[Shakti]

Ok, so here's my situation. I take Lamaictal and it has SAVED my life. But I was taking samples of the brand name until I could get in to see a doc. I saw a doc, got a prescription for the brand name. My ins refused to give me anything but th generic. I took the generic. So, I proceeded to have a psychotic break, want to kill myself by taking a boat out (I live on the ocean), slashing myself up good and bloody and then taking cyanide just as I dump myself overboard. That way the sharks and fish get a meal (hope the cyanide wouldn't hurt them). No body, no trauma in finding a body for my loved ones. This is the second time on the generic and the second time I have ****ing melted down. It does NOTHING. May as well not bother. So I went to a pdoc, thinking they could work with ins co and again they said no, that I have to be allergic to generic to get the brand name. So I'm stuck with this useless generic. I've been in a bit of a psychotic episode once starting the generic again. Don't know what to do. I've looked into coupons (still not affordable) and assistance programs (there really are none). When I was on the real Lamictal I felt well, healthy, and alive. On the generic I want to rip the worms out of my brain that are making me think these terrible things about wanting to die and obsessively planning it. I cry for hours every day. I'm not alive. I'm empty. And all I need is this medicine that saved my life and made me feel whole. I know meds are not everything, but the Lamictal was quite nearly a miracle.

Just needed to vent, I guess. I'm going off all meds. The Lamictal generic is making my episodes worse (I document carefully and my partner does too because when I'm irrational I need his objective view).

Life is ****ing ridiculous. I hate it. I just need this medicine. $208 a month and I could LIVE. But it's too much. I'm unemployed and too sick to work or do much.

Sorry about this vent.

Real Lamictal= beautiful quality of life.
Generic Lamictal= psychotic suicidal mess/

[Shakti]

Why can't we delete our own posts? I wish i didn't put this up. I'm not going off my meds.

Hey Shakti, it's alright. Glad you're not going off your meds, but the brand vs. generic on Lamictal is a topic of great interest to me, so I'm glad you posted. I started on the brand (wanted to see *if* in fact it was going to work for me, and had read some stuff on crazymed.us that gave me pause re: the generics) and went again for the brand the last refill though it killed me economically, because there were so many changes afoot and so much stress, it didn't seem like a good time to experiment. Going to see how it's going come time for the next refill. The price difference is HUGE, and though it's a big economic stretch for me, I hate to mess with success. It's been night and day for me for the most part (a recent stretch had me wondering if an adjustment was in order, but it's going better now and I'm hoping I've just pulled out of it) soooo, long and short, I'm loving it, and can't believe the difference it's made.
Thanks for posting on this topic. Really.

[BlackPup]

I'd heard something about that but not looked into, I noticed on my last script my doctor ticked brand substitution not permitted but the time before that I got a generic brand, I did get depressed then but who knows????
Zoloft and Epilim have different serum levels with generics, Maybe try a different dose?
Can you get your insurance to pay the cost of the generic and you pay only the difference?

[Shakti]

I'm in MA and I have fully subsidized health insurance (til I get a job, income, etc). But they allow they 12 visits per year to a "mental health care management group" which may or may not even have an actual pdoc on staff. I've been bounced around like a pinball and still not seen a pdoc. The 12 visits include anything at all--even therapy, an administrative appt for new doc, etc. After that I won't be able to afford it. It I could EVER get to see a pdoc I could go once a month or so for med management.

I've had two separate docs click "no substitutions" on it, but I got a letter in the mail today from my health ins co saying that their policy is that unless you are allergic (documented allergy) to an inactive ingredient that is not in the brand name the answer will always be no. You can appeal, but generally unless you suddenly become allergic to it you're a screwed. The med will cost me $186 a month with a drug store discount they offered me (down from $208), but I'm unemployed, have no income, and am seriously dependent on people for even things like food.

Since going back on the generic it's gotten worse and worse every day. Today I had to be watched all day because I was obsessed with killing myself, coming up with so many ways to do it, and crying/freaking out/sobbing/ and the rest of the time being catatonic. I've eaten a few times this week and just care about nothing. I'm not just depressed, though. This is a very very VERY mixed state sort of thing mixed with pure bipolar depression. I don't know what to do. I have exhausted all my resources. I'm teetering on actually killing myself. Something changed in me today. I died. I realized my bones are filled with sadness and that my legs and arms are sorrow. I wear lead boots. I'm nobody and there's no one left in there.

