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Old 03-04-2008, 12:46 AM #1
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Default Paxil and Tegretol for Misty

Quote:
Originally Posted by Mistyb333 View Post

What a great article. I agree with most of it. I was diagnosed about 16 years ago bi-polar, took a few years to get the right meds, but my combo has worked so well over the past 14 years, that I have kept jobs, relationships, my kids talk to me, and I have a few great groups of supportive friends.

I am in a little bit of a bind today however. I sent my prescriptions to the mail in pharmacy (being the first of the year I have to meet an insurance deductable) so the 90 day scripts for the meds I take weren't covered and they wouldn't mail them without an approval from me. Well, they kept leaving messages on my home phone, which I don't check and never tried my cell...so by the time I recieved the Letter in the mail informing me they were holding onto my scripts until they were authorized, I was already out of my meds!

I was told I would recieve them by the end of the week ( I now have been off them for 4 days, that will make 9 days).
I called my dr's office, explaining to them what happened and that I was already feeling like an electric current was running through my normally serene body, they agreed to call in 4 days worth to the local pharmacy.
When I landed at the pharmacy..they refuse to fill it...saying I could go to jail for it.

I believe in peace, love and joy. Serenity, bliss and happiness, so no I didn't threaten, though I did try to reason wiht the pharmasist.
She still refused to give me 4 days worth. I did not pull the mental illness card (which could have been fun, but sadistic).

SO
After all that,,,,I am trying to find out what kind of withdrawl symptoms I can expect to experience until the "pills come in the mail".
I have been on Tegretol and Paxil for over 15 years.
Every day, working in New York and Hawaii, I had my pills...
this is the first time I have not been able to get them
.
The electrical charge is strongest when I am sitting still... I am going to ask the Divine to assist me in this as I seem to be quite helpless tonight..
Any ideas?



Dear Misty,



Oh, dear. This is crummy. I'm sorry that you are going through this trouble with the insurance. The tapering effects are not fun either. Maybe you will be mostly ok. Some people can manage through this.

I'm not clear on why the pharmacy says it is against the law.

Can you call your insurance company for help? Can you get the pdoc to call the pharmacy and straighten this out?

The pharmacy knows that you can't discontinue Tegretal abruptly.
But now that it has been 4 days, maybe you are in the safe zone now. I really don't know about Tegretol so don't take my word for it. Is there a friendly pharmacist you can call just for information? Or even a non-friendly pharmacist?

I've heard of people going to the ER when they run out of meds and are in bad shape.

I hope you don't mind that I moved your post here. Perhaps more people will see it here than they would on the sticky.

Hugs for you.

Mari




Here is what crazy meds says re SSRIs. Not everyone goes through a bad time. Some people are mostly ok.
http://crazymeds.us/
Quote:
These symptoms will last anywhere from one to seven weeks, and then disappear.

Neurologic symptoms include:
-Dizziness
-Vertigo
-Lightheadedness
-Difficulty walking
-Somatic (bodily) complaints include:
-Nausea/vomiting
-Fatigue
-Headaches
-Insomnia

Less common difficulties:
-Shock-like sensations
-Parasthesia (skin crawling, burning or prickling)
-Visual disturbances
-Diarrhea
-Muscle pain
-Chills

Non-specific mental symptoms:
-Shock-like sensations
-Agitation
-Impaired concentration
-Vivid dreams
-Depersonalization - sense of unreality and loss of self
-Irritability
-Suicidal thoughts

Double-blind controlled studies now indicate that 35-78% of patients who, after five weeks or more of treatment with the medication, abruptly stop certain antidepressants or titrate down in 10mg increments or more, will develop one or more of the discontinuation symptoms.

When allowed to run its course, the syndrome duration is variable (one to several weeks) and ranges from mild-moderate intensity in most patients, to extremely distressing in a small number.
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Old 03-04-2008, 05:59 PM #2
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Exclamation Misty - risk of seizures

Tegretol is an Anti-Epileptic Drug (AED), also used for bipolar disorder as a mood stabilizer. in epilepsy, it is used to raise the "seizure-threshold" so ppl who suffer from epilepsy dont have seizures or have fewer of them.

However, even for those without epilepsy, abrupt discontinuation of ANY AED-class medication will lower the seizure threshold and possibly produce seizures. i have personally experienced this with Depakote. Like Mari i cannot understand why the pharmacy or your doc's office is not being cooperative. The electrical sensations you are experiencing are not a good sign, although seizures with retained consciousness are typically unilateral. The sizzly stuff seems more related to SSRI (Paxil) discontinuation...

Indeed, the fact that you actually halted both simultaneously could somewhat counter the seizure risk, since SSRI's actually lower the sz-threshold (opposite to AEDs), but now i am doing some serious NON-DOCTOR arithmetic here and you should still not be allowed to just drop off Tegretol abruptly, period.

Please call your doctor's office again and tell them what the pharmacy told you (clearly there was a "mixup" ? calling in the refill?) Ask the doc's office call in a NEW script AS OPPOSED to a refill ..... one can't refill same script# beyond the max number allowed, and perhaps that was the "legal" problem, given you had ordered by mail as well.) Insist the doc's office call in the NEW script ASAP and "lay it on thick" about the sensations you are having. If you don't get to speak to the doc in person, tell the receptionist/nurse that you are aware abrupt tegretol suspension can cause seizures, and that they need to work with you to prevent that. Call the pharmacy before driving there.

if you can't get your meds SAME DAY, i would go to an urgent care or preferably ER. There are other meds they can give you to help you out.... i am wondering about your insurance coverage now... do you have as-needed benzodiazepines prescribed, at home, such as Xanax, Ativan, Serax, Klonopin, Valium? Taking those as indicated could help in the immediacy - don't go overboard lol. specifically if you have any Klonopin or Valium until you resume the Tegretol, since those are easier meds to manage.

AND......are your symptoms worsening / getting better? Any changes?

GOOD LUCK. HOPE YOU WILL BE OK.

~ waves ~
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Old 03-04-2008, 07:00 PM #3
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Also you can call the mail order place and explain that you are out of the medicine. And that you need it immediately.

They should be able to call you local pharmacy and authorize the 4 days
of medication too.

For me, with Derrick its seizure medication so they authorize 2 weeks,
but I don't know they might just authorize the 4 days for you.

Donna
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Old 03-05-2008, 04:42 AM #4
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Ooo Jail?

That is a new one for me! Never heard that one before.

It is obvious that your mail away billed you already, and that is why the
local pharmacy could not fill it. All they needed to do is call for an override.
It is done all the time.

I suggest you find another pharmacy...as that comment to you is totally unprofessional and erroneous. Worst case scenario is that you would pay for the temporary fill. Jail? NO WAY...
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Old 03-05-2008, 07:11 AM #5
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I agree that that pharmachist was rude. Let us know how you are.

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Old 03-06-2008, 03:46 AM #6
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Misty,
How are you?

Mari
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Old 03-06-2008, 02:17 PM #7
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Quote:
Originally Posted by Mari View Post
Misty,
How are you?

Mari
Hope you're doing okay Misty. Please let us know how you're doing.
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