Dextroamphetamine And Medicare (Page 2) (Top voted first)

My mother was told that her doctor could no longer prescribe the dextroamphetamine that she has been taking, at minimum dose, for oer 50 years. She takes it for ADHD and narcolepsy. Her doctor tells her that it is no longer legal to "provide" it for her because congress has made it illegal to "provide" to any medicaid patient for any reason. Can someone help me follow this up? If the story she is telling me is true, I need to write my congressman to protest. Since when does the Federal government have the right to interfere in our private health care needs - she is not asking them to pay for the medication, she has simply LOST THE RIGHT TO HAVE IT PRESCRIBED TO HER. Is there anyone else out there that thinks this is WRONG?!

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Carl, from Arizona, ref post #4 dated 21 january 2012:

I am so sorry for not directly responding to all of your questions on your excellent post. I doubt you may even read this, but here goes, as, I feel a strong desire yet to respond, as, my home was Tempe, Arizona (Maricopa County) 1984 until 1992, career related.

Q1. I have been on many stimulants since January of 1969, and am now in my 60's. I have tried many, and, I still take 2 x 10 mg of dextroamphetamine sulfate I/R by Mallie. It is on my NC Blue Cross Blue Shield Medigap prescription optional insurance as well as I think perhaps on Medicare, I pay Rite Aid US 6.00 for sixty tabs x 60 of the Orange Book B grade tabs, not the best, but sure miss the old days intensely!!!

Dexedrine Sulfate by SKF E-19 orange hearts, 5 mg. yes, has the waxy matrix from at least 1995 until my last prescription for them in Dec of 2008 for 300 x 5 mg brand name. I also had my Psychiatrist, write me, Dexedrine Spansule (GSK) embossed on brown cap 3514, and clear cap SB or Smith Beecham, in 15 mg x 60 that had 10 fillers and binders, but, to my knowledge, these ER extended release tapered end patented Spansules had no waxy filler. Mfg from 1952 until last quarter of 2010.

Q2 Carl, I have a pronounced case of ADHD combined type, and have tried many stimulants, for me the golden days were 1969 until 1973. My choices (then) Dexedrine Spansules mfg SKF Phil PA embossed E-34 for 15 mg. Dexedrine 5 mg mfg SKF I/R embossed "E-19" Biphetamine mfg Strasenburgh, "Black Beauties" embossed "RJS" 20 mg Biphetamine T-20 by Strasenburgh, later, Pennwalt, from merger, embossed 18-900 1/2 red 1/2 black shiney capsule containing 20 mg of resin amphetamine/dextroamphetamine in a cationic exchange resin, added to 40 mg of the sedative methaqualone. Abbott Labs "Desbutal Gradumet" 10 mg of methamphetamine hci, combined with 60 mg of pentobarbital (Abbott Nembutal) in a sustained release version of Methamphetamine hydrochloride, with instant release sodium pentobarbital. Abbott Labs stronger version of same tab in 15 mg of methamphetamine hci sustained release, combined with 97 mg of instant release pentobarbital. The 10 mg tabs were peach one side blue opposite side, 15 mg tabs were yellow one side, and blue back side. The best ADHD product I have taken in my life from age 20 to now I am age 68!!! Also available until July of 1973 in a bright green capsule 5 mg methamphetamine hci with 30 mg of pentobarbital (Nembutal) by Abbott Labs. The DEA passed a law effective July of 1973 banning production of any/all stimulants with a sedative.

Carl, there was one outstanding exception, Smith Kline 'French got a special compliance order with the DEA to continue production of their brand name Dexamyl 5mg capsules, with 5 mg of Dextroamphetamine sulfate, and, 32 mg of Amobarbital, either in a green tablet, embossed D93 or a syrup, and, in a 10 mg Dexamyl Spansule of dextroamphetamine sulfate 10 mg, with 65 mg of amobarbital, finally, a 15 mg Spansule with again, dextroamphetamine sulfate ER, and, like the 10 mg ER formula, with, 97 mg of intermediate release amobarbital. This was produced until the year 1982, source PDR's 1966, 1968, 1971, 1973, 1982. Martindale, the Extra Pharmacopoeia, 29th edition, and, Redbook, Pharmacy's Fundamental Reference, 86th edt, for year 1982, and, Redbook, published by PDR, 113th edition, for the year 2009, Note: Martindale is published in London UK I have editions for the years 1993 until the year 2014 published every 3 years now covering 43 countries of the modern industrialized world.

