💊 I Don't Like My Drugs (But My Drugs Like Me) 💊

[jyoti]

Bloody hell, it’s horrifying reading about prices paid for American medicines. Here’s what I pay for mine: effexor/28 days $5.20 x 3 packs so about $16
Seretide/28 days $5.20
Eutroxsig (generic thyroxine)/200 tabs $5.20
The pill/4 months $10.99
Ventolin/2 pack $11.40
Paracetamol + codeine/100 tabs $12.70
Note: I’m on unemployment benefits now, which is why some things cost so little. Off benefits, it’s not so bad either: the most expensive thing is about $40.

My heart goes out to all those trying to manage medication, the cost of it, insurance and anything else related.

[Snowlark]

@fuzzyfungus

Risperidone: If you have an illness where this cure isn’t worse than the disease, you have my deepest sympathies. Otherwise, just fuck this stuff. A comparatively lightweight .25mg oral trial had me feeling a flavor of awful I can’t really describe and didn’t even know was an option until I terminated that experiment. Nasty stuff.

Risperidone seems one of if not the most loathed antipsychotic (for unfamiliar readers, this functional class of meds is often abbreviated ‘AP’). I’ve never taken an AP and given the reactions of friends who have, I hope I never have to.

[Medievalist]

@popobawa4u

I don’t use the prescription drug model, I think it is authoritarian nonsense. Fortunately I don’t need any drugs now. But when I do, I still avoid prescription

Totally agree, but I have committed to raising spawn, and owning property, which unfortunately empowers the authoritarian medical-industrial complex. Anyone can make a phone call at any time, giving the police “probable cause” to invade my property and privacy; at that point, any evidence of illicit healing will cause me to lose my family.

It won’t be much longer, though. Another couple of years and the youngest will legal age and off to college, and then it will be harder for the doctors to practice their extortion racket on me. Maybe I’ll plant some poppies!

[chgoliz]

I’d be dead. So yeah, other people’s mileage differs quite a bit from yours.

[popobawa4u]

@chgoliz

I’d be dead.

You only need the drug to survive - not the prescription. Did you really think I was suggesting that you don’t use it unless somebody else approves this? That’s pretty much the opposite of what I was getting at. If you need it, it shouldn’t matter whether or not others approve a drug which you need to survive, take it anyway.

@chgoliz

So yeah, other people’s mileage differs quite a bit from yours.

What I was saying above I think is applicable to anyone. If people are holding your survival in the balance to secure a degree of social control, that is simply an attempt at extortion, and I would treat it as such.

[chgoliz]

http://gifsec.com/wp-content/uploads/GIF/2014/10/Ugh-GIF.gif

[Snowlark]

It’s what came to mind first. And the Lucy Liu GIF wasn’t showing up on my end so I figured, hey, here’s a backup just in case.

[anon6955837]

@popobawa4u

Did you really think I was suggesting that you don’t use it unless somebody else approves this?

Eh, for somebody who is so wonderfully and frustrating cryptic are you really surprised your point could be lost?

[knoxblox]

Currently, I’m having a great time with prescription meds here in Tijuana because I don’t need a prescription for Omeprazole (Prilosec) or Zenhale (Mometasona/Fometeral combo), and the prices are crazy cheap in town. Better than the prices next to the border, even.
4 to 5 bucks for 120 tablets of Omeprazole, and about 50 bucks for 120 puffs of Zenhale.

One thing I wish I could figure out, though…

In 2013/2014, I was on Prednisone for severe nasal polyps before I had surgery in 2015.
I have always felt rather lethargic/unmotivated at times, but Prednisone fixed that up right quick, giving me the most intense focus I’ve ever had (as well as ridding me of asthma and sebhorrheic dermatitis - like cradle cap for adults).
Prednisone is a rather risky drug in general, but better for some and much worse for others when it comes to side effects.
The worst thing I ever suffered was racing thoughts at bedtime, but being a freelancer, it doesn’t affect my lifestyle and I still get my sleep.
Much like those who prefer to microdose certain illicit substances, I think it was more helpful than harmful, and kept me from going right back to bed after breakfast.

