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....

Yabu.
They can't be different, in terms of acutual components, by law.

Unlucky83, Im going to disagree with you about your comments below. In fact I have to say I find them quite bloody insulting. The fact is that for my son none of the below would apply due to the nature of what he needs the medication for.

"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"

Well, for those thinking in the placebo effect of branded medicines, my migraines react better to generic ibuprofen finished in pink coating. I swear to you I hate pink, but those pink tablets seem to have something that more expensive stuff hasn't.

Having said that, I am totally convinced that there is no such a thing as generic being the same as branded. You pay more for a good reason, I also noticed that when it came to ADs, the generic medicine was not half as good (or suit me as well) as branded medicines, but convincing the GP about that was lost battle.

OP yanbu as I have experience of this with 2 different medications. It's not so much generic v main brand but generic v generic. I can definitely notice the differences of different brands. It's not your imagination. When I find a brand that works best I like to stick to it and will go to different pharmacies to get it if they have it. This week I drove around to 3 different pharmacies none had the one I wanted so in the end I had to plump for one which luckily is ok. I know which ones I want to avoid so stay away from those.

The once asked a pharmacist who assured me the ingredients had to be exactly the same in each companies product but clearly there are discrepancies.

Like buying say an egg or a free range egg they are they same ingredient but one is just better.

If it's truly a placebo effect causing a bunch of weird side effects, don't you think that we could just give people sugar pills to cure depression?

Personally, I have terrible self awareness on meds. I feel fine or the same regardless, it's DH that let's me know when I'm acting a bit weird.

Switching brands affected my moods, energy levels, appetite, etc.. I'd be the last to notice. Or I'd go through my mood tracker app and notice things got weird after picking up a new prescription.

It has been shown in very good, randomised controlled trials, that brightly coloured tablets are more effective than dull white ones. Even when every other component is the same.

Wow! I take 200mg Tramadol extended release capsules. I have been having the same kind of brand for ages, until recently.
On the friday I picked up my bi-monthly prescription and noticed I had changed to a different brand. On the saturday I took said new brand tablets and went to a local museum with our DCs, I was absolutely out of my mind, felt high, giddy and well, really relaxed! I had eaten properly that morning, not drank the night before, nor taken any other drugs!
Make no mistake, I was around in the early 90's and I know what being high feels like! Thankfully these symptoms wore off after a week or so (And no, I did not drive or operate machinery)!
I am convinced there is tiny, minute differences in the opposing brands which affect people's brains differently.
DISCLAIMER- I am a waitress though, not a Pharmacist!

The 'active ingredients' are identical but sometimes it is something else, this is why coproxamol was withdrawn and cocodamol is still available, the amount of coedine and paracetamol is the same in both but the binding agent in coprox is different and caused a lot of people side effects.

Imagine it like scrambled eggs. I make scrambled eggs with just eggs and a touch of water, my mother makes them with a touch of milk.

Both are scrambled eggs but if you had a dairy allergy you would react to one not the other

Why don't they start people on the generic drugs and then only move onto branded if that fails to work.

I notice the difference if I'm given branded.

aprilanne Chemist shops are private contractors, not part of the NHS. They dispense tablets and then the NHS reimburses them for the tablets. For example, if the GP writes a prescription for 30 venlafaxine m/r 75 mg tablets, the NHS will pay the pharmacy about £11. The pharmacy won't dispense Efexor as these cost about £22 and they will be out of pocket.

It has nothing to do with free prescriptions for all. The same thing happens in England where prescriptions are not free for everyone.

If it's truly a placebo effect causing a bunch of weird side effects, don't you think that we could just give people sugar pills to cure depression?

It wouldn't be ethical to give people sugars pills if you told them you were giving them something else though.

Why don't they start people on the generic drugs and then only move onto branded if that fails to work.

Because there is absolutely no evidence that branded medicines are more effective than generics. They are just more expensive. If a medicine doesn't work it would be better to try a different medicine.

The 'active ingredients' are identical but sometimes it is something else, this is why coproxamol was withdrawn and cocodamol is still available, the amount of coedine and paracetamol is the same in both but the binding agent in coprox is different and caused a lot of people side effects.

That is not correct. Co-proxamol and co-codamol do not have the same active ingredients. Co-codamol is paracetamol and codeine whereas co-proxamol is paracetamol and dextropropoxyphene.

