Psychiatric medicine for depression & anxiety

[aussienam]

Hello, 

Am a low income retiree in Pattaya seeking antidepressant med Desvenlafaxine, an SNRI.  I have been on SSRI antidepressants over a decade but suffer restless legs syndrome that stops me from sleeping days on end (treatment worse than the condition). 

I can only see Venlafaxine sold here and not cheap. And it is not what I was prescribed overseas before I returned here.

I have some boxes of Desvenlafaxine but once on them you can't just swap to other antidepressants as they all work differently.  So cannot start on them without knowing if can get more or not? And if expensive or not?

Stopping them suddenly is dangerous too as there is 'Serotonin syndrome' and other serious side effects.

 

Depression and anxiety are worsening (ironically over financial issues) and cannot afford the expensive hospital or private psychiatric fees here. Medical insurance does not cover me. Before I end up joining the flying club wanted to see if any useful information from members. 

Edited April 6, 2021 by aussienam

[faraday]

https://medtide.com/product/desvenlafaxine-pristiq-50-mg-28-tablets-box/

 

Get well soon.

[Pottinger]

If you are cash-strapped, why not go to your local public hospital and either explain to the doctor you see your quandary, or ask him or her to refer you to a local psychiatrist who can understand the problem and offer you practical steps to resolve your situation, be they with medication or through some other method. Whatever happens, It's important that you do not allow your situation to fester.

[CharlieH]

Just a suggestion.

 

You may be low in magnesium. Magnesium can help with restless legs and all the issues you have mentioned.

A good Magnesium/ vit D/ zinc supplement is inexpensive and may help.

 

[aussienam]

1 hour ago, faraday said:

https://medtide.com/product/desvenlafaxine-pristiq-50-mg-28-tablets-box/

 

Get well soon.

Thank you.  But the price of over 2,100 baht for just one box is crazy.  Australia it cost me around $25AUD. The site you referred It is around $100AUD equivalent for just 28 tablets.  

Just cannot afford that. I would end up stopping taking them after one box.  

I will keep searching for something. Appreciate your input though. 

[simon43]

I know my comment may not be welcome, but since your medication in Australia is $25 AUD, have you not considered returning to live there?

[aussienam]

48 minutes ago, Pottinger said:

If you are cash-strapped, why not go to your local public hospital and either explain to the doctor you see your quandary, or ask him or her to refer you to a local psychiatrist who can understand the problem and offer you practical steps to resolve your situation, be they with medication or through some other method. Whatever happens, It's important that you do not allow your situation to fester.

Thanks, but from the forum posts, the costs of local psychiatrists are very expensive.  Not blaming anyone as it is what it is here in Thailand. I need antidepressant meds.  Valiums here are crazy as well. Less than 2 baht each in Oz and 20 baht here.  Never realised a developing country could be so expensive in certain areas. My fault. Regards.

[aussienam]

5 minutes ago, simon43 said:

I know my comment may not be welcome, but since your medication in Australia is $25 AUD, have you not considered returning to live there?

Thanks. I have considered it. High cost of living and respite were main reasons to come to Thailand.   Rent in Australia is too much.  I know what you are saying and it makes sense. I'm just trying to find a solution as things are all coming to a head.  

[aussienam]

58 minutes ago, CharlieH said:

Just a suggestion.

 

You may be low in magnesium. Magnesium can help with restless legs and all the issues you have mentioned.

A good Magnesium/ vit D/ zinc supplement is inexpensive and may help.

 

Hi, thanks.  You are right about what you said.  However, I have been on high doses of complex magnesium as well as D, zinc, multivitamins etc for a few years. My restless legs syndrome is linked to the dopamine reduction caused by antidepressants and Serotonin.  Magnesium deficiency (also iron deficiency) are other causes of RLS. But SNRI meds seem to be far less severe.  I don't currently have RLS. 

There are meds to take for RLS (Willis Ekbom disease) such as Cogentin, but they then have a problem that they cause augmentation over time and you end up on a cycle of RLS meds, which have their own side effects too.  And $$$$

Edited April 6, 2021 by aussienam

[BenDeCosta]

Some antidepressants such as fluoxetine are very cheap in Thailand. Have you considered switching over to something else, or is this the only one that works for you? Desvenlafaxine is relatively new, therefore still expensive.

 

It is possible to switch but you have to follow a protocol of reducing the one you're on whilst starting the new one, obviously the protocol depends on the two drugs in question.

Edited April 6, 2021 by BenDeCosta

[Sheryl]

The only brand of desvenlafaxine available in Thailand is Pristiq which is very expensive, no matter where you get it, as it is imported. It is also a controlled drug here so not allowed to purchase at a pharmacy.

