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....

I think there is some truth in the difference in effectiveness between branded and unbranded. My long-since retired GP used to swear by a well-known brand of soluble aspirin (I won't mention the name but it begins with D and is in a blue packet). He always recommended it by name and I have always found it works better than unbranded aspirin.

Very glad I read this thread. I take citalopram and am always given different generic packets. Some months I do feel physical withdrawal symptoms, even though I've taken them regularly. I've often wondered if the pills do actually contain the dose they're supposed to.

If its venlafaxine you're taking and they've given you generic instead of effexor you're right. the effexor is either xl or normal and generic isn't. if that's the case go to a different pharmacy and in the mean time take a cetrizine based antihistamine.

When it comes to psych meds, there's a huge difference between brand and generic depending on what you take. I think that's to be expected though considering they're medications that are meant to alter your brain chemistry, and the brain and how it works is still not fully understood. Generally the brand versions have a smoother release and less side effects. Sometimes generic works better for some people. But there is a noticeable difference if you're taking one and are switched to a different brand.

It's like saying Coke and Pepsi taste the same.

Pain meds, not so much. It doesn't take a sophisticated drug to dull nerve endings. It's a pretty simple and straight forward process. Even alcohol can do it.

Moreover, people have been perfecting pain meds for hundreds of years going back to medieval times when you simply drank to the point of passing out for surgery. So we've got centuries of research and perfecting pain management. Psych meds, not so much. Those have come about in the last couple decades. There's still lots of research to be done around them, and we're still not fully sure why some of them even work.

There's definitely something about the carrier medium for drugs that comes into play as well as the drug itself. I don't take medication regularly but for sure pretty much anything I'm prescribed and some OTC mess will make me sick.

After years of this, I now as a matter of course get an anti emetic with any prescription, but even that sometimes causes nausea. I'm convinced it's not the drug itself, as in "I can't take penicillin", I'm sure it's the capsule, or the powders, or the coating.

I think a large minority of medical professionals agree with OP (evidence) but no one sure why it happens. There aren't enough good quality RCTs to say one way or another. Manufacturing standards may be lower for some generic drugs.

YANBU. Theroretically there shouldn't be any difference but I've been on Efexor XL for years and I feel exactly the same as you do once I start a box of generic venlafaxine xtd release. I feel sure it's because of the capsule coating. Anyhow, I signed up for the Boots prescription service and they order the brand name stuff in for me after they talked to my doc.

A few people have mentioned that you should stick to the same brand of antiepileptic drug which is generally true. The same rule does not apply to antidepressants and most other medicines though particularly standard release preparations. They should be very similar.

You are absolutely right. I'm on Escitalopram (Cipralex). Some generics are absolutely fine and I have no problems on, others make me feel very ill. I've had 7 different brands so far (!!!) and 5 of them are fine but the other 2 have been awful. It does seem to be to do with the delivery system as the 2 generics which don't work for me make me feel high as a kite within a couple of hours and then into withdrawal within 12. Whereas with Cipralex I can go to 36 hours before feeling withdrawal. My pharmacists refuse to give me anything other than what's in stock though as they insist there's no difference so I'm trying to come off my medication so I'm not stuck with months of being ill.

Some anti-ds have really huge half lives, that's why they can take 6 weeks to kick in so I wouldn't expect you to feel differently after a few days especially when you are still getting the same main drug.

I think it's a psychological thing, you think it's not the same when really it is so it doesn't work. Different to epileptic medicine as that as a condition is extremely sensitive.

This is a major issue for people with thyroid problems. A friend of mine was for years prescribed a branded medication which was right for her and kept her stable. An edict then went out that they could not be prescribed and doctors have to prescribe generic drugs, with the result that the branded drug has now gone off the market. My friend is left with prescriptions which are either too weak, leaving her very slow and lethargic; or too strong, leaving her with her heart pounding and unable to sleep. To counteract this, she has been prescribed beta blockers - which are much, much more expensive than the few pence which are saved by prescribing generic medication.

