Can I insist I am given Dothiepin not dosulepin by chemist

[DothiepinUser]

I took great interest in a topic here some time ago (here for anyone interested).

I have been succesfully taking Dothiepin for several years. More and more often, the chemist dispenses its generic version, dosulepin.

I believe that this does not react in the same way as the Dothiepin. For instance, within a couple of hours of taking Dothiepin, I am practically comatose and can go to bed and sleep better. This doesn't happen with dosulepin, I sleep badly, and am pretty sure that my overall "mood" is affected for the weeks I am taking it.

I am hoping to get Dothiepin for my next prescription, and will ask dh to give me one or the other, and am certain that I will be able to tell which one I've taken within an hour or two (not exactly proof, I know!)

However, can I insist/request that the chemist give me Dothiepin? There is no way they are going to accept that I (with my label of "mental mother") is going to be taken seriously if I try to say that I think the medication is different.

I think the only way to be sure your chemist gives you the branded one is to insist that your GP write the prescription for it that way. Can you go back and discuss it with your GP? I'm sure if the script is written for the branded drug the chemist can't dispense a generic.

Dusulepin is the new name for dothiepin. Dothiepin is/was a generic name (trade name prothiaden)the names of a number of drugs were changed a couple of years ago to internationally approved names. I wouldn't have thought that "dothiepin" would be available at all now so the Pharmacist won't be able to give it to you.

I have been given Dothiepin in the last year, so I assume that there's still some stock hanging around! I am fairly sure my prescription has been written as Dothiepin, but perhaps not.

The pharmacist, if she gives me the packets of dosulepin, always says, "don't worry, it's what you always have, it's from Europe." I know I am different with it though, which I've slowly established over the last 18 months or so (which worried me when I read the thread I'd linked to), as the months I've had Dothiepin are OK.

I don't see my own GP at all (he's one of the "pull yourself together" brigade). He thinks that all women are hormonal, all mothers fuss about their babies too much, and any problems we have are due to stress - a really caring chap.

I am able to get repeat prescriptions by phone as the GP who finally "sorted me out" (but has now retired) has ensured that the practice understand that this drug is essential for me to lead a normal life.

Thank you both for your answers, I think I will have a chat with the pharmacist first. And then panic a little.

the name has changed to comply with EEC rules . This means that once any stocks labelled dothiepin run out you will never get any more with that label. You will have to change to a product with dosulepin on sooner or later. It is honestly only the name that has changed.

It is the same as the fact that Amoxycillin is now called Amoxicillin.

What may be happening is that you are getting the same drug from different manufacturers (pharamcists tend to source the cheapest supplier at a given time) and there are subtle differences in formulation which are causing the changes you notice. It will honestly not be down to the name on the packaging.

These "subtle differences in formulation" are what worry me though. Posters on the thread I linked to originally were talking some pretty serious life-or-death type situations.

I do realise that mine isn't on the same level (although it does feel like it sometimes), and I wish you could have a sensible conversation with the medics that don't involve them giving you a placatory pat on the head.

I have noticed a difference, my dh has noticed a difference (without me telling him what I felt was happening) - and it has only happened during the 3 months I'm stuck with the box labelled "dosulepin" and not with the 3 months I've had the box labelled "Dothiepin" (sometimes the 3 months has been longer, depending on what I've been given).

I sound completely and utterly barking mad really, but I'm not!! I'm a grown woman who does not suffer with stress, only have the usual monthly hormone upsets and athlete's foot, and I know this stuff is different (I took my dosulepin two hours ago, and I am as awake now as I was then ... hmmm).

I really wouldn't be so concerned if that was the only difference, but having read what you guys have said, I just have this sinking feeling that I might as well take a cube of sugar. I do not want to go back to my life of hell.

I have to admit I am not familiar with this particular drug, I am coming from a 'know a little bit about generics angle'.

A generic is merely a drug made by a company who didn't invent or discover the drug. I.e. it is essentially an (identical) copy of the chemical. The problem with generics is that the patent covering the medicinal entity often expires before the patents which protect chemical synthesis, manufacturing process and formulation of the drug... So early generics will be the same chemical entity but they have to make it a bit different to avoid infringing other patents - depending on the individual case. In most cases it does not affect the action of the drug or its side effects - but it can.

