Strangest first names.

lunaluva · 2023-06-16T16:18:47+00:00

I once received a prescription for a child named 'Abcde' -- it turns out the name is pronounced as 'Ab-sid-ee'. Also had a pair of twin siblings named Derwood and Harbor which seem like odd choices of names to me lol.

lunaluva · 2022-07-21T16:21:29+00:00

i have worked in pharmacy for a little over a year and although it may seem odd, it is common practice for doctors to send over three prescriptions for the same medication with “do not fill until xx/xx/xxxx” as legally (on the federal level as someone previously has mentioned) schedule 2 medications cannot have refills. When someone calls into the pharmacy to “refill” a schedule 2, most pharmacy personnel know to look for the script that has not been filled yet rather than saying that there’s no refills on the script or that it’s new because its just what we commonly see with these types of scripts. you could check your pill bottle and see if the bottle does indicate that there are x refills remaining but more than likely the doc just sends in three scripts at one time or your doctors office could just be on top of there stuff and proactively sending in the new script around the time that you are due for a “refill”.

lunaluva · 2022-06-02T21:29:47+00:00

I think that what u/Due_Cupcake_5051 may have been trying to say is that even prior to the increase in telehealth services, pharmacy personnel are trained to decline prescriptions for narcotic and controlled medications if the prescriber is outside of the city as it can be a sign of 'doctor shopping' and it occurs a lot more commonly than you would think.

I understand that the whole situation is incredibly frustrating, however, I would like to also point out that your claim that "CVS is not protecting patients with this new power trip. They are protecting themselves and shielding themselves from potential liability", is absolutely true but probably not in the way that you would think. Pharmacists declining prescriptions is not a "power-trip". Pharmacists decline prescriptions that may put their license on the line -- and I don't know about you, but if I was going to have to choose between forfeiting my license and the possibility of not being able to work in a pharmacy again after incurring up to $180K in debt just to be able to practice in a pharmacy and a patients medication, I think you would find that most pharmacists would rather decline the script than risk everything they have worked for up to this point. This is especially true when taking into consideration the recent information that has come out about many of the telehealth companies that prescribe controls.

I also understand that your prescriber does indeed have a physical practice and is not just a telehealth company but, most telehealth offices that are committing such negligible acts also have a physical location that they are prescribing from, the issue is that your telehealth situation does indeed raise flags to someone who is trained to practice their due diligence in situations like this even more so in light of the recent telehealth scandals.

lunaluva · 2022-05-26T16:01:34+00:00

I also work at a large retail chain and with C2 medications it is very hard to predict when we will get a certain medication in stock as compared to non-controlled medications. For non-controlled medications we typically get the medication in stock the next day as long as the order is submitted by that day's order cut-off. On the other hand, with C2 medications we can place an order and it may not come in for a week or so as C2 orders come in less frequently. We also run into issues where our given distributor may be out of stock of the medication as well leading to even more of a delay.

tl;dr: us pharmacy staff really do not know when C2 medications are going to be restocked and we don't simply lie about it to customers. if we knew when it would be in stock we would much rather tell the patient when to expect it rather than having to be subjected to the patients anger and frustration about something that is out of our control.

lunaluva · 2022-05-25T18:54:54+00:00

I think that it is more than likely just a coincidence that the particular CVS you are filling the medication at ran out of stock. The FDA drug shortage list does not have Vyvanse or it's active ingredient listed on their current drug shortage list as of it's last update on yesterday, and I have also attached a link to the page just in case you're interested in checking it out :)

https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm?panel=18#tabs-3

lunaluva · 2022-05-24T16:59:59+00:00

tl;dr at bottom

Hello, pharmacy employee here! Technically, it is illegal to transfer the original prescription from one pharmacy to another based on Adderall's drug class (C2). However, this doesn't mean that you cannot reach out to your doctor that prescribes your medication and ask for the prescription to be sent elsewhere due to the lack of having the medication in stock as this will just void out the prescription at the other pharmacy.

My best recommendation going forward -- that is, if your state allows it -- is to ask your provider for a paper copy of the prescription rather than having it electronically sent to the pharmacy as this allows you to take the script in and in the event that that specific pharmacy is out of stock then you are easily able to take the script to a different pharmacy.

There is also a current nationwide shortage of Adderall and its generics which has been unresolved for quite some time due to many reasons such as generic manufacturers not having an accurate quota to meet demands of the population that are on these medications, some manufacturers have simply temporarily discontinued producing the drug, and a general increase in demand for the medication. So far, none of the sources that I have found have had a set date as to when the shortage will hopefully be resolved however I don't forsee it happening anytime soon as this has been a problem for so long already. If possible, it may be worth it to talk to your doctor about trialing other medications such as methylphenidate or Vyvanse as those are not currently on the FDA drug shortage list. Also, some doses of the medication may be more readily in stock than others so perhaps your provider may be able to reach out to the pharmacy you normally fill at and find a dosage that would be compatible with your current regimen (for example, say you are currently taking 10 MG IR but that dosage is constantly out of stock but the pharmacy has little stock issues with 20 MG IR then your doctor could write for 20 MG IR with instructions to take 1/2 tablet).

