Discussion in 'Fibromyalgia Main Forum' started by Annette2, Sep 12, 2003.

  1. Annette2

    Annette2 New Member

    It seems today wasn't my day!!!! After talking to the sleep doctor yesterday, I decided to go off of Effexor. I have to wait until I stop taking Neurontin, so probably won't wean off it until a week or two. So I called my family doctor to ask him how to wean off. His nurse left a message on my machine and said I need to contact the psychiatrist who prescribed it for me. Well, I saw the psychiatrist only once! She did prescribe it for me, but I can't see her again because she doesn't accept my insurance. I don't want to see another one just to ask them how to get OFF of a medicine! I don't think my family doctor is comfortable working with these meds, and that's why he wants me to contact a psychiatrist. I don't know what to do!

    Second problem now. Today I got a bill from my rheumy's office. Seems I had an appt. on August 1st that I missed. They're charging me $25.00 for a missed appt. Well, I didn't know I had an appt. I must have made it months ago and lost the card. Usually doctor's offices call you right before your appt. to remind you and they never did. The business office is not in her office. I don't know who to call. I'm half ready to call her office and say I'm not coming back. But I like her and don't want to start all over. Especially since she is very good about prescribing meds. I don't know what to do. I don't want to tell my husband cos he'll get mad about the bill.

    I REALLY NEED HELP AND ADVICE FROM YOU GUYS!!!! I'm so upset about both these situations!!!!

  2. Annette2

    Annette2 New Member

    Some doctor's offices have notices that say if you don't cancel within 24 hours you have to pay for a missed appt. Maybe hers has that rule. If so, I'm screwed. Unless I call the business office and say they never reminded me. I dont' know. I don't want to pay them $25.00 for nothing. What do you think I should do about this psychiatrist business? I really want to get off of Effexor. Thanks.

  3. Susan07

    Susan07 New Member

    from the website for effexor:

    Discontinuing Effexor XR
    When discontinuing Effexor XR after more than 1 week of therapy, it is generally recommended that the dose be tapered to minimize the risk of discontinuation symptoms. Patients who have received Effexor XR for 6 weeks or more should have their dose tapered over at least a 2-week
    period. In clinical trials with Effexor XR, tapering was achieved by reducing the daily dose by 75 mg at 1 week intervals. Individualization of tapering may be necessary.
  4. Annette2

    Annette2 New Member

    Thanks! The problem is that my pills are 300 mg. apiece. I don't know how I can decrease them by 75 mg. at a time.

  5. Lana56

    Lana56 New Member

    As far as going off the medication-I wonder if you could call the psychiatrists office and talk to someone there.Just tell them you saw the doctor once and can't afford to come in and see them again and could the doctor just tell you how to go off the medication.Tell them your family doctor won't help.Maybe they wil just tell you what to do.Maybe worth a try????
    As far as that 25.00 charge for not keeping your app.I would call the billing office and tell them you can't pay that charge and didn't know you were missing a scheduled app.Yes some offices do have that rule,but in my experience they let it go for me a few times.Gee, we should send a bill for all the time we wait to see the doctor in the first place! We would all be rich! Good luck and stand up for yourself ok Lana56
  6. Rocinante75

    Rocinante75 New Member

    I have a doctor who is very helpful with regard to weaning meds and she takes a very slow and cautious approach so that there is no withdrawal or other side effects. Part of the problem in weaning is that another med is going to be used in its place so while one is going down, the other is going up.

    If your pills are 300mg. see how many eaully sized pieces they can be broken down into. If you break into quarters, then each quarter is 75mg. You can take 3/4s (or more, depending on the way you can divide pill)for a week and see if all is OK. Then, you can take 2 halves for a week and see if you are OK.

    The schedule really is up to how you are feeling as you lower the medication. A very slow approach is the best especially if you have been on this a long time.

    Another approach -- say you take 3/4 for a week. The next time you want to decrease, you may not want to go as low as a half. So, take 3/4s one day and a half the next and keep on this routine until ready to drop again.

    This is the way I have weaned off meds with doctor's guidance on a weekly basis. I hope this gives you a good idea how to do it but I cannot tell you what to do, only my experieces under a doctor's supervision. And, you have to look at the reason you are weaning and that might affect the schedule. Let me know if this helps.
  7. Dara

    Dara New Member

    capsules so mine can't be broken in half, are the 300mg also capsules? If not, then you could probably try breaking them in half, etc., to slowly wean off of them. But, I would think that whichever doctor's name is on the prescription bottle is the one who should be advising you as to how to wean off of them. I would think they would write a new prescription for a lower dose for X number of days, and then gradually wean you down to nothing. Even if the originaly doctor doesn't take your insurance I would think they are still responsible for the maintenance of the prescription. You might even ask your pharmacist what they think you should do.

    I agree that most doctor's offices do call you a day or so before your appointment to remind you. Have they called as a reminder in the past? If so, I would mention to them that you did not receive a phone call. If you really like your doctor I wouldn't take the chance of losing her. In my opinion, good doctors are very hard to find..especially since she's good about prescribing meds for you. If you end up having to pay the $25.00 will your husband really get that upset?? I know what I would do, I just wouldn't tell him, but that's only my opinion here.

