![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 25 to 49 of 49. Go back in thread:
Posted by CaptainAmerica1967 on February 3, 2009, at 20:07:05
In reply to No insurance / No doctor / Need help, posted by detroitpistons on January 10, 2009, at 18:06:36
Hi, I haven't read through the other comments but Parntership for Prescription Assistant and or Bridges to Access. There are others too.
Posted by detroitpistons on February 4, 2009, at 13:55:04
In reply to Re: No insurance / No doctor / Need help - UPDATE » detroitpistons, posted by rvanson on January 28, 2009, at 9:38:43
Posted by detroitpistons on February 4, 2009, at 13:55:51
In reply to Re: No insurance / No doctor / Need help - UPDATE » detroitpistons, posted by rvanson on January 28, 2009, at 9:38:43
I went in today and they told me that I have to apply for Medicaid so that I'll have a rejection letter, so that I'll be eligible for patient assistence. Apparently, the drug companies are such ***holes that you have to go through all that before they'll help you. I've bought and paid for Effexor XR for 5 years total. Throw me a friggin bone, Wyeth.
Posted by Phillipa on February 4, 2009, at 21:14:34
In reply to Re: No insurance / No doctor / Need help - UPDATE, posted by detroitpistons on February 4, 2009, at 13:55:51
No samples available? I'm so sorry but a clinic have you tried one? Love Phillipa
Posted by detroitpistons on February 5, 2009, at 8:16:26
In reply to Re: No insurance / No doctor / Need help - UPDATE » detroitpistons, posted by Phillipa on February 4, 2009, at 21:14:34
I'm going to the county mental health center. They said they'll get me meds for the next couple of months, but I still have to apply for Medicaid...I guess the drug companies won't do patient assistence unless you prove you've exhausted all options. Therefore, I have to apply to Medicaid and get refused before Wyeth will give me free meds.
What I find a little strange is that I have a friend who lives in a different county and he doesn't have to do this. They write him prescriptions and they send him to a specific pharmacy to pick them up, free of charge....In fact, one of his drugs is Abilify, which is super expensive, at least $500/ month.
I guess as long as I get free meds, I have nothing to complain about. I just hope the Medicaid application process isn't too much of a pain in the a**.
> No samples available? I'm so sorry but a clinic have you tried one? Love Phillipa
Posted by Phillipa on February 5, 2009, at 20:18:07
In reply to Re: No insurance / No doctor / Need help - UPDATE » Phillipa, posted by detroitpistons on February 5, 2009, at 8:16:26
No doubt it will be a pain. Anything Government funded is. I'm assuming you have old tax returns ets.? Great that you will get meds for now. Love Phillipa
Posted by detroitpistons on March 9, 2009, at 18:21:39
In reply to Re: No insurance / No doctor / Need help - UPDATE » detroitpistons, posted by Phillipa on February 5, 2009, at 20:18:07
When I went to the first appointment at this community place, I had well over a month of Effexor XR left. I had gotten the ball rolling with this place as quickly as possible, because I figured it might take a while to get an appointment and get meds, given the fact that I have no insurance, etc. I was trying to be responsible. When I told the doctor that I had a month of meds left, he basically just said, "Come back in a month."
So today I go back there and, after refusing to prescribe me adderall (I'm taking classes and I really do need it) he gives me a one month prescription of Effexor XR with 1 refill, and my standard Xanax prescription (taken once in a while for general anxiety), and Remeron for sleep.
After my appointment with the doctor, I had an appointment with my "case worker." I'm sitting there with my Effexor prescription in my hand and I say, "So how do I get this filled?" He was sort of surprised by the question. I informed him that one month of Effexor XR at a local pharmacy runs something like $350. He actually said that he's never heard of Effexor before!! What? Don't you work in a mental health clinic?
You know, I really hate to complain about free service, but I tried to make it very clear in the beginning that I COULD NOT AFFORD EFFEXOR XR, and that I can't, under any circumstances, miss a single dose of Effexor XR.
I've got 18 days left. Even if I get accepted into Wyeth's patient assistance program, it's going to take longer than that to get the meds. The case worker said that it usually takes around 2 months. He said he would find out about getting samples for me, so there's no guarantee about that. Even so, samples only go so far. I take 3 x 75 mgs/ day. That's a lot of samples.
