Leaving Seroquel and starting Rexulti

[PurplePaisley]

I was on Olanzapine for about one year and during that time I did excessive spending which may have caused  lowering impulse control and consequently am now in bankruptcy.

Have been off Olanzapine since December, 2018.

In March went on Seroquel and experienced manic situations, where I was out of control (never had this happen to me before). I became excessively hostile towards a clerk in Walgreens, reduced my veterinarian to tears and alienated alot of my neighbors by my raging.  We upped the Seroquel thinking I was having my first manic episode, it only made everything worse.  Since coming off of Seroquel in last two weeks, I am now calm and the urge to act out aggressively is gone and I am mortally embarrassed about my behaviors.

New psych doc now, former one retired.  Started Reluxti two days ago at .5 mg.  First day experienced some brain zaps and thinking it might have been due to the mixing of recently going off of Seroquel and introducing Reluxti.  Today, no brain zaps.  Taking Benadryl to help with insomnia as Rexulti may become stimulating. 

I know this is a very expensive drug and being on Medicare I do not qualify for any of the manufacturer's savings plans. My new psych doc believes he can keep me on his extra supplies forever or until they go generic.  I am worried about being on this drug and loosing him as a psychiatrist and ending up with a co-pay of $400.00 a month and ending up in the Medicare Donut-hole very quickly. The trial pack he gave me has a 14 day supply.

I recently did a gene study thru GenOMind.  I am an ultra-rapid metabolizer and subject to many skin issues.  When I first saw him, he became very frustrated with me and didn't believe me that I can't tolerate most of the behavioral meds out there but once he got the gene study, he then understood.  The only drug he would suggest is Rexulti. 

I am in a quandary as to what to do about going on this very expensive medication with no way of paying for this and getting stuck on this drug should I loose my new psych doc and his many samples.

Purple

 

 

 

 

[Iceberg]

4 hours ago, PurplePaisley said:

I was on Olanzapine for about one year and during that time I did excessive spending which may have caused  lowering impulse control and consequently am now in bankruptcy.

Have been off Olanzapine since December, 2018.

In March went on Seroquel and experienced manic situations, where I was out of control (never had this happen to me before). I became excessively hostile towards a clerk in Walgreens, reduced my veterinarian to tears and alienated alot of my neighbors by my raging.  We upped the Seroquel thinking I was having my first manic episode, it only made everything worse.  Since coming off of Seroquel in last two weeks, I am now calm and the urge to act out aggressively is gone and I am mortally embarrassed about my behaviors.

New psych doc now, former one retired.  Started Reluxti two days ago at .5 mg.  First day experienced some brain zaps and thinking it might have been due to the mixing of recently going off of Seroquel and introducing Reluxti.  Today, no brain zaps.  Taking Benadryl to help with insomnia as Rexulti may become stimulating. 

I know this is a very expensive drug and being on Medicare I do not qualify for any of the manufacturer's savings plans. My new psych doc believes he can keep me on his extra supplies forever or until they go generic.  I am worried about being on this drug and loosing him as a psychiatrist and ending up with a co-pay of $400.00 a month and ending up in the Medicare Donut-hole very quickly. The trial pack he gave me has a 14 day supply.

I recently did a gene study thru GenOMind.  I am an ultra-rapid metabolizer and subject to many skin issues.  When I first saw him, he became very frustrated with me and didn't believe me that I can't tolerate most of the behavioral meds out there but once he got the gene study, he then understood.  The only drug he would suggest is Rexulti. 

I am in a quandary as to what to do about going on this very expensive medication with no way of paying for this and getting stuck on this drug should I loose my new psych doc and his many samples.

Purple

 

 

 

 

He gave you literally no other options at all? 

[mcjimjam]

I would just try it and if the situation changes and you can’t afford it then cross that bridge when you come to it. Abilify is a very similar drug to Rexulti and it is generic, btw. If it came it to it, you could try that if Rexulti helps.

[PurplePaisley]

14 hours ago, Iceberg said:

He gave you literally no other options at all? 

