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Amphetamine Amphetamine AKA speed

 
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  #1  
Old 01-12-2009, 01:55
thebigdog thebigdog is offline
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Filling Multiple ADD Med Scripts at Same Time

SWIM is being treated for Adult ADD. He was initially prescribed Ritalin and given two post dated refill scripts. After trying Ritalin for a few weeks, he requested his doctor change him to Adderall, and the doctor has given him scripts for that.

Assume he fills his next Adderall script this week, paid for through SWIM's medical insurance. SWIM wants to know if he could also fill one of his refill Ritalin scripts a couple of days later.

Of course, SWIM would use use a different pharmacy (not the same branch or chain). He would also pay for the Ritalin out of pocket rather than submitting it to his insurance.

SWIM's concern is whether there is some mechanism that would alert the second pharmacy that he had just filled a script for a very similar medication at the first pharmacy. Is there such a system? Would it only apply to major pharmacies, or would any pharmacy have access to knowledge of filling the earlier script? Would the doctor receive a report at any time indicating that both scripts were filled (because he might stop prescribing anything)? Would any legal authorities receive notice of filling or attempting to fill both scripts?

SWIM believe the current dose of Adderall is too low and doesn't want to wait a couple of months before the doctor will consider increasing it. SWIM wants to supplement the Adderall dose with the Ritalin or increase the Adderall dose and then substitute it with Ritalin when the Adderall runs out early.

SWIM would really appreciate any information or advice about this situation and answers to these questions. Thank you very much!
  #2  
Old 01-12-2009, 02:02
wespawloski wespawloski is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

Controlled substances require at least a thirty day waiting period from what I remember, possibly three weeks. I doubt the pharmacy would allow you to grab your methylphenidate.

*** sorry, misread your post.
  #3  
Old 01-12-2009, 02:54
vantranist vantranist is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

Scheduled substances do not require any waiting time besides the time it takes to get it filled.

Just thought I would add that.


If you have a Ritalin refill left, they should fill it... i think.

They may be able to see when you need it tho. For instance if you had 3 refills remaining of Vicodin you couldn't go into the same pharmacy 3 days in a row asking for refills, this may only apply if you are going to the same pharmacy however.

One time SWIV lost half a bottle of Celexa (Not even scheduled) and had to get refilled sooner than he should of, they questioned swiv but he explained and they gave it too him. Had Celexa been a substance of abuse I dont think things would have gone so smoothly. They were both Walmart pharmacy's, but at different locations.

Last edited by vantranist; 01-12-2009 at 03:03.
  #4  
Old 01-12-2009, 03:05
staples Gold member staples is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

SWIY shouldn't need to use a different pharmacy, and SWIY shouldn't need to avoid using SWIY's insurance, however SWIY should be able to pay out of pocket if SWIY's insurance company does refuse to pay for some reason (some insurance companies have weird policies).

Pharmacies can query SWIY's insurance to find the details of previous prescriptions, however, I think if SWIY were to go to a completely new pharmacy and withhold his insurance information, they may not be able to immediately identify that SWIY recently filled an Adderall prescription.

However, SWIY's prescriptions are for two different drugs, and the prescriptions are written by the same doctor. It would be perfectly reasonable for SWIY to fill his postdated prescription for methylphenidate (ritalin) after filling his brand new amphetamine prescription (adderall)--it would look like SWIY and SWIY's doctor agreed to give Adderall a try but SWIY for some reason didn't like Adderrall and decided to stick with Ritalin. Later, if SWIY has his doctor increase his dose of Adderall, and if the pharmacist even thinks so far into it, the situation could simply be that the first dose of Adderall wasn't covering SWIY's symptoms, but it didn't cause side effects or anything that would warrant discontinuation. These things aren't really any of the pharmacist's business, they are things that the pharmacist should assume SWIY's doctor has considered. The pharmacist might be suspicious if it were two different doctors, or if the prescription called for refills (schedule II substances cannot have refills) or other signs of forgery, but that's not the case here. As I understand it, SWIY has two legal prescriptions.

The pharmacist will probably notice that SWIY should still have Adderall when he fills his methylphenidate and s/he may then instruct SWIY not to take them both--that happened to me when I switched from concerta+ritallin to vyvanse about a week after filling both concerta and ritallin. You see, what SWIY wants to do in terms of filling prescriptions is technically not illegal, but taking his medication other than as directed is; the pharmacy and insurance company can only impose restrictions on filling prescriptions, it is up to the patient to follow directions.

May I ask why SWIY wanted to switch from Ritalin to Adderall? It's hard to really give any advice without knowing why SWIY wanted to switch medications in the first place.
  #5  
Old 01-12-2009, 04:00
thebigdog thebigdog is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

The switch was made for two reasons. First, SWIM read that Adderall tends to be a bit more powerful. Second, when SWIM had last been treated about 10 years ago, he also ended up on Adderall after trying Ritalin--SWIM can't remember the details, but assumes that he switched then because he found Adderall worked better.

Is the doctor going to receive some report down the road that both prescriptions were filled? SWIM does worry about that since the doctor would assume the Ritalin scripts were destroyed when the Adderall ones were written. This is also one reason SWIM is worried about using the same pharmacy or one pharmacy knowing what was filled at another pharmacy--it might lead to an awkward call to SWIM's doctor by a meddling pharmacy.