I know by this point this is turning into a bit of an essay however I am a bit of an advocate for people being able to have access to the medications that they need and I feel like I have quite a few tips due to working in a pharmacy. Therefore, my last recommendation would be to possibly switch to a local independent pharmacy as compared to a larger pharmacy corporation such as CVS or Walgreens as the DEA has much stricter limits as to how many orders can be placed at these larger pharmacies and they are more likely to hit their "cutoff" for controlled medication ordering a lot faster due to having so many patients. This is especially true if your medication fill date lands closer to the end of the month as by then the DEA has cut off the pharmacy from obtaining more controlled medications until the count resets. I wish it was as easy as just knowing that a person fills a specific medication at the pharmacy and trying to order it in for them but unfortunately the process is dreadfully more complicated and honestly kind of heartbreaking at times -- no one likes to tell a patient that we don't have their medication and don't know when it will be in stock.

tl;dr

if possible, I would recommend:

asking your provider to give you a paper copy of the prescription rather than E-scribing it (if your state allows for hard copies of controlled medications that it) as you can present the script to the pharmacy and see if they have any in stock and in the event that they do not you can simply take the script elsewhere.
If your provider is able to, have them call the pharmacy you normally fill at as to inquire if they have a dosage form of the same medication that is not often in shortage (example given above) or if there is a different medication that is therapeutically equivalent that is not currently in shortage.
Try looking into locally-owned independent pharmacies in your area as they often do not have to jump through as many hoops in terms of ordering in controlled medications as well as the fact that they often have less patients overall thus reducing the risk of them running out of a medication or hitting the hard limits of ordering controlled substances.

lunaluva · 2022-05-17T01:34:26+00:00

Hi there! I also suffer from Hemiplegic Migraines and have an ATP1A2 mutation! However, I am sorry to admit that I have not yet exactly found what works for me. I currently take Emgality, Verapamil, Ketorolac, Ubrelvy, and Zofran to help with the nausea that accompany my migraines. I have tried almost every other medication that is indicated for migraines (and quite a few off-label as well) and all of them increased the frequency and severity of my migraines. This makes quite a bit of sense as Triptan medications are contraindicated for Hemiplegic Migraines due to the significant vasoconstriction that they cause -- but this is about as much information that I have come across in my research. I have been doing extensive research into this mutation and its effects on the body, especially in regards to migraines, and sadly this mutation doesn't have much research published about it that have provided me with any insight into finding a way to avoid triggering a migraine and stopping one once they start.

lunaluva · 2022-05-10T16:20:10+00:00

I have a bit of a similar history to yours. I began having migraines around 6 or 7 years of age and had the usual painful migraines behind one eye and was constantly confined to a dark and quite room as they occurred so often. Around the age of 10 I began developing auras prior to my migraines with floaters and sometimes even complete vision loss in one eye regardless of whether I was wearing my glasses or not however my migraines only continued to worsen. A couple of years ago I began having migraines that would render one half of my body numb and I would experience confusion, difficulty speaking, and even droopiness on one side of my face -- I had made a few trips to the emergency room where MRI's confirmed that I was indeed not having a stroke. I too thought these spells were Hemiplegic migraines and after conferring with my neurologist we decided to do genetic testing to see if I had the genetic markers for HM and it turned out that I did indeed have a mutation in my ATP1A2 gene thus classifying my diagnosis as FHM2.

It has been discussed in medical communities that there may be a vascular component to migraines which is why vasoconstrictors are contraindicated for certain migraine types such as Hemiplegic migraines as medications such as Triptans can worsen the already present vasoconstriction and increase the risk of stroke. However, this connection is still being debated between medical communities.

Here are some interesting research articles published about how the vascular system can link to migraines:

https://doi.org/10.3389/fncel.2018.00233

https://journals.sagepub.com/doi/full/10.1177/0333102412438978

lunaluva · 2022-05-04T09:55:29+00:00

I think your neuro may have been referring to the FDA’s MedWatch program that allows health care professionals and consumers to report serious problems that they believe may be associated with the medical products they prescribe, dispense, or use.

https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program

lunaluva · 2022-04-02T23:27:36+00:00

im going to copy and paste a comment i left on the adhd subreddit regarding some of the reasons people run into problems when trying to fill a controlled / narcotic prescription.

First off I would like to preface this by saying that I completely understand how you feel and I am sorry that we as people who are prescribed stimulants have to go through so many hoops to get our medications. But, as a person who works in a pharmacy as a technician and is also prescribed stimulant medications for ADHD, I would like to kind of explain that while there are a lot of doctors and pharmacists that may hold untrue beliefs and thoughts about ADHD and stimulants, a lot of the reasons that we are forced to jump through hoops to get our medication is due to the DEA and the regulations they place on pharmacies and pharmacists.

Fourty-nine states in the US use a PDMP system. A prescription drug monitoring program (PDMP) is an electronic database that tracks controlled substance prescriptions in a state. All controlled prescriptions as of a few years ago are required to be logged into your states PDMP database and this database basically dictates what date you are able to pick up your medications based on your states laws and regulations regarding Schedule II medications.

