Hi all,
so I’ve been in treatment for ADHD for the past 3 years, I’ve tried various medications for it but ended up with time-release Methylphenidate (called Equasym where I lived before). Now 3 months ago I moved back to Japan and brought a 3 month supply (which I later found out was probably illegal), but that’s about to run out and I’ve been trying to find a mental healthcare provider to get a refill.
My experience so far has been that typical Japanese mental health services are… basic. I’ve tried to reach out to the American Clinic Tokyo (I live in Saitama) but they’ve been slow to respond. On top of that, I keep reading contradictory information on the internet.
Some websites said that Methylphenidate was flat-out illegal (Japanese wikipedia says Concerta is available though), one expat healthcare provider I reached out to said that it was available but “highly regulated” and I would have to be in active regular psych treatment and take a bunch of diagnostic tests etc…
I have a stack of documentation, diagnoses from 2 therapists, both of which wrote me letters in english explaining all my symptoms etc. etc., I just want to get some form of ADHD medication from somewhere. I’d be willing to try Lis-Dexamphetamine or Atomoxetine or Guanfacine if I can’t get Methylphenidate, I just really, really don’t want to go back to being un-medicated.
Has anyone here been in this situation (or a similar situation with some other regulated psych medicine?) Any advice on how to proceed? I have like 3 weeks of meds left before I turn back into a frazzled unproductive depressed mess and I’m beginning to panic a little.
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Yes you can get Concerta (Methylphenidate) through a licensed psychiatrist in Japan. Not all psychiatrists can prescribe you Concerta and my psychiatrist explained that you have to go through quite a lengthy process of registering yourself to a system that allows you to get Concerta (since it’s a strictly controlled substance in Japan), waiting for the ID to get accepted, and finally getting the prescription. You can only fill out a month worth of pills at once though… also, not every pharmacy has Concerta.
I advise you to go to a psychiatrist that prescribes Concerta ASAP since it’s gonna be a lengthy process just to get the medicine. I go to Roppongi Mental Clinic, they can give you Concerta but i don’t know if they speak English or not…
edit: you can get Atomoxetine or Guanfacine a lot easier and for longer period, but I’ve heard bad stories from people on non-stims. I personally take Strattera (Atomoxetine) and it’s been doing wonders for me!
> one expat healthcare provider I reached out to said that it was available but “highly regulated” and I would have to be in active regular psych treatment and take a bunch of diagnostic tests etc…I have a stack of documentation, diagnoses from 2 therapists, both of which wrote me letters in english explaining all my symptoms etc. etc., I just want to get some form of ADHD medication from somewhere.
tl;dr: No doctor will “just prescribe ADHD meds” right out the gate, and your documentation isn’t really worth anything.
Longer version:
You have to play the game the way that it’s played here, and that way is going through their evaluation process, which _does_ involve regular treatment, diagnostic tests, etc. As doctors in other countries aren’t (usually) licensed to practice medicine in Japan, their documentation, diagnoses, and letters (in English, no less) don’t really carry any weight here, so you’ll basically need to start the process from the beginning.
Better get an appointment ASAP with a psychiatrist who is licensed to prescribe what you need. Explain the situation (minus the part where you illegally imported a highly-controlled substance), and maybe they’ll be able to get you an appointment earlier. That said, you should probably work on a contingency plan for how to manage being a “frazzled, unproductive, depressed mess” for a little bit until you can make it through the process.
Given that having these meds seems to be critical to your stability, you should have been figuring this out three months ago when you landed, not right before you’re almost out of medication. In the future, make sure you plan ahead for this type of thing. Since you can usually only get one month of medication at a time, each time be sure to go ahead and schedule your next appointment in advance so you can be sure you don’t actually run out.
I deal with all of this every month involving a family member, so I’ve seen it first-hand. It sucks, but there’s no way to skip the line or jump the process. Get started on it now.
Try going to a local doctor first and explain your situation. Generally, any condition that requires ongoing medication, even blood pressure medicine, as in my case, requires a monthly evaluation in order to get a prescription refilled. You may be able to find a local doctor who can accommodate your needs. If not, then try a university hospital next, if there’s one in your area. You’ll be better off getting your medication needs handled through the system than by trying to find your own source for acquiring the medication on your own.
Concerta (time release methylphenidate) is available but subject to special controls. You need a “concerta card” which takes a few weeks to get.
Look through clinics near you that deal with mental health. When you make an appointment explain that you’ve been previously diagnosed and prescribed medication for ADHD. Go for your initial consultation and explain the situation. The doctor will arrange getting a concerta card and a prescription.
When you fill your prescription make sure you have your health insurance card, a drivers licence/passport/residence card and the concerta card. If you don’t have all of them you can’t fill your prescription (easy to get caught out when you are waiting for your new health insurance card, with other medication you can pay the full amount but with concerta you cannot fill the prescription).