![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by Phillipa on January 3, 2007, at 16:44:10
No plans to take it but the neighbor says zyprexa is a controlled drug. I said I didn't think it is. So is it controlled or not. If so is it because of the risk of diabetes? Thanks Phillipa
Posted by laima on January 3, 2007, at 17:01:56
In reply to Zyprexa Is It Now Controlled, posted by Phillipa on January 3, 2007, at 16:44:10
What??? Does your neighbor mean "controlled", as in you need a prescription to get it?
Posted by laima on January 3, 2007, at 17:04:51
In reply to Zyprexa Is It Now Controlled, posted by Phillipa on January 3, 2007, at 16:44:10
I just checked New York Times- and there's nothing in there. They've been reporting all of the zyprexa news lately, so I imagine if there was a story they'd run it.
Posted by bassman on January 3, 2007, at 17:32:09
In reply to Zyprexa Is It Now Controlled, posted by Phillipa on January 3, 2007, at 16:44:10
You're right, it's not.
https://online.epocrates.com/front_porch/
DEA/FDA: prescription required; not a controlled substance.
Posted by laima on January 3, 2007, at 18:54:47
In reply to Zyprexa Is It Now Controlled, posted by Phillipa on January 3, 2007, at 16:44:10
When I think controlled, I think about meds that are deemed abuseable or sellable "on the street", such as ritalin or adderall. For those, no refills allowed (you must get a new script on paper every 30 days), doctor may not phone it in, you have to hand over your driver's licsence when you drop off and pick up the prescription-they write the number on the paper script. Absolutely no "refilling" before the thirty days are almost up-even if you are not using insurance. The paper scripts expire exactly seven days after they are dated. Note that even benzos are not controlled this way!
Posted by Phillipa on January 3, 2007, at 19:41:38
In reply to Re: Zyprexa Is It Now Controlled, posted by laima on January 3, 2007, at 18:54:47
I know that's what I told her. I'm sending this link when complete to her Mother's computer who lives near me. Thanks guys keep um coming. Love Phillipa
Posted by laima on January 3, 2007, at 19:52:04
In reply to Re: Zyprexa Is It Now Controlled » laima, posted by Phillipa on January 3, 2007, at 19:41:38
It's so strange- I wonder why she thinks it's a controlled substance? Perhaps she's just not too familiar with how precription meds work?
> I know that's what I told her. I'm sending this link when complete to her Mother's computer who lives near me. Thanks guys keep um coming. Love Phillipa
Posted by yxibow on January 4, 2007, at 3:50:45
In reply to Zyprexa Is It Now Controlled, posted by Phillipa on January 3, 2007, at 16:44:10
> No plans to take it but the neighbor says zyprexa is a controlled drug. I said I didn't think it is. So is it controlled or not. If so is it because of the risk of diabetes? Thanks Phillipa
Few psychoactive substances in psychiatry are actually Controlled Substances, of the act (US) 1970 and mirrored in EMEA and other areas.SSRIs, TCAs, MAOIs, Neuroleptics, (some) AEDs, Tetracyclics, SSNRIs, and I've probably forgot something, are not controlled substances (limits on refills and federal and state laws on everything from script pad material to record keeping.)
Most others are Schedule IV -- Benzodiazepines, some Barbiturates; Lyrica is an odd one at schedule V.
The only category that is strongly regulated really are the stimulants -- Schedule II for a number of them.
Of course all I mentioned above are prescriptions, but that's another story. Everything else is OTC. There used to be pseudo-schedule V codeine in some states long ago but that is gone as far as I know.
Canada has a similar situation, or at least used to but I think it has to be mixed with APAP/Ibuprofen/etc. England as well I believe.
The morning after / RU-486 is "behind the counter" -- I think there may be another one like that I'm forgetting. I don't know if state law or simply probably expense keeps nicotine gum and such behind the counter.