I'm frustrated. I'm angry. I'm SCARED TO DEATH of running out of Effexor, even for 1 day. This gives me a profound sense of anxiety, but hey, I've got some Xanax now, right? I wish I didn't take these stupid drugs. I wish I never started. I wish I could just stop taking them. I wish my stupid brain wasn't so messed up....Maybe it isn't. Maybe these drugs are just a crutch. Maybe I'm just weak. God, I suck.......All these thoughts start swirling around my insufferable little brain.
This is also very frustrating for me in a larger sense. I guess I'm a person of principle, and, aside from the Effexor problem, the fact that I'm in this situation in the first place pisses me off all by itself. It reminds me of how screwed up our healthcare system is, and how a lot of people don't really care as long as they have insurance. I'm pissed that I have to go asking for "handouts." I'm pissed that everything costs so damned much. I'm pissed that I have to feel guilty for going back to school instead of looking for a job that offers health insurance. I'm just pissed.
Wyeth's patient assistance form has a section that asks for your assets, including IRA's/ 401k. Ok, so I have a few thousand dollars in a couple 401k accounts. I see that question and I start to feel a little guilty because I am reminded that I do actually own something. Am I supposed to take this question to mean that I should cash out (at a terrible tax loss) my meager little life's savings to pay for Effexor XR? Do I lie about my 401k and the unemployment money that's about to run out?
As you can see, I'm pretty pissed off right now. I have a test tomorrow and I can't focus on studying right now because of this.
Posted by Phillipa on March 9, 2009, at 20:48:11
In reply to Re: No insurance / No doctor / Need help - ANGRY, posted by detroitpistons on March 9, 2009, at 18:21:39
I say do whatever it takes to obtain the med. This is just me though. Phillipa
Posted by softheprairie on March 10, 2009, at 2:47:18
In reply to Re: No insurance / No doctor / Need help - ANGRY, posted by detroitpistons on March 9, 2009, at 18:21:39
> When I went to the first appointment at this community place, I had well over a month of Effexor XR left. I had gotten the ball rolling with this place as quickly as possible, because I figured it might take a while to get an appointment and get meds, given the fact that I have no insurance, etc. I was trying to be responsible. When I told the doctor that I had a month of meds left, he basically just said, "Come back in a month."
>
> So today I go back there and, after refusing to prescribe me adderall (I'm taking classes and I really do need it) he gives me a one month prescription of Effexor XR with 1 refill, and my standard Xanax prescription (taken once in a while for general anxiety), and Remeron for sleep.
>
> After my appointment with the doctor, I had an appointment with my "case worker." I'm sitting there with my Effexor prescription in my hand and I say, "So how do I get this filled?" He was sort of surprised by the question. I informed him that one month of Effexor XR at a local pharmacy runs something like $350. He actually said that he's never heard of Effexor before!! What? Don't you work in a mental health clinic?
>
> You know, I really hate to complain about free service, butI really feel for you. The part above reminds me of a smaller similar vexation I'm going through now, with the VITA tax volunteer I used to get my taxes done for free messed up my state return for the second year in a row (when I went to the location I was specifically hoping I wouldn't get the same man, but out of the workers there, he had the opening when it was my turn, so I felt like I had to go with him again). So now I have to make return trips to try to get it corrected.
I tried to make it very clear in the beginning that I COULD NOT AFFORD EFFEXOR XR, and that I can't, under any circumstances, miss a single dose of Effexor XR.
>
> I've got 18 days left. Even if I get accepted into Wyeth's patient assistance program, it's going to take longer than that to get the meds. The case worker said that it usually takes around 2 months. He said he would find out about getting samples for me, so there's no guarantee about that. Even so, samples only go so far. I take 3 x 75 mgs/ day. That's a lot of samples.
>
> I'm frustrated. I'm angry. I'm SCARED TO DEATH of running out of Effexor, even for 1 day. This gives me a profound sense of anxiety, but hey, I've got some Xanax now, right? I wish I didn't take these stupid drugs. I wish I never started. I wish I could just stop taking them. I wish my stupid brain wasn't so messed up....Maybe it isn't. Maybe these drugs are just a crutch. Maybe I'm just weak. God, I suck.......All these thoughts start swirling around my insufferable little brain.