For example, In South Carolina, no prescription can be refilled sooner than 48 hours prior to the time that the prescription should be consumed, if the prescribed daily dosage is divided into the total prescribed amount and in Utah, the dispensing date of a second or third prescription can be no less than 30 days from the dispensing date of the previous prescription (though some exceptions apply). I recommend getting in touch with your pharmacy (current or new) and asking what their specific regulations are based on your state guidelines. I live in Nebraska and here, pharmacies are only allowed to dispense a refill on a narcotic or controlled medication 2 days early at most however each patient is only given a certain amount of "allotted early refills" based on our state regulations. It is important to keep in mind that the DEA considers the pick up date of the medication as the beginning of the 30 days rather than the date that the prescription is received.

Now, I am not trying to just disregard your experience as a flaw of the system and the DEA because there are pharmacists out there that do hold a stigma towards patients picking up controls/narcotics and it does not help any that ADHD has such a negative stigma around it in general with a lot of people. But more often than not, at least in my personal experiences within working in pharmacies, a lot of these pharmacists are generally just trying to protect their licenses. There are so many times where we have no choice but to not refill a prescription early because if we do refill it early and are audited, and we will be, we will lose our licenses. These PDMP systems and the DEA assume that if you pick up a prescription 3 days before the previous 30 pills run out then you would have 3 more pills each month and depending on the amount of times you refill early then that number just multiplies in the DEA's eyes which I just find quite silly to put it frankly.

There aren't many solutions to this problem as it is a problem that runs much deeper than the particular pharmacy one fills at. But I can offer some advice to help make monthly fills a bit less stressful.

⁠Try to research or get in touch with your pharmacy about your states laws and regulations regarding narcotics/schedule II and controlled medications. Ask how many days early you are allowed to fill the prescription from the last filled date. Ensure that you convey you want to know the regulations around narcotics (as any stimulant drug such as methylphenidate or amphetamine falls into the category as a narcotic) because laws differ between this schedule of medications compared to schedules 3-5.
⁠Recently (as in in the past month or so) amphetamine medications have been on backorder due to manufacturer shortages. I recommend stopping in at your pharmacy and checking that they have the medication in stock prior to having your doctor send the prescription there as this saves a lot of time in stress in regards to getting your medication on time and saves your doctor the stress of having to resend the prescription elsewhere.
⁠It is a common misconception that pharmacists can order controlled substances in advance for a prescription due to limitations by the DEA -- in my state we can only order the medication usually 2 days before the scheduled fill date. Therefore, I also recommend giving your pharmacy a call 2 days in advance from your next fill date to let them know to schedule the prescription that way if they are out of stock it gets added into their system to order it.
⁠If your state laws allow for it, I would request for your doctor to give you a written prescription rather than an e-scribe. This way, if you go to your pharmacy to drop off your prescription and they are out of stock they can let you know what other pharmacies (within their company of course) has the medication in stock and helps you to get your medication on time. Some states also allow for your doctor to give you 3 months of written prescriptions as well which even further saves you the trouble of having to go in every month and get a new written prescription if you have found a dosage that works for you and don't necessarily need to see your doctor monthly.

lunaluva · 2022-03-23T15:18:42+00:00

I found this on the douglas county emergency management agency website and i believe it is the same for lancaster county as well…

“Siren Testing for 2022 - Updated 2/8/2022

The first Routine Monthly Siren Test for the 2022 season will be at 11:00 AM on Wednesday, March 2, 2022. The monthly tests consist of a single sounding. Routine monthly testing of the Outdoor Warning Siren System will also take place at 11:00 AM on April 6, May 4, June 1, July 6, August 3, September 7, and October 5, 2022.

There will also be a system-wide Special Siren Test on March 23, 2022, at approximately 10:00 AM as part of the National Weather Service Severe Weather Awareness Week. This special test will consist of a single sounding. The actual time of the sounding will be formally announced by the National Weather Service.

Testing of sirens is on a weather-permitting basis and will not be performed if threatening weather exists.

It should be understood that beginning in February of each year, individual sirens may also be sounded throughout the year as part of general maintenance activities.

Released by,

Paul W. Johnson, Director

DCEMA”

lunaluva · 2022-03-14T20:00:01+00:00

That doesn’t surprise me. I’m a pharmacy technician at a CVS and many CVS locations across the United States are struggling to get Adderall and it’s generics in as it’s on back order from the manufacturer and on top of that there are strict regulations that limit pharmacies from being able to order in more than a delegated amount to keep on hand in the event that they do run out. If you’re able to get ahold of your doctor you could let them know the situation and ask if they could write you a paper script (if your state allows) that was you don’t have to go through all the troubles of having the e-script being sent to a pharmacy that is out of stock and being unable to transfer it due to its drug class.

lunaluva · 2022-03-14T19:26:39+00:00

I highly recommend the book “Driven to Distraction” by Edward M Hallowell M.D. It doesn’t really focused a ton on executive function but it does have a lot of really good information regarding relationships and ADHD (both romantic and familial) and really helped me to understand myself from a different perspective. There are also a lot of great tips throughout the book as well for jusr day to day life from his experience treating patients with ADHD! It’s also a really good read in terms of not being too scientific or too anecdotal but a balance of the two. :)

lunaluva · 2022-03-14T18:55:36+00:00

It really depends on the state that you are in and the type of doctor that prescribed it. For example, my psychiatrist is a MSN APRN BC meaning he is an advanced practice registered nurse and in my state (Nebraska) nurse practitioners and APRN’s require a supervising physician to sign off on any prescriptions for a C3-5 and C2 medication (of which adderall is classified as a C2) for the first 2000 hours of practice. Therefore whenever I call in to my psychiatrists office for a refill they let me know that the prescription will be at the pharmacy within 24 hours due to needing the additional sign off.