Decided today to hospitalize myself (would be the first time), but I don't even know how. Do I just show up? Do I have to call my insurance first? My primary care doc (who I saw once for a physical)? I have no idea what to do or how to do it and my fingers are exhausted from writing this.

I don't know what to do except die. And I want to die. Not the death part or the violence or the selfishness of leaving behind a teenager, but the end of this bipolar nightmare. I might get through tonight, but I'm doubtful about tomorrow. Even if I go into a hospital I have to wait a week or so. I have a surgical procedure scheduled for next Fri that must be done. It's medically urgent, can't wait, and have to take the appt I could get. After that? But if I don't seem "in crisis" will they tell me to go home? God I need help. I need help I need help.

Shakti, my heart so goes out to you. Please please please be careful. On going to the hospital, you BY NO MEANS have to wait a week.
GO. NOW. DO NOT HESITATE.
When you are in the state you describe, you need to get yourself in there. Right away. PLEASE.
Just go in. That is your part. Do not worry about anything else.

[Shakti]

My wonderful partner went this morning after I had a total meltdown--threw all my meds away, threw important and fragile belongings into walls, screamed and cried, and told him to go away so I could go through my stuff to throw out sensitive private stuff I didn't want people to see after i was dead. He was, of course, terrified, and left to go run an "errand" (after I repeatedly screamed for him to get out get out get out and even--and I'm so ashamed of this because it's NOT like me--pushed him hard when he tried to touch me). Turned out his errand was to go drop the $186 on my precious Lamictal. I took it (150 mg) and maybe it's placebo, but I feel ok again. Still exhausted, still sort of sad, very very embarrassed for my behavior, but so grateful and I'm lucky to be so loved. I'm still going into the hospital after my medical procedure (which has to do with hormones that very well may be not helping at all).

Tomorrow I'm making a sick visit appt w/ my primary care doc to request adding topamax. I've researched it a lot and I think it may be a good idea. She did give me klonopin but only 30 a month and when I have bad bad depressive episodes it takes 2-3 a day to just get by. On good days I take none. The real lamictal seemed to eliminate my need for klon at all.

Then I will be on 150 mg Lamictal, 300 mg (twice a day Wellbutrin), Klonopin as needed (I get 2 mg tablets, but like I said they don't last so I cut them in halves or ever quarters if I think it will work ok that way...I can always add another quarter later or whatever--I HAVE to make it last), and hopefully topamax. (Well, plus metformin for diabetes and synthroid for low thyroid). I also just started taking 5 grams of omega 3s daily. I also take a multi-vitamin, B-complex, and iron 3x a week as I'm slightly anemic.) I'm willing to try to spread my wings and freaking FLY if it might help. Or eat rocks. Or really anything. This is every level of hell in my head and every bad bad person lives in there (metaphorically).

I should get in to see a shrink for med management (within the next few months--ugh) and I'm going to ask for ECT. It's a long shot probably, but worth asking.

Thank you for your support. This may be far from over (my brain is still full of ****ed up, wacky, and BIZARRE thoughts, but it is the first day on the real Lamictal), but it usually works immediately but for now I'm ok and have my partner with me in case anything should happen.

I'm also appealing the decision with my ins co to deny me the med, even if I have to bombard every person in the company and even if I look like a fool. This is life and death. This med WORKS for me and I know how rare that can me.

I hope the topamax is prescribed. I cycle VERY ULTRA RAPIDLY between major depression and mixed states with psychotic features (hypomania and mania? Yeah, right--not anymore). I need the anti-depressant boost. Once I get into a deep major depression the mixed states come and go, but deep depression is the normal.

Thank you again so much. Having this place to come to and not be alone in this hell means the world.

God, I hate depending on meds. When I'm ok, I can use other tools from the toolbox--yoga, exercise, meditations, writing, projects, baking...things I usually love. But when I'm down, I'm just plain OUT.

Originally Posted by Shakti

Thank you again so much. Having this place to come to and not be alone in this hell means the world.

Ain't that the truth! I this forum too. BP can be so scary and it does mean the world to know we're not alone. Sooooooooo glad to hear that you're doing better now, Shakti!!! And that you're taking steps to get what you need. That can be so hard and frustrating (can soooo relate --we share many of the same issues in this regard and it's sent me around the bend a lot recently) but so important! And so glad that you have a caring partner. Keep us posted, ok? We're all in this together.

[Shakti]

Day 2 on the real stuff and I am as close as completely healthy and normal as could be. Yesterday was iffy, but better, and today I'm great.

I know this is not a placebo effect. The change is too drastic and I feel like a miracle just happened to me. Thank goodness for loving friends and partners.

