back there hanging off the cliff.

> It's too bad your doctor didn't want to let you try Cylert; did he say why? I took 18.75mg (the lowest dose it comes in) for about 6 months and it actually improved my sleep

He feels that if I am sleeping most of the time and getting to work that there's no reason to add anything. I think he is a little suspicious of the information I come in with from this site? THis is a doc at a mental health center who sees a lot of more dramatic cases. I have always tenaciously hung on, even at great expense to my physical and spiritual person--in some of the most terrible circumstances--all the while putting on a wonderful front to the world. I'm sure the doc is overly busy.

> Also, where in NH are you exactly? I'm in Boston and know a few good doctors here, if it's not too far away. It does sound like your doctor isn't taking your problems seriously enough. :-(

I live near Durham NH--about 45 min drive from MA border down Rte 95 or Rte 125. I am close to Dover and Portsmouth and Exeter also. If you can get recommendations of someone in NH it would be better since there's a better chance of insurance covering it (Healthsource). You can respond to my e-mail if you want. I am still waiting to get a # so I can use the insurance I pay for. Thanks

 

Response to Susan

Posted by DL on January 11, 1999, at 20:26:11

In reply to Toby, legality of sharing unused meds, posted by Susan on January 8, 1999, at 9:18:12

Thanks Susan for the thought! I am finding that living on my own with no real reserves financially is not so easy. There are constantly more bills and glitches. I don't see any reason why the ins co. will cover Prozac but not Remeron at the lower price. Someone on a board somewhere makes these decisions. If the Remeron you have was not a year old it would be great, but I was told to flush the scripts of Paxil, Effexor, Welbutrin and Pamelor I was given. I never was given samples and each script was only for a small supply. Thanks for the thought.

> Toby, if someone has a 90 day supply of a medication that cannot be used because of adverse reactions should that med (ex. Remeron) be flushed down the toilet or can it be given to someone who has a real financial need? It seems like such a waste to flush it when someone who has the same prescription could use it. Wouldn't it be the same as receiving samples? Do medications lose therapeutic properties after a year? I know it is illegal to share meds but if someone already uses them what is the harm? Thanks for your input.

 

Response to Dr. Bob

Posted by DL on January 11, 1999, at 20:33:52

In reply to Other options, posted by Dr. Bob on January 9, 1999, at 12:25:49


> Sometimes if you try working with a doctor, or an insurance company, and don't get anywhere, it's time to look for another.

I have expressed my feelings about the ins co to the rep at my work place. I am told this co is cheaper than the others and that it won't come up for a change till summer...Ins co still does not have me in their computers...It's hard to find a good Doc in the mental health field since most people don't talk about them like they do other docs. Maybe you could add a section to your site. I once visited the site for "Car Talk" a public radio show about cars. They have a place where you can add the name of a really good mecanic by state and town/city and also tell why you like the place. something similar for docs would be good..

 

Response to Toby

Posted by DL on January 11, 1999, at 21:06:30

In reply to Re: Other options, posted by Toby on January 11, 1999, at 10:22:35

> Is the doc that you see in private practice or at a mental health center?

The only place I have been over my stormy last few years is a local mental health center that services seacoast NH. When I was falling apart rapidly a few years ago I called other places and they would not see me for many weeks...only the health center would see me on an emergency basis. I have never been anywhere else. This doc rushes from pt to pt. At my last visit he was rushing in from intensive care. I'm sure my unhuman ability to hang on and look OK on the outside works against me sometimes.

> maybe you could talk to your doc about getting a month's supply of samples every other month or something so that your $25 copay would stretch a little farther.

I can try....he's never available by phone--no matter how many times he tells me to "call if you need anything". I could write a letter or leave a message with the secretary.

I called the ins co as the doc suggested to get a name for him to call. I was told that there is no one for the doc to call. They refused to give me a name. I was told I could write an appeal letter myself but that the rep I talked to had worked there 7 years and had never seen one do any good. She said the preferred and non-preferred drug lists are only updated when new info comes out from the FDA about drugs. At this point I am so tired and depressed with all the things moving in on me I don't think I will even try.

