Dreamingneonblack: getting off paxil - advice please

[dreamingneonblack]

Hi all,

 

First off I'd like to thank everyone for this great community to which I've been lurking on and off since paxil progress shut down (which I frequently lurked as well). I don't know where I'd be with this drug if I didn't have access to others who are struggling with getting off ssri's.

 

I have an insurance-related issue now. My new one no longer covers liquid paxil (a bottle now costs me $547, which may last 3 months) and so the pcp said he'd switch me to 10 mg pills and just cut by quarters. I figured I could just crush them and make my own oral suspension but I remember the transition from tablet to liquid was hard and I don't want to get withdrawal symptoms from switching drug forms (and between generic manufacturers) if I'm not even getting a lower dose out of it. I'm really scared because I have a lot going on in my new career and I can't afford to be sloppy at work.

 

Has anybody here switched back from oral suspension to tablets?

 

I want to call the doctor back tomorrow to ask him to plead a case with my insurance company but he thinks I'm exaggerating because the "amount of drug a body can absorb varies enough every day that these little changes wouldn't affect" but I guess part of the territory of living with a stigma is having my concerns just brushed off.

 

I wish I had done more tapering while I was in school and had week or month long vacations. I have a 3 day weekend coming up and have been contemplating making the switch to pill that Friday before if I have to.

 

I'm also feeling a bit of withdrawals today because I got very stressed last week when I found out my insurance didn't cover so I started a taper down 10% and it hit me quite hard, which is disheartening given the insurance situation.

 

I don't really know what is the best option for me anymore

 

 

2011 on paxil 10mg

2013 switched to oral suspension, 10mg

No documentation of tapers in this time period

2015 tapered down to 4.8 mg

2016 after enduring extreme depression for 6 months, psychiatrist suggested returning to previous dose. Back up to 5.2 mg

2017 4.8 mg

Edited March 5, 2017 by scallywag
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[ChessieCat]

Hi DNB,

 

Welcome to SA.  If you are getting regular non-enteric coated Paxil you could weigh your doses are make your own liquid

 

Here is SA's Tips for tapering off Paxil (paroxetine)

 

See also:  How to make a liquid from tablets or capsules

 

It is suggested that when changing from one form of a drug to another to not do it at the same time as a drop and to do a switch over, eg several days each at 3/4 + 1/4, 1/2 + 1/2 then 1/4 + 3/4.

[Altostrata]

Welcome, dreamingneonblack.

 

Do you have any of the bottled liquid left? You can make the transition from the prescription liquid to your DIY liquid easier by taking part of your daily dose in the prescription liquid and part in your DIY liquid for a few days before taking it all in DIY liquid.

 

Or, you might look into getting the generic liquid form by prescription.

 

Yes, sometimes we just have to make our plans and ask our doctors politely for the prescription rather than any advice.

[dreamingneonblack]

Thank you Chessie and Altostrata; that is really great advice about transitioning to the generic that I hadn't thought of.

 

I called a compounding pharmacist today about bringing my pills to make an oral suspension and he was the most incredible health professional I've encountered so far in regards to ssri. He even warned me that it may be a difficult transition from brand name to generic. I've never heard anybody take any of that seriously especially with my "low" dose of under 10mg. When I told him that my dr. didn't take it seriously he even sympathized with me. I've decided that on Monday I'm going to call the pcp and ask him (probably beg him, honestly) to work with my health insurance to get this medication covered. If he declines then I'll tell him that I'm going to get the generic pills as a liquid suspension and all I need is for him to give the OK to the compounding pharmacist.

 

The only concern I have is that the pharmacist was saying something about how he can't mimic the oral suspension of Paxil because it's proprietary. Not sure if that means he'll change the concentration or if he can't do it at all

 

I wish more health practitioners could take our real issues more seriously like the pharmacist I met today. I'm confident one day in the future people will not look kindly upon them much like we don't of 1940s psychiatrists

[Brandy]

I don't know if this suggestion would be helpful to you or not, but thought I'd mention that before I was basically required to purchase Medicare Plan D drug coverage, I was paying cash (full price) for meds until I found Rx discount cards that were being given away at my local library. I was skeptical but it turned out my pharmacy and other reputable pharmacies in my area were contracted with them, and you can use them whether you have insurance or not and there are no fees. In helping others on PP long ago, I found that there are many such discount cards (offering carying discounts) in many areas (city or state) in the U.S.

 

The Rx's are not free but you do get discounts - in some cases moderate but in other cases pretty substantial.

 

After getting curious, I went to the online calculator on the site for my old Rx card and found it would save hundreds of dollars off the price your post mentioned. I then googled "rx discount card" and "california" (since your profile says you live there), and found a "California Rx Card" that seems to offer even lower discounted prices.

 

Again, I have never used that particular card so can't speak from experience about it. Assuming your doctor would still prescribe the suspension, you'd need to contact pharmacies in your area that contract with the card (they use mainly large chain pharmacies, it seems) to verify whether they accept that card and that the price information online is accurate. (Be sure and do that; prices can change at any time.) And I don't know how dosages and quantities listed on their web page compare with the quantity and type you've been getting (I never used liquid), so you'd have to check that with the pharmacies to also make sure you're pricing comparable quantities.

