Geodon vs Risperdol: New Washington State Policy July 3, 2011Posted by Crazy Mermaid in Uncategorized.
Washington State just introduced a new policy regarding psychotropic medication for people with mental illnesses. This policy covers those people with mental illness who are without private insurance. The new policy is that psychiatrists are forced to put patients on older psychotropic drugs with more side effects because the newer drugs are prohibitively more expensive. At a time of severe budget cuts, quality of life can’t legally play into a psychiatrist’s decision on which medication to prescribe. But it should.
While I understand that there are a finite number of dollars available to treat patients without private insurance who have a mental illness, there should be a quality of life cost to consider in addition to the apparent financial cost when the decision is made regarding which medication to put a patient on.
A perfect example of this is the use of Risperidone, a generic form of Risperdol, versus the newer drug, Geodon. Geodon was developed as an alternative to Risperidone. It minimizes the number of side effects mentally ill patients have to put up with in order to be relatively symptom-free while being properly medicated.
While at the mental hospital, I was started on Risperidone, the less expensive drug. The side effects I experienced on Risperidone included extremely slow, fuzzy thinking (like my brain was in a fog and made of mush), loss of libido, lethargy lasting an hour or two after I woke up, and a tremendous increase in my appetite (and subsequent weight gain), as well as a multitude of other smaller side effects including fine motor skill problems. The bad news is that the net effect was a poorer quality of life than I had without the drug. The good news was that the voices were less prevalent.
When I was released from Fairfax Mental Hospital, my new psychiatrist brought to my attention Geodon as an alternative to Risperdone. He discussed the side effects of Risperidone versus Geodon, a newer generation of drugs with fewer side effects. The minute he had the opportunity to provide a better drug, he did it. Right then, we decided to wean me off the Risperidone (around $200 per month) and onto Geodon (around $700 per month). I was shocked at the price of Geodon, but my insurance picked up the majority of the cost. In effect, my health insurance allowed me to purchase a higher quality of life.
The problem with hearing voices, besides the obvious interruption of thought processes, is the fear that the voices might become overwhelming and permanent, driving me into a total eclipse of my personality and core being, unable to function in the world. That’s what medication keeps at bay.
The difference in quality of life between these two drugs can’t be emphasized enough. With Geodon, a person will be much higher functioning. Geodon will be the difference between someone being able to hold down a job and someone who has to stay cooped up in their room all day. The cost of recidivism because of the less tolerable side effects should be taken into account when a policy of “generic first” is implemented, but it isn’t.
Mentally ill people will be functioning at a lower level on Risperidone. They will have more health problems because of the tendency of Risperidone to cause weight gain. Their thinking will be fuzzy, their coordination will be affected. Their libido will be erased entirely. And there’s a good chance they’ll stop taking their medication when they get fed up with the side effects. The more severe cases will end up in a mental hospital, costing the taxpayer tens of thousands of dollars (see my blog about how expensive a mental hospital stay is). Or jail (also at tens of thousands of dollars per year). Or with drug and alcohol problems from self-medicating. So much for the cost-saving idea.
In short, I understand the new policy is due to budget cuts, but the initial monetary gains on paper need to be balanced against the quality of life as a medicated person and the reality of life as an unmedicated mentally ill person. In a perfect world, psychiatrists would be able to choose the best drug for their patients, with no regard for costs. Risperidone would lose every time if this were the case. Unfortunately for those people without private insurance, if they seek treatment, they will be stuck on the drug with more side effects and with a poorer quality of life. These are all additional costs that I wish the new policy would consider when choosing the appropriate drug. But it’s too late. They’ve already made their choice.