How to Save Money on Meds

October 22, 2009

If you usually traipse over to your local Rite Aid to get medications, you can easily save money.

Number one is to get generics where available.

Lamictal 200 mg 60 tablets $389.99
Lamotrigine 200 mg 60 tablets $323.14 :: cheaper

Number two is that your drugstore probably sells drugs online for at
least 10% lower than at your neighborhood store.

Number three is to buy larger pills and split them. If you took 100mg doses:

Lamictal 100mg 100 tabs $533.32 $5.33 per dose
Lamictal 200mg 60 tabs or
120 doses
$389.99 $3.25 per dose :: cheaper

Number four is to save by buying in bulk. Check before you order as it’s not a given.

Lamictal 200mg Tablets
60 tabs $389.99 $6.50 ea
180 tabs $1,138.09 $6.32 ea :: cheaper

Number five is to buy from overseas pharmacies, and remember they are NOT TAX-DEDUCTIBLE.

Lamotrigine 200mg Tablets 240 tabs $1,156.51 $4.82 ea 280 tabs $425.60 $1.52 ea :: cheaper

Bipolar Planet on Facebook

June 18, 2009

The Bipolar Planet has made it to the 21st century. Social Networking is all the rage, and though The Bipolar Planet has provided a private email list for over ten years and a web page for 15 years as of May 2009, I’ve resisted wandering. Ok, here we go… Become a fan at the official Bipolar Planet Facebook page.

The Power of Irrationality

March 27, 2009

If you haven’t read Kay Redfield Jamison’s “<a href="Touched with Fire: Manic-Depressive Illness and the Artistic Temperament“>Touched With Fire; Manic-Depressive Ilness and the Artistic Temperament” run out and get a copy. She is a psychiatrist at Johns Hopkins and is bipolar herself.

“I believe that curiosity, wonder and passion are defining qualities of imaginative minds and great teachers; that restlessness and discontent are vital things; and that intense experience and suffering instruct us in ways that less intense emotions can never do. I believe, in short, that we are equally beholden to heart and mind, and that those who have particularly passionate temperaments and questioning minds leave the world a different place for their having been there. It is important to value intellect and discipline, of course, but it is also important to recognize the power of irrationality, enthusiasm and vast energy. Intensity has its costs, of course — in pain, in hastily and poorly reckoned plans, in impetuousness — but it has its advantages as well.”
Dr. Kay Redfield Jamison, Author and Professor of Psychiatry and Behavioral Sciences at Johns Hopkins University
in “The Benefits of Restlessness and Jagged Edges”
NPR Morning Edition, June 6, 2005

There is a video of a speech she did about Exhuberance on YouTube that was quite inspiring. She wrote a great book about the love of life called Exuberance: The Passion for Life

Mental Health Parity in the Bailout Boondoggle H. R. 1424

March 17, 2009

This refers to a previous bailout, not to the latest ripoff.

H. R. 1424: Emergency Economic Stabilization Act of 2008

Here is the full text, and I suggest that everybody read this bill. It was pushed through with only a couple of days debate by lawyers who have little understanding of the workings of Wall Street or The Fed, and who have huge financial interest in the institutions that will benefit from it. To add insult to injury, they tacked a lot of pork barrel spending onto it to BRIBE Congress to agree to it.

Some comments:

“To amend section 712 of the Employee Retirement Income
Security Act of 1974, section 2705 of the Public Health
Service Act, section 9812 of the Internal Revenue Code
of 1986 to require equity in the provision of mental
health and substance-related disorder benefits under
group health plans, to prohibit discrimination on the
basis of genetic information with respect to health insurance
and employment, and for other purposes.”

This means that you only get parity if your employer provides your insurance AND that insurance already has mental health coverage. It doesn’t seem to require them to cover it. How many of you all work full-time?

There is a cost exemption so to limit mental health coverage if it increases costs by some undetermined amount. The insurance companies can still deny claims bases on their definition of “medical necessity” or by their definition of “reasonable and customary” services.