 

I don't want to get your hopes up if it doesn't help, but thought I'd mention it in case it might help you keep using the same liquid if the price might be within your means. (I have absolutely no affiliation with these cards, just hoping that you might find a way to get your med affordably.)

 

[dreamingneonblack]

Thank you so much Brandy!!! I spoke to the same pharmacist that has already helped me with a lot of advice and if I do have to buy it out of pocket I can attempt to use the california rx card to maybe get 5 to 20% off total price (which will be a lot off of a couple hundred). Going to call my dr tomorrow in one final attempt to request the insurance company to cover liquid and if not, to just buy one bottle out of pocket while I go through a busy phase at work

[Brandy]

Hope you found the same California Rx card I did when googling. I suggest shopping around the places the card contracts with. (These cards give discounts only with pharmacies they're contracted with, and this particular card seems to only contract with large chain pharmacies. Others, like the one I use in my city, contract with large chains as well as smaller ones, like the small independent one I use, but the prices are not necessarily as low - at least not with liquid paxil from what I could see on their site. (Discountscan vary enormously with different cards, as well as with different meds using the same card, if that makes sense. Have to "shop around" for each one for best price, which is something I've done only when they were very expensive, like the liquid paxil is. I was curious when I found the California card and entered random zip codes for several California cities - cities that friends of mine live in, some small, some large. The prices I got on searching their website averaged about $43 for a 30-day-supply of what I think was equivalent to 10 mg tablet. (I've never used liquid suspensions so not sure.) That was a much lower price than my discount card (for my city) listed for my pharmacy (which does contract with my city's discount card) and others. Given your present dose, it would appear that would last you at least two months if I'm understanding your situation correctly.

 

Doesn't seem possible, but worth checking out.

 

I think the California Rx card works primarily with CVS (not my favorite pharmacy by any means, though I've used some when I had to and things went fine), and also contracts with other large chain stores like Ralphs markets' pharmacies, as I recall. (They showed a lot of logos on the website.)  Not necessarily independent pharmacies, though you could contact them and ask. I only saw chain store pharmacies listed when doing my random search. You have to use contracting pharmacies with these discount cards - the cards negotiate special prices with the pharmacies they contract with. So you might want to check what , say, CVS's price would be for what your doctor would prescribe. You don't have to get any other medication prescriptions filled at the same pharmacy. If your doctor would cooperate and give you a prescription for the liquid paxil, to use at a different pharmacy than you usually use, you could continue to use your regular pharmacy for other meds, if you got just your paxil filled at one of the card's contracting pharmacies. (Just don't try to fill or refill prescriptions for the same med at more than one pharmacy in the same time period, of course.)

 

Ideal thing would be to have your insurance cover your med, and at your usual pharmacy. Just thought that suggestion might help you stay with your usual type/brand of med while you try to get your insurance to cover what you need, rather than putting your body through possibly needless changes.

 

Hope I have things straight (too sleepy to make much sense right now!), and that things work out well for you.

[Brandy]

P.S. If your doctor won't cooperate on trying to get your insurance company to cover the liquid, have you tried contacting the insurance company directly to see if you can request on your own that they cover orral suspension (liquid) because it makes a significant difference in how you feel and your ability to function?

[Frogie]

Have a fabulous sunshine day☀️☀️

[Frogie]

On March 20, 2018 at 10:07 PM, dreamingneonblack said:

Apologies if this has been done before and I couldn't find on search. I realized how negative I've become recently and I think having a positive outlook many years ago really helped me overcome pretty much any obstacle, or at least to live with it. I wanted to try and reframe my focus on good things and I thought it might be nice to try and start a thread for us to try and find good things that have happened or are happening in our life despite our struggles. And maybe reading these posts could help lift us when we are too down to see any of the good around us.

 

Today, I'm grateful for the resources I have to always better myself. If it wasn't for the internet or more specifically this community, I don't know where I would have gotten with these SSRI's. I certainly wouldn't have known to taper this way, or that the problem wasn't all in my head. Thank you to everyone reading this for being a part of my journey; I'm grateful for you.

I haven't heard from you forever!

 

Are you still tapering or are you done?

 

I'm down to 2mg, but have Xanax to go. Tried on dr orders to taper Xanax. Made it 3 days and was extremely sick.

 

I hope you are doing well.

 

Take care,

Frogie xx

[dreamingneonblack]

oh no :/ sorry to hear the xanax taper is going a bit rough. you're doing great powering through though!!

 

i'm still tapering unfortunately, it's gotten really difficult for me to go down any further than 4mg. I've been trying to do some at-home CBT (using the David Burns Feeling good workbook) to tackle my depressive episodes first since it's been getting worse. Fortunately, I solved the issue with the insurance coverage so I'm able to stay steady while I strengthen my mental health

[Carmie]

Hi dreamingonblack, 

 

Just checking in to see how you’re doing. Sending hugs🤗