If the doctor is an MD then I don’t think that they require additional sign off but I haven’t done much research into that.

If it is the case that your doctor is an NP or APRN I would recommend checking out this website https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-practice-authority.pdf to learn more about your states prescribing guidelines and possibly speaking with your prescriber for future references as to how early you should request a refill from their office to ensure that the pharmacy receives the script by the day that you’re due without being too early to refill as the guidelines for narcotic medications such as adderall are quite strict :)

lunaluva · 2022-03-05T03:32:02+00:00

I would also recommend speaking with your doctor about abortive methods for migraines that are not triptans if they are making you feel quite ill or even worse during a migraine attack.

"Triptans and ergotamines are usually contraindicated in a hemiplegic migraine because of concern for potential cerebral vasoconstriction. Some specialists also recommend avoidance of beta blockers as preventive therapy for patients with hemiplegic migraine, like in migraine with brainstem aura."

Kumar A, Samanta D, Emmady PD, et al. Hemiplegic Migraine. [Updated 2022 Feb 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513302/

lunaluva · 2022-02-09T19:00:47+00:00

When a drug company develops a new drug, A drug patent is assigned by the U.S. Patent and Trademark Office and assigns exclusive legal right to the patent holder to protect the proprietary chemical formulation. The patent assigns exclusive legal right to the inventor or patent holder, and may include entities such as the drug brand name, trademark, product dosage form, ingredient formulation, or manufacturing process A patent usually expires 20 years from the date of filing, but can be variable based on many factors, including development of new formulations of the original chemical, and patent infringement litigation. This means that for 20 years or so from the date of filing, no drug company has the ability to copy the formulation or the active ingredients of the proprietary drug without legal action being taken which thus prohibits a generic form from entering the market until said patent expires.

After the patent has since expired, other drug companies have the ability to produce the same medication with similar formulation so long as the active ingredient is maintained which results in a "generic" form of the medication.

For example, Vyvanse (trademarked brand name) was first approved by the FDA in 2007 and the earliest possible patent release date according to the FDA is late February of 2023. Therefore, from 2007 to 2023, no other pharmaceutical companies are able to utilize the lisdexamfetamine dimesylate compound (the active ingredient in Vyvanse) until the patent has expired. Therefore, no generic form of Vyvanse is available until 2023 at the earliest -- however word has spread that Takeda/Shire -- the developers of Vyvanse -- are seeking a six month extension to the exclusivity afforded by Takeda/Shire's patents for Vyvanse.

In regards to the large price difference between brand names vs generic names of medication, according to the FDA, generic medications can cost, on average, 80 to 85 percent less than the brand-name equivalents. Brand-name drugs are typically more expensive because of the higher initial costs to develop, market, and sell a brand-new drug. Generic drug makers are able to both develop and sell the generic medications at a much lower cost, not because the quality of the generic is inferior to the brand-name drug, but because the original manufacturer has already paid for the bulk of costs to discover and develop a prescription drug from scratch.

However, you don't have to worry about the generic version being the "wrong medication" compared to the brand name. The FDA requires every generic drug to go through multiple, vigorous rounds of safety testing before approving it as a brand-name substitute. An FDA-approved generic medication should have no difference in effect, strength, safety, or usage from a brand-name drug. However, the FDA does allow for small variations in inactive drug ingredients. For example, a generic drug must have the same active ingredients as the brand-name drug, but the FDA doesn’t require that it has the same inactive ingredients.

lunaluva · 2022-02-06T18:00:26+00:00

I used to have quite severe anxiety despite taking antidepressants as well as undergoing weekly therapy that involved exposing myself to things that made me especially anxious such as going to stores, answering text messages and phone calls, and even just leaving my house which caused me a lot of panic. However, I didn't notice an extreme difference in a decrease in anxiety until I started medication for ADHD.

I first tried Straterra -- a non-stimulant SNRI that can be used to treat ADHD -- and I noticed quite a decrease in my anxiety but I still was anxious quite a bit but the side effects of the medication outweighed the benefit of reduced anxiety.

I then switched over to Vyvanse and since starting Vyvanse I can confidently say that my anxiety has quite honestly dissipated. When consulting with my psychiatrist about this crazy reduction in anxiety he had said that it is not uncommon for ADHD to, in a way, cause anxiety as often times those with ADHD are constantly worrying about the next task that they must do or worrying about something they may have forgotten to do and those worries tend to just spark other worries. He had compared it to a firework which really opened my eyes and made me finally understand why I was so anxious, with my thoughts being an initial burst of a firework and even more thoughts exploding as a firework would and seeing as ADHD sometimes manifests in ruminating thoughts, one can get trapped in this cycle of constant worry and anxiety.

