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I’m terrified.
After my suicide try and subsequent psychiatric hospitalization in 2014, all my remedy 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 steady on these medicines ever since.
I began a brand new job this 12 months. Which means new insurance coverage. After 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 vital, I solely had one pill left, which I took this morning.
In an article printed by the AMA, Jack Resneck, a dermatologist and fast 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 medicines 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 referred to as antidepressant discontinuation syndrome which might occur if you happen to cease taking your remedy immediately.
In line with The Cleveland Clinic, “Antidepressant discontinuation syndrome (ADS) can occur if you happen to cease taking your antidepressant if you happen to’ve taken it for not less than six weeks. It’s extra prone to occur if you happen to immediately cease taking the remedy as a substitute of slowly truly fizzling out below the steering 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 slender set of brand-new issues that had simply come out, however now it is utterly unpredictable.”
I fantasize about Dr. Lev, within the peer-to-peer evaluation with an insurance coverage firm rep on the opposite finish of the cellphone, or nevertheless they do it lately, telling this individual, who might or might not be a psychiatrist, that this affected person has a historical past of extreme psychotic despair, that she has tried suicide 4 instances, that she has been steady of the 100 mg of Pristiq for 10 years.
She’s going to inform them that there’s a probability that if she is denied the 100 mg. of Pristiq, she’s going to turn out to be so severely depressed that her suicidal ideation will return. And she’s going to quote a examine printed in The American Journal of Psychiatry and inform them “A previous historical past of suicide try is taken into account one of the vital strong predictors of finally accomplished suicide.”
Will I matter to them?
