nicolee Posted April 14, 2017 Share Posted April 14, 2017 Hello to all. I am going to experience a medication change soon due to the fact that my Latuda costs $600/monthly with my insurance. I have been receiving the Latuda under the assistance program, but since I now have insurance I will no longer qualify for the program. In the past, I have been on both Geodon and Seroquel IR. As a matter of fact, I switched from Geodon to Latuda because Pfizer was discontinuing their assistance program for the Geodon, and I was able to qualify for Latuda's assistance program. As far as Geodon and Seroquel IR go, I did well on both of them, and found the Geodon to be weight neutral, and even lost weight on Seroquel. I bring up the weight issue because I have gained weight since starting Latuda 3 years ago, although I have not changed my eating habits. I see my pdoc next week and want to suggest either going back on Geodon or switching to Seroquel XR (the generics of the drugs). I need a generic so that my copay is reasonable. I am looking for input on the Seroquel XR and weight, as well as other options that are weight neutral and have a generic. Link to comment Share on other sites More sharing options...
Iceberg Posted April 14, 2017 Share Posted April 14, 2017 What are the symptoms you need to treat? Link to comment Share on other sites More sharing options...
nicolee Posted April 14, 2017 Author Share Posted April 14, 2017 I am Bipolar I, with most of my mood states being either depressed or mixed. I have been stable for about 5 years, with the occasional blip of depression that is usually resolved with a medication tweak. I currently take 200 mg Lamictal, 50 mg Topamax, and 100 mg of Trazodone (for sleep) along with 80 mg Latuda. The Topamax is primarily for my anxiety/irritability/binge eating - I haven't noticed much affect on mood states on the Topamax. Link to comment Share on other sites More sharing options...
Iceberg Posted April 14, 2017 Share Posted April 14, 2017 Ok- some Wikipedia md suggestions...Vraylar helped me ...with mixed and manic...and possibly depression. abilify can help depression and mania. If seroquel worked maybe a chance but all three of those would be expensive Lithium wouldn't be and it'll allow for less extreme swinging And has anti suicidal properties Link to comment Share on other sites More sharing options...
mcjimjam Posted April 15, 2017 Share Posted April 15, 2017 (edited) Seroquel did not affect my weight. Another generic one is Risperdal. Has your pdoc tried that? Neither of these drugs are weight neutral, either one could cause massive weight gain, but it certainly doesn't happen to everyone. As far as low cost/weight neutral mood stabiliser there are more options in the anticonvulsant category and also lithium. Is there a particular reason you are mainly taking AAPs? Lamictal is generic, weight neutral, proven to extend time between episode (a "true" stabiliser), many find it fantastic for BP depression but some find it to be not as good for mania. Generally it has a very benign side effect profile and not much in the way of long term risks. I have no side effects. Lithium is the cheapest option. It is the oldest and most studied. It has the most evidence to say it works. I find it extremely effective against mania, less so for depression. It's good for boosting the effect of ADs. It is thought to be weight neutral but it makes people thirsty sometime and if they respond by drinking high calorie sodas/juice etc can lead to weight gain. I haven't gained a pound and I drink nothing but coke and sugary tea. Lithium doesn't make me thirsty. I have no side effects. Any of the other anticonvulsant (that are used for BP) will have a generic AFAIK. Depakote can cause a lot of weight gain, but the other ones are weight neutral I believe. Edited April 15, 2017 by mcjimjam Link to comment Share on other sites More sharing options...
browri Posted April 21, 2017 Share Posted April 21, 2017 If you're open to alternatives to APs or you would prefer to take a lower dose of an AP, oxcarbazepine is a good anticonvulsant that has allowed me to manage my irritability/explosiveness/agitation without using full doses of antipsychotics. Loxapine usually doses 50-150mg multiple times a day but I manage with just 10mg at bed time and take oxcarbazepine and fluoxetine in the morning. Loxapine is good for neurotic or obsessive-compulsive stress. Like intrusive thoughts that you can't get off your mind that distract you from whatever you're doing. Intrusive distressing thoughts are a downward spiral for me into depression and preventing those has been critical to keeping me out of a depressive episode, whereas oxcarbazepine keeps me calm so I don't fly off the handle into a manic episode. Loxapine works with oxcarbazepine to an extent to synergistically prevent mania. But in my mind they're for very different symptoms of my condition. loxapine > racing thoughts. oxcarbazepine > explosiveness and reactivity. Link to comment Share on other sites More sharing options...
Swamp56 Posted April 21, 2017 Share Posted April 21, 2017 (edited) On 4/14/2017 at 1:15 PM, nicolee said: my Latuda costs $600/monthly with my insurance Have you spoken with your insurance company about this? It sounds like they're charging you their discounted cost they get with pharmacies without actually covering you. You should check with them to see if you can get an exemption or prior-authorization. I had to do that with Saphris and they started paying for it. Edited April 21, 2017 by Swamp56 Grammar Link to comment Share on other sites More sharing options...
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