What I was trying to say is that the name that the doctors and pharmacists will use for your drug from her on in is dosulepin. That is not going to change.

It sounds as though this change has co-incided with the introduction of a generic version. Do you have packaging from the variety you are happy with and that which you are not. You may be able to request that you have your drugs from teh manufacturer you are comfortable with - I don't know whether pharmacists will be able to meet your request or not. The other option is to specifically request 'prothiaden' - which is the brand name that the original inventing company have given it.

For example - rather than saying you want a bar of nougat with a layer of caramel on top, coated in chocolate, where you could be served with a range of supermarket own brand products - you ask spefically for a Mars bar, and get a Mars bar. I hope you can see my analogy. It doesn't gurantee you will get 'prothiaden' though - as it is obviously cheaper for the NHS to use the generics...

In summary - the problems you are suffering are not because the box says dosulepin. It is more likely to be because you have been given a "supermarket own brand" product rather than the original Mars bar. Incidently 'prothiaden' will still be labelled dosulepin in addition to prothiaden as dosulepin is the active incrediant.

HTH

(got your cape on tonight sms?)

Yes, I have kept the boxes - and my "nice" ones say "Dothiepin", my horrid ones say "Dosulepin". I have never had one with "Prothiaden" printed across it (will check small print later).

What you have said is really interesting - I can just imagine trying to discuss Mars bars with the pharmacist - last time I needed to check whether certain over-the-counter drugs would interfere with my medication, she had to ask me what Dothiepin was!! I told her it was an anti-depressant (I had to write it down because she didn't understand), and she still gave me incorrect information.

What you have said has been really helpful, many thanks.

(Are you really a super-hero??)

(she is a superhero)

(she is also a fruitloop)

What you need to look for on your packging is 'manufacturer' or 'license holder'.

As the 'prothiaden' is the brand name that would usually be in the biggest writing with dothiepin/dosulepin in smaller writing underneath. It sounds as tho you have probably always had a generic - maybe it is just onw brand which 'disagrees' with you.

I hope that I have been clear. Have a look at this article which explains a bit more about generics - and probably uses the better example of ibuprofen naming conventions. There is also an interesting list of drugs at the bottom which have to be sold by brand name as people are sensitive to changes between generics. Dosulepin is not on the list - but some epilepsy drugs are - which is probably relevant to the thread which you linked to.

I hope I have been of help. I am going to bed now - but if you have any further questions feel free to give me a shout.

... so someone completely mad is advising me, (who is medically and emotionally mad), on my medication. There is absolutely no hope for me at all!!

... I'll read the link properly after my anticipated-not-such-a-good-night's-sleep, had a quick scan already. Will also have a closer read of the small print on the packets.

(And I know I am going to forget to change my nickname from my normal one soon, and then you'll all know that I am mad).

night night. sleep well x

It sounds awful that you feel your GP isn't supportive. Is there any milage in switching GP? Im a great believer in spending time looking for a good one, especially if one suffers from a chronic/long term illness. It sucks that you are not getting what you need out of these tablets and it also sucks that you feel you are not being heard/understood. Good luck.

The Mad one is right - Dothiepin and Dosulepin are the exact same drug just with a change of name. Is it possible you were given a brand name in the past and are now getting a generic or vice versa? Alternatively, maybe your body is simply responding to it differently now for whatever reason, maybe you need a different dose, something... If your GP is not supportive I would strongly suggest finding one who you feel you can discuss this with. Good luck.

they are the same thing just need a name change to fit in with europe.

It is partly because there is a sulphur atom in the drug molecule (which used to be called a thio group hence dothiepin) and is now called a plain and simpler sulphur group (or increasing sulfa group) so there is a whole list of things with a name change (thyroxine to levothyroxin, cephalexin to cefalexin) spare a thought for the poor doctors receptionist having to get her head around it

ps it is nothing to do with generics it is the international non-proprietary name that is being standarised

I'll have you know I am only SlightlyMad you know...

I don't ever see my own GP, and only ever see another practice doctor if I am more or less at death's door. It's not an ideal system, but it works. The doctor who finally took me seriously was another GP at the practice who has, unfortunately, retired.

