To think that generic unbranded medication is different to the branded one?

[chickenmadcat]

I have been taking an antidepressant medicine for about 18 months. I've taken it in the past and it works brilliantly for me, however it does have rubbish withdrawal symptoms, and I notice it if I skip a day's medication for any reason.

I have always been given the main brand of the product, however in the past 6 months the pharmacy that I get the prescription from changes from month to month between the branded one and a cheaper generic one. This month it is the cheaper generic one.

Each time they change the brand that they give me, I seem to get awful withdrawal symptoms and feel ill for a few days. I didn't think too much into it, but I collected my most recent prescription on Wednesday, and although I've been taking it every day since then, because it's the generic one and not the branded one I had last month, I've felt ill with apparent withdrawal symptoms; nausea, dizziness, feeling like I'm on a boat, tearfulness, etc. I know they will subside in a few days but I hate feeling like this.

I just wondered really whether I am imagining things or reading too much into it, or whether it is possible for the branded and generic products to be a bit different (dosage is the same BTW, I've checked). WIBU to ask the pharmacy to make sure I consistently have one or the other in future? They request my repeat prescription each month for me and have the prescription ready for me to collect. It's easier as the pharmacy is in my village, and my GP surgery is a few miles away. The pharmacists in the local pharmacy are a bit scary and shouty though so I don't want to request anything unless I'm 100% sure I'm in the right....

If it has identical components, it shouldn't be any different... but is it possible the branded version has some extra something/ some kind of tweak that minimises the side effects?

OP, I do think you're right. I've heard about epileptics starting to have fits again after been changed from a branded version to a non brand version of the same drug.

That's a good point, 99problems.

I feel like they are withdrawal rather than the general side effects, so I am thinking if the branded one has an extra something in it then I could be withdrawing from that extra something couldn't I?

Ah, that's interesting to hear, Viva!

I think the changes you're experiencing are far more likely to be psychological, like the placebo effect only in reverse. It really doesn't matter what brand of medicine you use when the active ingredient is the same as they all have to go through clinical trials and all the rest. Teaco's own 16p paracetamol is exactly the same as a branded pack costing £3.50 but I still know people who refuse to buy the cheap ones.

Saying that, it may be worth requesting the other one consistently, even if only for the placebo effect it gives you. i'd let the pharmacist know your concerns - at worst there may be a mistake, albeit unlikely, but won't harm to mention it.

No you're not imagining it. Some people do not respond well to different brands of medication. I have a friend who has diabetes which goes out of control when she's switched to generic. My nan also suffers with her ibs if she has mebeverine instead of colofac. Some people are unaffected by different brands. You need to make your doctor write down the branded medication on the prescription, then make sure the pharmacist doesn't palm you off with the cheaper one. You have to open the bag and check the meds there and then and then tell them that the doctor prescribed the branded one and that they should give you it. Then possibly argue with them. (Been there done that!)

NoSynday that's not true generic drugs are different.

My father had this happen with a drug he takes to control his blood pressure and he had no idea it had been switched at all. He had just been merrily picking it up at the chemist and popping it twice daily as usual. It was only picked up at a check up. So how could it be reverse placebo or psychological?

The rules are this - if you have a prescription for a branded item, then unless you consent to being given the generic equivalent, then the pharmacy must give you the brand. If the prescription is written for the generic however, then the pharmacy can give you either.

If you want to get the branded item, then tell your gp to consistently write it as such.

The side effects in brand and generic normally come down to the excipients - the fillers and coatings that make up the tablet or capsule.

This affects me as well. After doing some digging on the 'net, I have found several research articles that has been conducted that backs your suspicions up.

I find that some generic makes of Citalopram give me problems and I experience withdrawal and a return of depression symptoms.

Oh, and most drugs are a hell of a lot more sophisticated than Paracetamol, so that comparison is useless NoSunday.

I'd go to a different pharmacy if they only have the generic one, I'd ask for the branded one as I hand over my prescription if I was you. If one set is a capsule and another a tablet you can get differences because each will be released differently. Your body could be adjusting to that over the first few days though if you are always using the generic then that wouldn't hold true.

Both drugs have exactly the same drug in them.

The difference in 16p paracetamol and the fancy three pound stuff, is the different coatings etc. The fancy stuff often has caffeine added and sugar. It's what gives you that boost of energy with say cold and fly tablets over cheapie paracetamol.

The cheap paracetamol and a coffee would do the same job.

And you'd be surprised the number of people who swear blind that branded drugs have more drug in them.

They don't.

Actually Hidden it's an apt comparison. There are quite a few generic drugs that are made by the same company, and repackaged for different companies.

Levothyroxine is one, as is desmopressin, quinine sulphate, and at least half a dozen others.

Hidden home, how many of those research articles were written by someone with an interest in the pharmaceutical company who supplies them??

And paracetamol is actually an amazing drug, and fairly complicated! It's just that it's such a common drug that we forget how dangerous a drug it is.

Actually if you really want to compare OP, you need to check the monograph for it. That's what both the manufactures would have to follow. You can probably find out where they are online and go to a big library or access online. Your GP may have access, you could ask next time you were there.

The capsule/tablet form makes sense, because some months I'm given a branded capsule, some months a branded tablet, some months a generic capsule, some months a generic tablet....

I think I really need to speak to the pharmacist next time I collect my prescription and tell them that they need to stick to one brand and one type of pill/capsule every time.

The chief scientific officer of the royal pharmaceutical society was on watchdog saying generic is the SAME as branded.

She should know what she's talking about .

When I was discharged from hospital after day surgery they gave me 4 different painkillers, the paracetamol were the same as aldi paracetamol only in a box of 32.

Dh swore they were much better than the "shitty aldi paracetamol you buy". He still wouldn't have it when I showed him both boxes together.

I think it blew his mind a bit.

As said up thread, there will be the same amount of active ingredient but there may be extras in the binder/coating etc which could be the source. OH has epilepsy and asks for the prescription to be made out to the branded drug.

It will likely be that then OP. The time release on both is different due to the nature of the delivery system. Digestion takes longer on one then the other. If you stick to one of the other you won't feel shit, it's your body having to adjust to the different does. Definitely talk to the and if they can't do it because they only have one type in then I'd go somewhere else.

Your GP may even be able to specify one of the other on the prescription.

Speak to your gp first, get them to confirm what they are prescribing, make a note of it, then speak to your pharmacist and say that you are having physical side effects because they are not giving you the same thing each time.

Always check what you're given before leaving the shop, and ask to compare the item against the prescription if you're not sure.

The drug is the same in the generic and the branded product, however the carrier often is not. The carrier can affect the uptake into the blood steam there is lots of good peer reviewed evidence for a variety of drugs that different carriers lead to different blood concentrations of the drugs. So no you are not imagining it you need to sit down and discuss this with your doctor so you are not prescribed a generic, but only the brand that works for you.
Examples of drugs with evidence are neurofen and generic ibuprofen and Plaquenil and generic hydroxychlorquine.

some info here

I find that crunching an under performing medicine up in my mouth can sometimes boost the effects.

I have asked my pharmacy to stockpile a supply of my preferred generic up for me as I have so many problems. They have put aside eight boxes aside for me.

I've been taking SSRIs for most of my adult life and I know when I've been given a duff generic.

Thanks for the replies everyone! It's good to know I'm not going bonkers! I will speak to my GP, and be extra vigilant when collecting my prescription in future.