6 ‘‘(A) IN GENERAL.—With respect to a
7 group health plan (or health insurance coverage
8 offered in connection with such a plan), if the
9 application of this section to such plan (or cov
10 erage) results in an increase for the plan year
11 involved of the actual total costs of coverage
12 with respect to medical and surgical benefits
13 and mental health and substance use disorder
14 benefits under the plan (as determined and cer
15 tified under subparagraph (C)) by an amount
16 that exceeds the applicable percentage described
17 in subparagraph (B) of the actual total plan
18 costs, the provisions of this section shall not
19 apply to such plan (or coverage) during the fol
20 lowing plan year, and such exemption shall
21 apply to the plan (or coverage) for 1 plan year.”

Discrimination on the basis of genetic information only affects illnesses for which genetic tests have been developed. This bill ignores a lot of of the provisions of the ADA, while modifying ERISA in ways that are completely meaningless. I am concerned that this will weaken the ADA by tightening the definitions to exclude non-genetic diseases.

Specific diagnoses this bill applies to will be determined by the GAO, which has 3 years to study it and present a report.

6 (1) IN GENERAL.—The Comptroller General of
7 the United States shall conduct a study that ana8
lyzes the specific rates, patterns, and trends in cov9
erage and exclusion of specific mental health and
10 substance use disorder diagnoses by health plans
11 and health insurance.”

Congress can continue to modify this Act.

I doubt this will change anything in the near future.

A few years from now you’re going to hear Congressdroids bitching because they didn’t have enough time to collect the facts before enacting this bill. Listen to them whine about how they were boondoggled into exercising the Bush Doctrine on Iraq.

TFTD: Self-reflection

June 24, 2008

Byron Katie Newsletter: June 2008

The following quote is exactly what I have been going on about, the need to have an objective observer, one who pushes the ego out of the way and takes a good long look at who we are. The first step to healing is to know what has to be healed.

Byron Katie’s “The Work” is an interesting tool for examining how much misery we cause ourselves by forgetting that what is, is.

Stop by The Work web page to read and listen to the freebies.

I want to go to one of the 5-day events.

“To question that things might not be as they seem can shake the very foundation of habitual clinging. This questioning spirit is the starting point for self-reflection. Could it be that this tightly-knit sense of self is not what it seems? Do we really need to hold everything together, and can we? Is there life beyond self-importance? These kinds of questions open the door to investigating the cause of our suffering.

“The actual practice of self-reflection requires us to step back, examine our experience, and not succumb to the momentum of habitual mind. This allows us to look without judgment at whatever arises, and this goes directly against the grain of our self-importance.

“Self-reflection is the common thread that runs through all traditions and lineages of Buddhist practice. It also takes us beyond the boundaries of formal practice. We can bring the questioning spirit of self-reflection to any situation, at any time. Self-reflection is an attitude, an approach, and a practice. In nutshell, it is a way to make practice come alive for us personally.”

— Aryadeva, Buddhist teacher.

Pharmaceutical Chastity Belt

April 17, 2008

Pretty much any psych med by itself will affect sex drive. I see folks taking a half a dozen of them, and then another med or two to counteract the side effects. The pdocs tell us that they DON’T because they don’t want us to quit taking them.

Perhaps we should refer to our meds as a “pharmaceutical chastity belt.”

Anything that tweaks your dopamine down is going to get rid of the emotional spark required to have something resembling a sex life. And anything that tweaks UP serotonin receptors does so at the expense of dopamine receptors. See this article, Notes on Anhedonia and SAD.

For men, there’s also the problem of peripheral blood flow – a strictly mechanical problem. Can’t get the old hydraulics to run, eh? Viagra and Cialis work by improving blood flow. Heck, coffee dilates the blood vessels too, and if you brew it at home it’s way cheaper than an ED pill. Diabetes is common cause of ED, so antipsychotics that affect blood sugar (most of the atypicals) might contribute to it.

Maybe the whole idea is to give us drugs that prevent us from breeding lots of little bipolars.

Bipolar or ADD?

March 20, 2008

A reminder: I’m an engineer. This is all my opinion based on readings in a field that is not my own. I request that as you read my posts, you also check my references.

Cigarettes are powerful anti-anxiety drugs. It’s my opinion that may smokers are self-medicating an anxiety disorder.

Nicotine has calming effects on stress-induced mood changes in females, but enhances aggressive mood in males

“Exposure to moderate stress significantly increased ratings of anxiety, discontent and aggression and nicotine blocked these mood changes in females, but enhanced them in males. This suggests that young women may start regular smoking as a form of stress self-medication, which implies that preventative and smoking cessation programmes would be more successful in women if they addressed issues of stress and anxiety, which may be core factors underlying initiation and maintenance of regular smoking.”