I've checked the packaging/inserts on both the packets I have, prothiaden is not mentioned at all. I started on dothiepin at least 14 years ago, and it always had dothiepin printed on the box.

If dothiepin and dosulepin are one and the same, does that mean it's impossible for them to have (what I think is) a different reaction? This has taken me at least 18 months to figure out!!! (Perhaps I really am going mad!)

SlightlyMadSuperhero - I've read your link, and it made for very interesting reading. The bit that says it could possible for a difference "in the amount of time it takes for a tablet to dissolve in the gut and be absorbed into the bloodstream" made me wonder whether that would explain why I don't get "knocked out" when taking the dosulepin (except that they are identical?? so not possible??)

At the back of my mind is the fact that, before I took dothiepin, I was given a different anti-depressant. It didn't seem to have any effect on me, although I was assured that it would - so the psychiatrist I saw despatched me for several timed blood tests. It apparently proved that I basically passed the drug through my body and didn't absorb any of it (he used a proper scientific word for it!) If I can do that, is is possible that I can do it with a "slightly different" formulation of dosulepin/dothiepin?

I work in adult psychiatry and I've had clients who find that their body 'reacts' better when taking a medication in a different form. eg Some medications can be administered in tablet form, syrup, dissolvable strips, depot injection etc. I can therfore believe that you might find a difference between the two meds.

I'd go back to your GP and discuss it with him/her. It may be that they can repeat the blood tests that you had before or else make a slight increase to your dose to see if it has any positive effect. Alternatively, you may need to change the time that you are taking your medication, so that you are sleepy at the time you need to be.

Best of luck.

summer111 - that's the sentence I like - "I can therefore believe that you might find a difference between the two meds."

Right then ... have just taken my evening dose of dosulepin, many hours before I would normally - will see what happens.

I will be ringing GP surgery tomorrow for repeat prescription, and will ask Very Helpful Receptionist (I will be very nice to her) to request the GP writes "dothiepin" - I will then ask Very (Un)Helpful Pharmacist to give me Dothiepin (I know it's been said I probably can't have it but, hey ho, worth a try).

I have a vision of marching in to see a GP and giving them this thread. That should prove interesting. I will end up being committed at this rate.

Many thanks to all those who have posted. It has certainly helped me understand a lot more about it all.

Good evening. Do you feel a bit more comfortable with my new name ?

Right - I am 99.999999999999999999999999999999999999999999999999999% confident that dothiepin is identical to dosulepin. The only thing that has changed is a few letters in the name - and I think there is a legal requirement for the new name to be used as of a certain date (but I doin't know what that date is and whether it has passed or not).

Your tablets contain drug (i.e do...pin) and other inactive ingrediants. It is the drug and inactive ingrediants together which make up the "formulation". (Have a look at this for a bit more info )
The drug is identical in your 2 tablets. They have to be to be whether they are labelled dothiepin or dosulepin. Dosulepin is the internationally accepted name for this drug now. The difference will be that there are different inactive agents in the tablet - which are not supposed to affect the medicine. The coating is usually a critical component of the way a medicine is absorbed - and if that is changes

For example - infant ibuprofen.
When it is marketed by Pfizer it is called calprufen and it has ibuprofen in as well as another inactive ingrediants such as syrups and sugars. It also has a strawberry flavouring.
When in is marketed by Reckitt and Benckiser it is called childrens Nurofen. It has the same ibuprofen in, with syrups which may differ and has an orange flavouring.
You can tell the formulation is different because it tastes different, but the drug is identical.

Bit delayed, but thankyou for your last post SensibleMissSuperhero (prefer your usual name though!)

I've discovered that if I take the Dosulepin very early evening and only after eating, I start feeling very weird, not tired exactly, but I have to go to bed as I'm not properly "with it." This is relatively positive as it certainly saves me from all the pigging out I usually do late evening. (Dothiepin, albeit that it is supposed to be the same, definitely has a different effect). It is certainly easier getting up in the morning, perhaps because the "weird" effect has worn off!

I've not yet got my new prescription, but don't feel quite so worried about it at the moment.

Many thanks again to all who have posted.