Hi Iceburg ~  No, he gave me no other option.  After reviewing the gene study thru GenOMind, I am in a category that with most of the behavioral meds I will over-react to and historically in the last 50 years of trying all these drugs, it happened to me.  Doctors in the past would excuse me from their practice claiming that I was not trying, when in fact, there was a genuine reason. 

He felt this is the cleanest drug on the market that will have a very low side effect profile.

Thank you for your valued response *smiles*

Purple

4 hours ago, mcjimjam said:

I would just try it and if the situation changes and you can’t afford it then cross that bridge when you come to it. Abilify is a very similar drug to Rexulti and it is generic, btw. If it came it to it, you could try that if Rexulti helps.

Thank you mcjimjam ~  that sounds like a very good plan.  I didn't realize that Abilify is similar to Rexulti, that gives me some hope in just knowing that.  I am on day 4 of Rexulti and see no results, in fact, my depression is worsening.  When I was on Olanzapine, by now I would be feeling relief, but he has refused to put me back on Olanzapine.

Purple

[breeny]

I've been on Abilify for a few months and it seems to be making my depression worse. If Rextuli is having that impact on you, Abilify may, as well.

[notloki]

On 7/6/2019 at 6:04 AM, breeny said:

I've been on Abilify for a few months and it seems to be making my depression worse. If Rextuli is having that impact on you, Abilify may, as well.

I got that when I was on too little a dose. Up to 10 mg, nothing. Once I went to ten mg, wow !

[PurplePaisley]

3 hours ago, notloki said:

I got that when I was on too little a dose. Up to 10 mg, nothing. Once I went to ten mg, wow !

Hi notloki ~    Was that Abilify or Rexulti you are referring to? 

I could withstand all of the side effects of Rexulti, but confusion. The confusion issue was extreme, it got to the point I did not recognize my surroundings, it was that scary.  Did you have any confusion like this?

When you said "Wow" at 10 mg, can you be more specific?

Thank you for your valued response notloki *smiles*

Purple

[PurplePaisley]

On 7/6/2019 at 8:04 AM, breeny said:

I've been on Abilify for a few months and it seems to be making my depression worse. If Rextuli is having that impact on you, Abilify may, as well.

I'm sorry to hear that breeny ~  what is your prescribing doctor saying about this?  Are you going to stay on this, increase dose or go off of it? I have heard that docs leave us on medications for up to two months to see what affect it has on us before making decisions.  What do you want to do?

Thank you for sharing your experience with me.  Yes, my depression got much worse with only being on it 5 days, along with the scary confusion.  Now that I have been off of Rexulti a week, my depression is lessening and I can function, whereas all I could do was sit in my recliner day after day,  with no incentive to do anything at all. 

Purple

[PurplePaisley]

On 6/30/2019 at 4:03 AM, mcjimjam said:

I would just try it and if the situation changes and you can’t afford it then cross that bridge when you come to it. Abilify is a very similar drug to Rexulti and it is generic, btw. If it came it to it, you could try that if Rexulti helps.

Thank you mcjimjam ~  like your nick *smiles*  Good suggestion.  I do have a bottle of Abilify (2mg) at home which I will take with me when I see my psych doc.  I have been off of Rexulti now for 5 days and feeling much better.  I was feeling quite intense side effects right out the gate.  I could deal with most but it was the confusion that scared me and when my psych doc heard that, he wanted me off of it immediately.  I couldn't recognize things, I didn't know where I was, nothing made sense to me.  What scared me most was wondering if that is what Alzheimers feels like. 

Thank you for the suggestion of Abilify.  I have some at home and will bring with me when I see my psych doc next week.  We are basically out of options since my GenOMind genetic report showed me as a ultra-rapid metabolizer. 

Purple

[notloki]

13 minutes ago, PurplePaisley said:

Hi notloki ~    Was that Abilify or Rexulti you are referring to? 

I could withstand all of the side effects of Rexulti, but confusion. The confusion issue was extreme, it got to the point I did not recognize my surroundings, it was that scary.  Did you have any confusion like this?

When you said "Wow" at 10 mg, can you be more specific?

Thank you for your valued response notloki *smiles*

Purple

Abilify. No confusion. Wow it really worked well at the right dose.

[PurplePaisley]

On 6/29/2019 at 6:10 PM, Iceberg said:

He gave you literally no other options at all? 