> Regarding the EMDR therapists, do talk with them on the phone and then just pick one you feel reasonably comfortable talking to.

I can't even do that until I have a card or # in the ins co system. Then they will give me an authorization for some visits....

If I hear this week, I will call to talk to the 2 EMDR/cog beh people. Perhaps I can talk on the phone without being charged --to get a feel for if I would feel safe with them. Sounds stupid, but I want to try this out at the same time I am terrified to do so. Sound stupid?

I just don't understand why the wall just tumble in on me sometimes?? Sometimes I am struck almost immobile in some normal daily situation. I watched a Disney movie the other night with a family marooned on an island. I knew the "pirates' were just actors, but when the yelling and guns started I had my hands over my ears and head in my lap and my heart was racing and my body was wired. HOW STUPID! But it just overcomes me..

I rarely see movies since the same thing frequently happens there. Sometimes I jump literally out of my seat. I did just see Patch Adams. I actually laughed a few times. I was so impressed with the real doc and his mission I found the web site on the internet and asked for more info. You, Toby have somethings in common with Patch--sense of humor, respect for people, and a willingness to see other perspectives. you should watch it if you haven't. I wish I were daring enough to follow a star like he did....

I wish someone would tell me why I am in the clutches of a monster sometimes with no warning. I feel terrified and want to hide--sometimes in the middle of a conversation--sometimes while watching TV etc. Why Why Why???? The energy to cope with life is emence sometimes.

Boy am I in a turmoil now. I want to cry , yell, run, hide all at the same time.
Thanks for letting me spout.

 

Discading Meds

Posted by alan on January 12, 1999, at 9:35:26

In reply to Response to Toby, posted by DL on January 11, 1999, at 21:06:30

I might mention that there are 'third world' countries where many people can' get an aspirin. They could use our discards, if we just maileed them, The problem is that I'm afraid of all the crazies out there and the frequent inability to test drugs in these countries, due to lack of equipmentt etc.. Widespread theft is also a problem: contributed drugs may never reach the poor, only the rich alreeaddy getting theirs from th UK, say. Any suggestions?

 

Don't disappear Toby!

Posted by DL on January 17, 1999, at 22:59:05

In reply to Response to Toby, posted by DL on January 11, 1999, at 21:06:30

Please don't linger on the posts arguing about your gender and intentions. I for one don't mind that you have chosen not to share personal aspects. The best of all worlds would of course to be able to access your skills as a professional in the non-cyber world. But outside of that I will take whatever you graciously offer to me. I don't think you will disagree when I say that I have not met up with the optimum in mental health care--and I didn't even know why I was so frustrated since I had nothing to compare to. Because of you I have been able to sleep for the last 2 months, and the frantic, crazy anxiety has melted. I don't know how much longer I could have lasted the way I was. The years had worn me down to the quick. The MD was charging for visits but not really doing anything--and he had given up long ago on trying to figure out what might help. Just " here, fill this prescription for klonopin and see me in 3 months"----

For all I know I could be in a much better place than I am now. I remember studying Maslow's levels (I think it was him). I have finally accomplished the survival level (which I think was the lowest). But I want to feel what it is like to really live--and your ideas: EMDR, cog-beh therapy, Cylert or similar, even the possibility a while back of sub-clinical thyroid issues, and I haven't forgotten Buspar. I remember all your suggestions. I just have no one to listen and work with me.

I for one want to thank you for being here. You have helped to give me hope and some direction--all the time with a caring and professional mannor. You also are not afraid to include non-drug ideas. I only wish I had a way to implement most of your suggestions.