-- tidings
Posted by laima on January 4, 2007, at 10:04:04
In reply to Re: Zyprexa Is It Now Controlled » laima, posted by Phillipa on January 3, 2007, at 19:41:38
Well, there is a zyprexa story in the New York Times today- and it mentions that Australia is demmanding Lilly disclose more about side effects. Also that Lilly is being investigated in the US over how it marketed zyprexa. New York Times: Your Zyprexa News-Source.January 4, 2007
Mother Wonders if Psychosis Drug Helped Kill SonBy ALEX BERENSON
At first, the psychiatric drug Zyprexa may have saved John Eric Kauffman’s life, rescuing him from his hallucinations and other symptoms of acute psychosis.But while taking Zyprexa for five years, Mr. Kauffman, who had been a soccer player in high school and had maintained a normal weight into his mid-30s, gained about 80 pounds. He was found dead on March 27 at his apartment in Decatur, Ga., just outside Atlanta.
An autopsy showed that the 41-year-old Mr. Kauffman, who was 5 feet 10 inches, weighed 259 pounds when he died. His mother believes that the weight he gained while on Zyprexa contributed to the heart disease that killed him.
Eli Lilly, which makes Zyprexa, said in a statement that Mr. Kauffman had other medical conditions that could have led to his death and that “Zyprexa is a lifesaving drug.” The company said it was saddened by Mr. Kauffman’s death.
No one would say Mr. Kauffman had an easy life. Like millions of other Americans, he suffered from bipolar disorder, a mental illness characterized by periods of depression and mania that can end with psychotic hallucinations and delusions.
After his final breakdown, in 2000, a hospital in Georgia put Mr. Kauffman on Zyprexa, a powerful antipsychotic drug. Like other medicines Mr. Kauffman had taken, the Zyprexa stabilized his moods. For the next five and a half years, his illness remained relatively controlled. But his weight ballooned — a common side effect of Zyprexa.
His mother, Millie Beik, provided information about Mr. Kauffman, including medical records, to The New York Times.
For many patients, the side effects of Zyprexa are severe. Connecting them to specific deaths can be difficult, because people with mental illness develop diabetes and heart disease more frequently than other adults. But in 2002, a statistical analysis conducted for Eli Lilly found that compared with an older antipsychotic drug, Haldol, patients taking Zyprexa would be significantly more likely to develop heart disease, based on the results of a clinical trial comparing the two drugs. Exactly how many people have died as a result of Zyprexa’s side effects, and whether Lilly adequately disclosed those risks, are central issues in the thousands of product-liability lawsuits pending against the company, and in state and federal investigations.
Because Mr. Kauffman also smoked heavily for much of his life, and led a sedentary existence in his last years, no one can be sure that the weight he gained while on Zyprexa caused his heart attack.
Zyprexa, taken by about two million people worldwide last year, is approved to treat schizophrenia and bipolar disorder. Besides causing severe weight gain, it increases blood sugar and cholesterol in many people who take it, all risk factors for heart disease.
In a statement responding to questions for this article, Lilly said it had reported the death of Mr. Kauffman to federal regulators, as it is legally required to do. The company said it could not comment on the specific causes of his death but noted that the report it submitted to regulators showed that he had “a complicated medical history that may have led to this unfortunate outcome.”
“Zyprexa,” Lilly’s statement said, “is a lifesaving drug and it has helped millions of people worldwide with schizophrenia and bipolar disorder regain control of their lives.”
Documents provided to The Times by a lawyer who represents mentally ill patients show that Eli Lilly, which makes Zyprexa, has sought for a decade to play down those side effects — even though its own clinical trials show the drug causes 16 percent of the patients who take Zyprexa to gain more than 66 pounds after a year.
Eli Lilly now faces federal and state investigations about the way it marketed Zyprexa. Last week — after articles in The Times about the Zyprexa documents — Australian drug regulators ordered Lilly to provide more information about what it knew, and when, about Zyprexa’s side effects.
Lilly says side effects from Zyprexa must be measured against the potentially devastating consequences of uncontrolled mental illness. But some leading psychiatrists say that because of its physical side effects Zyprexa should be used only by patients who are acutely psychotic and that patients should take other medicines for long-term treatment.
“Lilly always downplayed the side effects,” said Dr. S. Nassir Ghaemi, a specialist on bipolar disorder at Emory University in Atlanta. “They’ve tended to admit weight gain, but in various ways they’ve minimized its relevance.”
Dr. Ghaemi said Lilly had also encouraged an overly positive view of its studies on the effectiveness of Zyprexa as a long-term treatment for bipolar disorder. There is more data to support the use of older and far cheaper drugs like lithium, he said.
