Medication manufacturers

[Hopel]

I was reading through some threads in here the other day and I’m sure someone suggested (if I got the correct end of the stick) that different pharmaceutical companies vary in the ingredients of the same drug?
I just collected my latest prescription of Citalopram and noticed it’s a different manufacturer to my last prescription, which was different to the one prior to that...
I’m wondering what effect/side effects this could have, if any?
I’m wondering if this is why my horrendous fatigue isn’t shifting even 6 months later. I will make another appointment with my GP but wondered if anyone has any thoughts.

I believe the active ingredients will be the same. Citalopram has a specific chemical structure. The "carrier" my change though but there shouldn't be any difference in how you feel. I've been on citalopram and escitalopram for many years and I don't think I've had the same manufacturers twice in a row!

Incidentally, escitalopram is a purer version of citalopram and you don't need so much
I was on 40mg citalopram and like a zombie. Escitalopram 20mg is the equivalent but has fewer side effects.

Ask your Dr to change - citalopram is cheaper so they use that first

It's not unheard of that people can get starting side effects again, or withdrawal side effects, from switching brands.

In theory it's the same dose of the same drug, but I have read one explanation as being that the different brands can enter the bloodstream at different rates because of the differences in the other tablet ingredients.

As for fatigue, I don't think it would be responsible for that. That's far more likely to be just the depression, or the possible side effect of antidepressants that they may make some people tired, or some other physical problem.

The API (active pharmaceutical ingredient, the chemical that is the actual medicine) is the same but different manufacturers might vary the formulation (so the composition of the “rest” of the tablet eg colour, filler, casing).

This manufacturing process is tightly regulated and the new formulation should be equally effective as any other you have used in the past.

However, some patients find that the change of manufacturing process and formulation of their tablets effects how well their medicine works or the side effects that they get. (Colour of tablet has a surprising effect, yes, really, also size of tablet eg easier/harder to swallow, taste, how easy is the packaging to open, all sorts of things.)

If you notice your medicine seems not to be working as well as it used to or you get more/different side effects, your prescriber might be able to specify specific formulations or manufacturers, or make other changes to your prescription. Other patients (?most) are completely unaffected when the manufacturer of their medicine changes from one prescription to the next.

^^ the above is true across classes of medicine not only psych meds.

I have read that with lithium, the brand makes a big enough difference that they will specify one brand on the prescription.

It is possible for different brands to work differently if you're very sensitive to medication (as I am). Some meds (eg lithium, carbamazepine) definitely need to stay with the same brand all the time.