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Meprobamate (Equanil, Miltown) has been around since the 1950s. It was one of the most successful drugs of that era. This blockbuster tranquilizer was considered far safer than the barbiturates it replaced. It has been available generically for decades and should be dirt cheap. What went wrong?
The Outrageous Price Increase for Meprobamate:
Relatively few people may remember meprobamate, but we heard recently from one reader who does:
“At the age of 27, I began having numerous panic attacks daily. As a teacher, I found it increasingly impossible to function in the classroom.
“I visited my doctor and he prescribed a drug called meprobamate that made it possible for me to do my job, get married and function normally. Fast forward to 2016. I am 65 years old and have continued to take 400 mg of meprobamate four times per day under my psychiatrist’s care. I have never needed more than that.
“Originally, he tried to get me to take other medicines for my condition and wean me off the meprobamate. I tried Paxil, Xanax and buspirone among others. None of them gave me the relief that meprobamate does. (Paxil actually gave me agoraphobia.) He now prescribes meprobamate for me because it’s the only thing that works.
“The problem is this generic drug that used to cost $20 a month is now hundreds. I am trying to wean myself off, but it is difficult even though I’m down to two a day.
“I have a wonderful psychiatrist who made sure I was covered because at 65 I was too ‘old’ to take it without special approval from my insurance company. The thought of trying to find something else to deal with my panic attacks at my age is causing me even more anxiety.
“I am now retired from 41 years of teaching. This was the last thing I contemplated dealing with in retirement. I exercise and do yoga, and I am in good health. What suggestions do you have for my dilemma?”
A Very Old Generic Tranquilizer Becomes Unaffordable:
Forty years ago the brand name Miltown cost $8.45 for 100 pills. The same amount today in its generic form could cost almost $350. We can think of no good explanation or justification for such a price hike.
Drug companies, including generic manufacturers, now believe they can charge whatever price they want and get away with it. Old fashioned competition and capitalism no longer seem to apply within the pharmaceutical industry.
Because the tranquilizer meprobamate can cause dependence, the drug can be hard to discontinue suddenly. Like most anti-anxiety agents, including popular benzodiazepines such as alprazolam (Xanax), diazepam (Valium) or lorazepam (Ativan), the dose of meprobamate must be tapered very gradually over a long period of time under medical supervision.
Sadly, neither the FDA nor most drug companies provide detailed guidelines for getting off a tranquilizer or anti-anxiety agent. As a result patients and health professionals have to make up a program on their own.
People also differ in the way their bodies react to these medications. As a result, some people can phase off a tranquilizer gradually over several weeks without too much distress while others may suffer terribly for months. Cognitive behavioral therapy may help overcome some of the challenges of panic and withdrawal.
You can read about symptoms of withdrawal at this link.
Please share your own experience with drugs like meprobamate, alprazolam, diazepam or lorazepam. How well did the medication work? Were you able to phase off it smoothly? Others may benefit from your story, so please share it in the comment section below.
Margy
I am sixty and meprobamate worked since I was a teenager when I had my first panic attack; bad endocrine system, and early childhood trauma (my father died in front of me). I never became addicted or developed a tolerance to the 400mg tab. As I got older and life became more stressful, at most I would need 2 per day. Ever since my doctor took me off meprobamate and put me on clonazepam .5 3x per day, I am a mess. I used to have to explain it to doctors who never heard of it when I was in my twenties. I wish I could get an Rx for it.
John
Meprobamate can be tapered over days not weeks. It’s incredibly mild, and if they stop making it I don’t know what I’d do.
It’s so inappropriately stigmatized. I’ve never taken a more tolerable drug. In my experience, 1600 mg can be discontinued abruptly without much discomfort. It’s just criminal. They push Lyrica which makes me suicidal. This just works exactly as advertised. It kept me out of a hospital and gives me my life back. I’ve taken it periodically because of the cost. I cannot tolerate anything else or it just doesn’t work.
My grandmother suggested it to me years ago and in the days when doctors still knew what it was and weren’t afraid of it. The truth is, other drugs surpassed it because they’re much more psychoactive. In my experience, this just calms you without any dumbing down or intoxicated feeling. No dumb behavior comes as a result of taking it, and it’s the easiest tranquilizer to stop taking. I barely notice the difference. Absolute lunacy. The entire system is upside down. 3 new drugs for tardive dyspepsia, and they’re pushing quetiapine and things like that. I cannot advocate strongly enough for the awareness of this option.
