Antidepressants in Thailand

[Ralph4878]

Hello!

I am moving to Bangkok in July to take a new job, about which I am very excited!

In thinking about my move, I've done a lot of research about medical care in the Kingdom. I am fortunate that I will have private health and dental insurance paid for by my employer but, as an American who has always had health insurance with a prescription plan through his employer, I am not sure if I will also have a prescription plan, or if these even exist in Thailand. In my research, I did read that certain antidepressants are not available in Thailand, though many of these threads/posts were over 5 years old. Just wondering if this is still true today. Currently, I take Celexa (have for over 7 years) - anyone know if it is available in Thailand?

[Sheryl]

No, Celexa is not available.  Most other SSRIs are, however. I suggest you talk with your doctor and see if you can change to a slightly older SSRI (such as sertraline, which is readily available here including a an inexpensive local generic) and, if so, make that change before coming over here so as to be sure it is working well.

 

You need to find out the details of the private insurance you will have, most importantly its cap (maximum) as it is quite common in Thailand for employers to offer private insurance that is a locally issued policy with caps so low as to be of little value.

 

Unless you will be employed by a private school, by law your Employer should enroll you in the Thai Social Security System which provides full insurance (in and outpatient) but limited to one hospital where you are registered.  Even if they also chose to provide private insurance, they still have to enroll employees under SS (there is a small payroll deduction for that). However private schools are exempted from this.

 

Normally insurance may be inpatient only, or both outpatient and inpatient cover. If outpatient cover then outpatient medications will be covered but only if obtained at a hospital (most outpatient care in Thailand is obtained through hospitals which all have large OPDs). In practice, even people with such v=coverage will often opt to just pay out of pocket for the convenience of purchasing their medications at a pharmacy. Most of the drugs that require a prescription in the US are sold over the counter here (including SSRIs). Costs  are less than i nthe US -- much, much less if there is a locally made brand.

[Ralph4878]

Thank you, Sheryl, for your thoughtful and helpful reply! 

I will be working at a private school and the medical insurance looks very generous, in terms of limits, which was something I noted carefully. 

I am not surprised to hear that celexa isn't available - that's what every older post suggested. I pay about $2.10 (US) for a 90-day supply of the generic stuff here in the States, so I suspect I'm spoiled on this front...however, my salary is going to be massive by Thai standards, so it is a small price to pay to have to dish out a bit more for my meds. Fortunately, the only other medications I take daily are for allergies (Zyrtec). 

Thank you, again, for the information and advice! 

[Sheryl]

As a point of reference, you need a per incident cap of at least 3 million baht, preferrably 5 million, if you want the option of using private hospitals.  (For your health insurance).

 

I mention this because cost of living in Thailand has risen considerably in recent years and cost of private medical care even more so.  While your salary may be higher than the average Thai teacher it is unlikely to qualify as "massive". ..especially if you will be living in the Bangkok area. 

 

There are several locally made generic equivalents to zyrtec (Cetirizine) and also as mentioned before, locally made brands of sertraline (generic of Zoloft) so provided you do well on the latter,  routine med costs will be minimal.  It's hospitalization in case of an unexpected major illness or accident that you need to be concerned about.

 

There was a case on this board maybe a year or two back of a foreign teacher at a private school with private insurance who was hit by a car while walking home and suffered serious head injuries. His insurance cap was exhausted in less than a week with millions of baht in care still needed. Hence the warning to make sure your insurance is adequate.

 

 

[Ralph4878]

Very good to know.

Lots one can replace...one's health and life, not so much!

Thanks, again, for your time and care, Sheryl!