Sleep first. Bad night, bad day, more symptoms. Fix that before changing anything else.

Same shape here, different drug. The thing that helped was documenting the refusal rather than re-arguing it. They refer rather than write.

I would stop trying to convey how bad it is and start saying what you want them to do. Not on pharmacy work but the pattern is familiar.

Nobody has ever been talked out of a stack by a stranger on the internet.