Chris
IF your script is too much use Good RX. This script starts out at 52.18 for a 30 day supply. If you get Good RX Gold the price is 25.88 for 30 day supply
Daryl
Georgia USA
I was taking soma Carisoprodol for years then my insurance dropped it, but I did find out that soma creates a metabolite, meprobamate. So maybe one could use soma as a substitute. I know it made me relaxed and did help my anxiety
Lynda
Redwood city ca
All of the posts above are the same story . The drug has been around for 70 years, and there are many people who can live a better life with this drug. My latest Rx was for 100 pills or it may have been 50, and the cost was $800 +.
These are the only Rx that works for me and has for many years.
Medicare does not have this Rx in its book.
Richard
Florida
Unlike non-generic drugs it is my understanding that drug companies “generic drugs” are not regulated for price by anyone, and as a consequence they can charge anything they please. Is this true?
Becki
Arcadia
My Mother just passed away this past January. She was 92 years old. My mother had a miscarriage way back in 1956. This caused her to suffer from anxiety and panic attacks. She was put on Milton aka meprobamate 200 mg twice a day. Eventually, she was taking it “just as needed”. Through out her entire life she suffered from anxiety and continued to take one as needed. There were weeks to where she did not need to take one and other times when she would need one or even a half of one. Through the years her physician’s would laugh and tell her that there is no way this old no longer prescribed drug could work. It was a constant fight whenever there was a new physician involved. She was convinced to try Ativan many years ago while hospitalized and she suffered horrible and worsened anxiety within 3 days. The past ten years my Mom’s insurance refused to pay for her meprobamate and it would cost her $360.00 every time she would get a refill. Bottom line is this…..My Mother was on this drug for 62 years and it worked extremely well. Unlike other drugs in the same class that are used in the modern age Meprobamate did NOT cause liver problems and the other side effects or addiction…… It is criminal that the FDA is allowing the drug companies to charge such a horrendous amount for a drug that works so well for so many…..
Steve
Phoenix,Azy
I used to find a “no longer formlated” med, Deprol, to be of great benefit
I needed only occasionally. I recently went looking for meprobmate. $127 @ 60 400mg tabs. Still pricy.
Jose R. G.
Puerto Rico
My father was an MD who specialized in cardiology and internal medicine. Had all the boards, the FACCs and related. Designed, specified, and installed the first CCU in the hospital in which he worked. My mother was a RN.
In the mid 50s and unitil the early 1990s my uncles owned perhaps the second largest pharmacy chain in Puerto Rico.
So for better or worse, I have been in contact and familiarized with pharmaceutical companies and blockbuster products since my childhood.
I am sure most readers do not recall the days of the truly ethical pharmaceutical companies such as Upjohn, Squibb, Ayerst, Wyeth, Sterling, Winthrop, perhaps Warner Lambert, Parke Davis, Lederle, and many, many other fine chemical and pharmaceutical companies and others that I fail to recall now, or that these companies ever existed. Those were the days of good research and development, good solid products, and above all, ethical companies.
All that was gobbled and destroyed by Pfizer, which at the time was a third rate pharmaceutical company in terms of products and research and development.
One of those blockbuster products was a drug marketed by Wyeth and named Equanil. The generic name was (and is) Meprobamate. In Puerto Rico, as in the US, it helped many a patient to deal with anxiety disorders. We used it in our family until my father’s passing, and I still continue to use it, off and on. I am now 71 and will soon be 72. Doctors now a days are so inept and lazy that they do not look into the PDR (if there is one today) to learn of the benefits of the drug.
And the company that makes meprobamate today, Mylan, Wallace and others, charge a ton of money for a drug for which R&D, marketing and other costs were paid for long long ago.
It’s not the patient these companies care for.
And I hope I can continue getting meprobamate in my local drug store. Walgreens decided not to supply it many years ago.
Ron
Minneapolis, MN
My wife has been taking meprobamate for over 56 years. She is currently 84. Her current doctor has decided that he will no longer prescribe meprobamate and has told her that if she has to have meprobamate, she can find another doctor who is willing to prescribe meprobamate. She was referred to a psychiatrist who also told her that he would not write her a prescription.