Last year, Lilly paid $700 million to settle 8,000 lawsuits from people who said they had developed diabetes or other diseases after taking Zyprexa. Thousands more suits are still pending.
But Ms. Beik is not suing Lilly. She simply wants her son’s case to be known, she said, because she considers it a cautionary tale about Zyprexa’s tendency to cause severe weight gain. “I don’t think that price should be paid,” she said.
Mr. Kauffman’s story, like that of many people with severe mental illness, is one of a slow and steady decline.
Growing up in DeKalb, Ill., west of Chicago, he acted in school plays and was a goalie on the soccer team. A photograph taken at his prom in 1982 shows a handsome young man with a messy mop of dark brown hair.
But in 1984, in his freshman year at Beloit College in Wisconsin, Mr. Kauffman suffered a breakdown and was found to have the most severe form of bipolar disorder. He returned home and, after medication stabilized his condition, enrolled in Northern Illinois University. He graduated from there in 1989 with a degree in political science.
For the next year, he worked as a bus driver ferrying senior citizens around DeKalb. In a short local newspaper profile of him in 1990, he listed his favorite book as “Catch-22,” his favorite musician as Elvis Costello, and his favorite moment in life as a soccer game in which he had made 47 saves. A few months later, he followed his mother and stepfather to Atlanta and enrolled in Georgia State University, hoping to earn a master’s degree in political science.
“He wanted so much to become a political science professor,” Ms. Beik said.
But trying to work while attending school proved to be more stress than Mr. Kauffman could handle, Ms. Beik said. In 1992, he suffered his most severe psychotic breakdown. He traveled around the country, telling his parents he intended to work on a political campaign. Instead, he spent much of the year homeless, and his medical records show that he was repeatedly admitted to hospitals.
Mr. Kauffman returned home at the end of 1992, but he never completely recovered, Ms. Beik said. He never worked again, and he rarely dated.
In 1994, the Social Security Administration deemed him permanently disabled and he began to receive disability payments. He filed for bankruptcy that year. According to the filing, he had $110 in assets — $50 in cash, a $10 radio and $50 in clothes — and about $10,000 in debts.
From 1992 to 2000, Mr. Kauffman did not suffer any psychotic breakdowns, according to his mother. During that period, he took lithium, a mood stabilizer commonly prescribed for people with bipolar disorder, and Stelazine, an older antipsychotic drug. With the help of his parents, he moved to an apartment complex that offered subsidized housing.
But in late 1999, a psychiatrist switched him from lithium, which can cause kidney damage, to Depakote, another mood stabilizer. In early 2000, Mr. Kauffman stopped taking the Depakote, according to his mother.
As the year went on, he began to give away his possessions, as he had in previous manic episodes, and became paranoid. During 2000, he was repeatedly hospitalized, once after throwing cans of food out of the window of his sixth-floor apartment.
In August, he was institutionalized for a month at a public hospital in Georgia. There he was put on 20 milligrams a day of Zyprexa, a relatively high dose.
The Zyprexa, along with the Depakote, which he was still taking, stabilized his illness. But the drugs also left him severely sedated, hardly able to talk, his mother said.
“He was so tired and he slept so much,” Ms. Beik said. “He loved Shakespeare, and he was an avid reader in high school. At the end of his life, it was so sad, he couldn’t read a page.”
In addition, his health and hygiene deteriorated. In the 1990 newspaper profile, Mr. Kauffman had called himself extremely well-organized. But after 2000, he became slovenly, his mother said. He spent most days in his apartment smoking.
A therapist who treated Mr. Kauffman while he was taking Zyprexa recalls him as seeming shy and sad. “He was intelligent enough to have the sense that his life hadn’t panned out in a normal fashion,” the therapist said in an interview. “He always reminded me of a person standing outside a house with a party going on, looking at it.”
The therapist spoke on the condition that her name not be used because of rules covering the confidentiality of discussions with psychiatric patients.
As late as 2004, Mr. Kauffman prepared a simple one-page résumé of his spotty work history — evidence that he perhaps hoped to re-enter the work force. He never did.
As Mr. Kauffman’s weight increased from 2000 to 2006, he began to suffer from other health problems, including high blood pressure. In December 2005, a doctor ordered him to stop smoking, and he did. But in early 2006, he began to tell his parents that he was having hallucinations of people appearing in his apartment.
