I'm a mess
November 8, 2011 9:31 AM   Subscribe

I've run out of antidepressants. YANAD but can I take someone else's prescription of a different but similar kind?

I am on 20mg of cipralex (lexapro in the states). I take it every morning, and am extremely sensitive to it. By 2 pm, if I've forgotten to take it, I'll remember because I'll start getting brain zaps, a headache, and negative emotional reactions.
I recently moved provinces, and have been getting the pharmacy here to call up the pharmacy in my old province every month to get my refill transferred. WHen I went in today they said that my prescription had expired and that they couldn't refill it.
I'm at a loss for what to do, because I don't have health care in the province (I applied for it, they denied, I procrastinated appealing). I also do NOT have time to go to the doctor in the next couple of days, because I am unfortunately at the apex of 'omg so many university papers due' that I was already planning on surviving on little sleep in order to get everything done by Friday.
I can't survive these next two days without my meds. I can't see a doctor (even if I had healthcare, I live in a small town with no walk in clinic. I would have to go to the emergency room and pay up front, which I can't afford right now).
My roommate has a prescription for citalopram (10mg) which I think is really similar to cipralex? I know it's shady, but is there any way I could take that over the next couple of days to keep me stable until my papers are in and I can figure out my healthcare/try to see a doctor? If I was to take it, how much should I take?
I'm a mess over here...what can I do?
Thanks mefites.
posted by whalebreath to Health & Fitness (18 answers total)
Have you tried calling your old doctor, whoever prescribed it originally? You don't necessarily need an appointment if they're willing to call in a new prescription, even if it's just a month's worth or something. It would be a place to start, anyway.
posted by brainmouse at 9:33 AM on November 8, 2011

Response by poster: I called the clinic but my psychiatrist only works Monday mornings.
Oh also, I just took 5mg of cipralex that I found after rooting through every possible place it might be lurking.
posted by whalebreath at 9:36 AM on November 8, 2011

No one is going to give you the type of advice you are looking for. I'm sorry, but AskMe can't do this for you.
posted by Think_Long at 9:39 AM on November 8, 2011 [1 favorite]

Response by poster: Well If anyone has experienced switching from cipralex to citalipram even that would be helpful.
posted by whalebreath at 9:42 AM on November 8, 2011

Well then see if someone else in the practice (surely they have an on-call doctor?) will give you a short-term extension. If you're just asking for a week or a month or something to work out how to get a real refill, it's very possible they will give it to you, but you do have to ask.

Switching medications without a doctor's supervision is a bad idea. So is stopping your medication cold turkey. Spend more time finding a way to fix this before you start doing dangerous things. See if you can get an extension on one or more of your papers to deal with a real health issue. This is more important.
posted by brainmouse at 9:46 AM on November 8, 2011 [9 favorites]

Try asking the pharmacist you went to to 'advance' you a coupled of days' dose. They are often willing to do that. When you get a prescription, you will take it to them and they'll fill it minus the pills they already gave you.
posted by Paquda at 9:46 AM on November 8, 2011 [3 favorites]

As far as the chemistry goes, your drug is the es version of your roommate's drug. What that means is your roommate's drug has two forms of the drug (called enantiomers, mirror image molecules), where only one is active (desirable). Your drug is purified so as to only be the es (or active, desirable kind). This comes only from quick wikipedia research.

There is no way for any of us to know if the non-desirable enantiomer will have an effect on you.

I am not a doctor, chemist, pharmacist, so I don't feel qualified to say they are or aren't interchangeable. You might want to call a pharmacist.
posted by sarae at 9:49 AM on November 8, 2011 [2 favorites]

There is almost certainly a doctor somewhere who would be willing to give you a week or so worth of cipralex so that you don't start experiencing the withdrawal. I would keep in mind that if you barely have time to deal with this, you most certainly don't have time to deal with the brain zaps, headaches, and other side effects you might experience if you stop taking it without tapering or switch to a different medication. Start calling around...maybe another pyschiatrist who works with your previous pyschiatrist??
posted by thankyouforyourconsideration at 9:51 AM on November 8, 2011

Go to the pharmacy where you have/had the prescription. Generally (though not a guarantee), if you tell them that you need a refill badly, and you can't get through to your doctor until later, a pharmacy will spot you a day or so worth of pills. They'll also try to contact the doctor themselves to authorize a refill. Simply put, you're a better customer when you're alive and stable.
posted by Citrus at 9:53 AM on November 8, 2011

Depending on the university you're attending, you may have some health coverage through your school.