THANKS FOR GIVING OF YOUR TIME AND KNOWLEDGE!!
And, please warn me if you decide to stop. You have been a guiding path for me--if you suddenly disappear it would be a shock to my system. You will never know how many times I have been in an awful place inside--and found your posting waiting to pull me back up. Once on a Sat. when I started Remeron, I was afraid of its effects and also dealing with some scary things at home. I was very lost. Even though I knew you didn't post on Saturdays, I had no where else to go so I checked, and you were there! That was what I needed to pull by self back.

---Sorry for going on like this.
Questions:
1. Why is it so terribly hard for me to set up this EMDR/cog thing? Writing the letters was not hard, talking when they called wasn't so terribly bad, but for me to call and decide and set up an appt is unbelievable hard for me! I now have an insurance # finally. It was like pulling teeth, but on Friday I forced myself to call one office to set up an appt. And, they were out because of the snow and ice storm! Not in till Tue. Then I have to call from work and that's even harder. Why Why Why??

2. This weight thing is driving me crazy and I hate my self for it. I look in the mirror dispise myself. I have found that some of the eating is a way to keep myself alert. I have more trouble later in the day and look for something cruncy or strong flavored. But I seem to gain the weight out of proportion to the intake also. If you think the Cylert of Fastin (?) would work, what are some persuasive arguements I can use?

3. I also notice that now that I don't have someone yelling and throwing things and I have a safe peaceful place to come home to, a kind of inertia takes over me when I don't have to go to work. I can do nothing for long periods of time--I even can spend hours in a large store just wandering -trying to decide about some small purchase. I don't have the energy or will power to do the things I should be doing. Along with the decrease in anxiety I am finding that I am not rushing around getting things done. I find it hard to get out of bed unless I have to. And, as I think about it now, I have been spending most of my non-work time by myself--at my quiet apartment. All of this is scary to me. What is your take on this?

I feel like I am becoming a blob sitting on a log. Almost like I am hibernating for the winter--

Sorry for this dragged out mess....Perhaps when you have a chance you can put all your ideas for me in one post and I can print it out and use it as a guide when I talk to the cog guys. Perhaps they can suggest a good MD to switch to....

 

Re: Inertia

Posted by Toby on January 20, 1999, at 8:52:00

In reply to Don't disappear Toby!, posted by DL on January 17, 1999, at 22:59:05

Taking a leap into the unknown future is very scary and change is always disconcerting. Humans like things to be the same and changing our feelings and behaviors involves all sorts of biological changes which the body hates to have. Even when our current state is non-adaptive or even harmful, our biology tells us not to rock the boat. Perhaps that is why it is difficult for you to call for the appointment: the fear of facing the past and making changes, especially with all the changes you have gone through recently, can really put the brakes on assertive actions. Also, that may be part of the inertia you are having at home alone; the relief of stress makes your body loathe to get up and go, to make changes, to make decisions that might be wrong because it remembers what would happen before when any human interaction occurred or when you made a wrong decision. The body doesn't really realize that the danger is gone, so it continues to act the way it feels is protective of you.

Refer your doctor to Essestial Psychopharmacology by Stephen Stahl, MD, p227-229 for the fenfluramine. It acts to release more serotonin which helps with energy, depression and possibly the weight gain from Remeron.

 

Re: Inertia

Posted by Elizabeth on January 20, 1999, at 11:16:49

In reply to Re: Inertia, posted by Toby on January 20, 1999, at 8:52:00

> Refer your doctor to Essestial Psychopharmacology by Stephen Stahl, MD, p227-229 for the fenfluramine. It acts to release more serotonin which helps with energy, depression and possibly the weight gain from Remeron.

Hi Toby. Didn't they take fenfluramine (and d-fenfluramine) off the market (US at least) because of the PPH thing?

 

Book

Posted by DL on January 21, 1999, at 23:40:25

In reply to Re: Inertia, posted by Toby on January 20, 1999, at 8:52:00


> Refer your doctor to Essestial Psychopharmacology by Stephen Stahl, MD, p227-229 for the fenfluramine. It acts to release more serotonin which helps with energy, depression and possibly the weight gain from Remeron.