SWIM had this happen recently with pain meds. SWIM took a new script to a different pharmacy solely because it was late and the other pharmacy was closer than SWIM's regular one. The new pharmacy made a big deal about the fact that SWIM was going to a second pharmacy with a pain med script from a second doctor, claiming impropriety when in fact the second doctor was a specialist. PITA pharmacist threatened to call SWIM's first doctor (G.P.). SWIM was angry but not worried because there was clear reason for second doctor and second pharmacy. But now with just one doctor who wrote both scripts, SWIM doesn't want doctor called to confirm. Yes, both are legal scripts, but SWIM's doctor certainly doesn't expect both will be filled.
  #6  
Old 01-12-2009, 04:53
staples Gold member staples is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

I don't think the pharmacist would contact SWIY's doctor, especially if SWIY fills his prescriptions after SWIY's doctor's office is closed (the pharmacist wouldn't likely bother making a note of calling SWIY's doctor later, if he even intends to in the first place). What are the prescribed doses? How long has SWIY been filling prescriptions at this pharmacy? A pharmacist would only really be likely to call the doctor if something seems a little off--a doctor they've never heard of, a new patient/new prescription with an abnormally high dosage or abnormal administration instructions, or things like if some part of the prescription looks as though it was written with a different pen or an attempt was made to remove ink from the written prescription.

If SWIY truly doesn't think his dosage of Adderall is high enough, isn't it reasonable to temporarily switch back to methylphenidate until he discusses it with his doctor? Or has SWIY's doctor explicitly told SWIY not to do this?
  #7  
Old 01-12-2009, 05:39
SlimThugga SlimThugga is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

SWIM has done this B4 and the pharmacy raised hell but SWIM raised more hell and got his way plus SWIM knows friends prescribed 2 diff ADD/ADHD meds and they always get em. As for callin SWIYs dr it is highly unlikely unless they feel like bein assholes and have nothin better 2 do.
  #8  
Old 01-12-2009, 05:46
wespawloski wespawloski is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

Wouldn't that be a breach of doctor-patient confidentiality?
  #9  
Old 01-12-2009, 05:53
staples Gold member staples is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

No. If a pharmacist calls a doctor, it's not to figure out why the doctor has written a prescription, but to make sure that the doctor did write a prescription, that the prescription has not been altered, and/or to clarify administration instructions (sometimes doctors write unclear instructions--my sister was given some liquid medication, with instructions to take "1 to 2" with no units).
  #10  
Old 01-12-2009, 06:26
wespawloski wespawloski is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

Heh, makes sense. Thank you
  #11  
Old 01-12-2009, 06:42
sasafrass sasafrass is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

Nobody plays by the rules anyway. Legally scripts can't be dated in advance. Supposed to be dated day written, w/h note "do not fill" before a given future date. Nobody cares. You have legit scripts, fill them however your most comfortable. Lots of doc's will prescribe time release pain med w/h i.r. for break through pain. You get break through distraction. Its all the rage where your doc went to school.
Adderall is a superior product for most people, and many times ritalin is used just to break in a new patient. Changing gears is what add people do best anyway. For reference, you can tell your doc a guy told you he's prescribed 60mg. of adderall a day, 20mg. x 3 when your trying to get him to bump up your dose ...
  #12  
Old 01-12-2009, 19:05
staples Gold member staples is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

Quote:
Originally Posted by sasafrass View Post
Legally scripts can't be dated in advance. Supposed to be dated day written, w/h note "do not fill" before a given future date.
I know that this is a (relatively) recent change in federal regulations (in fact, I remember my doctor telling me that she would have to stop post dating prescriptions and begin writing "to be filled on or after" after December 17th, 2007), but I also know that some doctors didn't seem to get the memo. I know that pharmacies will no longer take post-dated prescriptions and hold them on record, but I don't think it's really the case that the doctor is (deliberately) ignoring the rules.

Whichever the case, at least one person should care: the patient him/herself. The patient's family, friends, and community care enough to establish and enforce the rules (to some degree, at least); they should care about someone abusing substances and possibly negatively affecting/endangering other individuals. Doctors don't typically go home to laugh about how a patient conversationally danced around simply asking "can you make me high all the time?" and how the doctor complied, presumably just to make a mockery of the FDA or DEA.

Most doctors are reluctant to prescribe above the FDA's maximum recommended daily dose for human consumption, because if (in the case of stimulants) the patient suffers a heart attack, the doctor is liable. Lawyers advertise all the time "if your doctor gave you this medication and you suffered these side effects, call us to sue your doctor." It's not a joke, there can be serious, even fatal repercussions, so please don't presume that SWIY's own good fortune with some doctor(s) means nobody cares.
  #13  
Old 02-12-2009, 08:22
thebigdog thebigdog is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

Well, SWIM emailed the doctor about what he's doing (more or less), so at least that issue is out of the way.

Last week Dr. was supposed to mail SWIM new scripts for Adderall which ran out Monday. New scripts haven't showed up yet, so SWIM has excuse to fill older Ritalin script (20 mg IR x 3) to hold SWIM over until new Adderall scripts arrive (40 mg IR x 3). SWIM emailed doctor of his intention to fill Ritalin while waiting and requested Dr. to resend Adderall scripts or confirm exactly when they were sent and should be expected.

Main issue now is pharmacy and insurance. Will advise pharmacist that Ritalin is being filled to use until new Adderall scripts arrive. Hopefully pharmacy wont balk and that insurance will cover both--Ritalin this week and Adderall sometime next.

Thanks for help to all.
  #14  
Old 03-12-2009, 14:25
wespawloski wespawloski is offline
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Re: Filling Multiple ADD Med Scripts at Same Time

A mother of mine once informed me, from a nurse's perspective, that health professionals put the regiment of medication in high regard. It would be very unlikely for a pharmacist to put you at risk of falling out of routine.

Best of luck.

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