A cheap replacement for Seroquel?

March 20, 2009 9:04 PM

PsychMedFilter: A cheap replacement for Seroquel?

I'm bipolar. I take Lamictal, Lithium and -- my favorite -- Seroquel. I just lost my job. And my health insurance.

I can find the Lamictal and Lithium for fairly cheap without insurance. But the Seroquel, and even its generic, Quetiapine, is killing me.

My doc is set on keeping me on the Seroquel; I can't blame him -- the stuff works wonders. I'm looking at different state and nonprofit programs for possible assistance in covering the cost.

But I'm curious. Have any bipolar MeFi-ers switched from Seroquel to something else and found it to be as effective?

posted by anonymous to health & fitness (18 comments total)

Hey. As your internet ambient-friend, I encourage you to do everything possible to continue the exact same medicine that's helping you. With the latest stress of losing your job, you don't want to put your health at risk. You know this already. I'm saying all this because I think you should ask your doctor for help. He/She or his/her colleagues may have some stash of free samples from the company that can tide you over -- I got a year's worth of Zoloft this way while I was abroad.
posted by foxy_hedgehog at 9:29 PM on March 20 [1 favorite has favorites]

A number of drug companies offer deep discount programs for patients without insurance. Try here or here, or ask your doctor.
posted by bettafish at 9:49 PM on March 20

You can get some meds free from the company as bettafish stated. If not, you might have a local clinic that has plenty of samples to offer low-income patients.
posted by IndigoRain at 12:08 AM on March 21

ok, FYI there is never any difference between a brand name drug and its generic counterpart, so to reduce your costs always take the generic if it's available (unless the brand name and generic are the same price, or you're getting free samples of the brand name).
posted by singingfish at 1:03 AM on March 21

Seroquel is the brand name of the drug Quetiapine. I don't know where you are obviously, so I'll assume the default (US). In the US the patent (owned by AstraZeneca) doesn't expire until 2011, so I think it's unlikely you'll get a generic form in the US. However, the patent has expired in Canada, so you may well be able to obtain it in generic form there.
posted by le morte de bea arthur at 3:03 AM on March 21

Curse my lazy typing. "I don't know where you are, obviously..." is what I meant.
posted by le morte de bea arthur at 3:04 AM on March 21

FYI there is never any difference between a brand name drug and its generic counterpart

This is actually not true, AFAIK. The amount of the drug can differ slightly, and the fillers can differ as well, according to my doctor, which can result in different bioavailability of the active ingredients. In a lot of cases this doesn't matter (birth control, for example) but I can't take the generic of my antidepressant. All this to say that generics might be a great option, but have a care.
posted by chesty_a_arthur at 5:22 AM on March 21 [3 favorites has favorites]

OK, this is a much better explanation than the boozer science I dropped above: http://counsellingresource.com/medications/discount-drugs/generics.html
posted by chesty_a_arthur at 5:28 AM on March 21

Look under Mental Health in the blue pages of your phone book: a lot of counties and cities offer assistance with medication.

Another possibility is your local NAMI organization: a telephone call to their offices might steer you in the right direction to obtain help.
posted by francesca too at 7:57 AM on March 21

There's also this prescription assistance program - actually it's supposed to help identify programs that will help, and has some kind of questionnaire thing on the site to do it.
posted by dilettante at 8:39 AM on March 21

FYI there is never any difference between a brand name drug and its generic counterpart,

Way, way, way, wrong, I'm afraid. In fact, the amount of the active ingredient is allowed to vary considerably in the generic form. Additionally, the generic is not required to use the same or similar delivery system. So, you can end-up with a generic that may, or may not, contain the correct amount of the active ingredient, contained in a carrier that could release too much of the drug too quickly.

The most common example of this problem are the generic versions of Welbutrin.

Moving from a brand that works perfectly to the generic can be very problematic, depending on the manufacturer.
posted by Thorzdad at 9:09 AM on March 21

I take lamictal, celexa and my favorite - clonazepam. My doctor once prescribed seroquel to help me sleep. It does a great job of quieting my mind, but I feel like crap (ie. hit by a train, depressed) the morning after having taken it.