Will it act like the SSRI's that so hyperaroused me? And is this the same as the Fastin? And is the ins co likely to list it as not covered if it was used for dieting?

I searched amazon.com for the book and then ordered it from my local college library through interlibrary loan (they don't know I am graduated yet!) I will be able to have it for a few weeks. I think it will be interesting to look up some things. Also if you go to amazon .com and search for Stahl, Stephen it brings up the 1996 version and the 1998 version and also lists one coming out next Fall called the "Atlas of Depression". Is the 1998 version the same as the 1996? The title is just slightly different.

I may take a "longcut" between visits tomorrow and find the office of the EMDR/beh guys. (small progress).

Is there a difference between practices that are called cog/beh and the ones that are just beh?

Thanks for hanging in there for me.

 

Re: Book

Posted by Toby on January 22, 1999, at 10:36:05

In reply to Book, posted by DL on January 21, 1999, at 23:40:25

There is a difference between cog/beh and beh therapy. Beh therapy doesn't involve looking at the automatic dysfunctional thoughts that perpetuate unwanted behaviors and an example would be some of the smoking cessation programs that involve snapping a rubberband against the wrist whenever there's an urge to smoke but don't look at why a person believes they need to smoke or why they believe they can't stop.

I'm not sure how different the 1996 and 1998 versions of Dr. Stahl's book are. Probably the 1998 version contains the newer medications that have been released since 1996.

Fenfluramine is still available, just not in the combo with Phentermine for weight loss. You won't be able to tell if the fenfluramine will cause jitteriness until you take it, but again, it hasn't had that effect with any of the other patients who have tried it, even when they had jitteriness from SSRI's. You will have to check I suppose with the insurance company as to whether they will cover it. Some companies cover meds for off label use.

 

Re: Book

Posted by Elizabeth on January 23, 1999, at 0:26:24

In reply to Re: Book, posted by Toby on January 22, 1999, at 10:36:05

> Fenfluramine is still available, just not in the combo with Phentermine for weight loss.

I looked this up...fenfluramine has been taken off teh market; phentermine remains. They were never sold as a combo, BTW: you got scripts for both drugs and took the phen in the morning and the fen at night.

Phentermine (and other stimulants) haven't been linked to any heart valve problems.

 

Behavioral Therapy

Posted by DL on January 24, 1999, at 19:37:57

In reply to Re: Book, posted by Toby on January 22, 1999, at 10:36:05

> There is a difference between cog/beh and beh therapy. Beh therapy doesn't involve looking at the automatic dysfunctional thoughts that perpetuate unwanted behaviors and an example would be some of the smoking cessation programs that involve snapping a rubberband against the wrist whenever there's an urge to smoke but don't look at why a person believes they need to smoke or why they believe they can't stop.

I asked because the EMDR person closest to me (one of the two we have talked about most) has a practice called "Atlantic Behavioral Therapy". Does this mean it is probably not cog/beh therapy?

Toby once told me you knew of someone in MA (for EMDR etc.). Is that someone accessible from NH? THe other person above has been described to me by the therapist I was seeing ( through other ins co)--as "a quiet, older man". She knew him since he had once worked at the same place she does. She said she didn't know he practiced EMDR since he had never mentioned it. He was the one who thought EMDR might not be his choice of a tx tool to use with me. I would like to find another therapist who is experienced in cog/beh as well as EMDR. Therapy was stopped because of ins. co change. I am realizing that I still need those sessions. Last one was 1 1/2 mo ago and I seem to be sliding within my self more and the issues I should work on seem to be getting burried again--back where they were for years. I'm not sure if my desire to just come home from work by myself and do nothing in particular is just my need to have peace after all those terrible years, or a sign that something isn't right?