    I hope get both problems solved first thing Monday morning. Take Care.

  8. annepat

    annepat New Member

    My dad was a dentist. It cost him more than $25.00 if someone missed their appt. He still had to pay his staff and overhead. Granted-he booked enough time for his patients, he NEVER allowed his office manager to overbook, and he also left time in his schedule for emergencies and to return phonecalls-there aren;t many medical offices thta are run that way any more.

    Yes, many doctors overbook-billables is a theme, but you might want to ask if the office will call you to mremind you of the appt. You can also call to find out he date and time of your appt.


    EZBRUZR New Member

    I have found Great salvation in the people Here. I am learning and your question came upin a search, you have sme crappy issues, (((((((((hugz))))))))),I just wanted to say you are gonna be better and please takes time, do not give up,listen and learn to live, do not expect to much and you will not get let down...
  10. Annette2

    Annette2 New Member

    You guys are going to hate me!!!! I got the Effexor mixed up with the Neurontin. The Neurontin I have is in 300 mg. capsules. The Effexor IS 75 mg. apiece. Sorry for being so spacy!!!! I'm going to call the psychiatrist tomorrow and see if she can help me. If not, I'll do it myself. You are all so wonderful - THANK YOU!!!!!!

    I'M SUCH A FLAKE!!!!!

    Regarding my missed rheumy appt., I first called the business office and got a bit belligerent with them (I don't like them). Then I called the doctor's office and explained it to the person who answered the phone. I told her I've been a patient for almost 5 years and would never miss an appt. on purpose. I told her I haven't been feeling very well and really didn't know I had an appt. She said she'd talk to the office manager and call me tomorrow. She was very nice. So hopefully they will waive the $25.00 for me.

    [This Message was Edited on 09/15/2003]
  11. annepat

    annepat New Member

    Good for your for calling the Dr.'s office!!! Did you feel better afterwards? Did you ask them to call you w/ a reminder of the appt from now on? The best offices always do.

    I try and handle 3 things per day. On many days, 1 thing is getting out of bed, second thing is getting dressed, but I find thta if I handle 3 things per day, I eventually accomplish something.

    Mixed up meds- Have you thought about a pill box-you probably take too many pills, but you could just put your important ones in it. The other thing thta I do is to take a pharmacy bottle and put the entire days supply of meds-but just one day. At the end of my day, the bottle is empty.

    definately take meds changes slowly-we tend to be very sensitive to any changes, let alone meds changes!


    LITEFLAMES New Member

    Hi Annette,
    You Sound like me not wanting to Get the Hubby upset about med Bill's ,,,I Get Charged 50 if I miss a appt, And have so I Know that worrie, I agree you should Call thiere office
    And Explaine What happend, Also Perhap's could Pay $ a mth,
    And Ask If they would give you a call Next time you have a Appt, I was wondering What resone you have for going of Effexor, {what you'r Dr.Said to you to want to go off it, Sense It wa a Slep Dr , I'm Thinking Its causing you problims sleeping? , If you need to wean off ,That;s exactly what you do, cut you'r xr down bit by bit,,I know this becuse I'v Been weaned of antideppresants In the past,
    Just call the psychiatrist, And Ask them to tell you over the phone,just explaine you cant afford a visit, That will work!!!!!
    Please let use know how it go's & As I said, Im realy Interested in what the Sleep Dr. told you to make you go of Effexor
    Good Luck God bless
  13. Annette2

    Annette2 New Member

    The sleep doctor didn't tell me anything to make me want to go off Effexor. I just can't lose weight and I'm afraid it's from this med. I wonder if it's making me too hungry. The Effexor doesn't affect my sleep one way or the other.

  14. baybe

    baybe New Member

    The fact that you are going off the effexor because of weight and your own feelings, is exactly why the physicians want you to go back through the Psychaitrist.
    Psychiatric drugs are very specific and patients choosing to go off of them on their own are exactly why they want you to follow up. When you chose to go to a psychaitrist you kind of made an unspoken pact that you were pursuing a a particular answer.
  15. Annette2

    Annette2 New Member

    Thanks for your reply. But I don't understand what you meant when you said "when I chose to go to a psychiatrist I made an unspoken pact that I was pursuing a particular answer". Can you explain that? Thanks!! :)

  16. baybe

    baybe New Member

    Fibrofog, I didn't understand me either. The point I'm making is the doctors give you the meds for a particular reason. Internist don't want to change psyche meds because they assume the psyche had a particular reason for prescribing it and only the prescriber of the med should make the change, because they know the whole story.
    Essentially, you and your psychiatrist agreed on this medication based on information that you two shared.
    Therefore, any other doctor changing that medicine then takes legal responsibility for what comes next. Doctors don't like that, lol.
    I am starting to realize how much the law and insurance companies dictate the actions of our physicians. That's what I meant about you and the psyche having made an agreement on your treatment.Mental Health meds and the prescribing of them come with all sorts of legal responsibility. I hate that as patients we need to understand the situation doctors are in.