Still in my loop

I still haven't decided what I am doing about the Vraylar. But I won't start it now anyway- not until another weekend. And next weekend I am at my brother's, so it will be at least 2 weeks away. Could I really get off of Zyprexa? I have tried so many times, failed so many times. But what I have done this weekend is cut my Effexor, and it seems to be helping. I think I was blaming the wrong med for making me tired and out of it- it isn't the half milligram of klonopin I take at night, it is the Effexor I take in the morning. How low will I go? I don't know. So far no increase in depression.

Westworld is on tonight, my current favorite show. I don't watch a lot of shows- Mr. Robot, Game of Thrones, the Daily Show, and now Westworld. It has even given me a way of thinking about my life. I am living in a loop, just like the "hosts" on the show. I need to break out of my loop. Because it isn't a very big loop, and it isn't a very happy loop. And too much repetition.

Today is my monthly Costco trip to fill my Provigil. And to buy as much food as I can for the coming month, because I am not into grocery shopping these days. That is one of the first things to go for me with depression. It's not in my loop!

Slaying dragons with Vraylor

No, I didn't make it up- I saw a post in which someone said that Vraylor sounds like slaying dragons, and it does. Maybe it is the name of some great dragon-slaying sword. Or just another sign that there are way too many drugs in this world and the names are getting ridiculous.

But I don't want to slay dragons, I want to swallow one. My life has been so blah recently, I need a little fire in me. But a dragon slaying sword by my side, maybe that would be OK.

The past few times I have seen my psychiatrist I have come up with all kinds of excuses to explain my bad mood. Maybe I was right, but I was still tired of doing that- and my mood has dipped recently with the season change. So I decided to see what he might have to offer, medication-wise. And his answer was Vraylar.

He said he has had good results with it with bipolar. The goal would be to eventually get off of the Zyprexa, but not yet. It is a new drug, there is not a lot out there on it. I have looked up all the side effect rates and efficacy rates and receptor occupancy rates and compared them to everything else I have been on- driven myself crazy, basically. And finally decided to give it a shot. Something has to change- and I'd probably have more energy on that than Zyprexa, if it works.

But the problem is insurance. My psychiatrist gave me a card for 30 free days of it- and said that if it worked he would deal with the insurance pre-authorization. And I didn't think it should be a problem- I have been on risperdal, seroquel, zyprexa, geodon, and abilify. But when I looked up the medical bulletin on Vraylar for Aetna, they want you to have tried at least 30 of a generic antipsychotic (I have), and also Latuda (I haven't). Latuda is a brand name drug, and must be giving Aetna a really good deal with rebates. It is really practicing medicine without a licence to say that you have to try a specific drug before you can try another.

I haven't taken Latuda and I don't want to take a drug just because my insurance company tells me that I should. So I don't know if I will get Vraylar approved, and I don't want to start it if it isn't going to get approved. And it is over 1,000 a month- truly ridiculous. I just think this is going to be too much drama dealing with insurance companies and I can't handle it. It makes me feel so vulnerable.

I don't even know if it would work. I find it hard to get too excited about another antipsychotic- I hate antipsychotics- but Zyprexa got me off of disability.

I got a call from CVS. My prescription is ready. I can pick up my Vraylar. I don't know what I am going to do, I suppose I should call my psychiatrist.

I think I'll be writing again

I've been on an unsuccessful quest to find a new therapist after a break. I'm trying to find someone who takes my insurance, and that is no easy quest. The last therapist I talked to told me that no good therapist is in-network anymore. She may have a point- I have tried a few in-network therapists and it hasn't worked out. I tried to tell her that she should change her listing on Psychology Today which states she takes Aetna (but it only meant she would send the bill to Aetna if you are lucky enough to have out-of-network benefits, and then balance bill you for the rest). I no longer have out of network benefits, so that doesn't help me at all.

The last person I called never called me back. I think I have another couple of prospects, but again I don't know if I can trust the listings anymore. If it says they take my insurance, does it really mean that they do?

But maybe all of this means I am meant to do without. That therapy is a luxury, and I'd rather spend my money on other things. I could go to my hospital's clinic, but I have never had good luck at clinics. I'd really rather not. And I don't want my therapy records anywhere near my work- with everything electronic.

I am still so mad at my hospital for getting rid of out of network benefits. In almost every field of medicine it is easy to find a provider who takes my insurance- except for mental health. People with mental health issues are the most affected. But we don't matter. 50% of psychiatrists don't take insurance, and I am sure it is much higher in my state- it has one one the highest levels of doctors overall who do not take insurance.

Of course if insurance companies paid more for mental health, more mental health providers would take insurance. My last therapist looked into getting a contract with Aetna, but they would have paid half of what she normally charges.

So that is my vent for the day.