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elby

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About elby

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  1. My partner takes an expensive drug for a neurological condition. The neurologist super pushed the saving card. It was great. Until it expired. Now we pay a ton of money. I didn't know the savings could be renewed (??). I thought it was just to get you "hooked" or used to the drug, then not want to switch when the savings dropped. That's why I'm hesitant about a savings card from the manufacturer. I don't want to go through withdrawals of an AAP again. I don't think there's anyway I can afford Vraylar. I remember when Latuda was first out, my pdoc wanted me on it. I checked with my insurance and my co-pay would have been over $600 a month. If I get approval, I imagine Vraylar would be at least that much. I'll probably be dead of my BP before it goes generic and I can afford it.
  2. I hope I am not thread-hijacking....but I found this thread because my pdoc suggest Vraylar because I crashed and I'm running out of options. I wanted to learn more about Vraylar. Then I looked it up on GoodRx. I'm in the position where my partner and I have enough income that we don't qualify for assistance, but our insurance isn't great, so there's no way I can afford Vraylar (partner is on expensive meds already for serious condition and I had to cut work hours because of my crazy). If I may ask, without intending to pry, how do you all afford Vraylar?
  3. Huh. I don't consider lithium "heavy" -- I think some of the AAPs are more hardcore. I'd take lithium over an antipsychotic any day. As mentioned, lithium is used off-label for depression. It's especially helpful in treating suicidality. It's also used off-label for neuroprotection in TBIs. I'd say I've been on lithium for at least 6 or 7 years. I'm am on a relatively low dose -- we keep my blood levels just about at .6. I don't find the side effects to be bothersome, or really noticeable. I'm careful to stay hydrated. I've not had weight gain (unlike on depakote and risperdal). I am bipolar, and I have had breakthroughs -- mostly mania, and not frequent -- when I've had severe external stressors. It's possible a higher dose would help with that, but I get agitated when I'm on too high a dose. They upped me too much once when I was in inpatient, and the pdoc there thought it was lithium starting to hit serotonin -- anything that hits serotonin with me makes me super agitated. I don't what that is, but if you are going to have unexpected reactions to meds, it's best in inpatient, where they will see it and actually believe it (wellbutrin gave me clonus in inpatient -- I doubt they would have believed that if I just told them). What it comes down to is lithium works for me. It works for a lot of folks here. But, it doesn't work for others. There's no guarantee for you. The sucky thing about mental illness is that there's no magic bullet to fix it. Lithium keeps me functional and reasonably sane, but I'm not "normal" or "fixed." Huh. I don't consider lithium "heavy" -- I think some of the AAPs are more hardcore. I'd take lithium over an antipsychotic any day. As mentioned, lithium is used off-label for depression. It's especially helpful in treating suicidality. It's also used off-label for neuroprotection in TBIs. I'd say I've been on lithium for at least 6 or 7 years. I'm am on a relatively low dose -- we keep my blood levels just about at .6. I don't find the side effects to be bothersome, or really noticeable. I'm careful to stay hydrated. I've not had weight gain (unlike on depakote and risperdal). I am bipolar, and I have had breakthroughs -- mostly mania, and not frequent -- when I've had severe external stressors. It's possible a higher dose would help with that, but I get agitated when I'm on too high a dose. They upped me too much once when I was in inpatient, and the pdoc there thought it was lithium starting to hit serotonin -- anything that hits serotonin with me makes me super agitated. I don't what that is, but if you are going to have unexpected reactions to meds, it's best in inpatient, where they will see it and actually believe it (wellbutrin gave me clonus in inpatient -- I doubt they would have believed that if I just told them). What it comes down to is lithium works for me. It works for a lot of folks here. But, it doesn't work for others. There's no guarantee for you. The sucky thing about mental illness is that there's no magic bullet to fix it. Lithium keeps me functional and reasonably sane, but I'm not "normal" or "fixed."
  4. What is your official diagnosis? I find the lithium issue unusual. I've been on it for years. It's cheap and proven. Are you BP II? Maybe they think you need to be BP I? I don't know, just throwing things out. Before I was dx'd officially as bipolar, I tolerated lexapro, but in hindsight, I think it just made me hypomanic and they overlooked it. I also was on prozac without mania. But Zoloft made me so manic I was committed to the psych ward. So I started ok but got more reactive to SSRIs, even on lithium. (I am also capable of going manic on my own unmedicated....) I haven't taken SSRIs in several years. It's not worth it.
  5. On mine....if I said 75, I was following OP. I don't remember the exact doses.... I just know the third jump was when I got too agitated. I probably did do 100 not 75. I just had one of those standard titration packs.
