Friday, August 29, 2014

He said it so nicely that I didn't get mad

I saw my psychiatrist the other day. I told him about my various adventures lowering meds- with the only  one that worked out being going down on the Zyprexa from 7.5mg to 5mg. He told me that it was okay that I adjust my Zyprexa between 5mg and 7.5mg as needed, but that I shouldn't adjust my other meds without discussing it with him. And then he said that I pay him for his advice, so I should probably take it.

Otherwise he raised the Synthoid to 75mg because my free T4 is still low. I have had more energy since going on the Synthroid. I had been writing off my fatigue as being overweight, not realizing it was thyroid. Everything else is still the same. I do get the feeling that he doesn't really approve of the Provigil- in fact a couple of times he even offered to prescribe an amphetamine in its place. But I have had too many bad reactions to amphetamines- although I think that I did tolerate Ritalin OK in the past. What I would really like to try is Nuvigil- because then I wouldn't have to take a pill in the middle of the day like I do now- but financially that is not possible right now. I can barely afford the Provigil, which is generic. And my insurance company is not paying.

Filling prescriptions has gotten too confusing. I really should have gone to Walmart to fill my synthroid- it would have been 10 dollars for 90 days, instead of 34 dollars at my hospital pharmacy. I am in a high deductible plan, and haven't met it yet- and my insurance company prices for drugs often are worse than Walmart. Although- then there is no paperwork for my claims to count towards my deductible and my meds are all at the same place. Except for my Provigil, which I fill at Costco anyway.


Unknown said...

Are you sure Nuvigil is more expensive? With a card to reduce the cost that is available from Cephalon it was cheaper for me. And when the card didn't work because my insurance refused to cover Nuvigil it was still cheaper. That was when Nuvigil first came out and one of its' advertising points was that it would be cheaper than generic Provigl. That's been maybe 4-5 years ago but I was able to get the highest dose of Nuvigil and I think break it (I want to say I took 3/4 tab daily so I did a lot of breaking) and I paid around $325-$375 I think. I also got one refill per year free from Cephalon through a coupon. I had a small family owned pharmacy that was really good at working with me on keeping the cost as low as possible; the same pharmacy stocked Emsam just for me. I miss the service in that place but my Med D says I go to CVS.

It sounds like your psychiatrist is very reasonable. I can even understand why it would seem compassionate to try to avoid the high costs of provigil/nuvigil but well I haven't tried the other drugs so I guess I don't know but I'd be very afraid of them. I had enough trouble balancing out provigil/nuvigil if my mood shifted between the time I took it and my afternoon dose of anxiety med (I took hydroxyzine during the day for that). Now I take it occasionally and nearly always get pretty manic from it.

Jean Grey said...

Now that Provigil is generic and the price has started to drop it is cheaper than the Nuvigil. There was a time when the company was trying to get everyone to switch to Nuvigil when they raised the price of Provigil so it was more expensive than Nuvigil right before it went generic. But the price is finally dropping.