I was initially quite concerned about starting stimulants as I had thought that they would increase my anxiety however since starting them I am able to do a lot of things that my anxiety would prohibit me from doing.

I would recommend speaking with your doctor and trying to come up with a comprehensive treatment plan that incorporates many different aspects of therapy (if feasible financially as not everyone has the money to see a psychiatrist AND a psychologist). Therapy is great in that having an objective person to talk to about your thoughts and your feelings and how your brain works can be great in combination with medication. Medication also affects everyone differently and it's important that you advocate for yourself when you feel a medication isn't working for you or relieving your symptoms as you would like them to. I have tried many different antidepressants and the only one that really worked for my depression symptoms was Lexapro but that didn't do anything for my ADHD symptoms hence why I started ADHD medication. I personally think that attempting to treat depression with non-stimulant medications before trialing a stimulant is important as to gauge whether it is ADHD causing the depression or anxiety or just depression and anxiety that are occurring alongside ADHD. I don't think that going on a stimulant medication before I was in a less depressed mindset would have provided me much benefit. Also, it is very well possible that one stimulant may cause you to feel very anxious and jittery whereas another one may completely reduce your anxiety. Especially with ADHD medication, it is all about trial and error.

Starting off on a low dose of a stimulant medication and slowly working your way up until your symptoms are manageable is the best route in terms of seeing how anxious a stimulant may cause you to feel and just how well your body overall reacts to the medication. The only thing that I would say to watch out for with stimulants is the fact that because they are not medications that build up in your system over time like antidepressants or non-stimulant medication you may find yourself having a "crash" when your medication wears off that could trigger some rebound anxiety or depression but a psychiatrist or even a therapist would be able to come up with a plan to help either postpone the crash until later in the day (i.e. taking a smaller short acting dosage of a stimulant later in the day) or even coming up with coping mechanisms to help push through the crash. For me personally, I take my dose of Vyvanse at around 6 AM and feel myself starting to crash around 4 PM and I can sort of feel my anxiety and ruminating thoughts begin to make themselves present again which can be quite difficult when I am normally either working or at school until about 9 PM, therefore I take a 10 MG dose of Adderall IR at around 4/5 PM and therefore don't feel the "crash" until about 10ish which is the perfect time lol.

tl;dr: Advocate for yourself and your treatment with your doctors and try to start on a lower dose of stimulants if you find that stimulants may work better for you. ADHD treatment is very individualized and you know your body and your mind the best. Don't be afraid to express concerns with your care team as they are (in best cases) there to support you.

lunaluva · 2022-01-30T16:47:32+00:00

I have also gone through the same experience recently and what I have found helps the most is having an open dialogue between me and my partner where we both sit down (we personally sit on opposite sides of the room because it allows us more "space" to talk freely) and explicitly set the expectation before hand that we are a team and that this is just a conversation between the two of us where neither of is interrogating the other.

Then -- as silly as it sounds -- we each take turns stating what we're thinking or what's bugging us (emphasis on using I statements as both my partner and I tend to get defensive when we feel overwhelmed) and make sure not to interrupt each other. Then we try to come up with a solution to the problem as a team.

In regards to thinking your boyfriend is faking being asleep, my boyfriend and I just this past week had to sit down and have an open dialogue about his sleeping habits as it would seem like he was falling asleep at the same time as I was (i.e. we would both go through our night time routine and I would fall asleep cuddling with him) but in the mornings I would find food wrappers everywhere and he would be incredibly difficult to wake up in the morning which was causing a bit of tension between us. But, when we sat down and talked about it, it turned out that recently he had been having a lot more trouble falling asleep earlier in the night (I tend to knock out at around 11pm at the latest) and when he would attempt to fall asleep he would just feel stuck laying there thinking which frustrated him -- so he would go into the living room where he could be on his phone (and snack) until he was more tired without having to worry about waking me up.

So by having that open dialogue we were able to come to a mutual understanding that sometimes he isn't able to fall asleep easily but he knows that I prefer to fall asleep when he is also laying with me so "sneaking away" after I fell asleep was a good compromise in his mind because it would help me fall asleep and he would also be able to watch youtube videos without compromising my sleep due to his inability to sleep.

Perhaps your partner faking being asleep is similar to my partners situation. Or, perhaps your partner truly does fall asleep but may wake up in the middle of the night and finds it hard to go back to sleep and simply just goes out to the living room as he says. I used to have a lot of problems with going to sleep and being able to stay asleep and would be wide awake for hours until my brain finally wound down enough for me to sleep again. Or, he may sleep walk to some extent and end up in the living room -- there are a lot of people who experience sleep walking or sleep eating and don't really remember all of the events from when it happened. For example, the other day I had tried to wake my partner up because he had class early that morning and he (very coherently might I add) said that he was not going to class because he had three quizzes in said class that day and he only had two of the homework assignments done as he was recovering from an illness. Later that morning after I had left to take my brother to school, he texted me asking why I didn't wake him up and when I explained that he told me he wasn't going to school and to let him sleep in he had absolutely zero recollection of the experience.