> Fenfluramine is still available, just not in the combo with Phentermine for weight loss. You won't be able to tell if the fenfluramine will cause jitteriness until you take it, but again, it hasn't had that effect with any of the other patients who have tried it, even when they had jitteriness from SSRI's. You will have to check I suppose with the insurance company as to whether they will cover it. Some companies cover meds for off label use.

Which of the many things you have talked about for me would be the best choices to try with the Remeron? (for weight gain and the concentration and the inertia?) I know the Doc I see now is not interested in working with me on meds., but if I connect with someone new I will ask about these meds. I am still having some trouble concentrating also. We all took infant and child CPR last week. When we took the test at the end I was the last one taking it. It was like taking my certification exam--so hard to keep my focus on the question--things kept flying out of my mind.

My take on this is that a combination of the medication and all the "stuff" floating inside my brain just under the surface are clouding things a little. I think some of the eating is a way I am "keeping myself alert" in the evenings.

I am still getting no where with the new ins.co.(Remeron as a non-preferred drug) and the MD does not want to call them. When I look back over the # of appts over the last few years and realize how many didn't accomplish anything, I wonder how they don't realize that a good initial workup and agressive treatment right off the bat--with perhaps one or two consultations with a MD focused on psychopharmacology--would have made sense????? Managed care is being trapped by it's own rules I think.

 

Re: Behavioral Therapy

Posted by Toby on January 26, 1999, at 13:19:33

In reply to Behavioral Therapy, posted by DL on January 24, 1999, at 19:37:57

From the name Atlantic Behavioral Therapy, it's hard to say whether the Cognitive component has been completely removed or whether it's just an easier name to have for a practice. The therapists I know for EMDR in MA would be on your list, I don't know anybody who has been recently added to that list.

Elizabeth corrected me about the fenfluramine. She is right. It is the fenfluramine that was removed from the market entirely, and phentermine remains. The phentermine is a good weight loss drug but does relatively little for depression (fenfluramine works on serotonin, phentermine does not), therefore it would be a hard sell to the insurance company. Since that has now been eliminated, I wonder about trying Wellbutrin (no weight gain, no serotonin, more energy) with the Remeron if the depression is returning. Samples are available as is an assistance program you may qualify for (the doctor would have the forms) since you are paying so much for the Remeron. Why don't you call the doctor or perhaps a nurse at the mental health center and see if samples of the Remeron are available (I think you were going to do this last week, but don't know what the results may have been)?

 

Re: Behavioral Therapy

Posted by DL on January 26, 1999, at 19:13:32

In reply to Re: Behavioral Therapy, posted by Toby on January 26, 1999, at 13:19:33

> The therapists I know for EMDR in MA would be on your list, I don't know anybody who has been recently added to that list.

When I wrote in for a list of therapists I listed 5 or 6 towns nearby since I live in a small town. They sent a list for only those areas--instead of for NH or New England. So I have a pretty restricted list.

> , I wonder about trying Wellbutrin (no weight gain, no serotonin, more energy) with the Remeron if the depression is returning. Samples are available as is an assistance program

Back when a number of meds were tried and all sent me into a whirling dervish of inner aggitation and jittery on edge nerves--Wellbutrin was the last tried (close to 2 yrs ago). I tried cutting those large pills into small pieces and it wasn't easy! But that same feeling came back.

Perhaps my experiences with all those (Paxil, Effexor, Wellbutrin) for VERY short (a week or less) periods was related to my totally stressed out condition and poor or no sleep at the time. Perhaps my reaction would be different now--sort of afraid to have that feeling again.

I also think that if I wasn't handed each one and told to come back in a few months, (if I had some coaching and help adjusting) that the results might have been different. What is your opinion on this? Would I likely react any different now to those meds? AND, WHY do they do that to me? Once, when I was desperate I wrote to the e-mail address of one of the docs who answers questions on the Question page of this site. He wrote back to me and suggested that since all those meds act in diff ways and I had the same problem with them, that I just didn't want to get better. That kicked me into the pit of low self esteem--thinking that I was the cause of the failure of the meds.....

