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I’m terrified.
After my suicide try and subsequent psychiatric hospitalization in 2014, all my treatment was modified. I used to be began on a unique antidepressant (Pristiq, 100 mg.) and a unique antipsychotic (Abilify, 15 mg). In 2018, following my stroke I turned severely depressed and returned to remedy. My therapist, Dr. Lev, added a second antidepressant (Remeron, 45 mg.) to my cocktail. I’ve been secure on these drugs ever since.
I began a brand new job this yr. Meaning new insurance coverage. Once I ran out of the Pristiq, Dr. Lev needed to ship in a refill to the pharmacy which triggered a previous authorization request from my new insurance coverage firm. Sadly, by the point she bought notified that prior authorization was needed, I solely had one pill left, which I took this morning.
In an article printed by the AMA, Jack Resneck, a dermatologist and quick previous president of the AMA, writes about prior authorizations, “A few years in the past, medical health insurance plans got here up with this course of, and on the time it was only for brand-new, costly drugs that had simply come to the market or new remedies that they wished to restrict use of.”
I can handle one or two days with out the Pristiq, however greater than that I begin to fear. I’m anxious that I’ll begin to undergo withdrawal or what’s extra formally known as antidepressant discontinuation syndrome which may occur when you cease taking your treatment instantly.
In keeping with The Cleveland Clinic, “Antidepressant discontinuation syndrome (ADS) can occur when you cease taking your antidepressant when you’ve taken it for not less than six weeks. It’s extra more likely to occur when you instantly cease taking the treatment as an alternative of slowly truly fizzling out below the steerage of your healthcare supplier.” Moreover, “ADS causes a number of signs, together with insomnia, nausea, and flu-like signs.”
ADS sounds crummy, however it’s one thing that may be endured. What I’m actually frightened about is: What if the insurance coverage firm denies the Pristiq, or denies the 100 mg. dosage, citing that fifty mg. is the utmost?
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Resnick’s AMA article states: “As we take a look at what issues require prior auth … it used to essentially be a slim set of brand-new issues that had simply come out, however now it is fully unpredictable.”
I fantasize about Dr. Lev, within the peer-to-peer evaluate with an insurance coverage firm rep on the opposite finish of the telephone, or nevertheless they do it today, telling this particular person, who could or might not be a psychiatrist, that this affected person has a historical past of extreme psychotic melancholy, that she has tried suicide 4 occasions, that she has been secure of the 100 mg of Pristiq for 10 years.
She is going to inform them that there’s a probability that if she is denied the 100 mg. of Pristiq, she is going to turn out to be so severely depressed that her suicidal ideation will return. And she is going to quote a research printed in The American Journal of Psychiatry and inform them “A previous historical past of suicide try is taken into account one of the crucial strong predictors of ultimately accomplished suicide.”
Will I matter to them?