Are Generic Medications Equivalent?

NO!

There's your short answer. The longer answer:
After  intense personal experiences with generics and some online research, I've come to the conclusion that:

• Drug companies, including those that produce generics, are mostly concerned with making money. 
• The major pharmaceutical companies that produce the original (name-brand) medications have a lot to lose if generic drugs are successful and therefor don't have a lot of incentive to cooperate with the generic companies. 
• The FDA is not able to handle the number of new drugs and generics coming into the market every year.
• Many generics come from countries with different standards of production from the original brand names, and bio-hazards (chemical and bacterial) have been found in some generic drugs.
• Some medications have more than a dozen ingredients in them but only one of these (the "active" ingredient) has to be "equivalent" in a generic medication. 
• The way a product is released can be just as important as the drug itself, especially with medications that are meant to release over time (often these have the letters "XR" or "XL" after the name). Because the "filler" used in generics is not the same, it may not release at the same rate as the brand name. 
• Some fillers used in generics have their own side-effects. 
• Even concerning the "active" ingredient, drugs sold as "equivalent" only have to demonstrate a 90% similarity to the original drug, and there is an additional 10% possible fluctuation in production which means a generic might be 20% stronger or weaker than the brand name.

In my online generic search, I've come across actual recalls for generic blood thinners, antibiotics, birth control pills, anti-seizure medications, infant and adult pain relievers, acne creams and antacids. If you do your own search you will find a lot of information about a recall of a generic for Lipitor. I guess a drug that lowers cholesterol has a lot of popular impact but my particular issue has been with psych meds. If you want to read a few horror stories, try these links:

Wellbutrin

Seroquel 

Cymbalta

Citalopram

Effexor

My particular visits to generic hell have been on the wings of two generic medications:

• Wellbutrin XL (Buproprion) the name brand saved my life (not an exageration) but the generic brought on a whole series of side-effects leading up to a suicidal cliff within a few days. 
• Seroquel (quetiapine) I don't take the extended release version - I only take 25 mg.s, which has been helping me sleep for  about five years now. With the generic, I not only did not sleep, but felt increasingly anxious and had a strong metallic taste in my mouth which lasted all day. I never had either of those issues with the Seroquel, but I might have overlooked them if the generic at least helped me sleep!

I believe those of us taking psych meds may be particularly vulnerable to generic incongruities because there's no big money in looking out for our well being and because most people have a tendency to turn away from mental illness. We've come a long way from the times when anyone with a different view of reality was locked behind actual, physical walls, but many people still hold tight to emotional walls erected to separate themselves from anyone different.

I'm not saying all the name brands are perfect, but they are more researched and better controlled. Whatever your generic medication, here's a VERY important and highly un-publicized point - you may be able to get the name brand as cheaply as the generic! If you call the company that makes your name brand medication you may find you can buy the name brand drug directly from them at about the same cost as the generic. This is not true of all drugs, of course, but I'm currently getting name brand Wellbutrin directly from Valeant for $50 a month instead of $550 a month at the pharmacy. Ipaid full price for years, ever since my pharmacy switched to a generic that made me absolutely crazy!

I'd be interested in hearing others' experiences with medications, especially generic UNequivalents and I'd really like to encourage you to do your own research. If you are taking a generic and the results are not as expected, don't assume it's you. Put the words, "generic" and the name of the drug in a search and see what you come up with. If you find (as I did) that hundreds of others are asking the same questions you are, it may be that the drug is to blame. And, if you are having an issue with a medication, make your complaint public. Others need to know they are not alone! Some of these generics stay on the market for years before the FDA realizes the dangerous truth, but with social media we can all become our own advocates.


   
   

Moving Back to the (Expensive) Name-brand Drug

Thanks to all for the comments, emails, hugs and encouragement. I am still here. Lots of racing thoughts and disconnects are making it hard to write coherently.

I was on name brand drug (from the previous post) for five years. Two years ago they switched me to a generic which still worked. Then, ten days ago the pharmacy switched to a different generic, and it does not work.  which did not work at all. I took it for five days, and each one was worse than the last.

Now I am back on the name brand. I believe it's already better than it was, but I'm just really pissed off that my life is so easily thrown in the toilet by a corporate decision  to switch to a cheaper generic - a decision over which I have no control.

Stupid Generic Drugs

I've been feeling very anxious for a few days. I set up my medications for a week at a time, in a dispenser. When I was taking my handful of pills this morning, I remembered the pharmacy had changed my Welbutrin - the antidepressent - from one generic to another.

I'm sure that the new manufacturer is cheaper for Walgreens, and that's why they switched. Since they can charge me the same thing, regardless, they make more money on it if they can get it cheaper.

And, it seems like one generic should be the same as another, but I was worried when I first saw them because they look entirely different. They are half as big, for one thing. They are also a chalkier consistency.

This is a slow release medicine, so I am concerned that it might not "release" the same way if they've used different fillers. I had an issue with this medication once before when I was in the hospital for one of my surgeries, a few years ago. The hospital gave me a different version of Welbutrin and I became extremely agitated and then, later, very depressed. It was hard to pinpoint that exact cause for my distress with all the other meds they gave me, but once I switched back to the name brand Welbutrin - my husband brought me some from home - it got better.

A couple years ago, the pharmacy started giving me the generic, and I was worried about it. The pills looked exactly like the name brand, so I gave them a shot. After a few weeks I decided that they worked just as well. The ones I picked up last weekend look very different and now I'm wondering if taking this different brand for three days (today is day four) is contributing to my anxiety level.

I keep a chart by my bathroom mirror. I fill in a number from 1 to 10 in these categories: How I've slept (recorded only in the morning); how I've eaten (recorded only at night); and my morning and evening levels of "connectedness", anxiety, sadness and irritability. At the end of the day I have 10 numbers filled in and I add them up. The total - a number from one to one hundred - gives me an idea of how the day was on the whole.

I write a little note next to each day as a reminder of what went on that day (meeting with C, CoDA meeting, writer's group meeting, daughter home, etc.)

On Sunday, the last time I took the old generic, my total for the day was 80. It dropped to 68 and 60 on Monday and Tuesday and to 47 yesterday.

Trying to get the name brand is going to be difficult and expensive, but I don't know what else to do. Wish me luck.