 

You could try at a government hospital but I am not sure they will carry it.  The main government hospital in Chionburi town will have a psychiatrist but English may be limited and diubtful they will carry desvenlafaxine.  If you can get up to Bangkok there is a government psych hospital on the Thonburi side of the river which is a more likley bet

 

https://www.somdet.go.th/public/Eng/Outpatient_services.php

 

Venlafaxine and desvenlafaxine are very similar chemically and have same action - in fact, venlafaxine is metabolized in the body to desvenlafaxine. Unless you have problems with nausea on venlafaxine it will likely works just as well for you and while still expensive is much less so than desvenlafaxine  and is easier to find. Note however that dosages are not equivalent.

https://pubmed.ncbi.nlm.nih.gov/22883424/

Locally made brand of venlafaxine is Valosine. Unlike Pristiq it can be bought at a pharmacy without prescription.

 

Have you considered returning to your home country? Aside from the immediate problem of your meds, other medical costs are likely to be an issue as you age here and it sounds like you may not be financially placed to really afford retirement here.

 

Meanwhile if things really start to get to you, keep this number handy:

 

Samaritans Hotline

English language: 02-713-6791 (you may have to leave your number for a call back from an English speaker)

Facebook:  https://www.facebook.com/Samaritans.Thailand/

 

 

[dodgybros]

5 hours ago, aussienam said:

Thank you.  But the price of over 2,100 baht for just one box is crazy.  Australia it cost me around $25AUD. The site you referred It is around $100AUD equivalent for just 28 tablets.  

I feel for you, I take a medication that was covered by PBS in Australia but not so in Thailand, costs me an extra 100AUD per month. You need to work out what is most important, good luck friend.

[rcuthbert]

I would try Fachino pharmacy on Patttaya Nua. They may have a generic equivalent.

 

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjbu5jrr_LvAhUt8HMBHQcADZoQFjACegQIBxAD&url=https%3A%2F%2Fforum.thaivisa.com%2Ftopic%2F1032216-fascino-pharmacy-north-road-contact-info%2F&usg=AOvVaw3zhjqMCQXrmh5sfj3FXgMI

[ivor bigun]

As Sheryl said Chonburi govt hospital is very good ,although i do not use them for the same problems as yourself they are first class ,i get my heart meds there ,very cheaply ,i did get ativan ,as well ,when i could not sleep ,it says that it is also for anxiety problems ,again ,only from the hospital . although many doctors there speak English very few falangs go there so i would take a Thai speaker ,sorry about your problems ,it must be a real hardship

[cyril sneer]

On 4/6/2021 at 1:19 PM, faraday said:

https://medtide.com/product/desvenlafaxine-pristiq-50-mg-28-tablets-box/

 

Get well soon.

Some good medicines on that site 

[IvorBiggun2]

I use the psychiatric hospital in Korat. The cheapest antidepressant they dispense is Sertraline (Zoloft). Cost all depends on ones dosage. Find your nearest psychiatric hospital and register there.

 

https://www.google.com/search?q=is+sertraline+available+otc+in+thailand&rlz=1C1CHBF_enTH917TH917&oq=is+sertraline+available+otc+in+thailand&aqs=chrome.0.69i59.22239j0j9&sourceid=chrome&ie=UTF-8

Edited April 11, 2021 by IvorBiggun2

[from the home of CC]

On 4/6/2021 at 2:35 PM, aussienam said:

Thanks, but from the forum posts, the costs of local psychiatrists are very expensive.  Not blaming anyone as it is what it is here in Thailand. I need antidepressant meds.  Valiums here are crazy as well. Less than 2 baht each in Oz and 20 baht here.  Never realised a developing country could be so expensive in certain areas. My fault. Regards.

valium would not help your depression and in fact could make it a lot worse, in your case, the cost is a blessing in disguise. As another has said, perhaps it's time to go home before the depression gets to the point of no return. Happy go lucky days are not in store for those in Thailand in the coming months imo. 

Edited April 11, 2021 by from the home of CC

[IvorBiggun2]

On 4/6/2021 at 2:35 PM, aussienam said:

the costs of local psychiatrists are very expensive. 

No you are wrong. To see a psychiatrist at a government hospital will cost you EXACTLY 50 Baht once you register. Free to register.

Edited April 11, 2021 by IvorBiggun2

[aussienam]

1 hour ago, IvorBiggun2 said:

No you are wrong. To see a psychiatrist at a government hospital will cost you EXACTLY 50 Baht once you register. Free to register.

Really?  Never heard that before.  Is that everywhere?  In Pattaya? And any government hospital in particular? 50 baht is cheap.  I really need proper antidepressants. Getting worse.  

[aussienam]

2 hours ago, from the home of CC said:

valium would not help your depression and in fact could make it a lot worse, in your case, the cost is a blessing in disguise. As another has said, perhaps it's time to go home before the depression gets to the point of no return. Happy go lucky days are not in store for those in Thailand in the coming months imo. 

Thanks but I do not abuse Valium and understand the addictive nature etc.  I have been on a strict medication dosage on a PRN basis via qualified psychiatrists in Australia.  It is not only for my chronic PTSD and depression as I have other comorbid issues.  

I understand valium abuse and what you are saying but I would rather go by my few specialists in Oz said for my treatment plans.  Not sure if you are a qualified medical professional or not.  

 

Easier said than done to just suggest I go home to Oz.  I have no home there. Would be on the street as rent too much. Think suicide the way to go if I have to return. Looks like the end of the road is nigh. 

