Patients may not comply with their doctors’ orders for many reasons. They don’t understand the orders (“Does ‘once’ mean ‘una vez’ or 11?”). They don’t understand they reason for the orders (“It’s not like I could cause any ’superbacteria’ by not finishing my antibiotics”). They stop following orders when they start feeling better (“I don’t feel schizophrenic anymore”). They stop following orders when they start feeling worse (“I’d rather be manic than feel like a zombie on lithium”). They disagree with the orders (“No vaccines for us, thank you”).
Of course, there are myriad other reasons for patient noncompliance. My current reason for noncompliance is health insurance. I am taking myself off of Depakote ER because my insurance won’t pay for any seizure-related expenses, and the medication is too expensive for me to keep paying out of pocket every month.
Depakote ER has been costing me $148 for sixty 500-mg pills. Since I am supposed to take two pills per day, one prescription lasts me one month. To make a script last longer, I have played around with how many pills I take each day. I’ve been taking one on odds days and two on even days. If I start to get a migraine, then I take two for several days, then go back to alternating days.
For the most part, Depakote works well for me. It keeps seizures auras away. It lessens the frequency and severity of my migraines. It stabilizes my mood. The side effects aren’t awful. I don’t like the increase in acne or the shaking in my right hand. But I don’t tend to gain uncontrollable weight on it, and the mental sluggishness isn’t debilitating.
Ultimately, it’s having to pay for the drug myself. I’m not going to start a U.S. healthcare discussion right now. I’ll also delay a diatribe on the cost of prescription drugs. This is more of a personal decision than an attempt at social reform or protest. Though what a ripple we could create if we all just went off of our expensive anticonvulsants!
No, I’m not inciting anything. Yet.
I’ve been taking one Depakote every 36 hours for the past few days to take myself off completely. I have only 3 pills left. I already ended up with a migraine yesterday. My daughters were leaving town, so I just had to suck it up. But it kept building all day. I finally knocked it out (or masked it) last night by taking 2 Tylenol, 2 Motrin and plain Alka Seltzer; a few hours later 2 Excedrin and more Alka Seltzer; and finally 2 more Motrin and Alka Seltzer Cold. Today I feel groggy and hungover. The headache is the worst, but the day after is always almost as bad.
Paying $148 per month may end up feeling quite reasonable. In the meantime, maybe Dr. V will put me on some generic med that still helps.
[...] 30, 2008 by brainside Well, that was short lived. I said a few weeks ago (see post) that I was taking myself off of Depakote because my health insurance won’t pay for it. I [...]