I’m thinking of asking the doctor about something to improve my mood and concentration, and if there’s anything less risky to my physical health I could try. I really don’t know if something like Adderall or similar would have the same effect. Anyone have any suggestions on what I may ask the doctor about?

[fuzzyfungus]

Your milage may vary; but I’ve had very good results in terms of energy and focus with extended release Adderall(or one of it’s generic equivalents). Amphetamines will fuck you up good and hard if you go dose chasing; but in moderation, and produced to FDA quality standards, they aren’t that scary.

(The two biggest issues are 1. stimulants make you feel even hotter than you otherwise would in hot weather. 2. Adderall improves focus; but not necessarily prioritization: If you just can’t seem to keep your attention on anything, psychostimulants can fix you right up; but if you just can’t keep your attention on what you need to be doing, psychostimulants may just allow you to slack off with incredible intensity. Assuming you can keep yourself on task, the increase in focus is a great boon; but if you can’t; don’t be surprised if the increase in focus just lets you research Platypus venom for 28 hours straight or drives you to see how quickly you can lead your Magyar horde to burn down all of civilization in Crusader Kings II. Totally, um, hypotheticallly, of course.)

[knoxblox]

Hahaha!

That’s what I was worried about. The Prednisone kept me motivated and orderly. I’m not really looking for speed (pun intended), just focus and drive.

[fuzzyfungus]

It was tried on me for some of its ancillary effects(it is classified as an ‘atypical anti-psychotic’ and has a somewhat eclectic list of possible effects and seems to be a relatively popular “well, hopefully this will maybe work…” option for autism spectrum stuff.

If it had any positive effects, they sure as hell weren’t worth it. I can imagine that it beats psychosis; but as for its use as a ‘mood stabilizer’, it just isn’t even close to worth it.

[fuzzyfungus]

You get focus and drive; but you have to bring your own trajectory. That’s the real trick. (This is obviously all in my anecdotal, N=1 experience) the stuff doesn’t distract you; but neither does it fight distraction.

When I was at work, say, amphetamines would make it way easier to attack and debug a problem with intensity and focus I couldn’t otherwise muster. My environment handed me a trajectory; and the drug helped me follow it good and hard. In situations where I was just sort of drifting aimlessly, and couldn’t set my mind to something, the same increase in focus and drive would cause me to latch on to whatever pointless thing was incrementally more compelling than all the other pointless things and run with it.

I don’t know of anything that actually helps you prioritize(much less develop priorities if none are available; that’d be worth more than its weight in gold); but the psychostimulants will put some serious vigor into your execution of whatever priority you are following. This is good if your problem is distraction; not so good if your problem is failure to get on task at all.

[LDoBe]

I’m not at that level, but I do meditation when I have a migraine. It’s really more of a visualization technique I’ve combined with self-hypnosis to sort of localize where the pain exactly is, visualize it as a white hot nail, then “drive it out from the inside”. Doesn’t really get rid of the pain, but it’s enough that I feel in control, so it’s much less emotionally salient, and doesn’t cause so much distress and depression.

[LDoBe]

Modafinil (US trade name Provigil, with a levorotary-pure form Nuvigil) is a fairly “new” drug in the class of eugeroics. In my experience, Modafinil does exactly all the therapeutic things for daytime sleepiness and focus that methylphenidate (US trade name Ritalin) does, but a little better, but without the fun stuff like a rush, or the letdown side-effects (suicide tuesday is a real thing for people who love traditional stimulants… Like me.)

I switched and it’s great… I wish I could get that rush ritalin had, but if we’re being serious adults and treating psychiatric and physical stuff, Modafinil is a great drug. Works on the same stuff in the brain as Ritalin, but starts earlier in the chain so it’s less reinforcing and less addictive.

When I would go a day without ritalin I’d get sweaty and fiend for it and start looking for other sources of classical stimulants just to get my fix. When I miss a day of Modafinil it’s more like my brain is just slower than normal and I’m dumber than I usually am. Not so much withdrawal as I’m running on lower grade gas. At least I don’t get headaches and feel like I’ve run a marathon when I miss a day of it.