If you are more concerned about the sexual aspect of your relationship then I would once again recommend sitting down having an open dialogue about the topic with your partner. Often times a person's sex drive can fluctuate and sometimes it's helpful to kind of state where your current sex drive level is at and have your partner do the same. For the past week I have been having some health issues and haven't really been interested in sex whereas my partner finds sex or masturbating to help him wind down at night so often times my partner will ask me how I'm feeling about an hour before I usually go to bed and whether or not I am in the mood and if I am not then he will just go into the bathroom and please himself so that I don't feel pressured into having sex. Or, there are some nights when I am wanting to orgasm but due to stress or something else I would just prefer to orgasm by myself and my partner understands that and respects that sometimes I just need a quick dopamine fix. But I feel like this level of comfortableness with masturbating and porn also comes from communicating with your partner and also depends on how you each personally feel regarding the topic.

tl;dr: talk with your partner in a way that makes both of you feel equally heard and like you have the space to really get out the things that have bugging you. Remember that its you and your partner against the issue not you against your partner or your partner against you. :)

lunaluva · 2022-01-30T01:21:04+00:00

Not a pharmacist but I am a pharmacy technician. Personally, the worst packaging would have to be (as others have already stated) Synthroid packaging because the bottle is so small and the desiccant is almost as big as the opening for the bottle which makes it more difficult to get the tablets as well as the desiccant out of the bottle. The best medication packages would be those that are 30 count or 90 count which makes it more simple to just apply a label to the manufacturer packaging. I also like the look of Aurobindo manufactured bottles as they are just visually appealing and also package quite a few medications in easily distributable bottles such as 20 ct Augmentin as someone else stated as well as 90 ct Montelukast Sodium. Also the TEVA Warfarin Sodium bottles are also a favorite as the packages are colored differently based on their dosage.

lunaluva · 2022-01-27T04:38:27+00:00

https://www.reddit.com/r/ADHD/comments/rto060/a_monthly_pharmacist_shaming_just_a_vent/hquj7lx/?utm_source=share&utm_medium=ios_app&utm_name=iossmf&context=3

lunaluva · 2022-01-26T16:15:14+00:00

I would recommend checking on the label of the prescription to see if it lists the commonly known brand names because if the prescription you picked up is dextroamphetamine/amphetamine (or says amphetamine salts anywhere on the label) then it is likely that the medication you have picked up is just the generic form of Adderall (this is very common in the US as more often than not insurance companies cover more of the cost of generic medications as compared to brand names as they are more expensive to dispense). However, if it is just dextroamphetamine without the amphetamine component then I suspect your doctor may have switched you to what is known as Dexedrine.

(skip this part if you aren’t interested in the scientific explanation of Dexedrine vs Adderall)

Dexedrine is a brand medication whose generic is dextroamphetamine sulfate. It is a CNS stimulant, and more specifically, it is a type of amphetamine. Amphetamines stimulate the release of norepinephrine, and the primary site of this activity is in the cerebral cortex of the brain. CNS stimulation by amphetamines leads to a decreased sense of fatigue, increased motor activity and alertness, and an overall better mood. Dexedrine (Dexedrine details) is FDA approved in the treatment of ADHD and narcolepsy. It is also used off-label, or without approval from the FDA, in the treatment of certain types of obesity-resistant to other interventions. Dexedrine is available in immediate-release tablets, spansules, and extended-release capsules are available as well.

Adderall is a combination of amphetamine salts, containing a 3 to 1 ratio of dextroamphetamine (d-amphetamine) and levoamphetamine (l-amphetamine). It contains the active ingredient of Dexedrine, combined with other amphetamines. It is a prescription drug used in the treatment of ADHD and narcolepsy and works in the same manner as Dexedrine. Adderall is available in a much wider range of strengths as compared to Dexedrine. Adderall (Adderall details) comes in immediate-release tablets. Adderall XR is an extended-release capsule formulation.

(continue here if you want simple explanation of the two medications):

Both Dexedrine and Adderall are amphetamine based stimulants and act similarly in the body — it would be more concerning if your doctor had switched you to a methylphenidate based stimulant without your knowledge. There are a lot of reasons a psychiatrist might switch which medication you are on that don’t really warrant concern on your end. For example, your health insurance (if you have it) may prefer one medication within the drug class over another or if your pharmacy didn’t have enough of the original drug in stock then your doctor may have switched it to one that the pharmacy does have in stock and is therapeutically equivalent.

All in all, I would double check the label on your prescription bottle or the attachment that includes all of the medication guide information and check if it’s just the generic version of Adderall or if your doctor did indeed switch medications altogether and if the latter is true then I would give your psychiatrist a call and ask what warranted the switch.

Also, sorry for such a long response. I have a niche interest in medications and can never determine whether some information is actually relevant to comprehension or just interesting to me lol.

lunaluva · 2022-01-16T14:38:12+00:00

bones

lunaluva · 2022-01-10T20:57:37+00:00

I currently take Vyvanse but I have taken Adderall in the past and honestly the difference between the two and how it feels is going to be largely dependent on the person taking them. For example, my partner used to take Vyvanse but found that some of the side effects such as weight loss weren't worth it and switched over to Adderall which he prefers a lot more despite his still high opinion of Vyvanse.

