Problems with Generic Prescription Drug Brands

[Lotus97]

My question is about all generic brands. I know quality of generics can vary from brand to brand, can the quality of the same generic brand change?

I've been having a lot of health problems these last 3-4 months, but miraculously the one thing that has remained relatively stable is my mood. I've been taking Aurobindo Prozac/Fluoxetine 10 mg for at least 5 months and haven't had problems until recently. I've been taking a new bottle of Aurobindo Prozac for about 12 days. After about a week of taking the new bottle my mood began to drop rather quickly to the point where I'm very depressed now. I don't understand how this could happen since the new bottle was Aurobindo which was working great before. The exact same thing happened when I tried switching from Prozac to Paxil last month because the Paxil brand they gave me (Zydus) was a bad brand and taking it was essentially the same as taking no antidepressant. After I had been off the Prozac for 7-9 days my mood dropped rather drastically. Prozac has a very long half life which is why it took so long for it to clear my system. When I switched back to Prozac my mood improved again until recently. I guess I'll give it another week before I really start to worry, but I wanted to ask about this here first. Should I call the pharmacy about this? I have a feeling they're going to blow me off. I've been on various prescription antidepressants for the past 15 years so I know when a medication is working and when it isn't.

 

[Lotus97]

I've been trying to think of other possible causes. A few days ago I started probiotics. Maybe the depression could be a result of die-off. Also, I've been on Zyprexa for about 3 weeks. Zyprexa is a serotonin and dopamine antagonist, but I'm on a low dose (2.5 mg) and I take it at night yet I'm depressed for 24 hours after I've taken it.

 

[heapsreal]

I think anything sedating could potential worsen depression and a double whammy if coming off prozac. Sleep is double edged too as not enough can worsen depression.

Zyprexia has a long half life which would linger in your body through out the day. If u are using it for sleep maybe try seroquel which is a similar class of med but half life is much shorter, although the first few days on it many are groggy throught the day at first but its great for sleep.

 

[Lotus97]

I think anything sedating could potential worsen depression and a double whammy if coming off prozac. Sleep is double edged too as not enough can worsen depression.

Zyprexia has a long half life which would linger in your body through out the day. If u are using it for sleep maybe try seroquel which is a similar class of med but half life is much shorter, although the first few days on it many are groggy throught the day at first but its great for sleep.

I'm still taking Prozac, but I feel the same way as I did when I went off Prozac. The weird thing is that it's the same brand, but it's a new bottle so maybe the new batch changed somehow. I'm not sure what sort of quality control standards these generic drug companies have. Still, I should give it a few more days before I jump to conclusions.

Until a few days ago my main problem was overstimulation so being sedated would be a welcome change. Right now I don't really feel overstimulated or overly tired. Just really depressed. My main concern with atypical antipsychotics like Zyprexia and Seroquel is the weight gain. I suppose I should also be concerned about their other side effects such as high cholesterol and high blood sugar...

 

[heapsreal]

I'm still taking Prozac, but I feel the same way as I did when I went off Prozac. The weird thing is that it's the same brand, but it's a new bottle so maybe the new batch changed somehow. I'm not sure what sort of quality control standards these generic drug companies have. Still, I should give it a few more days before I jump to conclusions.

Until a few days ago my main problem was overstimulation so being sedated would be a welcome change. Right now I don't really feel overstimulated or overly tired. Just really depressed. My main concern with atypical antipsychotics like Zyprexia and Seroquel is the weight gain. I suppose I should also be concerned about their other side effects such as high cholesterol and high blood sugar...

with seroquel, i only use it at most a couple of times a week for sleep in low doses like 25-50mg, low doses and using intermittently i think helps reduce any chances of side effects like weight gain etc i havent had any side effects using it like this anyway.

 

[peggy-sue]

I was given Prozac several years ago, it was grand, then I came off it.
I was fine for a while then, because of bullying at work, needed to go back on an AD.
I was given Prozac again and it did nothing.
I was led by my gp to believe this is quite common for Prozac that it only works the first time you take it.
I do not know how accurate that is, my gp does bluster a load of fibs.

However, while I'm currently on citalopram, I am seriously contemplating asking to change to Wellbutrin XL as it's the only AD which doesn't act as a chemical castrator.
Having to be on ADs long term affects not just the person on them but their relationship too, if they have one.

So I've been doing a bit of research, and it seems that there is a huge furore going on about Wellbutrin - the generic drug does not work apparently - only the brand-named one does.

This is the site I use to look up drugs - I think it is an excellent resource. For each drug, there are also patient comments and experiences. I find that useful personally, given the peculiar peccadilloes of reactions to drugs when you've got ME.

http://www.rxlist.com/script/main/hp.asp

 

[Lotus97]

I was given Prozac several years ago, it was grand, then I came off it.
I was fine for a while then, because of bullying at work, needed to go back on an AD.
I was given Prozac again and it did nothing.
I was led by my gp to believe this is quite common for Prozac that it only works the first time you take it.
I do not know how accurate that is, my gp does bluster a load of fibs.

However, while I'm currently on citalopram, I am seriously contemplating asking to change to Wellbutrin XL as it's the only AD which doesn't act as a chemical castrator.
Having to be on ADs long term affects not just the person on them but their relationship too, if they have one.

So I've been doing a bit of research, and it seems that there is a huge furore going on about Wellbutrin - the generic drug does not work apparently - only the brand-named one does.