>
> This is also very frustrating for me in a larger sense. I guess I'm a person of principle, and, aside from the Effexor problem, the fact that I'm in this situation in the first place pisses me off all by itself. It reminds me of how screwed up our healthcare system is, and how a lot of people don't really care as long as they have insurance. I'm pissed that I have to go asking for "handouts." I'm pissed that everything costs so damned much. I'm pissed that I have to feel guilty for going back to school instead of looking for a job that offers health insurance. I'm just pissed.
>
> Wyeth's patient assistance form has a section that asks for your assets, including IRA's/ 401k. Ok, so I have a few thousand dollars in a couple 401k accounts. I see that question and I start to feel a little guilty because I am reminded that I do actually own something. Am I supposed to take this question to mean that I should cash out (at a terrible tax loss) my meager little life's savings to pay for Effexor XR? Do I lie about my 401k and the unemployment money that's about to run out?
>
> As you can see, I'm pretty pissed off right now. I have a test tomorrow and I can't focus on studying right now because of this.
I so concur with your assessment throughout your post. I wish I had something more constructive to say, but I don't.
I don't know if I would have the guts/forwardness to actually do this, but what if you mailed a copy of your post here to the director of the community clinic in question. That person might be able to do something.
If it really gets to be that you are out and can't get enough samples, you might be able to have a pharmacy call the doctor's office to authorize some (relatively) cheaper immediate-release generic venlafaxine and take those spaced throughout the day, but just buy a week's worth at a time while you try to pressure a speed up from any of the parties who can get free ones to you.
You are definitely one of the far too many falling between the cracks in our messed-up country, aka "playing by the rules but losing," which I also feel.
Posted by detroitpistons on March 10, 2009, at 10:56:53
In reply to Re: No insurance / No doctor / Need help - ANGRY » detroitpistons, posted by softheprairie on March 10, 2009, at 2:47:18
Thanks. It's nice to know that someone understands. There's no easy answer here. As far as the short term situation with Effexor, the suggestion you made about going on immediate release Effexor for a while is a good idea....I just have to remember to take them at the right time (easier said than done for me). If I can get these people to actually help me out and write scripts for me, I think that will be a good strategy. But this isn't like a normal doctor's office where you can call with emergencies and they will help you. It seems like it's really hard to get help outside of your scheduled med reviews. But if I have trouble, I'm going to raise hell.....They should go through Effexor withdrawal and see what it's like. It amazes me that, for years, drug companies and doctors denied that withdrawal, or as they like to put it, "discontinuation syndrome," exists at all.
> I so concur with your assessment throughout your post. I wish I had something more constructive to say, but I don't.
> I don't know if I would have the guts/forwardness to actually do this, but what if you mailed a copy of your post here to the director of the community clinic in question. That person might be able to do something.
> If it really gets to be that you are out and can't get enough samples, you might be able to have a pharmacy call the doctor's office to authorize some (relatively) cheaper immediate-release generic venlafaxine and take those spaced throughout the day, but just buy a week's worth at a time while you try to pressure a speed up from any of the parties who can get free ones to you.
> You are definitely one of the far too many falling between the cracks in our messed-up country, aka "playing by the rules but losing," which I also feel.
Posted by Merge on March 10, 2009, at 16:42:08
In reply to Re: No insurance / No doctor / Need help - ANGRY » softheprairie, posted by detroitpistons on March 10, 2009, at 10:56:53
It was actually cheaper for me to order the generic XR (venlafaxine XR) from Canada rather than to pay for the generic non-XR (venlafaxine, non-XR) in the United States.
Posted by jflange on March 10, 2009, at 21:53:00
In reply to Re: No insurance / No doctor / Need help - ANGRY » softheprairie, posted by detroitpistons on March 10, 2009, at 10:56:53
detroitpistons,
I completely agree with you that the US health system is sick and twisted and I think you are right to be very angry. I have been there.
I am also sorry to hear that you don't qualify for patient assistance (a scam by drug companies to keep from getting sued- a scam I happen to benefit from at the moment).
