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28 Mar 2003

BI-POLAR DISORDER
LAST YEAR I HAD 4 BREAKDOWNS AND WAS HOSPITALISED MANY OCCASSIONS FOR THE ABOVE DISORDER. IS THIS EVER CURABLE OR NOT. I AM ON MEDICATION BUT WHEN I AMNOT ON THE MEDICATION I GO REALLY BAD. I DONT SLEEP,I AM CONSTANTLY IRRITABLE AND MY NERVES ARE UP. MY HANDS SHAKE CONTINUOUSLY. I JUST DO NOT COPE NORMALLY. I TAKE TOPAMAX 150MG; RIVOTROL 1.5MG ; ZOLOFT 25 MG; SEROQUEL 50MG DAILY. MY PROBLEM NOW IS THAT MY MEDICAL AID WILL NOT COVER THE COST OF TOPAMAX AND RIVOTROL AND I AM NOT SURE IF I CAN DO WITHOUT THESE TWO TABLETS DAILY. PLEASE ADVISE.
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Expert
CyberShrink
cybershrink

01 Jan 0001

Dear Shelby,
In many of us, a Bipolar Disorder is a lifelong vulnerability and potential illness, which, with careful management with expert advice, can be controlled in the long-term, enabling us to lead a pretty normal life, and to avoid the worst excesses of what it can do with us if it goes untreated. One's illness may be much more turbulent when we are younger, and may become easier to manage as one gets a bit older. So BPD is a bit like Diabetes or High Blood Pressure --- neither of those conditions are ever "cured" but people can, with the aid of medication and their own good sense, gradually gain control of the disorder, rather than being controlled by it.
The medications you describe sound like a pretty potent and complex regimen. Actually, you would need to discuss with your psychiatrist, who prescribed this combination, to what extent each component of it is essential or simply desirable, and what alternatives there may be. I know that Medical Aids which are cautious about trying to keep overall costs down, are troubled by how some doctors tend, for various reasons, to make the error of starting treatment of a bipolar disorder with the most new and expensive drugs, which are often more than is needed, and before making a proper trial of the potential value of using the more basic, tried and tested, older and less expensive drugs ( Like Lithium ). Where they do not see that someone has received a proper trial of these earlier and cheaper drugs, sufficient to make sure that they do or do not siffice to control the disorder, they will usually refuse to pay for the newer, less tested, and most expensive drugs.
if your shrink has been responsible about this, and has indeed tried the older drugs in your situation and found that they really don't help you, then he has the ability and the duty, to petition the particular Medical Aid, to provide the necessary extra information, and to appeal to them to allow the extra expense in your case.
Medial Aids aren't always run by notably sensible people. But, in the right situation, which might include yours, it can be a good deal less expensive for them to provide you with a much more expensive drug IF it prevents a degree of instability in you disorder, which might require repeated admissions to hospital, and other treatments, at a potentially even higher cost.
Your shrink /doctor should be able and happy to discuss these issues with you, including how to seek permission from the medial Aid to pay for the other meds, or to explore alternaive, cheaper medications, which might be equally effective, and would get paid for.
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical examination, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
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