This will undoubtedly have shortened my friend's life, and is a problem being encountered all over the country. The strong suspicion is that the Department of Health closes its eyes to the problem because it mainly affects older women.

hi chicken you are correct .my hubby was on venlafaxine ./efexor for mh problems but pharmacy gave him cheap stuff and it made him ill .our gp had to write to pharmacy and specifi the brand .but you always get cheap brand if they can get away with it .because here in scotland we get free prescriptions .which means the scottish government can,t afford it so therefore you get cheap crap medicines .better paying and getting good quality .

YANBU, this is not uncommon with anti-depressants.

I have been on branded and generic sertraline and notice absolutely no difference whatsoever between them. And I am fairly sensitive to withdrawal, by 36hrs I've usually started being very unreasonable.

I could never be confident any changes in my mood were due to meds anyway. Could be hormonal, anything.

I think people need to be minful that there is an enormously powerful industry out there that has a vested interest in getting GPs to prescribe branded meds.

Some epilepsy meds are a special case I gather, though.

aprilanne If the GP wanted your husband to receive a particular brand then he/she would write the brand on the prescription otherwise the pharmacy will not be reimbursed for it and could be out of pocket. They don't give a cheap brand "if they can get away with it" they give a cheap brand because the NHS will only pay for the cheap brand if that is what the GP has prescribed.

I found a difference in my lamotrigine when I started getting given generic rather than branded Lamactical. Didn't realise at first, it was only when I was struggling to walk with the joint stiffness that I had a good look at what had changed.

It's an epilepsy drug, but I have it for bipolar disorder.

Agree about difference within carriers, coatings and I strongly agree with capsules vs tablets etc but as others have said it could be 'just' a placebo effect...
It does mean it is all in your mind BUT the effect exists. It is a strong recognised known effect ....we don't understand it but it definitely exists. It is nothing to be ashamed of - it doesn't mean isn't real to you. It is absolutely fascinating.

Things like homeopathy seem to work - logically it is nonsense - it can't work but (some) trials have shown it does....except there
are arguments as to why it might (consultation times, etc) which are nothing to do with the 'water'.

Or (and I can't remember the name for it) but 'coincidence' - so you have a headache, you take a tablet and the pain goes - so the tablet took away the pain - or could the pain have been going away anyway. (I never take headache pills for just a headache (not a head cold/migraine etc )- I will have a drink water (or coffee - I get caffeine withdrawal headaches) and even nasty headaches get better quite quickly.

Or a standard coincidence -for whatever reason (fighting off a virus etc) you are not feeling 100% - and the different drug gives you a cause or reason.

And to those saying my child couldn't know etc - you know. You have less confidence in it and maybe they are picking up on that, you are looking out for the symptoms, you are expecting them, asking them if they feel ok more often etc etc. (This is reason that when they test drugs it should be a double blind test - you and the person giving you the drug doesn't know what you are getting - drug, 'sugar pill', another drug).
Think about if you hurt yourself and all you can think of is that part of your body, the pain etc. Because you are concentrating on that.
We distract toddler after they fall down and hurt themselves for similar reasons.

Our brains (and bodies) are absolutely fantastic - we understand so little. It is never JUST a placebo effect.

But I find that most generics DO work for me and I notice no difference whatsoever. There is a definite difference in the two that didn't work for me and the five that did. I have no problem with using the generic at all, I have swapped between Cerazette and Cerelle with no issue for example. It is clear to me that there is a difference in those two generic antidepressants which makes them problematic for me.

As PPs have said, it's not the medications themselves, it's the swapping between different generics that seems to be the issue. I'm sure if I had been on one of the 2 generics I feel didn't work for me for years my body would be used to it. It's the contrast in effects of different generics that causes the issues.

I had been
On a generic brand and then started yet another generic brand so
It weren't a placebo effect for me! I weren't expecting anything different to happen.

WHATEVER5 i did say that the gp had to write to pharmacy about particular brand .yes they only give the cheap brand because of this free for all attitude .we can,t afford free prescriptions for all .my hubby was happy buying a yearly prescription if he got the decent medicine .but i noticed someone else also noted problems with the same brand being switched ,

Well, none of my family are on regular drugs (and although DH insists Nurofen is better than generic I have always disagreed) but I didn't know you should crush medicines!

yes yabu