I don't know how much you can afford, but I did find an RX card program (County RX Card) that will allow you to have your Effexor XR for about $140. As long as you have the script, then you can shop around for rx card programs (another one I know is PS Card but I am sure there are others). If it were up to me, we would never pay more than 10 bucks for any medication, like they do in sane countries. Still, if you are in a pinch, 140 is way better than retail, which is a screw job.
It would be horrible if you have to discontinue and I hope it doesn't come to that for you.
Good luck!
jflange
Posted by metric on March 13, 2009, at 15:32:41
In reply to Re: No insurance / No doctor / Need help - ANGRY, posted by detroitpistons on March 9, 2009, at 18:21:39
> When I went to the first appointment at this community place, I had well over a month of Effexor XR left. I had gotten the ball rolling with this place as quickly as possible, because I figured it might take a while to get an appointment and get meds, given the fact that I have no insurance, etc. I was trying to be responsible. When I told the doctor that I had a month of meds left, he basically just said, "Come back in a month."
>
> So today I go back there and, after refusing to prescribe me adderall (I'm taking classes and I really do need it) he gives me a one month prescription of Effexor XR with 1 refill, and my standard Xanax prescription (taken once in a while for general anxiety), and Remeron for sleep.
>
> After my appointment with the doctor, I had an appointment with my "case worker." I'm sitting there with my Effexor prescription in my hand and I say, "So how do I get this filled?" He was sort of surprised by the question. I informed him that one month of Effexor XR at a local pharmacy runs something like $350. He actually said that he's never heard of Effexor before!! What? Don't you work in a mental health clinic?
>
> You know, I really hate to complain about free service, but I tried to make it very clear in the beginning that I COULD NOT AFFORD EFFEXOR XR, and that I can't, under any circumstances, miss a single dose of Effexor XR.
>
> I've got 18 days left. Even if I get accepted into Wyeth's patient assistance program, it's going to take longer than that to get the meds. The case worker said that it usually takes around 2 months. He said he would find out about getting samples for me, so there's no guarantee about that. Even so, samples only go so far. I take 3 x 75 mgs/ day. That's a lot of samples.
>
> I'm frustrated. I'm angry. I'm SCARED TO DEATH of running out of Effexor, even for 1 day. This gives me a profound sense of anxiety, but hey, I've got some Xanax now, right? I wish I didn't take these stupid drugs. I wish I never started. I wish I could just stop taking them. I wish my stupid brain wasn't so messed up....Maybe it isn't. Maybe these drugs are just a crutch. Maybe I'm just weak. God, I suck.......All these thoughts start swirling around my insufferable little brain.
>
> This is also very frustrating for me in a larger sense. I guess I'm a person of principle, and, aside from the Effexor problem, the fact that I'm in this situation in the first place pisses me off all by itself. It reminds me of how screwed up our healthcare system is, and how a lot of people don't really care as long as they have insurance. I'm pissed that I have to go asking for "handouts." I'm pissed that everything costs so damned much. I'm pissed that I have to feel guilty for going back to school instead of looking for a job that offers health insurance. I'm just pissed.
>
> Wyeth's patient assistance form has a section that asks for your assets, including IRA's/ 401k. Ok, so I have a few thousand dollars in a couple 401k accounts. I see that question and I start to feel a little guilty because I am reminded that I do actually own something. Am I supposed to take this question to mean that I should cash out (at a terrible tax loss) my meager little life's savings to pay for Effexor XR? Do I lie about my 401k and the unemployment money that's about to run out?
>
> As you can see, I'm pretty pissed off right now. I have a test tomorrow and I can't focus on studying right now because of this.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.
Posted by detroitpistons on March 13, 2009, at 16:35:21
In reply to Re: No insurance / No doctor / Need help - ANGRY, posted by metric on March 13, 2009, at 15:32:41
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.
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.
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.
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.
> 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.
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.
