Saturday, October 18, 2014

Why this provigil thing has me so upset

I know I could try an amphetamine again. It's not like I want to live forever. It is more the principle- knowing that I am taking something that gave me tachycardia before... I have already made my peace (sort of) with taking Zyprexa which has made me obese and will sooner or later give me diabetes. The lithium will probably take a toll on my kidneys. The benzodiazepines I have taken increase my chance of getting dementia. Antidepressants and anticonvulsants greatly increase the change of osteoporosis. And then- to go back on the drug that gave me asymptomatic tachycardia, which I only caught because I was playing around with the pulse ox one day at work, that is too much. My PCP already thinks I have enough cardiac risk factors to need my cholesterol numbers to be lower and probably need a statin. What will she say if my resting pulse is 114?

And then there is the fact I went psychotic on dextroamphetamine. Really seriously paranoid.

So I have my reasons not to want amphetamines.

And yet, during the period between going off of stimulants and discovering Provigil, life was really hard. I can think now. Maybe I am still not the best at paperwork- but so much better than I would be. I passed the CHT exam. I can think. I can focus much of the time. I can work. And I don't feel drugged- unless I have been taking klonopin or extra Zyprexa. If I lose that, I wouldn't want to work. I don't even know if I could work full time. And work is really all that I have going for me right now. My life is that pathetic.

Ritalin is worth looking into again, I suppose. I can't remember serious problems with that- other than anxiety and the on/off feeling it gave me. There are longer acting versions- but none that will last all day. Perhaps with the Zyprexa on board the anxiety wouldn't be so bad. Or perhaps without the Zyprexa I wouldn't need a stimulant. I can't help thinking that.

And then there is the fact that the manufacturer of Provigil paid off the generic companies to delay making generics- and that is why it is still so expensive after all this time.

And then there is what Costco did- raising the price from $276 to $900. Of course it is their right, and they were way under market- but why would you? I don't think your neighborhood drug dealer would more than triple the price of your favorite drug in a month without a good story.

Anyway, I have done very little today except cry and take the drugs that I swore I wouldn't take because I hate the fact that I take meds. I hoped this would bring me sleep, I hoped it would knock me out. It didn't.

Monday I will call my psychiatrist and have him try again to get it authorized. If it does not, I will appeal. If I lose, I don't know what I will do. I might have to take a leave of absence to figure out medication options- whether that be getting thru the withdrawal of the Provigil and seeing if I can handle life without a stimulant or trying to find a stimulant that I can both afford and tolerate. I know from the last couple of times I have run out of Provigil that it will get really bad that first week without it- and I have never lasted longer than that so I don't know what is on the other side.

Right now I have enough until next Friday, if I skip a couple doses. Then the fun begins. Unless, of course, my insurance company comes around. But I don't want to get my hopes up.

On the other hand, if they do decide to pay for my Provigil, I will even forgive them for dropping out of network coverage next year- although that is admittedly a hospital decision, not an insurance decision.

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