Haven't posted in quite some time

[Heaven_Scent]

(posted in meds forum also)

Hi, it's been a long time since I was last on here (which is a good thing I suppose) Anyway, things have been on a downwards spiral for me for the last 6 or so months resulting in me having a bit of a psychotic episode which means I've been signed off work. I have been in contact with my GP and diagnosed with depression (again) Initially I refused a ref to mental health services for professional reasons however my GP is unable to prescribe the medication she thinks most suitable (venlafaxine) she prescribed citalopram but after taking it for 3 days I could no longer stand the side effects. I have been prescribed it before for mild depression but I'm sure it didn't make me feel that poorly. Feel like I've shot myself in the foot a bit. I have been left unsupported feeling very low, anxious, have no motivation and I'm really struggling.

Thanks

[shiznit76]

why can your GP not prescribe venlafaxine, it's a standard anti depressant

[Heaven_Scent]

Funding. Plus its not first line treatment and seeing as SSRI's don't seem to agree with me I have to wait for an appointment with mental health services as the prescription has to come from a specialist.

[shiznit76]

would think that if you couldn't tolerate citalopram that they wouldn't prescribe you venlafaxine, it's not that much dearer and is a standard AD

[Heaven_Scent]

I don't know what else I can do. They suggested Trazadone but I work shifts so it's not really suitable.

[shiznit76]

they suggested that for me the other day too, but I want see a psych for proper assessment.

[Heaven_Scent]

You do right

[Istherehope?]

Just to say I can't tolerate normal SSRIs but I am on Venlafaxine (as well as Mirtazipine) and it's worked really well for me.

---------- Post added at 20:36 ---------- Previous post was at 20:35 ----------

P.s. I'm really sorry things are so hard for you.

[Heaven_Scent]

Thanks for your reply. How have you found it? Has it lifted your mood? That's what I'm struggling with at the moment rather than anxiety. Think I've gone past the point of getting anxious because I'm so low.

[MyNameIsTerry]

Funding. Plus its not first line treatment and seeing as SSRI's don't seem to agree with me I have to wait for an appointment with mental health services as the prescription has to come from a specialist.

Neither is Trazodone a first line. SNRI's are usually 2nd line. Both lines are within a GP's remit.

Ven and Traz aren't that different in cost. Here is an example:

http://www.sussexpartnership.nhs.uk/...6_-_oct_14.pdf

http://www.sussexpartnership.nhs.uk/...451/attachment.

28 days of Traz at 150mg = £21.23
28 days of Ven at 75mg = £2.32
BUT 30 days of Ven at 225mg = £34.

So, somewhere in between Ven at doses above minimum and below the high dose will be a more reasonable costing. I disagree with your GP's rationale on cost anyway since there are GP's prescribing Pregabalin, per members on here, and that drug is far more expensive and more 3rd line.

If your GP says Ven is not licenced for anxiety but Traz is, don't let them use that excuse because Citalopram & Sertraline are not licenced for anxiety either yet are commonly prescribed by loads of GP's.

Going back to Ven for a minute. See here on page 4 where it says Ven can be prescribed in primary care:

http://www.wlmht.nhs.uk/wp-content/u...d-18022015.pdf

Ven costs are little different to Traz as far as I can see. For example:

http://www.awp.nhs.uk/handlers/downloads.ashx?id=9162.


Venlafaxine XL capsules

150mg x 28

£36.81

Venlafaxine XL capsules

75mg x 28

£22.08

Venlafaxine XL tablets

225mg x 30

£33.60

Venlafaxine XL tablets

150mg x 30

£18.70

Venlafaxine XL tablets

75mg x 30

£11.20

Venlafaxine XL tablets

37.5mg x 30

£6.60

Venlafaxine tablets

75mg x 56

£2.52

Venlafaxine tablets

37.5mg x 56

£2.14