>
>
Posted by metric on March 15, 2009, at 15:19:02
In reply to No insurance / No doctor / Need help, posted by detroitpistons on January 10, 2009, at 18:06:36
I just checked an overseas online pharmacy that I've used a few times in the past and found reliable and price-competitive. The forum rules don't permit me to publicly post where, but the following information should be permissible:
This should give you a ballpark estimate of what it'd cost to obtain the Effexor-XR via importation: the 150 mg caps of Effexor-XR were slightly more than a dollar/capsule (34.99 for 30 caps and 99.99 for 90). They're made by Solus. You'd pay substantially more for the equivalent dose in 75 mg tablets, so I'd advise using 1 + 1/2 (150 mg) capsules instead of 3 of the lower strength.
If you want more details, that can probably be accomplished inconspicuously. I have no affiliation with any pharmacy.
Posted by Neal on March 15, 2009, at 23:09:20
In reply to Re: No insurance / No doctor / Need help - ANGRY, posted by detroitpistons on March 9, 2009, at 18:21:39
Detroit;
I recommend you don't go off your meds. Really. Until we get some decent health care here, think about what metric wrote. It might be a way to go. Are you USA or another?
I have to get my babble mail turned on. But there are other ways to get meds you need. Don't go off your meds if they're doing you some good.
Posted by detroitpistons on March 16, 2009, at 7:19:01
In reply to Re: No insurance / No doctor / Need help - ANGRY, posted by Neal on March 15, 2009, at 23:09:20
I'm in the US. I'm waiting to hear back from Wyeth on patient assistance. That would be good for 1 year, and then I might be able to reapply for another year. I would need that because I will be in school. Also, it just occurred to me that the XR will become generic next summer (2010) as well.
The clinic suggested possibly replacing Effexor with something cheaper, but I'm hoping Wyeth accepts me for patient assistance....I don't see why they wouldn't.
The only other reason why I would have considered going off of Effexor (and keeping Lamictal) is because I've been on it now for 3 and a half years. I don't know if it's even doing anything. I'm pretty sure Lamictal is working though.
> Detroit;
>
> I recommend you don't go off your meds. Really. Until we get some decent health care here, think about what metric wrote. It might be a way to go. Are you USA or another?
>
> I have to get my babble mail turned on. But there are other ways to get meds you need. Don't go off your meds if they're doing you some good.
Posted by Neal on March 16, 2009, at 20:47:02
In reply to Re: No insurance / No doctor / Need help - ANGRY » Neal, posted by detroitpistons on March 16, 2009, at 7:19:01
Other options:
Go to Effexor regular and take small amounts around the clock; if a significant savings can be accrued.Go to some Pdocs; tell'em you don't have money; and ask for the samples that Pdocs regularly get from pharmacuetical salesmen. I've gotten some myself.
Posted by JadeKelly on March 17, 2009, at 21:28:41
In reply to Re: No insurance / No doctor / Need help - ANGRY, posted by metric on March 13, 2009, at 15:32:41
>
>" 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."Metric,
I am finding that we have some very different views in reading some of your posts. And thats fine. I feel this post, however, may very well put this poster at risk. Please understand that I am not attacking you, there are very real dangers in discontinuing certain meds with certain people. However informed you may be, that is one decision that should be made with his PDoc, even if he decides to do it. In addition, I know from personal experience, not everyone withdraws in the same way.
~Jade
Posted by JadeKelly on March 17, 2009, at 22:07:33
In reply to No insurance / No doctor / Need help, posted by detroitpistons on January 10, 2009, at 18:06:36
> Hi all,
>
> It's been a while since I've been on this board, although I was never a regular. I mostly lurked in the past, but also did some posting....
>
> Anyways, I'm back because I need some opinions. I was laid off from my job and then was on COBRA for several months, but couldn't afford it anymore (almost $400/ month). I recently moved back home to go back to school because I couldn't find a job. I had my last appointment with my old doctor in December, and I got 3 months worth of meds at that time. It's been that way for a while. I've been relatively stable for a nice, long stretch. I just had maintenance appointments every 3 months and my pdoc would refill my scripts.
>
> I'm on Effexor and Lamictal (I also take Xanax as needed). My last doctor thought I was BP2. I've been doing relatively well on this combo. I just need to continue my supply. I could probably afford to pay $100 for a pdoc maintenance appt every 3 months (although there will be an expensive initial intake appointment), but I don't think I can afford the Effexor XR until it goes generic. Lamictal is already generic, but I don't think Effexor XR goes generic until the summer.