On March 16, a psychiatrist increased his dose of Zyprexa to 30 milligrams, a very high level.
That decision may have been a mistake, doctors say. Ending smoking causes the body to metabolize Zyprexa more slowly, and so Mr. Kauffman might have actually needed a lower rather than higher dose.
A few days later, Mr. Kauffman spoke to his mother for the last time. By March 26, they had been out of contact for several days. That was unusual, and she feared he might be in trouble. She drove to his apartment building in Decatur the next day and convinced the building’s manager to check Mr. Kauffman’s apartment. He was dead, his body already beginning to decompose.
An autopsy paid for by his mother and conducted by a private forensic pathologist showed he had died of an irregular heartbeat — probably, the report said, as the result of an enlarged heart caused by his history of high blood pressure.
Ms. Beik acknowledged she cannot be certain that Zyprexa caused her son’s death. But the weight gain it produced was most likely a contributing factor, she said. And she is angry that Eli Lilly played down the risks of Zyprexa. The company should have been more honest with doctors, as well as the millions of people who take Zyprexa, she said.
Instead Lilly has marketed Zyprexa as safer and more effective than older drugs, despite scant evidence, psychiatrists say.
Ms. Beik notes that Stelazine — an older drug that is no longer widely used even though a federally financed clinical trial showed it works about as well as Zyprexa — stabilized Mr. Kauffman’s illness for eight years without causing him to gain weight.
“He was on other drugs that worked,” she said.
Copyright 2007 The New York Times Company
Posted by Sebastian on January 4, 2007, at 12:01:17
In reply to Zyprexa Is It Now Controlled, posted by Phillipa on January 3, 2007, at 16:44:10
Can't be controled, I just ordered some.
Posted by Sebastian on January 4, 2007, at 12:07:49
In reply to Re: Zyprexa Is It Now Controlled » Phillipa, posted by yxibow on January 4, 2007, at 3:50:45
You have to be 18 to buy nicotine gum, just like ciggarettes.
Posted by blueberry1 on January 4, 2007, at 15:21:45
In reply to Re: Zyprexa in the news AGAIN, posted by laima on January 4, 2007, at 10:04:04
I'm glad I'm finally off this poison. If you could mix up a batch of goodness and total evilness all in one recipe, that's what zyprexa is.
Posted by laima on January 4, 2007, at 20:49:04
In reply to Re: Zyprexa in the news AGAIN, posted by blueberry1 on January 4, 2007, at 15:21:45
There really does seem to be something sinister around the marketing of zyprexa. I'm glad you were able to get off, I know from reading your posts that it wasn't easy- hope you are able to stay off. My own trials of this drug have been brief but not good-no more. Meanwhile, I'm a bit concerned about another Lilly favorite, prozac. Specifically, what do we not know about its long term effects- does it have anything to do with the stubborn avolition which now plagues me? They sure marketed that one heavily, too.
Posted by med_empowered on January 4, 2007, at 21:10:47
In reply to Re: Zyprexa in the news AGAIN » blueberry1, posted by laima on January 4, 2007, at 20:49:04
prozac long-term can cause apathy. apparently, its also causing tardive dyskinesia over the (very) long term in some people, so that's something to look out for.
Posted by laima on January 4, 2007, at 22:31:30
In reply to Re: Zyprexa in the news AGAIN, posted by med_empowered on January 4, 2007, at 21:10:47
Yes, I know (apathy). The part I wonder about is if it's some kind of permanent damage? I stopped using it about 7 years ago when it pooped out, and the apathy became noticeable sometime after, and has persisted through all kinds of meds. I was on it for about 9 years.> prozac long-term can cause apathy. apparently, its also causing tardive dyskinesia over the (very) long term in some people, so that's something to look out for.
Posted by yxibow on January 6, 2007, at 13:29:22
In reply to Re: Zyprexa in the news AGAIN, posted by med_empowered on January 4, 2007, at 21:10:47
> prozac long-term can cause apathy. apparently, its also causing tardive dyskinesia over the (very) long term in some people, so that's something to look out for.
