Now there’s a scary word.
Why is it there?
It goes through my mind on a regular basis. Like – every time I run out of a few medications at once. And especially on those really special occasions when they all run out at the same time. You know the ones? Or perhaps you don’t.
Me – I have what is known as Treatment Resistant Depression. It means what it says. It’s a bastard to treat. It doesn’t respond to the basics and I go to a psychiatrist who is a specialist. Yay me! It also means that what works is an interesting combination of meds. This is complicated by the fact that my depression is the result of surgery that I had in my early 20’s that also left me with a tendency to partial seizures (now controlled – by medication…). I also have a history of really nasty and persistent migraine that I resisted medication for until the summer when I had them for 4-5 days a week every week for about 5 months and found myself at risk of losing my job over the number of sick days that I was accumulating. I also have low levels of vitamin D and a back injury that has resulted in the growth of osteophytes (essentially arthritis).
I figure that I am lucky to live in Australia where a large proportion of the cost of most medications is subsidised by Medicare – the government scheme to ensure that health care is affordable for everyone. It says something that I generally reach the threshold of what people are expected to pay without further subsidy (Medicare’s safety net) by about October or November each calendar year.
My meds for Depression include Lexapro (also known as escitalopram) an SSRI, Edronax – a SNRI, Lamictal (lamotrigin) which works as a mood stabiliser but is also an anti-seizure medication and Valdoxan – which is only new. I’m taking Valdoxan at a low dose as an augment to my other anti-depressant medication. I’ve tried to go without an augment several times, but it just isn’t enough to hold me – I relapse with the slightest of triggers.
Valdoxan is expensive however because it is not PBS listed (ie not on the Medicare Pharmaceutical Benefits Scheme list) but is sooo much better than Lithium which is what was what was used as an augment before. Valdoxan wouldn’t replace Lithium for someone whose primary medication need was for Lithium – but as an augment it has been great. It helps me sleep at night, doesn’t leave me drowsy through the day, doesn’t put on weight or make my hair dry and frizzy – just costs a lot of money. But it allows me to function so much better than the Lithium did that I don’t begrudge a cent. I also take a very small dose of Abilify which has helped with some other weird symptoms that used to come when I was low on sleep.
Next, I take Topamax to prevent migraine. Much as I hate to admit it – this has proven very worthwhile. While I still get an occasional breakthrough migraine a few times a year – they are nowhere near as severe, don’t last more than a day and don’t leave behind the ghost migraines for days afterward. In short – I can function. On top of this I take Vitamin D supplements and Glucosamine with Chondriatin (and I notice the difference with my back stiffening if I stop taking it).
Finally, one of the fall out effects of my depression has been the decrease in concentration and attention span that has come with it. This year to see if we can improve that my doctor has been prescribing me a low dose of dexamphetamine – and I think it’s working. The catch has been that it gave me tremors in my hands and, in the beginning, headaches – I had finally managed to get rid of all antidepressants that caused this – so it was back to the Propanolol for me to get rid of the tremors. Propanolol also helps with prevention of migraine too, so it adds a bit of reinforcement to the Topamax (not that I would take it if it wasn’t for the tremor!).
That, ladies and gentlemen, totals at eight prescription medications and two over the counter alternative medications. Not what I would call ideal – but they all serve a specific purpose and thinning them out would leave me very vulnerable to relapse – trust me, I’ve tried – under the supervision of my doctor whom I’ve told point-blank that I won’t take something or other … several times. One day I hope to successfully reduce them, but I think that it will take a lot more skill in managing my depression on my part, more research time, planning and preparation.
I buy the Vitamin D and Glucosamine at discount pharmacies.
The rest I go to the same pharmacy for all the time. This helps if I run into any trouble with any scripts or if I’m physically ill – they’ll run it around to my place for me. Also if I get prescribed something else or go to buy something over the counter – the pharmacists there know what else I take and can tell me if it will cause me any problems.
Recently I had to get all my scripts filled at once. It cost a lot of money. At first I cringed. But really, I’ve done this before and its nothing new. It’s about four weeks medication that I’m paying for. I know how much my medication costs. In the end I just shrugged my shoulders and paid. I said to the lady who served me the same as I’ll say to you.