>
> I've been fortunate to never have been in this position until now, but I have no experience with this and I don't know where to go or what to do. I've always had some form of insurance.
>
> Anybody have any advice?
>
>
> Thanks a million!Hi Detroit,
This is a long thread so I haven't read everything but wanted to share a couple things. It is common for a drug to be working, then dicontinued, then fail to work a second time. I urge you to recall how you felt before taking whatever med you are considering d/c'ing or replacing as you may not get a second chance. If its not helping at all, then...
Secondly, I believe you mentioned several bouts of serious depression? This is my first, but the unfortunate fact is you will likely need to stay on meds to stay well. Is it a great choice? NO! But we have to pick the lesser of two evils. If your depression is mild, thats one thing. If its like mine was, major, I'll stick to my meds.
As for your med situation, again, may have been said already, I would think PDoc would cover you for a while in samples, mine did, also, could you hit up you regular GP? I'd bet they would help with samples if you have proof you are taking it. Did you say you hit up the school clinic? Also I'd google free clinics, even if they are a distance. Just make sure they prescribe or carry the med first. Maybe there is some kind of student disability program in your area. Call local hospitals and ask for either patient advocate or Psych dept and tell them your situation. Seems like someone out of that group can help or would know where to get it. I'd try to stay with exactly what your taking if its helping. I've found if you start changing things, ie: XR to reg, it may not work the same. It'll take some time but if you stay on it I believe you'll get what you need.
Good Luck ;-) ~Jade
PS-Might be good to put together a generic letter that describes your situation, and keep mailing it to anyone who could help. Never know, you might get a hit. Example: CC:to several dept's at the drug co., etc. Oh, what about the local chapters of Depression Groups? May have to attend a couple meetings but they would definately know "the ropes" I would think. Or may have the literature handy to send.
Posted by detroitpistons on March 18, 2009, at 13:20:43
In reply to Re: No insurance / No doctor / Need help - ANGRY, posted by metric on March 13, 2009, at 18:51:18
I just moved back to my home state at the end of December, so my old doctor is 400 miles away and pretty much out of the picture. He has no idea I'm in this postion. If I was still living there, he would have helped me out.
> > 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.
> >
> >
>
>
Posted by Neal on March 18, 2009, at 14:16:06
In reply to Re: No insurance / No doctor / Need help - ANGRY » metric, posted by detroitpistons on March 18, 2009, at 13:20:43
_
Detroit;Call your old Pdoc and tell the secretary you want a telephone appointment, i.e., an full 20 or 40 minute appt on the phone. It's done all the time. Have her give you the telephone number you can call to reach him/her at the appointed time. They usually have a "back line" other than the regular number.
Have the phone number of your local pharmacy handy so the Pdoc can call in a script for whatever you need. Or the Pdoc can fax a script to you or the pharmacy.
_
Posted by JadeKelly on March 18, 2009, at 19:38:03
In reply to Re: No insurance / No doctor / Need help - ANGRY » detroitpistons, posted by Neal on March 18, 2009, at 14:16:06
> _
>
>
> Detroit;
>
> Call your old Pdoc and tell the secretary you want a telephone appointment, i.e., an full 20 or 40 minute appt on the phone. It's done all the time. Have her give you the telephone number you can call to reach him/her at the appointed time. They usually have a "back line" other than the regular number.
>
> Have the phone number of your local pharmacy handy so the Pdoc can call in a script for whatever you need. Or the Pdoc can fax a script to you or the pharmacy.
>
>
>
> _
Yeah, good idea, I've done that as well!~Jade
Posted by Neal on March 19, 2009, at 22:19:50
In reply to Re: No insurance / No doctor / Need help - ANGRY » Neal, posted by JadeKelly on March 18, 2009, at 19:38:03
And then it helps to make a note of the exact time to call and be sure you have a quiet place to call and talk in privacy. If the appt. time is during or near your work time, or if it's hard to find privacy at home, you can always go to your parked car and call from there. Have a pen and paper handy to take notes if the doctor should give you instructions or a name of a med or whatever.
Yeh, I've done it a lot too:)
This is the end of the thread.
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