She has suffered none of the side effects that these doctors are so concerned about. She has tried many other tranquilizers, but none have worked for her. I have seriously considered bringing suit against the doctor and the healthcare firm he is associated with for malpractice.
Why can’t a doctor be held accountable for treatment he WITHOLDS that causes unnecessary harm as well as treatment he GIVES that causes harm. Malpractice works both ways. Now we are trying to find that doctor who will prescribe meprobamate and who is really committed to DO NO HARM !!
RW Minneapolis, MN
Barbara
Orlando, Florida
I was first prescribed meprobamate in 1980 when I was on a period of high prednisone doses (20-60 mgdaily) for severe asthma. The prednisone (and perhaps also the stress and coping with the terrible coughing type asthma symtons and It’s impact on my marriage) made me extremely emotional. The meprobamate was wonderful. It took the edge off my anger and stress and anxiety without causing tranquilizer like dude effects. Plus we noted a big improvement in my asthma. I think I took 2 pills a day for a few weeks. I no longer seemed to need it when weaned from the prednisone.
Since then, it is my anti stress pill of choice. I rarely, rarely take one. I note that I now have 3 pills left in the 10 pill bottle that was prescribed in 2006. Not sure that they haven’t completely expired and lost effectiveness. But I feel more secure knowing they are there if I should need them.
I am now on Medicare and was looking thru the part D formularies. Meprobamate is not there.
I worry that I may not be able to cope with something like the loss of my pet, or a loved one, without it. Is there anything else equivalent to it? Or can I get a prescription for it filled without using Medicare?
Kayla
OREGON
I was given Miltown (Meprobamate) for mild postpartum depression when my first born was 4 days old in the late 60’s. I took it for 2 – 3 days and was ‘cured’. In my early 50’s, I went into a depression after a painful relationship loss, coupled with the start of menopause and the death of my treasured dog.
I tried St. Johns Wort, swimming, yoga, herbal teas, to no avail. After about a year of tearful despondency, my provider convinced me to try Paxil. Within a week or so, I had every side effect the sympathetic nervous system could come up with and was still sad and weepy. I weaned off of it. Then I remembered the experience with meprobamate 30+ years earlier and asked my doctor about it. He said it had gone out of use, replaced by more modern anti-depressants, but finally, he reluctantly wrote me an Rx for it.
I took them for a week and was ‘cured’ again. Now, I keep an old prescription in my medicine cabinet and take one every few years when I can’t shake depressive/despondent state. It always works with one or 2 small doses. No side effects. For me, it’s a wonder drug for short term depression.
Amy
FL, USA
Over the past 44 years, since I was 12 years old, I have tried literally every anti-anxiety medication as well as every anti-depressant, anti-convulsant, anti-psychotic, beta blocker, etc. for my social anxiety and anxiety that leads to insomnia.
What works for me is .25 to .5 mg [not a typo] dissolvable klonazepam. The most I have ever needed to take in one day is one (1) mg. It’s available as a generic and costs me with insurance $15 for three months worth. Yet every time I go to a new doctor – for any condition – he or she makes some remark indicating that I really need to find a different medication for anxiety (most of which either have documented side effects of long-term use that are much worse than those of benzodiazepines) or try exercise, meditation or some herbal remedy for which there is no real evidence that it actually works.
I get so anxious about having to explain to every new doctor – and about feeling judged – that I now tend to avoid going to doctors unless it’s absolutely necessary. It’s so very very tiresome that the medical profession in the United States still is so poorly educated about anxiety and so ready to try the newest expensive and understudied wonder drug.
lee
usa
I guess nobody can beat me on the meprobamate I am 61 and was first prescribed it for ulcerative colitis and then anxiety@ 16 400mg 5x a day. I do not like the hangover effects of the Benzos. But oh well i have been taking meprobamate for a million years same dose….I really believe it just became a very expensive placebo for me.
I have no problem starting and stopping . The only addiction from this drug for me is the act of putting in my mouth. Really I recently said ya know enough and its like a cigarette something to put in my mouth and I feel better without it..