TD with SSRIs is still a very rare occurrence. Certainly more rare than TCAs. Neither a reason to discontinue the use of either, both of which have had millions of patient-years by now. Yes, there are some isolate cases of TD but they're somewhat different, and definately long-term.
Posted by kotsunega on January 8, 2007, at 3:56:06
In reply to Re: Zyprexa Is It Now Controlled, posted by laima on January 3, 2007, at 18:54:47
>
> When I think controlled, I think about meds that are deemed abuseable or sellable "on the street", such as ritalin or adderall. For those, no refills allowed (you must get a new script on paper every 30 days), doctor may not phone it in, you have to hand over your driver's licsence when you drop off and pick up the prescription-they write the number on the paper script. Absolutely no "refilling" before the thirty days are almost up-even if you are not using insurance. The paper scripts expire exactly seven days after they are dated. Note that even benzos are not controlled this way!Some of those controls must be state implemented because I take Adderall, do not have to give a driver's license to pick up my script; carry the doc's written script around with me for sometimes two weeks at a time; and because of my job and travel that makes getting a refill at exactly 30 days each month impractical, sometimes get refills several days ahead of when I'm actually due for a refill.
I actually live on the border between two states and have noticed that if I get the script filled in one state, I have to provide my SSN each time, while in the other state, I only have to sign a script pickup sheet, along with all other pharmacy customers. Hmmph. Interesting.
Posted by laima on January 8, 2007, at 8:57:44
In reply to Re: Zyprexa Is It Now Controlled, posted by kotsunega on January 8, 2007, at 3:56:06
It must be controlled state by state- and my prescription is actually only good in my own state! Your area sounds much more reasonable, I occassionally feel like a quasi-criminal or something, especially if I try to refill before a full 30 days are up and the pharmacy staff makes a fuss.
Once, I was not allowed to fill a klonopin prescription out-of-state either. That really surprised me- two separate pharmacy managers said so.
> >
> > When I think controlled, I think about meds that are deemed abuseable or sellable "on the street", such as ritalin or adderall. For those, no refills allowed (you must get a new script on paper every 30 days), doctor may not phone it in, you have to hand over your driver's licsence when you drop off and pick up the prescription-they write the number on the paper script. Absolutely no "refilling" before the thirty days are almost up-even if you are not using insurance. The paper scripts expire exactly seven days after they are dated. Note that even benzos are not controlled this way!
>
> Some of those controls must be state implemented because I take Adderall, do not have to give a driver's license to pick up my script; carry the doc's written script around with me for sometimes two weeks at a time; and because of my job and travel that makes getting a refill at exactly 30 days each month impractical, sometimes get refills several days ahead of when I'm actually due for a refill.
>
> I actually live on the border between two states and have noticed that if I get the script filled in one state, I have to provide my SSN each time, while in the other state, I only have to sign a script pickup sheet, along with all other pharmacy customers. Hmmph. Interesting.
Posted by yxibow on January 8, 2007, at 12:34:51
In reply to Re: Zyprexa Is It Now Controlled » kotsunega, posted by laima on January 8, 2007, at 8:57:44
> It must be controlled state by state- and my prescription is actually only good in my own state! Your area sounds much more reasonable, I occassionally feel like a quasi-criminal or something, especially if I try to refill before a full 30 days are up and the pharmacy staff makes a fuss.
That sounds a bit obtuse since February has only 28 days. For that reason and for a possible loss of a pill maybe, I surmise, insurance company X, for me, at least at the pharmacy I go to, refills around 25-26 days. I think it is more of a pharmacy and insurance decision than state laws, for substances of non obvious diversion. I may pay slightly more, who knows, but I prefer the neighborhood type of pharmacy that I go to than the big box types. I go to the others if I have to because they are a little closer, but often I just use them for low cost generic PRN prescriptions and don't use insurance under "HIPAA privacy."> Once, I was not allowed to fill a klonopin prescription out-of-state either. That really surprised me- two separate pharmacy managers said so.
Cat-IV over state lines... that doesn't sound reasonable but I don't know how federal laws have changed and the regulation of interstate commerce -- I do know that by browsing on the net that things vary but generally a written controlled substance prescription can be brought over state lines in some states. I don't know if it can be faxed. I believe it can be even called in by a doctor in some states with their DEA information and your SSN or birth date.
