Antidepressant Discontinuation Syndrome: Simply the Starting

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I’m terrified.

After my suicide try and subsequent psychiatric hospitalization in 2014, all my treatment was modified. I used to be began on a special antidepressant (Pristiq, 100 mg.) and a special 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. Which means new insurance coverage. Once 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 received notified that prior authorization was crucial, I solely had one pill left, which I took this morning.

In an article revealed by the AMA, Jack Resneck, a dermatologist and rapid previous president of the AMA, writes about prior authorizations, “A few years in the past, medical insurance plans got here up with this course of, and on the time it was only for brand-new, costly drugs that had simply come to the market or new therapies 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 known as antidepressant discontinuation syndrome which might occur for those who cease taking your treatment out of the blue.

In response to The Cleveland Clinic, “Antidepressant discontinuation syndrome (ADS) can occur for those who cease taking your antidepressant for those who’ve taken it for no less than six weeks. It’s extra prone to occur for those who out of the blue cease taking the treatment as an alternative of slowly petering out underneath the steerage 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 actually 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 telephone, or nonetheless they do it lately, telling this individual, who could or might not be 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’s going to inform them that there’s a probability that if she is denied the 100 mg. of Pristiq, she is going to develop into so severely depressed that her suicidal ideation will return. And she is going to quote a examine revealed in The American Journal of Psychiatry and inform them “A previous historical past of suicide try is taken into account probably the most strong predictors of finally accomplished suicide.”

Will I matter to them?