Hi Iceberg ~  I just had a gene study for mental health medications.  It came back showing me as being an ultra-rapid metabolizer which means 99% of the drugs won't work with me.  I have tried everything.  The only two drugs that worked were Zonegran (developed many kidney stones even though I drank alot of water) and Depakote (which damaged my liver and now have chronic hyperammonia).  Everything else had intolerable side effects. 

Most psych docs give up on me right away, which is where this new psych doc is heading now, he literally threw up his hands in my face several weeks ago.  I wouldn't be surprised if he dismisses me as his patient next week and sadly, he's the only one left on my insurance panel I can see. 

Purple

[PurplePaisley]

8 minutes ago, notloki said:

Abilify. No confusion. Wow it really worked well at the right dose.

I am soo happy for you notloki, I really am because I cannot adjust to any medication now.  I don't know if it's my age or whether I did not give the medicine enough time or by upping the dose as what happened to you. How long did you give it before you noticed a difference?

Are you still on Abilify now?

Purple

[breeny]

5 hours ago, notloki said:

I got that when I was on too little a dose. Up to 10 mg, nothing. Once I went to ten mg, wow !

i'll have to see if my pdoc will up the dose next week then. 

[notloki]

4 hours ago, PurplePaisley said:

I am soo happy for you notloki, I really am because I cannot adjust to any medication now.  I don't know if it's my age or whether I did not give the medicine enough time or by upping the dose as what happened to you. How long did you give it before you noticed a difference?

Are you still on Abilify now?

Purple

i've been on Abilify for several years, still on it. I titrated to 10 mg starting at 2 mg and giving each dose 2 weeks, basically doubling the dose each increase. 

[browri]

On 6/29/2019 at 2:04 PM, PurplePaisley said:

I was on Olanzapine for about one year and during that time I did excessive spending which may have caused  lowering impulse control and consequently am now in bankruptcy.

Have been off Olanzapine since December, 2018.

In March went on Seroquel and experienced manic situations, where I was out of control (never had this happen to me before). I became excessively hostile towards a clerk in Walgreens, reduced my veterinarian to tears and alienated alot of my neighbors by my raging.  We upped the Seroquel thinking I was having my first manic episode, it only made everything worse.  Since coming off of Seroquel in last two weeks, I am now calm and the urge to act out aggressively is gone and I am mortally embarrassed about my behaviors.

New psych doc now, former one retired.  Started Reluxti two days ago at .5 mg.  First day experienced some brain zaps and thinking it might have been due to the mixing of recently going off of Seroquel and introducing Reluxti.  Today, no brain zaps.  Taking Benadryl to help with insomnia as Rexulti may become stimulating. 

I know this is a very expensive drug and being on Medicare I do not qualify for any of the manufacturer's savings plans. My new psych doc believes he can keep me on his extra supplies forever or until they go generic.  I am worried about being on this drug and loosing him as a psychiatrist and ending up with a co-pay of $400.00 a month and ending up in the Medicare Donut-hole very quickly. The trial pack he gave me has a 14 day supply.

I recently did a gene study thru GenOMind.  I am an ultra-rapid metabolizer and subject to many skin issues.  When I first saw him, he became very frustrated with me and didn't believe me that I can't tolerate most of the behavioral meds out there but once he got the gene study, he then understood.  The only drug he would suggest is Rexulti. 

I am in a quandary as to what to do about going on this very expensive medication with no way of paying for this and getting stuck on this drug should I loose my new psych doc and his many samples.

Purple

I'm thinking one of the reasons he wanted to try you on Rexulti is because it has such a long half-life. That means even if you are an ultra-rapid metabolizer, he can titrate you up to higher doses without issue because you'll be able to tolerate them. The alternative is generic aripiprazole, but if quetiapine of all things made you rage out, then I would say starting on Rexulti before aripiprazole (Abilify) makes more sense.

That being said you can always fall back to aripiprazole as an option because it too has a long half-life which should help combat the ultra-rapid metabolism issue. Although it depends on what KIND of ultra-rapid metabolizer you are. I'm assuming CYP2D6, but it could be CYP3A4 which is different altogether.