After all those years living with fear hormones and no sleep I am very protective of this good sleep/lower anx level I have. The Remeron has dampened the anxiety and given me good sleep. Perhaps after a few months to savor those benefits I am noticing what was underneath that I could not attend to before?

> Why don't you call the doctor or perhaps a nurse at the mental health center and see if samples of the Remeron are available (I think you were going to do this last week, but don't know what the results may have been)?

Yes, I can do that. Although they may save them for people who have no insurance at all--and I have been there before.

Still procrastinating on the EMDR/cog issue. It's so much easier if there is a recommendation from someone who has been to them instead of chosing a name out of a hat...Wish I could tell how experienced they are. This is so hard for me to do that I'm afraid if it doesn't turn out good this time I won't try again....

Thanks again for hangin in there for me. If I just had a recommendation of someone competent , experienced and caring, I would be able to call right now....

 

Re: Behavioral Therapy

Posted by Toby on January 28, 1999, at 14:04:35

In reply to Re: Behavioral Therapy, posted by DL on January 26, 1999, at 19:13:32

Was the Wellbutrin the sustained release form? When it was the old immediate release form there were a lot of complaints about jitteriness, but with the sustained release form, not so.

Am working on a referral of a therapist in southern New Hampshire. Will let you know when I get a response.

 

Re: Behavioral Therapy

Posted by DL on January 28, 1999, at 20:11:07

In reply to Re: Behavioral Therapy, posted by Toby on January 28, 1999, at 14:04:35

> Was the Wellbutrin the sustained release form? When it was the old immediate release form there were a lot of complaints about jitteriness, but with the sustained release form, not so.

I don't think so. At least it didn't say it on the box. That was the only med offered to me as a sample. I do remember they were large hard to cut pills..And it was almost exactly 2 yrs ago. After that my tx was just to take klonopin and "try to relax"...

I NEVER NEVER NEVER WANT TO RETURN TO THE WAY I WAS POSTPARTUM AND THREE YEARS AGO! I know I would fall over the edge this time. I'm pretty sure hormones had something to do with it each time. After all a good part of my life felt like being in front of a firing squad and sometimes I slept and survived... Or maybe it was just coincidence?

On that topic, the only other medication I take is the small amounts of natural hormones--since last summer. I don't know if they are helping but I am terrified to do anything that might take away the sleep and lowered anxiety. The synthetics (Provera and Premarin) were precipitants to this tumble into the depths 3 yrs ago. I have been struggling with the new ins co for the last 2 wks to transfer scripts to them and as it turns out, since they are compounded (estradiol and progesterone in oil), they are considered to be NON PREFERRED!! What else, huh? I am so tired of all this bargaining with the ins co that I will probably just stop taking them. With the Remeron that is 3 non-preferred meds=$75/mo=around $1000 a year. What if anything else were to come up? Every time I called I got a new person and a new story...


> Am working on a referral of a therapist in southern New Hampshire. Will let you know when I get a response.

Thank you, Thank you, Thank you.

I told them(EMDR) I lived near Durham, Dover, Portsmouth, Exeter and so that's all they sent me. I would like to find someone I could trust and who is experienced --who has background in more than EMDR--something that will allow me to start struggling uphill toward what other people around me seem to come by naturally?

I don't know why this is so hard for me...I think I have lost some trust in the mental health professions in my area because of my experiences over the last few years with the nice but not very helpful doc. And, it was so nice to go in to the therapist--to be able to cry, to be listened to, cared about and nurtured--to feel some humanity. But I knew soon enough that there was more for me to do than that-

 

Re: Behavioral Therapy

Posted by Toby on January 29, 1999, at 11:45:44

In reply to Re: Behavioral Therapy, posted by DL on January 28, 1999, at 20:11:07

Dr. Kathy Gibney in Dover is a Level II certified
EMDR therapist. She comes highly recommended from other therapists in NH who are too far away from Durham to be of help. Words used to describe her are "excellent therapist," "very caring therapist," and "will be able to put her (you) at ease immediately." She can be found in the Dover phone book.