Q3 Preludin, (phenmetrazine hydrochloride) that became a C-II in January of 1972, (citation needed) I have been prescribed the 25 mg of Geigy Preludin instant release, and, the Preludin Prolonged Release "Endurets" embossed 62 peach in color, round tabs, on several occasions, in the early 1970's. In my personal opinion, I could tell no remarkable difference with Preludin, that, with the pure Abbott Desoxyn, in either 5 mg, or the 15 mg Desoxyn, formerly manufactured, in tablet form, Both were very powerful stimulants, and, as I remember, I had a tendency to slightly over focus, from the effects of these referenced, former medications!!! What happened to Geigy Preludin, once, like Dexedrine, and Biphetamine, offered as physician samples, as they all were not controlled BNDD or DEA controlled substance C-II category, but yes did require a prescription, perhaps, a schedule III?? The diet pill craze which IMHO unmasked many male and female ADHD people, came to a radical halt by the year 1972, with no refills obtainable no phone in RX's, and, the BNDD, which became the DEA 1973, and FDA, IMHO highly discouraged any MD to prescribe these stimulants, as diet pills, as, even the language changed in the 1970's in the PDR's. Geigy was a victim of radically reduced prescriptions being filled, and, Geigy Preludin, was no longer in the 1978 USA PDR, as, ADHD was only recognized in the 1970's as a possible med for males prescribed before they reached high school age, "minimal brain dysfunction" and, Narcolepsy, was recognized in all adults but, as most know, is a relatively somewhat rare disorder.

Q4 Placidyl by Abbott Labs, back in the 1970's the same M.D. my family doc, wrote me a separate prescription ask me to get it filled at a different pharmacy, than, for my Dexedrine Spansules 15 mg, so I would not get embarrassed, nor he embarrassed. (taking uppers and downers was frowned upon by the middle 1970's). I tried the 500 mg Placidyl red Vitamin E size gel caps, and, later one, upgraded to the dark green 750mg Placidyl for my insomnia. (ethchlorvynol) in the state of Florida, at the time, it was a Schedule IV, thus I could get up to 5 refills within 6 months of a script of 30 tabs. I only tried Abbott Placidyl for about one year. I much preferred, back in that era, in time, the USV Doriden 500 mg, of course, in 1973, and 1974, the William H Rorer "Quaalude" 300 mg tablets, for my insomnia, they were relatively easy to get, prior to July of 1973, when they went from a Schedule VI (6) very soft very light schedule, to a Schedule II, due to all of the abuse of methaqualone, and, the media reporting so many car accidents and alcohol and quaalude visits to ER, at least in the state of Florida.

To answer your question, Abbott last advertised Placidyl in the 1998 PDR, and production stopped, again, due to a increasing shift to safer hypnotics, as, I found it very rarely prescribed, the last ten years Abbott manufactured this ethchlorvynol, and, it was only made worldwide in the USA. A generic firm made Ethchlorvynol in the year 1999, but, it was not on the USA market very long, as generic Placidyl. Ambien (Zolpidem), Restoril, and, to a lesser extent the late 1980's/early 1990's Upjohn Halcion seemed to replace the C-IV sedative Placidyl. Doriden, which, strangely rose in popularity, after Methaqualone got banned, was changed in the November of 1991, from a federal C-III, to a C-II, and, the former USV who sold the license in the late 1980's to William H Rorer stopped production of Glutethimide, (Doriden) 500 mg tabs, when sales just dropped like a bombshell from alleged recreational abuse of Doriden and Tylenol #4 and with the merger buyout of Rorer, of Ft. Washington, PA, to Rhone-Poulenc and the remaining stock was returned from USA pharmacies, to the manufacturer of the end of 1st quarter of 1993.

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Re: Ridgerunner007 (# 20)

Attn: "Carl" ref original post dated January 21, 2012 to respond to target specific questions... hope you are still around!!!

1. I am not 100% positive if any "waxy fillers" are, or, were in any of the I/R or E/R Barr Labs (Teva) the parent mfg of Dextroamphetamine, and, of the other C-II stimulant generic Adderall I/R.

2. Citation needed, my memory is a bit foggy, but last time I checked Barr Labs generic DextroStat, had about 10 fillers in the I/R dextroamphetamine vs the Mallie version of dextroamphetamine I/R, had about 4 fillers and buffers.

