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Generic vs brand versions of antidepressants?

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Altostrata

Tabby, your prescription was filled with two generic types of Effexor, from different manufacturers.

 

As LexAnger indicated, if your husband is sensitive, the changes in generic brands might cause him problems. Many people are not that sensitive, however.

 

To avoid the risk, you should make sure the prescription is always filled with the same brand, whether generic or name brand.

 

Are the beads you saved all from the same manufacturer and same dosage of generic Effexor? If they're beads from different dosages, such as some from 150mg capsules and some from 37.5mg capsules, it's unlikely you can make up consistent 37.5mg capsules from them, there can be bead variation between dosages.

 

(If they're all from 37.5mg Teva capsules, you might be able to make up 37.5mg capsules from them if you have a digital scale. First, you need to empty a few intact 37.5mg Teva capsules to get the average weight of the beads in each capsule, then you need to weigh the loose beads you have to approximate that.)

 

Please start a topic in the Introductions forum for your husband so we can go into more detail about his particular taper. The topics in the Tapering forum are for more general information.

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Tabby

Thanks for the replies!  

 

I've called our pharmacy to see if they can specifically get the Teva brand of venlafaxine for us, and they're to call me back.  Otherwise, I will call around and see if any others have it.  

 

You all are right--if his brain is used to the Teva brand, and we're "successfully" coming down off of it, we don't need to go changing something else in the mix that might make things worse.  He's already feeling "iffy" enough to need to hold at this dosage awhile, I don't want him having to feel even more iffy because of a manufacturer change.  

 

The thing about our excess beads, though--I haven't kept them separate between doses.  They all look EXACTLY the same.  It makes sense to me that the manufacturer would make the bulk compound, venlafaxine, and then "dose" it out in the capsules.  To do it differently doesn't seem to make financial sense for them, but I'll do some digging around to see if I can find any more info.  

 

His psych. says she'll do whatever we want (prescribe whatever dose, etc.), but she doesn't think he'll ever be able to get off it!   We intend to show her!  I think his health depends on it.  

 

Thanks again!

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Altostrata

Tabby, please don't assume those beads are all the same.

 

Please start a topic for your husband in the Introductions forum, that's where we discuss individual tapering situations.

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Tabby

Good news is, our pharmacy was able to get his current "brand" of venlafaxine.  They are even able to fill it before his current pills are finished (because almost half were the other brand).  

 

Thanks everyone.  

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Altostrata

Good to hear. Please let us know how he's doing in an Introductions topic.

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laineyk

I have been on Zoloft for almost 14 years (on and off a few times. used to be on this forum all the time until I realized I have to get off the benzo 1s then work on getting off the AD

 

question is I have been taking sertraline from Auborino?sp?  for a year now and just got new script from Camber. I hae no idea what pharmaceutical company I was taking prior to that, never paid any attention.

 

but being in w/d from valium I am super sensitive. was just wondering who has opinions on which generic sertraline is best

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Altostrata

I don't believe there is any information about what generic sertraline is best. If your system is accustomed to a drug from a particular manufacturer, AND you are one of those people sensitive to differences among manufacturers, ANY switch in manufacturers may cause problems.

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sunshine01

Hi everyone. Quick question here. If someones antidepressant was changed form brand name to generic, if they were going to notice anything would it normally be in the first little while? as in the first few days??

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cymbaltawithdrawal5600

It could be at any time while they are taking it and not everyone notices any change at all.

 

Would you like to start a topic about yourself in our Introductions forum and tell us about yourself:

Please start a topic about yourself in this forum

Post #5 is very helpful.

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sunflower

Hi Sunshine,

 

Most people don't have a problem going from brand name to generic. However, many people do and there is research that shows that some people have a negative reaction to being switched. At I've heard of instances where people have to slightly increase their dose of the generic to equal that of the brand name.

 

A number of years ago I was on brand name Zoloft and was switched to generic due to medical insurance issues and I noticed a difference like 6 weeks later. I felt like I had tapered the Zoloft.

 

Hope this helps.

 

Sunflower

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Altostrata

People are sometimes even sensitive to the differences between generic brands.

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LoveandLight

So what did you do you then sunflower..?

 

Dunno if I'm reacting to this new brand and I cannot get hold of the brand I normally have...this brand is the only type I've found that will make a suspension..I had a window the day of changing the brand (after reacting to liquid sertraline) and an immediate uplift in mood after taking it but the day after and since things have been really bad..could I be reacting to this even although I had an immediate uplift in mood the first day?

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wantrelief

I realize this topic is old but it is relevant to a situation I think is happening to me.  The brand of Klonopin I am taking was changed from one generic to another and am noticing a difference.  Has anyone had a problem initially with a generic but then gotten used to it?  I called all of the pharmacies in the area and no one carries the generic I was on previously.

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manymoretodays

I did.  I initially had increased difficulties on generic Lexapro........stayed on it..........  So I guess you could say I got used to it.  It wasn't too long after that switch over by the pharmacy and insurance company that I really began getting off of it completely.  The irony.