  6. Shackles? That's rough. My hospital had a no physical restraint policy, but the psych techs can tackle and restrain until you get a shot. I was picked up by police and involuntaried. The good thing was the policeman was kind. I've heard horror stories. But the ER was the most de-humanizing experience ever. Involuntaried got me the naked body search once I finally made it to the psych ward. After police, ambulance, horrible ER, treated like shit, the naked search sort of caught me off guard. I was there two weeks. I think other people here will relate. You are not alone. It sucks. Sorry you had to go through it.
  7. I had something similar on lamotrigine. On 25mg, I felt my head was clear and was quite hopeful. When I hit 50mg, I started getting agitated. When I went up to 75mg I was so agitated that I eventually had to titrate down and off. We considered it a failure. Other anticonvulsants have not had that effect on me. Have you had similar responses to SSRIs? One of the pdocs I had while inpatient said he thinks I just don't respond well to drugs that hit serotonin (which lamictal does).
  8. Esketamine would be intranasal -- but the panel recommended that it be administered in a doctor's office. A doctor's office requirement and the fact that it's on patent may make it expensive also. But with FDA approval, it can be covered with insurance. (I should put "can" in quotes because there are some shitty insurance companies in the US that restrict drugs or make them so expensive, you can't afford them....like mine....)
  9. It's been used for decades as an anesthetic, so it's effects in that use are well known. It doesn't close airways, so it is good for war medics. In fact, some people theorize that some of the "near death" or out-of-body experiences that some wounded soldiers in Vietnam had were because of the dissociative effects of ketamine. They use it a lot with pediatric patients. I have an anesthesiologist friend who does pediatric dental sedation on the side and he uses ketamine. I don't think they know what the long-term effects are though. It's usually a given one-time (anesthesia) or short-term (IV for depression). I've been on it going on 6 months. My pdoc is thinking I may stay on it for the time being. I don't think there are many studies for people in my situation. The trials that the FDA will put esketamine through will be ostensibly to test that, but they can't, in reality, do a trial to determine long-term effects. I'm a little bitter about pharma trials these days too. The recreational drug users to have kidney issues and a few other issues, but they are taking much higher doses than I ever will. I have never k-holed.
  10. It gives me about a 50 minute high, which I personally don't like. But I don't like any kind of high. I have bipolar I, am treatment resistant and ketamine saved my life (I had ECT as another option, but chose ketamine). I would never suggest it be first line for anyone, but it's been amazing for me. And not amazing in a manic way like SSRIs, it just gives me a feeling a well being that no other med has done. (I noted in the BP forum, it has great anti-suicidality effects, which haven't worn off, but the antidepressant effects do wear off somewhat after a few months).
  11. I miss all the experts on crazymeds .... they always had the answers. So ketamine is racemic, so it is left and right twisting mirrored molecules. Esketamine is the s-enantiomer (s = sinister = left) of ketamine, so technically more potent. But....ketamine is generic and cheap. Esketamine is patented, so even if this does go through trials and is FDA approved, I wonder what J&J would charge for it.....probably a lot....given pharma in the US these days. I guess since ketamine is generic, there will not likely be trials comparing ketamine with esketamine. I think it's good news anyway, as an old friend used to say, ketamine (for me) is strong magic.
  12. This is from the New York Times, Feb 12, 2019 F.D.A. Panel Recommends New Depression Treatment https://www.nytimes.com/2019/02/12/health/depression-drugs-ketamine.html I've been taking a compounded ketamine nasal spray off-label (prescribed by my pdoc). It's worked surprisingly well for suicidality. It sounds like since the expert panel recommended it, it likely will become FDA approved. I remember there's a slight difference between esketamine and ketamine but don't remember exactly. Esketamine is less dissociative? I'm wondering if I switched ever, what the difference would be.
  13. I don't tolerate antipsychotics, but I found that my brain worked well with anti-convulsents (except Lamictal). When a I take an AC, I describe it as going from a noisy stadium in my brain to an empty room. Everyone is different though, but they are regularly used for BP. Depokate worked quite well but I got a rare side effect with it and had to give it up. ACs are super calming for me. There's some weight gain, but about the same as the older APs (like Risperdal).
  14. My first inpatient I had this really good pdoc. He hated big pharma. He wouldn't even use a pen if it had a pharmaceutical company's name on it. Since I was in inpatient for a while we talked a lot. He complained that big pharma made the younger doctors think that all the new, expensive AAPs were "better" than lithium and he was concerned that many of them wouldn't even try lithium..
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