A bipolar most certainly will get a high score on an ADD screening test like the Copeland symptom checklist. The symptoms of ADD overlap with the symptoms of bipolar. A bipolar child scores higher on the ADD screening test that a child with ADD. Your GP isn’t qualified to make a differential diagnosis, and in fact is likely to misdiagnose you and make your illness worse.

I’m going to quote from articles about children because misdiagnosis kills so many of them. It applies to adults too, but we don’t have parents to FORCE us to continue taking ritalin when it is obviously tearing us to pieces.

Diagnosing Bipolar VS. ADHD: Similarities

“There is concern that ADHD is being overdiagnosed and bipolar disorder underdiagnosed in the population of children.”

That being said, yes, I have ADHD combined type. My psychiatrist diagnosed it after I’d been seeing him for 10 years and after an evaluation that DIDN’T included taking an ADD screening test. Screening tests are useless for bipolars. You have to be cautious.

I have been through the entire pharmacopia, or it seems that way. Every ADD med I’ve taken makes me hypomanic within a week. So how I work it is that on days I really REALLY need to focus I take it. I have tried:
Ritalin (methyphenidate) – this is the one they give our children. Somebody please explain to me why 40% of American children need psych meds?
Strattera – this was the absolute worst for me. It interferes with metabolism in the liver of SSRIs, resulting in a huge buildup of both drugs. I was up there in 3 days and in a nasty mixed state in a week.
Provigil – similar to Strattera, but takes longer to build up. YMMV! 🙂
Adderall – amphetamine. SPEED FREAK! Three days in a row and I’m have “racoon eyes” and am well on my way to psychosis.

Strattera Risks May Widen
FDA,s warning about Eli Lilly’s drug Strattera causing suicidal thinking in children used for ADHD caught many parents and doctors by surprise.

“Dr. Laughren says the agency also plans to ask Lilly to include a stronger caution on Strattera’s label about its risk of inducing mania and similar mood destabilization, along with the new “black box” warning out this week. The new warning will focus on the drug’s risks for kids with undiagnosed bipolar illness, according to Dr. Laughren. In fact, “very often bipolar illness is not recognized until you [give] patients a drug like Strattera,” he says.”

Bipolar Disorder, Co-occurring Conditions, and the Need for Extreme Caution Before Initiating Drug Treatment

“Now understanding that early-onset bipolar disorder is frequently co-morbid with other childhood psychiatric conditions, doctors and parents should be concerned that a medication used to treat these other conditions may “flush out” a previously quiescent bipolar gene that can significantly worsen the course of illness and potentially wreak havoc with that child’s life. It is therefore vitally important that parents learn everything they can about their family histories, and if mood disorders (depression or manic-depression), suicide, or alcoholism come to light, treatment should proceed very cautiously. Mood stabilizers should perhaps be the first line of treatment (and it may take two such medications to stabilize the child), and attentional, obsessional, or depressive symptoms be treated only after a therapeutic dose of the mood stabilizer is achieved.”

The Overlap With ADHD

Perhaps the greatest source of diagnostic confusion in childhood bipolar disorder is that its symptoms overlap with many of the symptoms of attention-deficit disorder with hyperactivity. At first glance, any child who can’t sit still, who is fidgety, impulsive, easily distracted or emotionally labile is more likely to receive a diagnosis of ADHD than bipolar disorder. However, since over 80 percent of children with a bipolar disorder will meet full criteria for attention-deficit disorder with hyperactivity, ADHD should be diagnosed only after bipolar disorder is ruled out. While these two conditions seem highly co-morbid, stimulants unopposed by a mood stabilizer can have an adverse effect on the bipolar condition. 65 percent of the children in our study had hypomanic, manic and aggressive reactions to stimulant medications. Parents wrote to us and described some of their children’s reactions to stimulants. They said things like: “He got sky-high on Ritalin and then violent”; “Ritalin caused physical aggression”; “She got psychotic on stimulants”; “He got suicidal and tried to get run over by a car”; “He went bonkers…”

Don’t let a GP play with screening tests. See a psychiatrist.