See if they could reimburse you for a trip to the ER if your pharmacy doesn't want to give you a few days worth of pills.
posted by emilycardigan at 9:59 AM on November 8, 2011

Lexapro is a brand name for escitalopram, not citalopram. Citalopram and escitalopram are isomers -- specifically, S-enantiomers -- of one another. In a clinical study (http://www.ncbi.nlm.nih.gov/pubmed/18158074), escitalopram 10mg was found to have a more significant effect than citalopram 20mg.

Don't take your roommates drugs because you think they are similar. They have different effects, and are chemically related but not identical. If you truly "cannot survive" without your medication, call your doctor or pharmacist and have them guide you.
posted by ellF at 10:13 AM on November 8, 2011 [1 favorite]

Definitely ask the pharmacy to give you a couple of pills to hold you over. They usually do that if you have a regular ongoing prescription that is pending refill.
posted by radioamy at 10:33 AM on November 8, 2011 [1 favorite]

OK, I've done the reverse of this -- substituted 10mg of Lexapro for 20mg of Celexa for just one day -- but I am not nearly as sensitive to SSRIs as you are, and, as Sarae pointed out, the direction I was going did not mean getting an extra form of the drug I wasn't used to. You haven't exhausted your options yet. If 1) the pharmacy won't spot you a couple of pills, and 2) your old doctor can't call in a prescription, 3) call the clinic again. When somebody runs out of a prescription during one of the six and a half days your psychiatrist isn't there, which has to happen sometimes, the clinic should have somebody to refer you to who might themselves be able to call or fax something in. In fact, your psychiatrist ought to be able to call or fax in a prescription from his or her actual office, if you can provide the name/location/phone number of the pharmacy. Be aggressive about this. You're not asking for a controlled substance or an antibiotic. Even a GP can prescribe this.

In the meantime, running out of a required prescription because you can't afford healthcare on demand is an extremely reasonable reason to request an extension. Write one short, sweet email and send it to each of your professors; if all of them say no, you're no worse off, you're just in the same position you're already in. If anybody says yes, you've got time to see a doctor. If none of these things work, you probably need to make that unfortunate time investment anyway, because the anxiety of monitoring yourself for possible side effects is probably not going to make you work more efficiently.
posted by Adventurer at 11:54 AM on November 8, 2011

My university has an office for students with disabilities, which includes mental heath disabilities. In this situation, they could probably intervene and get you an extension on one of your papers whether or not your professor wanted to give you an extension.

Perhaps your university has something similar?

I think your first priority needs to be taking care of your health. If you have brain zaps or unexpected side effects from your roommate's drugs, you won't be able to write your papers anyway.
posted by insectosaurus at 12:14 PM on November 8, 2011 [1 favorite]

I know you said you couldn't afford to pay up front for the ER visit but if you are in ON the cost is quite cheap ($40ish is what I have helped friends pay). Call and ask about the cost, it will be refunded to you if you are eligible for provincial care. Bring a copy of your medication record from the pharmacist so the DR knows this is an on-going prescription.
posted by saucysault at 12:42 PM on November 8, 2011

A little late, but yes, taking Celexa instead might hold you over, it is a very similar drug. I have a friend whose insurance changed and he had to switch from Lexapro to Celexa. Celexa is basically to old version of the drug, doesn't work quite as well for most people, has more side effects, but it would probably help stave off withdrawal for several days.
posted by catatethebird at 8:27 PM on November 8, 2011

A little late, but yes, taking Celexa instead might hold you over, it is a very similar drug. I have a friend whose insurance changed and he had to switch from Lexapro to Celexa. Celexa is basically to old version of the drug, doesn't work quite as well for most people, has more side effects, but it would probably help stave off withdrawal for several days.

Please don't listen to this, despite the good intentions. Switching between psychoactive drugs is something that should only be done under observation/orders of a professional. In the absence of a medical history and full knowledge of your reactions, it could even be dangerous.
posted by ellF at 8:46 AM on November 9, 2011

Response by poster: Just an update: I have made it this far by bearing the withdrawal symptoms as I got my papers done. After I finished the last one tonight I headed to emerg., all shaky and brain zappy, and got a prescription. They didn't make me pay upfront for the visit (don't know why, didn't question it). The physical effects of withdrawal have been bad but somehow i have felt energetic and happy otherwise! Thanks to everyone who chimed in with advice!
posted by whalebreath at 9:57 PM on November 9, 2011 [2 favorites]

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