I'm still asking for another anti-dep (topamax--good for ultra rapid cyclers) to be added and next crisis I'm going to inpatient immediately.

Thank you thank you for your support.

No problem Shakti, glad to be able to! Happy you are feeling better and that you have a plan for things before they happen. Yea!

[RRU96]

Not sure if this will help, But I know there is a patient assistance for Lamictal because my docs office filled out the paperwork for me. Now that I am not on the Titration kit, I get a 1 months supply at a time, sent to my docs office. The office charges me a small amount, though I think it is just to help them. Each office is different, for me it is just $5. I did find information online for a program through GlaxoSmithKline (the company that makes Lamictal). The site for the program is

http://www.bridgestoaccess.com/

It is for non-cancer meds for those that meet the income and eligibility guidelines. I dont know how your coverage you have works, but this is definatly something to file away in the bookmarks page for future reference. It might not hurt to even call them, if you dont meet the criteria, and let them know the situation. Maybe there is something they can help you with that you might not be able to find elsewhere. It's usually a toll-free number and it can never hurt to ask.

[Shakti]

I have to pay for mine out of pocket despite having fully subsidized (free) insurance. ALL of my other meds cost me $3 a month. This one: $186. They see no difference at all in the two and if I kill myself on the generic (fakemictal, I call it), oh well. I also qualify for none of those bridgeaccess programs or any others because in order to be eligible you must not have prescription coverage of any kind. I do. They just don't cover it. There is a $40 coupon (via same site) that you can fill out for $40 off the cost of it (pretty sure there are no limitations on this), but four times I've filled out the form and clicked submit and it just takes me back to the main page with a small line of red writing at the top that says there's been a server error. After so many tries and unsuccessful calls I gave up. I have no idea how I'll pay for it again in less than a month (unemployed, no income, and BROKE), but something will have to happen.

The bridgestoaccess program should be able to help the OP though...be persistent.

[Shakti]

Started Topamax today. Wheeeee....here we go. Adding new meds is always so lovely.

[rkba97]

Lamictal saved my life, too. I have to get an Rx for the name brand because the generic does nothing for me. It's the only med I'm on where it makes a difference. Money is definitely a big issue for me too... maybe this new insurance deal that's coming through will recognize that mental health problems are just as valid as physical health problems... and that generic is a DIFFERENT drug than the name brand, otherwise why would there be an option anyway?

Stay strong.... and I also need to add, although I'm not the first, that you shouldn't regret that original post... when I read it, and then the one right after it, where you said "I wish I hadn't posted that".... I swear I could have written that. We're all in this together!

Speaking of... time to post my own rant!

[billieJ]

Shakti ~ you ARE in a terrible situation! I know what you mean about being caught in the managed care system and being too poor to afford the brand names. Have you considered trying another drug altogether. I, too, have to been too sick to care much and and meds don't do much good. Trouble is, I'm on one of the those that cost brand name price but is actually generic. Try another med before you give up. And remember this: Ins would rather have you on a brand name before paying for repeated hospitals. Head the hospital way, not the boat and sharks. If you hurt yourself, they win!

[Shakti]

I've been on SO many meds and I'm SO med sensitive that when I find something that works I will fight tooth and nail to make it stay in my hot little hands no matter what. In fact, I'd go so far as to say that the meds that don't work, REALLY don't work, as in nearly kill me (one way or another). I'm just really sensitive to meds and chemicals. I think I'm onto the right combo. Now if I can just get through adjusting to topamax and learning to give up coffee (caffeine and topamax are, together, like an overdose of cocaine or meth from what I've read and heard and whatever the case, I don't need the extra anxiety). Coffee has been my favorite reason to go to bed at night--so I can wake up and have it! So this will be a huge change. But I will do anything to get and be healthy (healthier). We'll see. Caffeine-free, perhaps? I never saw the point of caffeine-free coffee, but I love my morning coffee in the sunlight at the table at my laptop writing, so maybe it's just the comfort of the ritual.

If there are issues with this cocktail I am willing to try lithium next and ECT after that. After that, though, I'm done.

Things seem to be working out, though. It's just so frustrating, isn't it?

[birdcrazy]

Huh... I took real Lamictal for a while then went to generic. No change... I wonder what's up?

On the other hand, they put me on lithium too and so far that's not doing squat and I think I'm gaining weight... basically I am having mild cycling, very occasionally getting SU thoughts, but not very bad, but I want them to go away.