I don't know if this advice will be helpful to you as everyone reacts to psychotropics differently, and I'm bipolar II (you didn't say which one you are). But if you are looking for something to help you sleep and slow you down when your mind is racing, you might give clonazepam a shot if you haven't already. It really quiets my mind down so that I can fall asleep. It seems to releive anxiety and I have on occasion taken it during the day. And when I take it at bedtime, I don't wake up during the night, don't tend to have (or remember) nightmares, nor do I wake up with the tight, sore muscles and jaw pain I tend to get if I go a night without it.

Drug costs really suck. Good luck to you.
posted by kitcat at 9:14 AM on March 21

ok, FYI there is never any difference between a brand name drug and its generic counterpart,

In addition to the pharmacological issues raised above: since there is plenty of robust evidence for a placebo effect even from active psych medications, and since there is research that supports the notion that people get better placebo effect from brand name placebos, there is likely to be a difference in efficacy simply at the level of expectation.
posted by OmieWise at 9:40 AM on March 21

Seroquel is in a class called "atypical antipsychotics", which appeared in the early 1990s. They have somewhat less side effects than the older antipsychotics, although they probably aren't any more effective. YMMV. The older antipsychotics, such as haloperidol, are dirt cheap. If you need that sort of med, you're better off taking haloperidol than holding a Seroquel prescription that you don't get filled.

This assumes you're relatively young. Risk of side effects (low blood pressure, urine retention etc.) increases with age, especially above 60. Below 40, the risks are quite low.
posted by neuron at 11:06 AM on March 21

Benzodiazepines (clonazepam) have problems. They can cause agoraphobia, depression, anxiety and all kinds of other problems if used longer than 2 weeks. Once you have been on them a month or so, quitting becomes very difficult and troublesome physical withdrawal symptioms are to be expected, horrible insomnia, cravings, etc. I wouldn't suggest adding them as a long term treatment to replace antipsychotics.

Risperdal is an atypical antipsychoyic that is pretty cheap, i/e generic. Main problem is it often causes hyperprolactinemia, which is an elevation of prolactin that can cause impotence gynecomastia and osteoporosis. Taken habitually (a couple months) this antipsychotic has awful withdrawal symptoms, but it isn't adictive in any way, i/e no drug seeking behavior observed. It works very well, but doesn't really have much of an antidepresant effect, seroquel does.
Your best bet is to try to get the seroquel for cheap, failing that talk to your doctor, tell him/her you are broke, he/she will work with you to find an option.

Also, if you can afford it, COBRA will let you keep your health insurance for 1.5 years, but it is hellaciously expensive.
posted by jester69 at 12:45 PM on March 21

BTW, i'm not a doctor, and would never give medical advice, above post is just my research/experiences as a regular person.
posted by jester69 at 12:47 PM on March 21

As other posters have said, if the Seroquel is working for you, try your damnedest to stay on it, especially during times of stress. That said, if it becomes a choice between switching or nothing, describe to your doctor exactly what it is that Seroquel does to make you feel so much better. For example, does it calm your anxiety? Make you feel more emotionally "levelled-off"? Slow racing thoughts? Or is it purely that it knocks you out so you can get a nice, uninterrupted night of sleep? Remember also to ask your doctor what changes he/she has seen since you started the medication, as s/he may have noticed benefits which you hadn't been aware of.

Atypical antipsychotics all work the same way on psychosis, but their other effects on brain chemistry are very different (they all bind to a number of different receptors), so you cannot simply switch to another drug of the same class (like risperidone or olanzapine) and expect the same effects. By targeting the specific symptoms that Seroquel improves, you will have better luck switching medications.
posted by TheLittlestRobot at 1:32 PM on March 21

you should be able to get samples on a consistant basis, if you head to community mental health center. Sometimes they take people with no insurance.
posted by captainsohler at 10:23 PM on March 21