Concerta costs too much/generic alternatives?

[philoscybin]

My dear friend SWiM wrote me the following email & I thought I'd ask for advice here...

I've been suffering from severe depression & anxiety/PTSD for practically my whole life. And with exception to MAOIs, I've been on virtually almost every anti-depressant medication with no (long term) success. Anyways, I was recently "re-diagnosed" with ADD by my psychiatrist, and he believes that alot of my symptoms of depression/anxiety stem from unresolved issues from ADD. So his objective now is to treat the ADD.

At first he tapered me off of the current ADs I was taking (Cymbalta & nortriptyline) and prescribed Strattera (crap)- 40 mgs the 1st week, to 60 mgs the 2nd week. Unfortunately taking the Strattera without the ADs caused extreme irritability & aggression. So he's now having me take a combo of Cymbalta- 30 mgs & Strattera- 40 mgs along with a few other meds I've taken for some time and are pretty irrelevant (Suboxone- 16 mgs, clonazepam- 4 mgs & Ambien CR- 12.5 mgs). My psych now plans on adding a stimulant to the mix, most likely Concerta. As opposed to an IR stimulant where the crash is really depressing and anxiety provoking, I have a good feeling about taking Concerta (I've been on it before at 54 mgs), since the comedown isn't as harsh. My only problem is the fact there's no generic version, and on top of all the other brand-named/non-generic meds I'm on, I'll be paying alot of $$$. I wouldn't mind trying some other CR stimulant, like generic Dexedrine XR, but I doubt my psych would prescribe any sort of amphetamine, since his specialty is in addiction medicine, and I originally started seeing him to undergo Suboxone maintanence.

So I'm not sure whether to ask him about cheaper alternatives including generic Dexedrine XR or even generic Adderall. I obviously can't tell him I've experimented with pharmaceutical amphetamines in the past and know they work much better than SNRI and methylphenidate meds. I wonder if I could stop taking Strattera and just continue with Cymbalta- since it works on both serotonin and norep.- while starting Concerta.

[Micklemouse]

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[rxbandit]

First off there are a few drugs similiar to concerta that should be cheaper. concerta is closely related to methylphenidate or ritalin, so generic methylphenidate would likely be a cheaper option. also focalin is quite similiar chemically to concerta as well with less of the negative side effects that concerta has. dexedrine really isnt prescribed to often for ADD unless its very severe however generic adderal or amph salts are a very cheap generic.

It seems that alot of the obscurity of your problems may be caused by overdiagnosis and over medication. Instead of seeking for a chemical panacea for your legitimate problems you might want to try and resolve various issues in your life. Many pyschiatrist over perscribe medication which can in turn make a condition much worse and convince a patient they are dependant on chemical assistance, this however is not true.

I would invest in some good old therapy, try to eat and sleep right and begin working out while tappering off of some of your medications, or just do these in conjunction with medication. they should help resolve many of your symptoms despite the fact they seem unrelated.