[Shakti]

It must just have to do with individual body chemistries....well, brain chemistries. Just like how some drugs work for some people and not at all for others.

By the way, I love your avatar picture. That blue is just so....blue. I love it.

[WLFTW]

Originally Posted by Shakti

Tomorrow I'm making a sick visit appt w/ my primary care doc to request adding topamax. I've researched it a lot and I think it may be a good idea. She did give me klonopin but only 30 a month and when I have bad bad depressive episodes it takes 2-3 a day to just get by. On good days I take none. The real lamictal seemed to eliminate my need for klon at all.

Ativan might be worth looking into as well. I know that when I'm having a fit, so to speak, ativan always helps; it's nearly immediate whereas klonopin is slow acting and needs to be built up into your system first. At least, that's my understanding; I have been on both of those.

I also take lamictal 300mg a day. I checked and I am taking the generic form. Fortunately, it's not causing harm to me like the generic lamictal is for you.

Then I will be on 150 mg Lamictal, 300 mg (twice a day Wellbutrin), Klonopin as needed (I get 2 mg tablets, but like I said they don't last so I cut them in halves or ever quarters if I think it will work ok that way...I can always add another quarter later or whatever--I HAVE to make it last), and hopefully topamax. (Well, plus metformin for diabetes and synthroid for low thyroid). I also just started taking 5 grams of omega 3s daily. I also take a multi-vitamin, B-complex, and iron 3x a week as I'm slightly anemic.) I'm willing to try to spread my wings and freaking FLY if it might help. Or eat rocks. Or really anything. This is every level of hell in my head and every bad bad person lives in there (metaphorically).

ok this is just my opinion but people who have bipolar disorder should not be on Wellbutrin as it could trigger a manic episode. That happened to me. I was misdiagnosed as having major depression and wellbutrin was prescribed. Unbeknownst to me and my doctor, I actually had something closer to bipolar disorder...it's just that my first episode was depression. Since I have bipolar tendencies, a lot of antidepressants like wellbutrin make me have a mania. A regular physician might not realize that antidepressants could be ill-advised in patients who might have bipolar disorder. It can work but the patient must be closely monitored for mania.

The tricky thing is that it probably helps with depression and it might be hard to find an alternative antidepressant for you.

Or perhaps the wellbutrin will not have a mania for you... but it's worth asking your doctor about the risks of wellbutrin.

I should get in to see a shrink for med management (within the next few months--ugh) and I'm going to ask for ECT. It's a long shot probably, but worth asking.

That's quite drastic but, then again, you are in dire need of a solution. I once asked my doctor for a lobotomy. She didn't authorize it.

God, I hate depending on meds. When I'm ok, I can use other tools from the toolbox--yoga, exercise, meditations, writing, projects, baking...things I usually love. But when I'm down, I'm just plain OUT.

I feel exactly the same way.

[Shakti]

I don't get mania. Well, not pure mania. I get mixed episodes. They do qualify as mania (thus earning me the BP1 label although there's been some NOS talk--whatever, though--it's just a label to me), but they are not happy mania at all--they are insane, psychotic, depressed, racy, energetic, delusional, do a million things, miserable, ya know...that sort of thing.

Wellbutrin was the only anti-depressant that worked for me after trying almost every other one in the book. But I'm also now on two mood stabilizers, so that probably helps combat the manic tendencies with bipolars and anti-depressants. Although SSRIs did cause happy happy mania and in a huge way. What a lovely two weeks..that ended in absolute crisis--every time they insisted I try a new SSRI. And they kept doing it! The dummies. Now they know better. I've been on Wellbutrin for two years with no issues on doses varying from 150 to 300, although it has worked exponentially better once I went on a mood stabilizer. I just resisted the mood stabilizer for a long time, not wanting meds, not wanting to be bipolar, not wanting to be sick or different or to think I could not beat this myself with my own strength or the power of my mind or whatever else.

Ativan worked for me like taking tic tacs. I actually flushed them down the toilet and never refilled them. Valium (no doc will give me this and I don't care to have it) and Klonopin work for me and nothing else. I have an unusual body chemistry, though. Klonopin works immediately in my system. Within a minute, I'd say.

I actually find it exceptionally interesting how different our brains are and how they work and metabolize things. The meds are so hard to get right and so many of us forget we actually do have other things in our toolboxes...but then again, it's easy to do when we are in a bad place.

[WLFTW]

Using a mood stabilizer in conjunction with a drug like welbutrin is probably a wise way to go... To qualify what I said earlier about welbutrin, I was not on a mood stabilizer at the time.