And there’s a legal, unregulated prodrug for Modafinil widely available in the US called Adrafinil. You have to deal with purity issues and the standard bullshit from chem suppliers, but it generally works. It’s harder on your liver though. And while I’ve never tried it, a friend has, and they get sleepy when they take Adrafinil, so, YMMV. They haven’t compared it with Modafinil because the real prescription stuff is so expensive. At my local pharmacy without insurance 30x200mg tablets costs $3000 even though it’s been out of patent for years now. It’s just that there’s only one company that makes it, and they’re not sharing how, even though patent filings BY LAW need to be good enough for an average pharmaceuticals chemist to synthesize the drug just using the patent.

Blah blah, patent is broken in the US, my standard spiel etc.

ETA: For me, a dose of Modafinil has a therapeutic effect for about 6 hours. YMMV of course, but I had to get a script for ritalin on top of it, because I work an 8 hour shift and have a 1-2 hour drive home depending on whether there’s a sportsball game in town. The Modafinil wears off about two hours before my shift ends, and my performance goes down the toilet. And a 10mg tablet of ritalin works for about 5 hours for me, so I take it about 3 hours before end of shift, get a burst of work done, make a ton of calls, and drive home like a madman. I have a lot of blood with my >40 BMI so it doesn’t really affect my ability to go to bed. That’s what the BBS is for. I hang out here till it’s way past when I should go to bed, then I crash.

ETAA:

The term “Eugeroic” means: wakefulness promoting agent. And that’s really the best way to describe the effects of Modafinil. It doesn’t wire you up the way stimulants do. It makes you, almost miraculously not tired. Like I can have my alarm go off four hours before my normal wakeup time, take my Modafinil, go sit in a chair and doze for half an hour, and when it kicks in, I’m as awake as I am at lunch time, but I’m not jittery or speeded up. Just suddenly awake and ready to do whatever, like I’ve had a good night’s sleep.

[LDoBe]

@fuzzyfungus

you have to bring your own trajectory.

That’s definitely true. I know from experience that if your pre-determined trajectory is to avoid doing your homework and working on learning how to do music production, then of course the boring homework won’t even rate as a thought, and you’ll do music production with a deadly vengeance.

I never got the people who said “I took Adderall once, and then spent the next four hours cleaning my house to within an inch of collapse.” That’s the boringest shit ever. And Adderall won’t make you do boring shit. It’ll let you latch onto what you already wanted to do, and do it compulsively.

[jsroberts]

@jyoti

Bloody hell, it’s horrifying reading about prices paid for American medicines.

I pay 10 EUR for 90 bupropion tabs, and I work. Most of the kids’ medication and healthcare is free on our insurance, but in the US one Ventolin inhalor cost $50. In China the pharmacies sold them for about $0.50 (3元), and that was uninsured with no prescription. Obviously it’s going to cost more in the west, but $50 is so far from being justified that it’s essentially extortion.

I don’t really know what to do about my medication – bupropion doesn’t really help my concentration, and that seems to be common for a lot of people (it does help my mood though). On the other hand, my psychiatrist seems to be basing a lot of things on a very simple flow chart: Ritalin –> Strattera –> Bupropion. I’ve reached the third one, and that’s the end of the line. I suppose a mix would be good, to try to get the benefits and manage the side effects. Alternatively, I might just quit altogether.

On small doses of Ritalin, my pulse went down to 45 and I felt like I was about to faint all the time. I couldn’t concentrate and felt like there wasn’t enough blood reaching my brain, which is probably accurate.

I’ve been trying to find the vocabulary for what happened under Strattera — like bipolar with mixed episodes, although I could tell that I was being irrational. Insomnia, racing thoughts, anxiety, depression, paranoia. Like a bad trip that lasted for weeks at a time, but also with the good parts – I was able to sort a lot of my life out and issues that were in the background had to be dealt with. I couldn’t stop talking about things that I knew upset people around me, but this was sometimes good as some things needed to be addressed. Still, being anxious and obsessive about everything and having panic attacks all the time, then going into suicidal depression isn’t fun. Like a mid-life crisis where everything gets thrown out of the box, every foundational element and relationship in your life is strained and you have to put your life back together again. Like a mental breakdown. Even then, I wanted to make it work because the feeling of being able to concentrate was good and I wasn’t zoned out all the time. I could do a good day’s work and finish in time to pick up the kids, then spend the late afternoon and evening helping around the house and being with the family. My mood was like a lead balloon – I could lift it briefly, but it wouldn’t stay there. Most of the time I didn’t feel happy, just satisfied that I was able to coordinate everything in my life and I could make other people happy. My ADHD is bad enough that my wife preferred being with me like this (although obviously she didn’t want to see me suffering).

