Med change - help!!!
 

[/B]So my hubby went to p/u my refills today and out of 2 refills - I was denied 2 prescriptions. Gotta love those insurance companies - NOT!! :mad:My husband's insurance changed and now they are stating they won't refill my Lyrica or Cymbalta. I was just getting to sleep a little at night too! The pharmacy stated that the new insurance wants me to start out on the cheaper meds and work my way up if they wont work to the Cymbalta or Lyrica. Neurotin makes me swell so thats why they chose Lyrica - so not sure what else to choose? As for the Cymbalta - it had started working, at least I'm not crying every day (hehe). But I was starting to sleep a little deeper so I think it was working pretty good. Does anyone take other meds that work like Lyrica or Cymbalta? I know I have to call my doc tomorrow & discuss. I tried to get about 3 days worth of Cymbalta to get me by, but 6 pills was going to cost me $40.00. I said thanks but no thanks. So - anyone know what side effects I might have coming off of these two? As if I am not having fun enough with my leg & knee burning pain, no meds and now its snowing again. How many days left in the year?? LOL

I've never had withdrawl but seen it discussed. I would imagine that any sort of withdrawl depends on how your body processes meds and I believe most importantly, how long you've been taking a particular med. The things I know a lot of people have felt are: being jittery,sleeplessness,feeling nauseous and/or actually being sick, sweating,shaking. That's all the ones that come to mind at the moment. Of course depending on how high the dose of med was, how long you took it for would dictate how bad the withdrawl symptoms are. Milder symptoms to omg I want to die symptoms.

When you call the doc tomorrow, let them know right off the bat it is an EMERGENCY! If you can avoid withdrawl of any kind, mild or otherwise, then yeah, go for it! Tell them you can't get refills of cymbalta and lyrica, tell what the stupid insurance company said. I know docs will call and let them know, in no uncertain terms, you've tried "the other stuff" and doesn't work, hence the reason you're on what you're on!!! DUH!!! Then, if able to have the docs office drill into the stupid desk jockey's head that you NEED these meds, they'll approve, you go pick it up and "withdrawl" just becomes an ugly word without having to actually experience any of it.

I'll be thinking of you and hoping, really, really hoping, that this is what happens for you. No fuss, no muss. :)

Hugs,

Karen

Lindkaye

As far as I am aware, there is nothing like/similar to the action of Cymbalta out there. You might have more luck with Lyrica - you could try Gabapentin which is older and is available as a generic. Lyrica is a, newer drug derived from Gabapentin.

I stopped Cymbalta suddenly after being on it for a couple on months and had no withdrawal symptoms. That may not be the case for other people. I stopped Gabapentin after 3 weeks and had no withdrawal symptoms and I have so far not taken Lyrica. Withdrawal is like effectiveness and side-effects - completely individual. However, it is certainly not advised that either ofthese drugs are just stopped so I guess you have grounds to try and argue for at least enough to get you off slowly.

How dare they?
 

HOW DARE THEY believe that can diagnose without seeing you, or even talking directly to you? This is truly a really bad example of an insurance company looking at the bottom line only. To repeat what Karen said (below) get your doctor involved. They are undermining his/her practice and essentially telling him/her that he/she does not know how to manage your case.

If they refuse to budge -- don't let it go too long -- contact your state's Insurance Commissioner. That is what the office is called in Wisconsin. I'll bet every state has one. It is usually part of the Attorney General's Office and is set up to prevent fraud and abuse.

Best wishes to you. Keep us posted on what happens.

:hug: Mike

For my 2 cents...
 

off the top of my head, as far as the Cymbalta, it sounds like you were getting more help from the anti-depressant action rather the claims that it helps with neuropathic pain. If that is the case, then any of the other anti-depressants may help. My wife has tried many, including Cymbalta, and most recently is using Trazadone. Some of the literature indicates that for RSD Trazadone is one of the better medications since the side effects of the tricyclics (weight gain and craving of sweets) are often a complication for RSD patients. I personally have found that this, better than many others, has helped her sleep better and deeper when she sleeps.

Re: Lyrica - she is currently taking this - as mentioned in the earlier posts, alternatives to also try (the name of the brand) are Neurontin (which I believe you already tried), Tegretol, and Depakote (much older version).

Hope this helps and I too am sorry for the frustration of the insurance. Maybe a call from the MD to the insurance company would suffice to explain why some of the other meds would not work - although I think sometimes it may be easier to try them for yourselves- just don't give them too long before switching. Best of luck!

Thanks for everyones response and suggestions, they are very apprecited.

Well, I got up this morning all ready to conquer the insurance prescription deliema and set them straight! I then had my cup of coffee and after 1 hour on hold for the pharmacy div of the insurance co - and STILL listening to that elevator music with the annoying lady stating every 3 minutes or so "we will be with you very shortly" - my phone battery had died and I came back to earth, pinned my insurance card to my bulletin board and threw my son's darts at it. :D I did feel better! Who needs Cymbalta if you have darts?
I then called them back on my other phone and I got customer service again and they stated the pharmacy division were a "little back logged" this morning. Duh, you think? I tried to tell the Customer Service my plea of help - but they could not help me - I had to talk to the pharmacy dept. So what is the terminolgy "customer service" for? Sorry - I am just a little heated still! I ended up calling my pain management dr and got the receptionist who whole heartedly took my plea and stated the nurse would call me back today. Yes you are right - they did not call me back today. I do understand that they get backlogged. At least she seemed to know what I was saying and more or less made the statement the dr needed to fill out the form stating I really needed these prescriptions. I guess the insurance company thinks we like taking these pills just for the heck of it - huh? Again- I apologize for the sarcastic remarks and this is so long. Its just that I was starting to be able to sleep a little bit. I have tried Trazadone and had a reaction to it, as well as Lexapro and Celexa. As for the Lyrica - I cant take Neurotin but I know there are older types out there. Guess I have to wait for my pain mg dr tomorrow to get hold of me. In the meantime, hubby took the darts away from me. Hehe. :D

Lindkaye,

Go ahead and vent. That's partly what this forum is for. We can get things off of our chest. We have all been there.

I'm glad your husband confiscated your 'missles'. :D

Mike

have your
 

doctor call the insurance and get a "prior authorization"
for you.

Most insurances will do it with a doctor's urging.

You don't have to go without. You just have to make some noise of the right kind!

Yes, do that. And call the insurance, ask to talk to a supervisor.

Tell him/her which meds your doc has RX'd for you, and that you will accept no substitutes - you have tried the alternatives and they do NOT work.

If the insurance does not want to pay, your next move will be to get online and contact the State of WA Department of Insurance to file a complaint. Tell them you are going to do that, too. They hate the idea of being buried under a ton of state paperwork. Give them a chance to make things right.

I have had to file complaints with ODI (my state's Ohio) and believe me, the problem was solved within days.

:)

And now, all I have to do is mention ODI, and the insurance knows I mean business.

I am not asking for any benefits I'm not covered for, but they WILL pay for stuff I am supposed to get, and I am supposed to get my meds.


So are you.
:cool:


Good luck.

They may need to talk to your pain guy anyway. Most insurance companies WILL budge if they are given docymented proof (your chart) that what they will pay for will not work. Had to do the same with my husband's stomach meds-called many docs from way back when my insurance changed and they suggestion OTC Pepcid-uh, hello, like we hadn't already thought of that! The doc can also help by getting "pre-approval" and pushing it through the system. However, he will also be on the phone going through the same elevator music, so if he agrees, send him a card-you know what he had to go through.
Hope that helps
Lori Lee