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Friday, August 20, 2004

Chronicles of Paxil  
I'm downshifting back to 20mg. I saw my regular doctor for a follow-up and she said she likes to start people on 10mg, then increase to 20mg and hang out there for a while before deciding whether to increase to 30mg. My regular doctor was out when I called for the urgent appointment so I saw a different doctor; she was really sweet and friendly. But they have different opinions about dosage. My regular doctor said I could drop back to 20 if I had any problems with 30. I didn't really have much trouble with 30 but if I can feel fine on 20, why not stay with that? So, I'm going to give the 20 a better chance before I decide to increase.

Incidentally, it's a really good thing I chose to do the drug and therapy. Just making it through the HMO maze to get to the therapist could drive you insane. It took two weeks to get my authorization letter from Lakeside, the company my medical group contracts with. I called them and they told me to call MHN, the company to which my HMO contracts out the mental health management. So I called MHN and they gave me a reference number and told me to call College Health IPA, the medical group for mental health services in my area. I called them and gave them the number and they took some information from me and gave me a few doctors to choose from. Now I can make my appointment and then I have to call College Health back to let them know which doctor I chose so they can finalize my authorization.

Fortunately the Paxil kept me nice and calm while negotiating this maze. The lady at College Health was really good, though. She went over my benefits with me. Turns out I get up to 20 sessions per calendar year for a $30 copay. I could go every week for the rest of the year and almost every other week next year. Plus my employer reimburses copays. Now that's some good benefits.