Thanks anyway. 

[madmen]

2 hours ago, IvorBiggun2 said:

No you are wrong. To see a psychiatrist at a government hospital will cost you EXACTLY 50 Baht once you register. Free to register.

Not for farang. It was proposed a decade ago and then the 50 baht scheme was scrapped for farang 

 

OP if you are from a country with a strong social umbrella free Medicare and $6 capped pension meds then it may be an alternative since you most likely don't have health insurance here either 

[aussienam]

1 minute ago, madmen said:

Not for farang. It was proposed a decade ago and then the 50 baht scheme was scrapped for farang 

 

OP if you are from a country with a strong social umbrella free Medicare and $6 capped pension meds then it may be an alternative since you most likely don't have health insurance here either 

Thanks.  I am from Australia. Psychiatric services are not free, but are part subsidized under Medicare. However, psychiatrists charge way over the rebate amount meaning it still costs a fortune there.  Psychologist fees the same.  Medicines are subsidized under the Pharmaceutical Benefits Scheme there which helps a lot, albeit different rates for different meds.  

I don't qualify for a pension so lose out there as well. And would be homeless in Oz due to cost of living.  Everything is pointing towards me choosing one particular inevitable outcome.  Not blaming anyone. It is what it is. Thanks for all the input.  Maybe time to end this post as not going to solve anything. 

[ivor bigun]

At Chonburi hospital my average fee for seeing a specialist is about 490 baht ,plus as i said all my meds are cheap . there actually was a farang there who was a victim of Parkinsons ,he had no relatives here or in UK i believe ,but they were looking after him , i am sure he could not pay ,as he was out of it .

 

Edited April 11, 2021 by ivor bigun

[Sheryl]

Full cost for consultation at most government hospitals is 50 baht for everyone not covered by the free aystwm. Prior poster was confusing this with the "30 baht" scheme which is another matter.

 

This 50 baht is only the consultation fee. Med cost would be additional to  it.

 

The larger problem is very limited availability of psychiatrists at provincial govt hospitals and language/culture barriers. Also limited range of meds.

 

I strongly suggest the govt psych hospital in Bkk rhat I mentioned before. Might be more than 50 baht but likely not more than 100.

[IvorBiggun2]

2 hours ago, madmen said:

Not for farang. It was proposed a decade ago and then the 50 baht scheme was scrapped for farang 

Yes it is 50 Baht to see a doctor at a government hospital. I should bloody well know as that's where I get my antidepressants. Last visit for meds was 5th April. 

Edited April 11, 2021 by IvorBiggun2

[IvorBiggun2]

54 minutes ago, Sheryl said:

The larger problem is very limited availability of psychiatrists at provincial govt hospitals

No, there is a good availability of psychiatrist at the government psychiatric hospital in Korat. Highly recommended. Only problem that appears to be is that there are no children's psychiatrists available in Korat other than private ones. St Mary's private hospital has a good clinic.

[Bruno123]

3 hours ago, aussienam said:

Thanks.  I am from Australia. Psychiatric services are not free, but are part subsidized under Medicare. However, psychiatrists charge way over the rebate amount meaning it still costs a fortune there.  Psychologist fees the same.  Medicines are subsidized under the Pharmaceutical Benefits Scheme there which helps a lot, albeit different rates for different meds.  

I don't qualify for a pension so lose out there as well. And would be homeless in Oz due to cost of living.  Everything is pointing towards me choosing one particular inevitable outcome.  Not blaming anyone. It is what it is. Thanks for all the input.  Maybe time to end this post as not going to solve anything. 

 

Possibly way out there; so I won't be surprised if someone with experience will strongly disagree; but on growing up I have met a lot of people with anxiety, depression(manic even) and thoughts of dying. The one thing that seemed to work for them was Cannabis.

Since you can obtain it legally here, it might be worth a try for you, under supervision.

 

As I said, I could be way off base. But this is from years of experience with quite a few sufferers. Sheryl might have a comment, as an apparent professional.

 

[Bruno123]

 

Seems  to be some agreement here.

 

[Gumballl]

11 hours ago, aussienam said:

Thanks.  I am from Australia. Psychiatric services are not free, but are part subsidized under Medicare. However, psychiatrists charge way over the rebate amount meaning it still costs a fortune there.  Psychologist fees the same.  Medicines are subsidized under the Pharmaceutical Benefits Scheme there which helps a lot, albeit different rates for different meds.  

I don't qualify for a pension so lose out there as well. And would be homeless in Oz due to cost of living.  Everything is pointing towards me choosing one particular inevitable outcome.  Not blaming anyone. It is what it is. Thanks for all the input.  Maybe time to end this post as not going to solve anything. 

I'll bite.

 

What are you depressed about?

 

Are drugs your only relief?

[tonray]

45 minutes ago, Gumballl said:

I'll bite.

 

What are you depressed about?

 

Are drugs your only relief?

Depression is a disease, one which is poorly understood, especially to the causes. You don't necessarily need to be depressed about anything. It may be a chemical imbalance, or some other underlying organic cause. Learn a bit about it.