Tuesday, November 4, 2008

Irreplaceable

I am so frustrated amd angry I could scream and before this madness is all over with I probably will. Let me give you a little history for those of you who don't know it. I have major depression and anxiety which started very early in my childhood. I was FINALLY put on medication at about 12 years old and have been on it since except for a few brief periods when I thought I didn't need it and learned very quickly why I did. It has taken many years of tinkering with the meds to get it right. I have seen many different doctors, all of which tried their cocktail of drugs for me. Since being started on meds I have taken Tofranil, Paxil, Zoloft, Lexapro, Celexa, Prozac, Wellbutrin, Depakote, Lithium, Seroquel, Risperdal, Zyprexa, Ativan, Concerta, Abilify, Cymbalta, Klonopin, Lamictal and Effexor XR. Some worked for a brief time and then quit, some never worked, some made me gain horrid amounts of weight, some gave me acne, some made my muscles rigid, some made my hair fall out a bit, some made me a raving bitch, some never helped, some ended me up in the ER with a hypertensive crisis... But there is one that works and has worked for years and makes me the normalish person I am today. People who don't know my history ask how I am so even tempered and laid back- it is not me, it is the Effexor. The drug has its side effects, don't get me wrong- it makes me sweat like crazy, keeps my B/P a bit elevated, and sometimes makes me nauseated and jittery. These side effects are mild and I am willing to trade them any day for the way I feel off of the medication. Off of this medication I can singlehandedly destroy relationships, my career, my finances, and anything else near and dear to me in a matter of minutes. My mood swings are unpredictable and my depression, anxiety, and anger are uncontrollable. I am not a nice person off of my meds and I am unpredictable as hell. I am not ashamed of these things, I was born this way. I really think that my depression has helped me to feel things deeper and therefore be much more compassionate than most. I used to be afraid to tell people I was on meds but over the years I have become confident of the fact that I had nothing to do with putting together my chemical makeup and its flaws so I have nothing to be afraid of. OK, so enough of the background- I think you get the point, I need the Effexor, this is not optional for me and never will be. Fast forward to today. I go to the pharmacy to pick up my Effexor just like I have every month for as long as I can remember and the pharmacist says, "That will be $135." Uh, no it won't. It has always been $35 so now why all of the sudden is it $135. He tries to run it again and gets the same price. I told him I would call the insurance company and have the mistake corrected and then come pick it up later. I call the insurance company and here is where it all went downhill. Our drug benefit is 70/30. They pay 70% and we pay 30% of whatever the drug cost is. They have never before chosen or cared which drug we chose- if we chose the more expensive drug that just meant our 30% was more money out of our pocket. After being hung up on by the first idiot (I had to explain my plan to her and she works for the insurance company) I got a very nice lady who explained that Effexor is "no longer covered." I talked at length with her and her supervisor who couldn't tell me why. I explained that we have never ever had a a drug rejected and that our plan does not have tiers- we can chose what drug we want. They said yes, but not this drug, we will no longer cover it at all. If you chose to stay on it you will have to pay the $135/month. They then proceed to tell me that I should try instead a new drug called Pristiq which is the "new Effexor." I can get it for $29/month. Here's the scoop- Effexor will be going generic soon so Wyeth Pharmaceuticals has come out with Pristiq which is the s-isomer of Effexor- that means it is supposed to have Effexor's good properties and eliminate the bad side effects. In theory that is splendid. For me, not so great. If you have ever taken Effexor and stopped it abruptly you will know that the withdrawal is unbearable (you should really google "Effexor withdrawal"). I am out of pills so here is where my withdrawal begins. I have done much reading and the Effexor should be tapered. The Pristiq is not the same as Effexor and thus will not stop the withdrawal. So back to the Wyeth thing- in an effort to not loose the billions of dollars they are making a year on Effexor when it looses its patent they are offering incentives for insurances, etc. to cover Pristiq and not Effexor so they continue to make their money after the Effexor is generic. So the withdrawal will happen, I cannot stop it. I am going to be sick and that is just how it is. I can deal with that but here's the real bitch of it all- what if the Pristiq doesn't work? If it takes about 4 weeks to get a good level in my system that is 4 weeks I could potentially be crazy. Then if it doesn't work and by some miracle the insurance says, "OK, you tried and failed the Pristiq, we will cover your Effexor" it will take 4 more weeks to build an Effexor level back up. Yep folks, won't the holidays be grand? If this crap doesn't work the devastation that will happen in my life will be unimaginable. I am scared shitless and just want my Effexor back... Please pray for me, my family, my friends, and my coworkers. I am not kidding, we will all need it. If you have ever had the misfortune of being around me off of medication you know I am serious. I am so angry with the insurance and the drug company- they are not just messing with meds, they are messing with my life. Seriously, if you are a drug company and you are going to jack with a patient population would you honestly choose the psych population to jack with- probably not a wise decision, eh?

4 comments:

  1. I have been accused of being a pill popper (even this weekend by my mom & sister). I told them that zoloft has honestly saved my life. I can tried to get off it this year and can pin point when I was inches from a nervous breakdown. That was the last of the no zoloft me.

    I have to do what's right for me. Luckily my insurance will cover the generic zoloft. But I know how you feel and I will do alot of praying for you!

    ReplyDelete
  2. That is unimaginable. There has to be something that can be done, that is so shady! Yeah, don't mess with the psych population. I just hope they have had constant harassment over this. They must be stopped!

    ReplyDelete
  3. Good post, Jamie. Hopefully the new medicine will work well for you... Let me know if I can help... Love you!

    ReplyDelete
  4. That is awful. Just awful. Are you able to appeal the decision with the insurance company? You'd think they'd give you a little advanced warning.

    You are in my thoughts.

    ReplyDelete