YANBU, I take thyroid meds and I had to get them from a different pharmacy at one point. They gave me a different brand, I didn't think it mattered but I began to go really down hill when taking them. Felt like they weren't working properly so i got my usual brand asap. I don't know why and I don't care just as long as I don't feel like a zombie I'm happy.

The cheaper drugs have the same ingredients in them but can only be done once the patent has run out. For instance I've heard that viagra's patent is due to run out soon which means they'll be cheaper ones on the market, with the same affects.
I have the cheaper branded med and have noticed no difference whatsoever, neither, had partner with his meds.

Bulbasaur
If it's truly a placebo effect causing a bunch of weird side effects, don't you think that we could just give people sugar pills to cure depression?

Interesting discussion goes on about how effective antidepressants actually are ... a taster here
www.badscience.net/2008/01/washing-the-numbers-selling-the-model/
(Fact - ADs don't work for everyone and clinical data has been hidden)

I used to be a biochemist/research scientist - this was not testing drugs!!!! but I know in order to be successful you need to publish as much as possible, as quickly as possible - I know that some of things published were not as thoroughly investigated as they might have been and some things were later found out to wrong at least in some aspects but these were never corrected in print. These were peer reviewed things.
I am being very careful what I say here but I looked at a drug (not ADs) to investigate their effect on specific cell types in the body. Basically the drug was found to have a helpful effect on a whole body (from a health pov) but how it worked wasn't known. I was in part supported by a big drug company - as well as their drug I also compared their drug to competitor's similar drugs (tiny differences in structure ) - 'my' drug seemed more effective. It came onto the market but was partially withdraw due to side effects (might now be fully withdrawn).
Reading all the literature surrounding this chemical there were several inconsistencies on how it could work - some papers would support a certain mode of action - which would suit the drug company but several including my data (never published) didn't. See above how things get published that are inaccurate. I thought the evidence was stronger for a different mode of action.
Several years later I heard a talk from a scientist I vaguely knew and didn't think was a particularly thorough researcher. Joint work with the drug company 'proved' that the mode of action that suited the drug company was the right one. Didn't look into it again - nothing to do with the work I was doing then - but part of me thought -'well that's convenient isn't it'

unlucky83

Yeah, I do agree AD's aren't a be all end all, and I have no doubt that pharmaceutical companies are pushing their drugs.

But after being on weird cocktail of meds I needed just to function for a bit, I will venture to say it's not just "in your head" and they do work. At least for me. It certainly wasn't me "believing" they were working either because it took a little while to find the right doses. But they were never intended to be a permanent thing either, once I was feeling better, they slowly weened my off and that was that. I don't think I would have gotten better without something to physically stop panic attacks and psychosis.

The brain is still not understood, so I don't think it's a big stretch to say that something as simple as how the pill is released or how it's coated would effect how it works.

I have to have a certain brand of Levothyroxine or the filers mean it just doesn't work for me. I now have to trudge around every month to an independent chemist so that they will get it for me, as Lloyds and Boots no longer stock anything but the generics. The hospital put me on this one brand and acknowlegde that it's a lot more stable, there have been countless reports of huge variation in dosage in Actavis brand Levo in particular.

It's a bit of a scandal, really.

Bulbasaur - I've been on ADs too ...something like valium works without a doubt but the SSRIs (and I've been on them too) not sure that they 'work' in the way they are supposed to ...
but even if they worked just because you believed they worked that's a good enough reason to take them (and I'm not saying that is the case at all) - they work!.

(Hence me saying it is never JUST a placebo effect...whether it is or not is unimportant)
Cariads meant to say - sorry if I upset you - that wasn't directed at you directly it was just a comment on it is a documented fact that if someone giving someone a 'sugar pill' knows that's what it is even if they don't say anything different it has less of a placebo effect -amazing really.

And generics are cheaper because they reflect more how much the drug costs to manufacture - the branded ones include the cost of the research & development, discovery of leads, extended clinical trials etc that go into them - that's why they are patented for a certain amount of time to recoup some of that expense.

confused70

Viagra's patent ran out quite some time ago, and sildenafil is available under all 3 strengths on both nhs and private prescription. The price difference between the brand and generic on a private prescription is eyewateringly large

I always wondered whether coproxamol bought my depression on...
Silence sorry random q, how do you get on with your sliw release tramadol? How do they work?