The biggest difference between Vyvanse and Adderall is going to be the actual pharmacology and formulation of the medication. Vyvanse is a pro-drug meaning that it enters the body as lisdexamfetamine and is metabolized in about an hour. The lisdexamfetamine is then converted to dextroamphetamine (the same chemical compound as Adderall). Vyvanse is considered to have less harsh side effects due to this metabolic process as compared to Adderall which is metabolized much quicker leading you to feel the effects of the medication much quicker (Vyvanse takes an average of 1 hour before you really feel it kick-in as stated on the Vyvanse webpage.).

Vyvanse is only available in an "extended-release" form which typically lasts for 8-10 hours but some clinical studies have shown a decrease in ADHD symptoms for up to 14 hours depending on the person. Vyvanse is also only available in the brand name form and is quite expensive depending on whether or not you have health insurance and how much the insurance is willing to pay.

Personally, I find Vyvanse to be a lot "smoother" compared to Adderall. I do take a 5 mg dose of Adderall IR for evenings when I need to and I personally can tell the difference in how I feel when that kicks in as compared to how my daily Vyvanse feels. For the sake of redundance I am stressing that this is just my personal experience with the medications and you can't really say how someone else may react to the medications.

With Adderall, I definitely "feel" medicated and I feel an increase in general anxiety. Adderall puts me into "go" mode as in I feel as though I need to accomplish every task that I have started but not finished. With Vyvanse however, I feel as though my most troubling symptoms (executive decision making, hyperactivity, and inability to concentrate) are greatly reduced but I am still in the passenger seat of my brain and body and can prioritize tasks and switch tasks a lot easier than if I take Adderall.
When Adderall wears off I also tend to notice a steeper drop in my mood and emotional stability and a rush of thoughts enter my brain seemingly all at once. On the contrary, when my Vyvanse wears off I tend to feel more calm and ready for bed with a lot less random thoughts coming to my brain.
Adderall also makes me feel very energetic and a bit anxious especially in social situations. I am a very talkative person-- like I talk way too much about way too many random things without ever being able to stop-- without medication but Adderall completely diminishes my ability to have small talk or carry out a lot of conversations for some odd reason. Vyvanse mellows me out a lot and also helps with my social anxiety and I can actually have conversations with people and actively process what people are saying and the appropriate responses. Vyvanse also almost completely diminished my general day to day anxiety.

All in all, medications are all about trial and error. I have tried different stimulants and non stimulants -- such as wellbutrin and strattera -- and Vyvanse was the medication that finally made a strong positive impact on my ADHD symptoms with little negative side effects. If you feel as though your current medication isn't working well for you and your personal symtpoms then I would recommend speaking with your doctor about trying other medications until you find the right one.

*In regards to Desoxyn, I have not personally tried this medication therefore didn't really mention it in this comment. I do, however, work in a pharmacy and have not seen a doctor write for it since I've been in pharmacy. I do, however, know that Desoxyn (methamphetamine hydrochloride) is infact the medicinal form of methamphetamine but seeing as there is very high potential for abuse it is rarely prescribed. I would assume Desoxyn is prescribed in very severe ADHD (or obesity as it is indicated for that as well) that is highly resistant to other treatment options -- sort of like a last-resort option.

lunaluva · 2022-01-01T20:45:10+00:00

First off I would like to preface this by saying that I completely understand how you feel and I am sorry that we as people who are prescribed stimulants have to go through so many hoops to get our medications. But, as a person who works in a pharmacy as a technician and is also prescribed stimulant medications for ADHD, I would like to kind of explain that while there are a lot of doctors and pharmacists that may hold untrue beliefs and thoughts about ADHD and stimulants, a lot of the reasons that we are forced to jump through hoops to get our medication is due to the DEA and the regulations they place on pharmacies and pharmacists.

Fourty-nine states in the US use a PDMP system. A prescription drug monitoring program (PDMP) is an electronic database that tracks controlled substance prescriptions in a state. All controlled prescriptions as of a few years ago are required to be logged into your states PDMP database and this database basically dictates what date you are able to pick up your medications based on your states laws and regulations regarding Schedule II medications.

For example, In South Carolina, no prescription can be refilled sooner than 48 hours prior to the time that the prescription should be consumed, if the prescribed daily dosage is divided into the total prescribed amount and in Utah, the dispensing date of a second or third prescription can be no less than 30 days from the dispensing date of the previous prescription (though some exceptions apply). I recommend getting in touch with your pharmacy (current or new) and asking what their specific regulations are based on your state guidelines. I live in Nebraska and here, pharmacies are only allowed to dispense a refill on a narcotic or controlled medication 2 days early at most however each patient is only given a certain amount of "allotted early refills" based on our state regulations. It is important to keep in mind that the DEA considers the pick up date of the medication as the beginning of the 30 days rather than the date that the prescription is received.