3. Barr Labs was purchased by Teva world headquarters (Israel) in December of the year 2008.

4. 'Preludin Endurets" were last made by Boehringer Ingelheim Ltd, after, the original patent holder, "Geigy" who made the 25 mg and the 75 mg versions of Phenmetrazine from the early 1960's, due to a merger in the late 1970's by Boehringer Ingelheim Ltd. They were another victim of increasingly a lower demand, and fewer USA MD's who would write the very very potent C-II, especially for those patients needing a diet suppressant. It just disappeared by the early 1990's forever, worldwide!

5. A softer version was available (a C-IV) for many years, called by another proprietary protected names such as "Bontril PDM" (Carnrick Pharma) and by another firm, called the med "Prelu-2" for "Phendimetrazine Tartrate in I/R and S/R versions...especially "Bontril SR" 105 mg vs the I/R which were 35 mg. Prelu-2 were made by Boehringer Ingelheim. This "softer formula" converts 30% the formula into pure original "Phenmetrazine" by the human body. It was once made by 8 to 10 USA manufacturer's in their heyday source 1985 PDR for USA. All of those mfg had a different marketing name for phendimetrazine tartrate.

6. Yes, I well remember the sedative "Placidyl" which once came in sizes by Abbott Labs from 100 mg up to the very large 750 mg big green jell filled capsules!!! a USA C-IV, it popularity was at its peak in the 1970's!! It was finally discontinued by Abbott Labs, either by the end of calendar year 1998 or, 1999. It was very briefly made by a generic firm, "ethchlorvynol capsules" but, the demand, and USA MD's who were still willing to prescribe this once very popular sedative were few and far between, for many reasons, including the brief rise and fall of the late 1980's benzo called "Halcion" by Upjohn, and later by the new semi benzo called "Ambien" in mid 1990's by Searle Pharma "Ambien" (Zolpidem Tartrate). (Halcion is triazolam, another C-IV, like today's Zolpidem Tartrate, as the patent expired in late April of 2007 by the mega French pharma firm Sanofi.

7. "Placidyl is extinct in the entire modern industrialized world" source is the Martindale the Complete Drug Reference of 4,500 pages of ethical pharma meds in now 43 countries. edition 38 printed in 2014 (London UK). It was only available in North America, USA, perhaps once Canada only.

Sorry not edited for errors, I am sorry for posting now, 5 years late!!!

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ATTENTION EVERYBODY PRINT THIS PDF DOCUMENT AND SHOW IT TO YOUR HEALTH CARE PROVIDERS!!!!

Hope this helps. I'll be showing this to my doc as well. I was diagnosed with ADD when I was 5. I hear Dexedrine has had a positive impact on many ADHD/ADD patients.

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TaxiPriest:
Only $10 with insurance.
I am assuming your blood has been tested? You are obviously lacking something or have too much of something. Not a man made drug but a natural chemical made by the body. Have you tried changing your diet and do you work out? Of course see a chiropractor.

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Carl, what's the name of the drug Co. that you pay 23.80/month for all generics? I think everyone would be interested.

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I see you got your prescription filled or did you just have some leftover; i'm sure it's a girl do you and your personal psychiatrist also need a personal psychiatrist, at least one. There is an awful lot of corporate and corporate conspiracy theory dialogue/lingo and your post attributed to your shrink factual or not it is no credit to his practice your persona tone (IMO) or that you attribute such authority to the DEA.

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I have cancer that is causing me to sleep 18+ hours per day, at a time that we are trying ot move into assisted living. Persons on cancer forums talk about how helpful ritalin and adderall have been. However, my pharmacy says that they are out of Ritalin because the government rations what the pharmacy is allowed to receive every month,

The career big government politicians have decided that they are smarter than doctors, and they are the crux of this problem. The remaining Insurance companies continue to drop out of Obamacare, and the insured are facing 30% price increases.

Vote for persons that believe in individual liberty, and vote against big government politicians, or medical choices will continue to get worse.

Thanks for the posts, but it looks like the government is leaving us no good choices.

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Well if you did for some reason end up protesting and or telling a member of Congress, thank you so much because it must have made a difference. My mom just switched over from medi-cal to Medicaid and they covered her dextroamphetamine amphetamine (generic adderall made by sandoz) her copay was 1.20

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Yes it is wrong. I was told the same thing. I have been on dextro for years and now they wont fill my medication. I am so upset right now and I feel so tired. Now my life is going to be so hard.