Tapering off was the worst - two months with the worst concentration I’ve ever had (once I was only able to do one normal day’s work over seven days (where I was actually trying hard all of those seven days). I couldn’t concentrate on a simple conversation and had to keep apologising and saying that it was still me, I just couldn’t give as much as I could before. Terrible depression and the feeling that I just couldn’t keep going like this - I had to rely on inertia and the fact that I was at home most of the time to avoid doing something I’d regret. I couldn’t trust my own judgement, which was stressful in itself and threatened my ability to do my job.

On bupropion, a couple of people said I looked slightly drunk. I started reacting to people around me more and smiling for the first time in months. I could exercise and enjoy it. Still, my concentration didn’t improve much at all and that had an effect on my mood. My psychiatrist doubled my medication, which helped a little. I’m tempted to stick with this – it’s not great, but it could be worse. Now I have insomnia without the racing thoughts, but increasing my physical exercise could help with that and with the concentration problems. I have chest pains, but my blood pressure isn’t too bad. Maybe I should just taper off again and try to get by on supplements, exercise and techniques like mindfulness and meditation – I hate how much medication and its absence affects me. I feel sorry for people who are on more extreme medication or who don’t have a choice about whether to take it or not.

[L_Mariachi]

Lialda for ulcerative colitis. Works pretty well but if I were paying retail out of pocket it would be around $1000/mo. Apparently the drug itself (mesalamine) is long out of patent, but the delivery vessel that releases it only into the large intestine is still encumbered. I think there’s a cheaper enema version but jfc.

Doxepin for prurigo nodularis. Nice side effects of being both a sleep aid and an antidepressant. Not doing much for the itch/pain though. They’re considering Thalidomide. Thalidomide! I didn’t know that was still a thing, after those flipper babies. Not that I’m in any danger of getting pregnant.

I preferred being young and healthy and stupid to old and decrepit and slightly less stupid.

[Snowlark]

@fuzzyfungus

2. Adderall improves focus; but not necessarily prioritization:

This this this. I wasn’t happy with the outcome of my trials with Adderall (mixture of amphetamine salts) or Vyvanse (effectively a sustained-release form of dextroamphetamine). Hyperfocus with no prioritization whatsoever, so I ended up obsessively working on stuff that didn’t matter. And any single good piece of writing rested on top of a pile of long-winded, overwrought crap.

And yes, I have a diganosis of ADD-PI (Primarily Inattentive) from four independent psychiatrists and three psychologists.

@knoxblox: if prioritization is a concern, I can’t recommend Strattera (atomoxetine) enough. I’d still be on it if it weren’t for some unpleasant (but apparently rare) side effects. I found it to be much more productively motivating than the amphetamine-based psychostimulants.

Finally: prednisone’s indications are for immune system disorders. Yes, it’s very energizing and motivating; I was prescribed a course of prednisone for severe mono and it increased my daily functioning very quickly. But unless you have a chronic immune system disorder (like Addison’s disease), it’s a really fucking bad idea to take it long-term or even as-needed.

[TobinL]

@Snowlark

Finally: prednisone’s indications are for immune system disorders. Yes, it’s very energizing and motivating; I was prescribed a course of prednisone for severe mono and it increased my daily functioning very quickly. But unless you have a chronic immune system disorder (like Addison’s disease), it’s a really fucking bad idea to take it long-term or even as-needed.

Seconded. Prednisone is a strong steroid and should be avoided unless you have a serious reason to be taking it and you just can’t quit you have to cut down the dosage in steps. It is amazingly good at reducing inflamed tissues which is why you got it. However I can state it will also make you get angry at anything and just lash out before you notice cause that is also what steroids are really good at among other long term effects that you probably don’t want either.