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Switching SSRIs abruptly


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My health insurance ran out. I was on Paxil and have one 20 mg pill left for tonight. I'm wondering if it would be possible to switch to Celexa, Zoloft, or Prozac tomorrow without a major problem or if I'm gonna feel whacked out. I've got samples/leftovers from before of those so I'm wondering if it would be ok until my new health insurance kicks in, or if I should just completely wean myself off of Paxil sort of abruptly by cutting the Paxil into fourths and then supplementing with a benzo to get through it.

any advice?

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Taking the old meds would help with discontinuation symptoms but it might take a while for the new med to get up to speed with your depression and anxiety. Plus, SSRIs are notorius for not working as well the second time if you go off one and then go back on it. If the Paxil is working for you, you need to find a way to stay on it. I think it's like $10 a month for generic Paxil at Wal-Mart. See if you can get your pdoc or gp to call you in a prescription for while you're waitintg.

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My health insurance ran out. I was on Paxil and have one 20 mg pill left for tonight. I'm wondering if it would be possible to switch to Celexa, Zoloft, or Prozac tomorrow without a major problem or if I'm gonna feel whacked out. I've got samples/leftovers from before of those so I'm wondering if it would be ok until my new health insurance kicks in, or if I should just completely wean myself off of Paxil sort of abruptly by cutting the Paxil into fourths and then supplementing with a benzo to get through it.

any advice?

You can do it, but if it's working that would be a really bad idea. There's generic paxil now. Try to get that instead. It's cheap too. Call your doc.

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You can do it, but if it's working that would be a really bad idea. There's generic paxil now. Try to get that instead. It's cheap too. Call your doc.

I'll second the switch to generic. Also, it may be cheaper in the long run to see a GP at an urgent care clinic for a new script for the same stuff you're already on (bring the bottle) than to deal with all the potential problems that can come with a med switch.

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I had a refill on the Paxil and went to the pharmacy to see if I could pay out of pocket. It was $60. Sixty bucks? And it was generic! I can't afford that whatsoever at least not this month.

I took 20 mg of Prozac last night instead and honestly, feel like pure garbage. I definitely feel the SSRI withdrawal. crappppppppp. I hate this feeling of being in a bubble. I took 1 mg of Xanax but that did nothing. Add to it that I have a toothache from a root canal gone bad in 2 teeth and no insurance to get it looked at and I'm NOT a happy camper right now.

what to do...

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You need a new pharmacy.

Call around. Price for paroxetine generic should be less than $15. Check Costco - even if you're not a member, you can use their pharmacy (you just can't write a check.) Check anywhere. But that is too damn much for paroxetine/generic. I live in the sticks, things are expensive around here, and you could still get the stuff for $4 at (damn it, I hate to recommend them, but this is the time) Walmart or Target.

If they didn't give you your paper rx back, then call the expensive pharmacy and ask them to transfer the rx to the cheaper pharmacy that you will no doubt find with 10 minutes of calling.

Here is how you ask for the price:

"Hi, I have a prescription for Paxil, generic, 20 mg, 30 tablets of it. How much will that cost at your pharmacy? I am uninsured."

More concerning is this: how the heck are you getting your Zyprexa? Because that's not cheap. Ever.

Drug assistance for Lilly is good, but it takes a while, so, if you aren't doing that already, you might want to start the process.

The drug assistance for Paxil and Paxil CR is through Bridges to Access, which is really quite fast (someone from the office has to call in and enroll you), but the copay for the first month would be more than the $4/month you would pay at the pharmacies listed above.

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I'll call around in the morning and see what I can find and try to get my Rx transferred. It was a Walgreens, for the record. ;)

The hospital I go to gave me a gazillion Zyprexa samples and I'm only taking that p.r.n., so I have a bunch of that left. My Xanax is almost out though but that's generic too so I might as well ask about that when I have Walmart or wherever on the phone.

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Go figure that Walmart offered Paxil generic for $9. Like a 50 dollar difference? Why is that? Isn't that some massive price gouging?

Glad I have it now. It is my 2nd day off of it and boy do I feel the "bubble" effect. I hate that. I also feel a LOT more depressed. I guess that Paxil is working for me after all. Who knew? ;)

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Go figure that Walmart offered Paxil generic for $9.

I was going to mention that Sam's Club also allows non-members to use the pharmacy. Some of the price difference may come from the fact that for certain medications (certain any things) Sam's Club/Walmart is buying in bulk orders that even other national pharmacy stores can't match.

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Some of it's the bulk price, but not as much on the generics that are out of exclusivity. I checked the price for generic paroxetine at the local independent pharmacy. Paroxetine 20 mg, 30 tabs, $11; paroxetine 20 mg, 90 tabs, $14. So the fill fee was the bulk of his cost. For those who don't know, the fill fee covers overhead: lights, little orange bottles, staff, etc.

I asked him what the AWP was (wholesale) and he said, "Not using my name, right?" Right. $1.03 for the 90 tabs.

If you go to a community health center / federally qualified health center that has a pharmacy, those prices are unbelievably low, because of the bulk pricing that comes from this little buyers' club called the federal government. But they can only fill rx from their own providers for their own patients.

LeadingLady, I'm glad you're feeling a little better, and, well, at least this was a valuable experiment... and now you know how drugs are priced in your town.

Might see how much a 90d rx is next time, because, as you can see above, that can save you some money as well.

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