Low cost bipolar ADD meds in US
September 5, 2012 2:37 PM   Subscribe

Low cost bipolar ADD meds available in the US?

Losing my insurance, currently on Zoloft generic - (tier 1) sertraline and Intuniv ER.
My bipolar depression isn't serious and has been pretty well controlled (small infrequent hypomanias). The intuniv (tier 3) was added as a non-stim ADD med to help with cognition. But it is a whopping $475 for a 3 months supply WITH the plan I have.

The last combo that sort of worked for me was Lamictal and Strattera along with Celexa. But insurance plans change and here we are. And I know different meds affect people differently. I just need to function normally.

Any off label or anecdotal info I can tell my psychiatrist about? I have no idea if I will qualify for state aid or how much these meds will cost me yet.
posted by jchinique to Health & Fitness (6 answers total) 1 user marked this as a favorite
Check with your pharmacist. Some are more helpful than others, but they really should be able to help you figure out what meds are similar to ones you are taking and how much they would cost. Then take that information to your psychiatrist to write the prescriptions.
posted by MonsieurBon at 2:54 PM on September 5, 2012

Intuitiv is an expensive, slow-release version of another medication that's older (and cheaper) than dirt. Ask your doctor about switching to Tenex (generic guanfacine), it's something like $10/month without insurance.
posted by TungstenChef at 2:56 PM on September 5, 2012 [1 favorite]

Seconding guanfacine. I am a licensed pharmacist in the US. Good luck!
posted by Pocahontas at 3:07 PM on September 5, 2012

If the generic won't work for you, the manufacturer of Intuniv has both co-pay assistance and a patient assistance program (in the PAP, the patient is provided with no-cost medication).
posted by shiny blue object at 3:17 PM on September 5, 2012 [1 favorite]

Talk to your pharmacist. CHADD has some good resources you may want to look into, including a hotline.

The rest of this is "another person with bipolar and ADHD" talk.

There are three different non-stimulant ADHD drugs out there; I was on Strattera for a while. If you don't qualify for Shire's patient assistance program, you might still qualify for Lilly's. There's also Kapvay, but I don't know anyone on it and I don't recognize the manufacturer's name; I literally can't say anything about it other than that it was approved by the FDA for ADHD and isn't a stimulant.

The immediate-release version may work well for you (and would be the first thing to ask about if Shire's programs won't help) but it might not, so keep the other options in mind.

Also, if you're a BPII, you may want to consider other stimulant-but-not-that-bad drugs. I'm on Vyvanse and it doesn't send me up at all. I don't know anyone with BPI whose doctors were willing to give them Vyvanse, but if you have no history of full-blown mania, and have proven yourself super-compliant and willing/able to report small episodes, they may be willing to give you a shot; three or four BPIIs that I know are on something like Vyvanse (one is even on Adderall, which I still can't quite get over.) One of the doctors at my psychiatrist's practice is kind of an expert in mood disorders + anxiety + ADHD, and she was very OK with writing me this month's Vyvanse scrip, even while worrying about refilling my Cymbalta.

There's also, ahem, a ton of stuff about using various antidepressants (even weird stuff like tricyclics and MAOIs) for ADHD, but you know how doctors get about antidepressants and BPI/BPII. Wellbutrin may be worth a shot; it's well-tolerated in BPI/II compared to SSRIs, in a kind of "well, crap, what now" sort of sense (no one ever tries it first, or second, or third, but after that, Wellbutrin shows up higher on the list than Lexapro.)

Lexapro has gone generic, BTW. And at some point relatively soonish, maybe, Strattera will go generic, too. There's been legal wrangling. Lamictal is definitely available in generic form (it cost me $5 last time I got it refilled, though, so I'm guessing it's still not on the $4 lists) and so there might be an easier path to your last combo that worked, than this combo.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 4:06 PM on September 5, 2012

not in the U.S, but I get my asthma meds from 4 corners pharmacy. They ship fast! I have ordered from them multiple times over a 4 or 5 year period. Worst thing that happened was about 3 years ago, it got stuck in customs on the east coast for a couple weeks but then was ultimately received. They do have generic zoloft & lexipro, I didn't find the others, but I didn't search real hard.
posted by couchdive at 6:34 PM on September 5, 2012

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