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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 secure on these drugs ever since.
I began a brand new job this yr. That means new insurance coverage. When 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. Unfortunately, by the point she bought notified that prior authorization was crucial, 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, “Many years ago, health insurance plans came up with this process, and at the time it was just for brand-new, expensive medications that had just come to the market or new treatments that they wanted to limit 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 could begin to undergo withdrawal or what’s extra formally referred to as antidepressant discontinuation syndrome which may occur in the event you cease taking your remedy all of the sudden.
According to The Cleveland Clinic, “Antidepressant discontinuation syndrome (ADS) can happen if you stop taking your antidepressant if you’ve taken it for at least six weeks. It’s more likely to happen if you suddenly stop taking the medication instead of slowly tapering off under the guidance of your healthcare provider.” Additionally, “ADS causes several symptoms, including insomnia, nausea, and flu-like symptoms.”
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 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 nonetheless they do it as of late, telling this particular person, who might or is probably not a psychiatrist, that this affected person has a historical past of extreme psychotic despair, that she has tried suicide 4 occasions, that she has been secure of the 100 mg of Pristiq for 10 years.
She will inform them that there’s a probability that if she is denied the 100 mg. of Pristiq, she is going to grow 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 prior history of suicide attempt is considered one of the most robust predictors of eventually completed suicide.”
Will I matter to them?