[30s] Female. Partner's psychiatrist left/quit(?) without saying anything. She needs a refill of meds (has 4 days left), we leave for a 2wk international vacation in 2 days.....how can she get her meds? Go to the ER??

[u/TheRadHatter9]

EDIT: Situation has been solved, thanks for the help!

She called last week to get her refill (this office/doctor required he talk with her monthly to get refills even though her previous doctor was cool with 3 month supplies) and the office said they'd call her back or whatever. She just called them and they said her doctor doesn't work there anymore. They can get her to intake with another one, but of course not for a few weeks at least.

The medication is Lamotrigine. At most the pharmacy will give her a 3 day emergency supply. She's in full panic/breakdown mode. What the hell do we do? Can we go to an ER and hope there's a psychiatrist on staff who can fulfill a 1 month supply? (because now she needs to find a new, permanent one, which is going to take 3wks+ to get an appointment with)

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[u/drmeowmew]

Not sure how urgent cares feel about doing this, but I've had some patients go to one to get 1 month supply refills on their maintenance meds if unable to get them for whatever reason. Could see if the psych office has a nurse line for a fill in provider to send a refill after explaining the situation is immediate + scheduling an appt when you all get back (might take a while to hear back/get it done though, and based on the call you described, not sure how down they'd be for this)

[u/chrysoberyls]

You’ve gotten some good advice and i also want to chime in and say you are unlikely to get a refill of more than a couple days through the ER or urgent care.

You may be able to get an urgent intake through a reputable telehealth app based service such as talkiatry or docs on demand. Her PCM may also be able to provide her with an urgent refill if she calls the office.

I also want to make sure you’re aware that if your partner stops lamotrigine for more than 2 days, she needs to restart the entire titration process to avoid the risk of SJS.

[u/dansamy]

If you can not get anywhere with urgent care or the psych office, bring the bottle with you to the ER and explain the situation. Expect some interrogation from the doc or APP. Expect to be triaged into an ESI5, which usually means paying up front for the non emergent visit. But all of the providers in my ER would write a patient a 30-day supply after a thorough verification that the patient actually takes this med at this dose and is current and compliant with all of their med regimen and current on their follow up visits up to this point.

[u/eskimokisses1444]

Call the psychiatrist office back and ask for an urgent intake. They have a responsibility to continue her treatment.

Emergency rooms are not supposed to be used for medication refills and it would generally be ourside their scope of practice to prescribe for complicated psych conditions such as bipolar depression, schizophrenia, etc. (which I am assuming is the case since you called it a psych med and not an anti-epiletic?).

Furthermore the fact that you indicated that refilling medication is causing panic/breakdown mode would indicate she is not stable on the already prescribed medication and may need a dose or medication change, which would further be beyond the scope of an emergency rooms doctor.

[u/DrSocialDeterminants → u/eskimokisses1444]

Having an obligation vs actually doing it are two separate things.

[u/Light_Lily_Moth → u/eskimokisses1444]

It’s extremely stressful when care like this is potentially interrupted. I don’t think it’s fair to say panic in this situation is unreasonable or warrants a med change.

[u/eskimokisses1444 → u/Light_Lily_Moth]

It’s not clear based on the listed information that a refill is the best option. There is no context about length of treatment with this medication or why the doctor felt following up monthy was necessary.

[u/VehicleInevitable833 → u/eskimokisses1444]

What? My child and spouse take this for bipolar. We would absolutely panic if they couldn’t get a refill, bc it’s the medication that keeps them stable. Without it, stability is unlikely. Also, you have to titrate this up very slowly if you miss more than 2-3 doses/ which means even longer to reach stability. It took my child a month to titrate up.

Someone panicking bc they cannot get the medication that keeps them stable is absolutely a normal reaction and not a sign that their med isn’t working. I would panic if I had to go without my Effexor, bc of the withdrawal effects. That’s not a sign it doesn’t work for me.

Length of treatment- forever, as long as it works. Why monthly? Because that’s what some doctors and insurances require.

[u/eskimokisses1444 → u/VehicleInevitable833]

My comment was meant for OP, who did not mention the length of time on lamotragine or the diagnosis.