> > I actually live on the border between two states and have noticed that if I get the script filled in one state, I have to provide my SSN each time, while in the other state, I only have to sign a script pickup sheet, along with all other pharmacy customers. Hmmph. Interesting.
That can be annoying but probably a likely situation as I can think offhand just now of at least 5 interstate urban areas in the US.
Posted by laima on January 8, 2007, at 17:26:59
In reply to Re: Zyprexa Is It Now Controlled » laima, posted by yxibow on January 8, 2007, at 12:34:51
I swear up and down that the staff at my pharmacy know me by name (much to my chagrin), but they absolutely refuse to fill ahead of time-insurance or no insurance. They also insisted that the doctor couldn't call in to adjust does or date. I've had to go back to his office to get new scripts before if any change needed to me made.And as for out of state- I tried to refill my Illinois klonopin in NYC- and two different Walgreens managers at two separate Walgreens there insisted it was against their state law to fill or refill a benzo prescription if it originated out of state.
Posted by Phillipa on January 8, 2007, at 18:35:59
In reply to Re: Zyprexa Is It Now Controlled » laima, posted by yxibow on January 8, 2007, at 12:34:51
My next door neighbor is from Florida and flies down twice a year and her pdoc gives her postdated scripts for xanax that she fill in North Carolina. Love Phillipa
Posted by laima on January 8, 2007, at 21:30:25
In reply to Re: Zyprexa Is It Now Controlled » yxibow, posted by Phillipa on January 8, 2007, at 18:35:59
Guess Illinois is tough! New York kind of tough, too.We even put our cough syrup behind the pharmacy counter. Heard one must show a drivers lisence to buy it, but I haven't tried.
> My next door neighbor is from Florida and flies down twice a year and her pdoc gives her postdated scripts for xanax that she fill in North Carolina. Love Phillipa
Posted by yxibow on January 9, 2007, at 2:52:11
In reply to Re: Zyprexa Is It Now Controlled » yxibow, posted by laima on January 8, 2007, at 17:26:59
>
> I swear up and down that the staff at my pharmacy know me by name (much to my chagrin), but they absolutely refuse to fill ahead of time-insurance or no insurance. They also insisted that the doctor couldn't call in to adjust does or date. I've had to go back to his office to get new scripts before if any change needed to me made.
>
> And as for out of state- I tried to refill my Illinois klonopin in NYC- and two different Walgreens managers at two separate Walgreens there insisted it was against their state law to fill or refill a benzo prescription if it originated out of state.
New York has all sorts of restrictive laws when it comes to anything medical from what I can see, is one of those states with some sort of odd restriction on mail ordering something, etc. I suppose it comes from having a 9 million urban relatively progressive population juxtaposed against a small town conservative capitol. But NYC still is a great place to visit. :)
The restrictions on exactly 30 day supplies seem rather hardnosed, as I say, since some are 31 and one is 28 or 29. Additionally, most insurance companies will bend unless they're really pedantic if you need vacation medication. Its sort of in their interest to keep their patients safe and alive to get more copays.
Posted by laima on January 9, 2007, at 10:26:29
In reply to Re: Zyprexa Is It Now Controlled » laima, posted by yxibow on January 9, 2007, at 2:52:11
I do wonder a bit if the rule about no refilling stimulants (schedule 2) until a full 30 days has passed is my pharmacy's interpretation of regulations, or an actual fact in my state. I know that my prescriptions are always written as if each month lasts 30 days-wonder if that's a standard or just easier for the doctor. Well, even when I used klonopin, and the bottles had refills available, the pharmacy always refused to refill unless at least 3 weeks had gone by, but I noticed that there was some variation in the lenience of the employees. Once, I was actually grilled over why I was refilling so early-"what happened to the pills- you should still have some left". Uh- I had an appointment that day and wanted to drop everything off at the pharmacy at once? And the time I had the snafu in New York was the result of a no-refill-allowed-yet drama. Another time I wanted to "refill" ritalin early because I was going out of town- and they refused to let me pick it up until the morning of my flight! When I went to get it, they were slow and I was getting ancy. I got a rude, "Well aren't YOU in a hurry for this ritalin!" comment along with the prescription.I like the idea of refilling everything on one go, not having to be a "regular", just going to the pharmacy once monthly. Incomprehensable to some of the staff there.
