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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 distinct antidepressant (Pristiq, 100 mg.) and a distinct antipsychotic (Abilify, 15 mg). In 2018, following my stroke I grew to become 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 medicines ever since.

I began a brand new job this 12 months. Which means new insurance coverage. After 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 obtained notified that prior authorization was vital, I solely had one pill left, which I took this morning.

In an article printed by the AMA, Jack Resneck, a dermatologist and speedy previous president of the AMA, writes about prior authorizations, “A few years in the past, medical health insurance plans got here up with this course of, and on the time it was only for brand-new, costly medicines 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 could begin to undergo withdrawal or what’s extra formally known as antidepressant discontinuation syndrome which may occur if you happen to cease taking your treatment out of the blue.

Based on The Cleveland Clinic, “Antidepressant discontinuation syndrome (ADS) can occur if you happen to cease taking your antidepressant if you happen to’ve taken it for not less than six weeks. It’s extra prone to occur if you happen to out of the blue cease taking the treatment as a substitute of slowly really fizzling out beneath the steering 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 have a look at what issues require prior auth … it used to essentially be a slender set of brand-new issues that had simply come out, however now it is fully 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 nevertheless they do it as of late, telling this individual, who might or is probably not a psychiatrist, that this affected person has a historical past of extreme psychotic melancholy, 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 likelihood 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 printed in The American Journal of Psychiatry and inform them “A previous historical past of suicide try is taken into account one of the crucial sturdy predictors of finally accomplished suicide.”

Will I matter to them?