Yvonne
Georgia
I understand and empathize with your dilemma. I, too, take lorazapam (ativan) 1mg. daily for anxiety and panic attacks and have been taking it for about 7 year now. I can go 2-3 days without taking it but any more than that and the panic attacks set in and it takes me weeks to get back on track. My psychiatrist who first prescribed the drug for me retired and I am now seeing another psychiatrist who recommends I taper off lorazapam and try another drug. He mentioned that this class of drugs has been shown to possibly contribute to dementia is some patients. I explained that I tried other meds in the past but suffered from severe side effects and lorazapam is the only one that works for me with no side effects. I get a 30 day generic supply at around $3.50 per month. I find myself getting anxious at the thought of again having to try other meds that may or no work for me. I take such a low dose and am frustrated that I’m being told now to “fix something that is not broken.”
J. David Auner
Springfield, MO, USA
Corruption. Elect corporate tools – get what you select.
B. G.
PA - Pennsylvania
I’m surprised that many docs are still writing for Miltown. I’m sure it’s a very rare instance to even find a pharmacy that even stocks meprobramate.
Obviously, the outrageous price for a script is due to the fact that the only generic companies that make it know the rarity of it. Therefore, they price gouge.
I suppose carisoprodol is always an option. For anyone who may be unaware; carisoprodol (Soma) is a sort of “combination”, which includes meprobramate.
RisingWolf46
Montana
I am a 69 year old male combat vet.
I have been on Quetiapine, for bipolar and depression; Lamotrigine for bipolar; Sertraline for depression and anxiety; Gabapentine for PTSD and bipolar.Also, I have been on varying dosages for 5 years now through a car wreck, open heart surgery, lower back surgery and my wife’s breast cancer treatment. The back surgery eliminated my back pain and allowed me to wean (6months) off 550mg dose/day of Tramadol. Now that is a NASTY chemical !!
I am now getting Stellate Ganglia Block injections to treat PTSD symptoms and more importantly the actual brain injury causing PTSD!
It is working! Among a lot of other evidences ie.; solid restful sleep, anger control, impulse control, no racing thoughts, OCD diminishment and the fact that I am slowly decreasing the meds dosages, experiencing minimal withdrawal effects.
HelenM
Modesto
The greed of the pharmaceutical companies is horrid and very pervasive. Seniors are particularly hard hit because of the donut hole. Before the end of March, I slid in. Some of my generics are still covered; however, my insulin is not. In the last 20 years I have seen insulin go from $13 a vial to close to $300. This is a huge cash cow; the medication costs pennies to make.
I use xanax for sleep – however, never more than once a week. It works well in spite of the fact that I have been taking it for over 25 years. A friend was on ativan, she had extreme anxiety during heavy cancer treatment; it too worked very well and she was able to stop once the cause was gone. But, every day usage for years is a whole ‘nother story. Rather than take more xanax, I simply resign myself to sleeplessness, get up and read for an hour or two, try again. Before the xanax, I used valium, same way. For about 20 years. Strangely, tho, doctors in CA prefer Xanax, opposite to those in the east coast who preferred valium when I lived there. So I strongly advise very careful usage of these medications and settle for relief no more than once a week. Which is a whole lot better than nothing.
Leslie
Ardmore Ok
This year my husband I each have different part d plans. Has anyone else noticed the higher number of physician authorizations the rx plans are requiring? My husband’s physician and staff spent a lot of time faxing what the plan wanted, but kept changing. The end was a denial and a denial of appeal. Now they say we can appeal to Maxinus.
They make it so difficult my doctor said to pay cash price for a pa drug. They are questioning the doctors knowledge of the patient and making it so difficult the doctors are becoming irritated. Has anyone else had this problem and does People’s Pharmacy see it happening more?
Conie
I was given Xanax for anxiety caused by IBS symptoms (the nerve that runs from the gut to the brain.) It helped some but left me feeling awful. I have had trouble with generic drugs many times. I got an Rx from the doctor for Valium. It works great. I only have to take 2 mg per day but 30 tablets of 2mg each cost $100.
Johanna
Illinois
I was having surgery, and the docs prescribed 1 milligram of Ativan. That was the first time in my life of 63 years that I felt relief from paralyzing anxiety. The one milligram dose was effective for two and a half days. The generic was not. I had to take one milligram twice a day. However, now that they do not make Ativan at all, the generics are simply a crapshoot. Walgreens uses the cheapest generic every month so not only are you getting something you haven’t taken before, but you’re getting something that’s untried in terms of effectiveness for you.
Does anyone know where I can buy real Ativan with a prescription?