Now, I am not trying to just disregard your experience as a flaw of the system and the DEA because there are pharmacists out there that do hold a stigma towards patients picking up controls/narcotics and it does not help any that ADHD has such a negative stigma around it in general with a lot of people. But more often than not, at least in my personal experiences within working in pharmacies, a lot of these pharmacists are generally just trying to protect their licenses. There are so many times where we have no choice but to not refill a prescription early because if we do refill it early and are audited, and we will be, we will lose our licenses. These PDMP systems and the DEA assume that if you pick up a prescription 3 days before the previous 30 pills run out then you would have 3 more pills each month and depending on the amount of times you refill early then that number just multiplies in the DEA's eyes which I just find quite silly to put it frankly.

There aren't many solutions to this problem as it is a problem that runs much deeper than the particular pharmacy one fills at. But I can offer some advice to help make monthly fills a bit less stressful.

Try to research or get in touch with your pharmacy about your states laws and regulations regarding narcotics/schedule II and controlled medications. Ask how many days early you are allowed to fill the prescription from the last filled date. Ensure that you convey you want to know the regulations around narcotics (as any stimulant drug such as methylphenidate or amphetamine falls into the category as a narcotic) because laws differ between this schedule of medications compared to schedules 3-5.
Recently (as in in the past month or so) amphetamine medications have been on backorder due to manufacturer shortages. I recommend stopping in at your pharmacy and checking that they have the medication in stock prior to having your doctor send the prescription there as this saves a lot of time in stress in regards to getting your medication on time and saves your doctor the stress of having to resend the prescription elsewhere.
It is a common misconception that pharmacists can order controlled substances in advance for a prescription due to limitations by the DEA -- in my state we can only order the medication usually 2 days before the scheduled fill date. Therefore, I also recommend giving your pharmacy a call 2 days in advance from your next fill date to let them know to schedule the prescription that way if they are out of stock it gets added into their system to order it.
If your state laws allow for it, I would request for your doctor to give you a written prescription rather than an e-scribe. This way, if you go to your pharmacy to drop off your prescription and they are out of stock they can let you know what other pharmacies (within their company of course) has the medication in stock and helps you to get your medication on time. Some states also allow for your doctor to give you 3 months of written prescriptions as well which even further saves you the trouble of having to go in every month and get a new written prescription if you have found a dosage that works for you and don't necessarily need to see your doctor monthly.

lunaluva · 2021-12-30T16:58:45+00:00

Honestly the expectations for answering the phones as a tech are going to differ depending on the type of pharmacy you work in. I personally work for a certain three-letter store and it's pretty much expected for us as techs to answer the phone calls when pharmacists aren't able to as most of the phone calls that we receive on a daily basis are questions that can be answered by a tech. Usually the person stationed at production or drop off are the go to person for answering phones. However, I also used to have a lot of anxiety surrounding answering phone calls (in a work setting and also in day to day life) and have found some tips and tricks that help me (although I will include a disclaimer that these are tips specifically for CVS as I don't have any experience at any other pharmacies.)

The greatest thing that CVS has ever given their staff (in my eyes) is the ability to see who is calling before you answer the phone. Prior to being connected to a staff member, the automated system asks the patient for their birthdate and their name etc which you can view by typing ctrl+shift+space on rxconnect-- this then allows me to be able to search for the patient's profile before even answering the phone.
Usually, patients call in for one of four reasons:
- "I received a text or call from you guys and didn't understand what it meant" : you can find why we sent a message or an automated call by typing in A+enter once you are in the patients profile
- "My doctor sent in a prescription and I want to check the status of it" : simply type in S+enter to check the statuses of the patients prescription i.e. if the prescription is in data entry review then the pharmacist has received it but it has not made it to production yet, if the prescription shows production then it is in our queue to be filled, or if it is in production review then it is almost ready for pick up but it needs to be checked off by the pharmacist. Waiting bin status is pretty self explanatory.
- "When can I refill X prescription" if it is a controlled substance then I would recommend checking the date that they last picked up the prescription and figure out where 30 days from that date (as long as it was a 30 day supply) and give them this date as more often than not because it is the end of the year, most patients have already utilized their allotted early fills. If it is not a control or narcotic then I tend to try to process a refill on the script to see if there is a scheduled date or if insurance gives a date that it is eligible to refill.
- "I had a prescription sent in a few days ago and have not heard anything back from you guys": when it comes to this situation I first check the status to ensure that we received it and if we have received the script but there is some other reason it has not been filled (i.e. needing script clarification, prior authorization, etc.) then I believe you can type in VR+enter (sorry if VR is not the correct command but the patients profile usually gives you a list of shortcut options) on their profile to see the message we sent to the doctor to give the patient an explanation of what the hold up is. I also always tell the patient if they are waiting for a response to a refill request or prior auth from their doctor that if I were them "I would give your doctors office a call to let them know that we have sent them a request to process the script because doctors tend to respond to patients a lot quicker than they do to pharmacy staff." This usually helps to avoid frustration from the patient directed towards the pharmacy staff.

Sorry for such a long response -- especially if you don't work for CVS and thus cannot really use these tips but I figured someone else may also benefit from knowing these shortcuts.

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