Another odd irregularity: when I used provigel in the past, the bottle would have refills, and I never had any hassles. Nothing like with the other or real (whatever) stimulants or even benzos. That always amazed me considering all the flap about provigel being abuseable or unfair in the sense that people could use it to not sleep.
> The restrictions on exactly 30 day supplies seem rather hardnosed, as I say, since some are 31 and one is 28 or 29. Additionally, most insurance companies will bend unless they're really pedantic if you need vacation medication. Its sort of in their interest to keep their patients safe and alive to get more copays.
>
Posted by yxibow on January 9, 2007, at 13:21:50
In reply to Re: Zyprexa Is It Now Controlled, posted by laima on January 9, 2007, at 10:26:29
>
> I do wonder a bit if the rule about no refilling stimulants (schedule 2) until a full 30 days has passed is my pharmacy's interpretation of regulations, or an actual fact in my state. I know that my prescriptions are always written as if each month lasts 30 days-wonder if that's a standard or just easier for the doctor. Well, even when I used klonopin, and the bottles had refills available, the pharmacy always refused to refill unless at least 3 weeks had gone by, but I noticed that there was some variation in the lenience of the employees.
Some of these may come from your insurance company but some may be state law for C-IV. Three weeks would be 21 days and a bit under the "fudge factor" that I have seen around 25-26 days. But as they say your miles may vary.
Once, I was actually grilled over why I was refilling so early-"what happened to the pills- you should still have some left". Uh- I had an appointment that day and wanted to drop everything off at the pharmacy at once? And the time I had the snafu in New York was the result of a no-refill-allowed-yet drama. Another time I wanted to "refill" ritalin early because I was going out of town- and they refused to let me pick it up until the morning of my flight! When I went to get it, they were slow and I was getting ancy. I got a rude, "Well aren't YOU in a hurry for this ritalin!" comment along with the prescription.
I'm beginning to see the connection with schedule II, its like they think you're begging for crack with a legal prescription. That's totally rude though regarding the Ritalin comment. I mean if you came in looking strung out and started yelling at the pharmacy techs that would be different, but I can sympathize, this is not good behaviour.Things are clamping down in general on all chemical substances and precursors because of a resurgence of meth diversion and creation in place of previous heroin addiction.
The whole Sudafed fiasco is, while understanding from a law enforcement perspective in some hotbed parts of the midwest, nothing less than nanny monitoring of innocent people who want their legal 3.2 grams per day and sign a poison pad. (And pharmacies don't even know the federal law regarding this -- it is an extraordinary rarity now that you will see a 96 tablet generic let alone original -- so you try two 48s on them and they say no and then their computer says its okay finally after insistance, so you've just paid almost double for your hayfever medication. And the "cards" on the aisles aren't stocked and depleted according to what they have behind the counter so you might as well skip that and go to the counter itself and look. There was an article in the WSJ about this not that long ago.) Then they take Neosynephrine and call it Sudafed PE and expect it to have any value, which at best is half. Anyhow, end soapbox, but we're talking now "category V" or VI if it existed.
> I like the idea of refilling everything on one go, not having to be a "regular", just going to the pharmacy once monthly. Incomprehensable to some of the staff there.Well if you're refilling it at the same pharmacy approximately once monthly (I have splits because of when I started on different medications), you are a "regular" in a sense. Unfortunately if you're going to a big box store, its hit and miss as to whether you are a "regular". Still why I like the "corner pharmacy" even if they can be slightly disorganized they are still professional and know well the patients that they've seen for years.
If you are taking Cat-II prescriptions to the same chain but not the same location, you may not seem to be a regular at first even if you're in their "system" and to play reverse roles, they're just as under the fire from the DEA because they have to dot their Is and cross their Ts on amounts of prescription and any lossage, etc.
> Another odd irregularity: when I used provigel in the past, the bottle would have refills, and I never had any hassles. Nothing like with the other or real (whatever) stimulants or even benzos. That always amazed me considering all the flap about provigel being abuseable or unfair in the sense that people could use it to not sleep.
Provigil is C-IV so 6 refills would generally be allowed with phone-in sometimes and a follow-up faxed prescription or the like depending on state law.
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