Dr. Longpre was also recommended, but I'm thinking a female therapist might help you be more relaxed at this point, since it is so stressful for you to even think about a new therapist, much less addressing those old issues.

Now, then, (the one and only time I will probably ever tell you what to do), go call her. Good luck.

 

Therapist

Posted by DL on January 30, 1999, at 22:06:36

In reply to Re: Behavioral Therapy, posted by Toby on January 29, 1999, at 11:45:44

> Dr. Kathy Gibney in Dover is a Level II certified EMDR therapist. She comes highly recommended from other therapists in NH who are too far away from Durham to be of help. Words used to describe her are "excellent therapist," "very caring therapist," and "will be able to put her (you) at ease immediately." She can be found in the Dover phone book.

Thank you so very much for going certainly beyond the call ofa fellow poster on this site... I know this has taken time and thought on your part and be assured that I deeply appreciate it!

When I finally got into the site last night for a short time, and found this post, I was so excited I smiled and felt felt like dancing around ( I know this sounds like a small response, but little steps lead to bigger strides--remember your story about the little shift inside the circle producing a big difference on the outside?) I felt a sense of relief that I could feel safe contacting this person.

But I found myself becoming wary today. And I need you to boost my spirits again! I looked in the phone book (mine covers Dover) and she was not listed under psychotherapist, psychologists etc--no where. So I assumed she was part of a group. I then tried the white pages and found her listed as Kathleen Gibney Dr. I used Mapquest to find the road and today I drove up to find where it was. I thought there was always a chance her office might be open on Sat. Well, the house is on a narrow road in a fairly crowded old residential area (some of the houses are not in such great shape). It has no sign or name out front and looks to be just a family home with a small driveway. Being me, I was then beset by all sorts of thoughts, including that I was at the wrong place, or that she had an office somewhere else. So I did not go in. But, when I got home I checked again and that is the only listing for her. I even checked the yellow and white pages on the web and there was no listing for her.

Yes, I know you must be shaking your head at me... And I WILL her call on Monday to see what's up. She must work at home and use no form of advertising (not even a sign). Is this common? My only experience has been with the Mental Health Center so I don't know how this stuff works elsewhere.

Any comments? Do you happen to know if she is experienced in cog/beh therapy? Or what her brand of therapy is? (other than EMDR?) Sorry for being such a pain. AND I WILL CALL. I sort of feel strange calling on a weekend.

> Dr. Longpre was also recommended, but I'm thinking a female therapist might help you be more relaxed at this point

Thanks again for being so caring--something I don't expect since I had become accustomed to its absence.... If contact with Ms Gibney does not work out I will call and talk to Dr. Longpre. And, in case you have other names, it is 15 min drive to Dover, 20 min to Portsmouth, about 25 min to Manchester, and about 30 or so to Concord-all doable.

,>since it is so stressful for you to even think about a new therapist, much less addressing those old issues.

Sorry I am such a pain....I just don;t know why I am so tied up and afraid sometimes. Why was I able to stand up in front of large classes and teach a session (in college), I can go to meetings in my job and speak--but I can't do such mundane things as these?

> Now, then, (the one and only time I will probably ever tell you what to do), go call her. Good luck.

Thanks, I needed that!!!! (the orders and the luck!)

PS: One small stroke of luck. Remeron runs out in a few days so I took the new script in to fill it. Instead of giving them the new ins co info I let them try under the old one---AND IT WENT THROUGH! (this means $10 instead of $25) All I can figure is that my ex-husband's co does changes on the first of the month and he didn't give them the info till into Jan...Now I am berating myself for not trying the same with the hormone script--but i can't get ahold of the Doc to call it in before Feb 1st. One small savings through!

THANK YOU, THANK YOU, THANK YOU FOR CARING.


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