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I agree with you 100 percent. I live in Lancaster, CA. And I've seen 3 Mental Health Therapists. I'm 45. La care - a form of medical won't authorize it. I can't get Aderrall anywhere in LA county. Can someone please tell me a good Doctor out there that will prescribe Aderrall? I feel like I've been violated for my rights to receive the one and only medication that saved my life! I've been struggling with impulsiveness and focusing for two years now. HELP

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I have been also denied the right to take my Adderall Meds for ADHD. I can't get any psychologist or Mental Heath Specialist to prescribe it. I think Sylmar walk in clinic will prescribe it and I'm trying Tarzana in Lancaster next. They do however have a coupon for Adderall at most pharmacies. You can get 60 pills for $30-$50 bucks. Any advice for me, let me know. Let's try to help each other.

{edited for privacy}

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Re: TaxiPriest (# 5)

Excellent points. I am in a similar boat to you, albeit less severe. Sedated by all stimulants (especially Adderall and Focalin) except Dextroamphetamine, and even on Dex I end up asleep 10- 12 hours a day, without Dex it's more like dangerous sleep attacks ANYWHERE, 14-17 hours a day, and ADHD on top of it, the leaden hypoactive type, inattentive.

Yep, the only drugs prioritized are those that fix erectile dysfunction either directly or indirectly (by making eyelashes longer or other stupid crap). That and extending the suffering of terminal patients by a few months to better bilk them and their families out of more money and suffering. But pain relief for those cancer patients or antianxiety meds for their families? Nope, the FDA/DEA won't permit that!!! It's crazy and cruel.

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Re: Ridgerunner007 (# 3)

Just noted an older (2011) and just as wise as all of your superb contributions. Having personal and professional experience with ADHD/Stimulants, your article covers 1. The medications psychopharmacology 2. The decline of the forms and the quality of stimulants available. 3. The forces of popular and professional bias, lack of governmental critical, careful thinking leading to misinformed yet powerful regulations, and then the movement of the various pharm companies [certainly the original producers did a fine job) into ceasing/transferring the manufacture over time so that present product less effective/reliable. Apologies for my ramble and thank yous for your well researched and helpful information. Your data and analysis is the rare,, real, light illuminating the shadows and fog of this field.

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Re: Ridgerunner007 (# 31)

Ridgerunner007 (# 31) --
Thanks to you and your years of experience and your generous efforts to share your hard earned expertise--there is a resource--grounded in solid science. Hard work. Critical thinking. Open curiosity on all levels. Yet, result is almost magic in its clarity. Your search for the most effective/safe pharm component for you and others, your education, training, and professional experience along with your collaboration over time with an equally scientific/educated/clinically expert physician has produced as clear and correct text, indeed, a textbook on stimulants. Psychiatric, Historical, Economic. My grateful thanks is too general. Your text is full if detail, specifics, timeliness. Anen, pgl

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It is up to each individual doctor what they prescribe. It is not illegal to prescribe Dextroamphetamine. Provided the patient has been diagnosed with a condition where Dextroamphetamine is indicated and the doctor thinks the risks are worth the benefits

It is also up to each State Medicaid program, Medicaid Health Plans , Medicare Drug Plans and Medicare Advantage Plans which drugs they prescribe. They can also set restrictions and limitations on the drugs they prescribe. Sometimes a Prior Authorization (PA) is required. Unfortunately, some doctors do not want to take the time to do a PA. This is especially true when it comes to Medicaid.

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Re: BlessedLady (# 35)

Medicare Part D Drug Plans can advise a doctor when caution should be used when prescribing a drug to patients 65 and older. Some doctors use this as an excuse for not prescribing a drug.

Pharmacies like Walgreens that use NarxCare. Can also notify doctors when caution should be used when prescribing a drug to patients 65 and older

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Re: Kimberly (# 27)

I have LA Care medi-cal & have always had them pay for adhd meds. You must see a psychiatrist, you HAVE to pay out of pocket, cash to see any shrink, medi-cal does not cover them (even if they say they do, they will not ever give you ADD meds). Everyone I know w/ mental health issues pays for their psychiatrist in cash, even people w/ decent insurance. It is hard to find the meds now, but if you call pharmacies beforehand to tell Dr. where they have in stock. Good Luck

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