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Flowers

I so wish I had found this topic before I changed from one generic to another a few weeks ago. 

 

For 17 days I took a different generic brand from the Pharmacist and thought nothing of it. At first things were fine and I did feel a little nauseos and headachey but nothing serious. Over the days different WD symptoms began to rear their ugly head and suddenly the penny dropped that it might be the drugs.

 

The symptoms I am now facing are:

 

Nausea

No appetite

Giddiness

Heart Palpitations

Fatigue

Cortisol Spikes

Low mood

Anxiety

Muscle twitching in legs

 

So this is almost like when WD first hit but not quite so bad thank goodness.

 

I have been tapering very successfully  and did my last drop weeks ago so I cannot think of any other reason why this should suddenly happen. I have always been sensitive to any meds.

 

I have managed to get my usual generic now and have been taking it for 5 days. Can't see any improvement so far but guess my CNS has had a shock and I will have to use all my skills to get through this and get back to where I was.

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JamesF

Hello, 

I previously thought SSRI pills were standardised across different manufacturers. I.e. that 100mg sertraline looks and weighs exactly the same from 2 different manufacturers. 

I recently got a new prescription and found that 50mg sertraline weighs about 8% different from 2 different manufacturers. From one, pills are 0.150g, from the other, 0.160g. I had previous never checked the total weight, because I'd always been breaking them in half and crumbling them down to the appropriate weight. I'm very glad I checked before starting to use them.

This has big implications when it comes to tapering, because an equal weight of the pill contains a different amount of SSRI. 

This leads me to a question I'm wondering if anyone knows...

Are all SSRI pills all homogenous?

(That is, is the active ingredient always evenly distributed with the filler ingredients? So that breaking off any particular part always contains the same % active ingredient as the % volume of the total pill. E.g. breaking off 50% of the pill always contains 50% of the total active ingredient?)

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brassmonkey

Hi James-- this question comes up quite frequently. Yes, the pills are homogeneous. The only part that doesn't have active ingredient is the XR coating, which, if the pill has one, is a very tiny percentage of the tablet.  Because of this it is better to crush the tablet into a fine powder instead of breaking pieces off.  However, the ratio of coating to tablet is so small it won't make any difference in the dose amount.

 

If you're going to be getting pills that are different each time then it would be a good idea to calculate your dose using the active ingredient/ pill weight ratio as a basis instead of using a straight percentage reduction. The AI/PW ratio is determined by dividing the active ingredient concentration (the strength listed on the bottle) by the average pill weight. So using the numbers you gave above:

 

Pill one  is;  50mgai / 150mgpw = 0.33mgai per 1mgpw

Pill two is;  50mgai / 160mgpw =  0.31mgai per 1mgpw

 

Using these ratios you would determine the mgpw of your dose by dividing your target dose by 0.33 or 0.31 depending on which pill you're using.  So if you wanted to take a dose of 18mgai it would be 18/0.31 = 58mgpw for pill two or 18/0.33 = 55mgpw for pill one.

 

When it comes down too it though, there is only a 2/100 mgai difference between the two pills.  Even at a full dose this isn't enough to make a difference for most people and at the lower doses the amount is so small you couldn't even manipulate the powder to make corrections.  Unless you are showing an extreme sensitivity to the drugs I don't think the extra book keeping and calculations would be worth the bother.

 

I hope that helps.

 

Brassmonkey

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Altostrata

Different brands sell different tablet weights. Even within the same brand, there is no consistency from dosage to dosage; within dosages, tablets or capsules will be close in weight.

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JamesF

Yesterday I got another prescription for sertraline. The pill was another brand I had to not used before. Colour was different. Pill weight was much different. (I worked out to take the same mg active ingredient of course)

 

Asssumed it was normal when I took it, but now I feel like I've taken a significant updose or cut. I read that the amount of active ingredient entering the blood stream from different generics is not tightly regulated. I've seen some figures that it only must be within "80 to 125%" of the leading brand.

 

http://articles.latimes.com/2007/dec/17/news/OE-WAX17/2

 

https://www.webmd.com/depression/features/generic-antidepressants-what-you-need-to-know_

 

Feeling a bit desperate because I can't get another script for 2 days. Not sure whether to keep taking it or what.

 

I didn't know this even happened :(. Any advice ?

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Centime

I’ve had the same experience with generic Paxil. It simply doesn’t work for me. There’s no way it’s identical to the brand name drug!

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brassmonkey

The only thing a brand name tablet and a generic tablet have to have in common is the dose weight of the active ingredient.  All of the fillers and time release materials are up to the individual manufacturer.  The size and shape of the tablet is sometimes dictated by the local regulatory agency as every different tablet must be identifiable from every other type of tablet via size, shape or identifying markings. These differences can cause the tablet to react differently between people because they can affect the absorption rate of the medication.  Because of the difference in the fillers etc, some generics will cause problems for some people while others won't.  It's a trial and error thing to find out which will work and which will not, but experimenting can be painful.

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