This is the site I use to look up drugs - I think it is an excellent resource. For each drug, there are also patient comments and experiences. I find that useful personally, given the peculiar peccadilloes of reactions to drugs when you've got ME.

http://www.rxlist.com/script/main/hp.asp

Do you know if your Prozac was the same brand both times? Because the difference between 2 drug brands can be night and day. Thanks for the link. Another good site that discusses prescription drugs (mostly psychiatric drugs) is Crazy Meds
http://www.crazymeds.us/pmwiki/pmwiki.php/Main/HomePage

 

[peggy-sue]

There was only the brand name available at that time - it was still under patent, so yes, it was the same make and same brand each time.
CrazyMeds looks sort of interesting - but I think the Rx list is good because it gives you the clinical pharnacology and a load of other formal scientific info. about the drug as well as the patient reports and comments.

 

[Lotus97]

Thanks to everyone for the suggestions. I've been off the Zyprexa for about a week and that didn't seem to make a difference. I'm not sure I want to go back to taking the Zyprexa though. It didn't help that much with sleep and I'm concerned about the weight gain even though it's a low dose. I have some 20 mg capsules of Prozac left over from before I switched to 10 mg, but if my depression is from die-off/herx from my probiotics and my antidepressant is still effective then it would be a bad idea to change my meds. However, the Prozac seems to cause some overstimulation or at least heart palpitations which is why I'm still questioning whether the new bottle is good (despite how unlikely this is) since the depression occurred right when the overstimulation stopped. It could be that there's nothing wrong with the new bottle of Prozac and the depression isn't a cause of die-off herx either, but rather that it just stopped being effective as peggy-sue suggested. I had also been taking B12 before this, but stopped because it seemed to be causing overstimulation. Maybe the depression is related to stopping the B12? I've started taking B12 again, but I'm taking a really low dose now which doesn't seem to be helping much. I guess I could increase the dosage of B12 before I make any changes with my meds. I've even considered taking a little bit of folinic acid and methylfolate, but I've had bad experiences with that in the past. I also wonder if Glutathione depletion could be a factor since I've noticed sometimes when taking glutathione my mood improves. I think what bothers me the most isn't the depression itself, but not knowing what's causing it.

 

[Lotus97]

I don't think the problem is with the Prozac. I had some 20 mg capsules left over from before lowered my dose to 10 mg. I've been on it about a week and it's helped a little, but not much. Since I have Lyme disease I'm thinking it could be related to that. My depression seemed to start right after I begun taking probiotics (although I'm not 100% sure about the timeline). Could this cause the depression?

 

[peggy-sue]

I'm afraid I'm clueless!
I don't know anything about Lyme or its treatment or any of the methylation stuff and the other things you're taking - we don't get that level of help here.
However, you don't seem to be in the complete utter depths of it - you've still got enough motivation and oomph to be concerned about it and where it came from. SSRIs take 6-8 weeks to kick in, I don't think you'll see what's happening from just a week.

I also find that ME sometimes gives me the odd bout of sudden inexplicable deep clinical depression (despite the citalopram) but when it's an ME symptom, it only lasts a few days than lifts as suddenly as it appears.

I had a bad couple of months recently, when life lost it's lustre, things which should get me on top of the world were merely "pleasant-ish". But I'd had sciatica and had been on powerful painkillers. I believe now it must have been withdrawal or rebound from the codeine, or perhpas just that my body had had to work too hard to deal with all the useless paracetamol I had to swallow in order to get the codeine!

Sorry I can't be of more help - I just hope for you it flipping well goes without get any worse.

 

[Lotus97]

I'm afraid I'm clueless!
I don't know anything about Lyme or its treatment or any of the methylation stuff and the other things you're taking - we don't get that level of help here.
However, you don't seem to be in the complete utter depths of it - you've still got enough motivation and oomph to be concerned about it and where it came from. SSRIs take 6-8 weeks to kick in, I don't think you'll see what's happening from just a week.

I also find that ME sometimes gives me the odd bout of sudden inexplicable deep clinical depression (despite the citalopram) but when it's an ME symptom, it only lasts a few days than lifts as suddenly as it appears.

I had a bad couple of months recently, when life lost it's lustre, things which should get me on top of the world were merely "pleasant-ish". But I'd had sciatica and had been on powerful painkillers. I believe now it must have been withdrawal or rebound from the codeine, or perhpas just that my body had had to work too hard to deal with all the useless paracetamol I had to swallow in order to get the codeine!

Sorry I can't be of more help - I just hope for you it flipping well goes without get any worse.

Thanks for the support. That's true. I've been far worse. As I mentioned, right now I'm more curious what's causing it and increasing my dosage of Prozac has helped. In the past, Prozac has taken a few weeks to kick in and that's true with most people, but with this brand it seemed to kick in right away when I started 6 months ago. That could possibly because I was on Zoloft at the time so maybe my serotonin was already up. It's just really surprising because my mood was pretty stable for the past 6 months and then out of the blue it just dropped. Nothing emotionally traumatic happened to set it off and my physical symptoms had been going on for awhile. As for the methylation and Lyme treatment, unfortunately my doctor doesn't know anything about either of these topics so I'm basically self-medicating.

 

[peggy-sue]

Does the methylation stuff do anything with your hormones?

Mood is hormonal. It's not serotonin, which is an incredibly important neurotransmitter. One of serotonin's functions is in regulation of hormone systems.
Is there anything which could have been affecting your hormones?
How long has this recent sudden drop been going on?


(and now I want to tell my dear old Dad's bad joke:- Apologies in advance. I do not expect this to cheer you up or even raise a smile. But I miss my dear old Dad, and I even miss his bad jokes, so here it is.)

Q. How do you make a hormone?

A. Refuse to pay her!
(whore moan....)

 

[Lotus97]

Does the methylation stuff do anything with your hormones?

Mood is hormonal. It's not serotonin, which is an incredibly important neurotransmitter. One of serotonin's functions is in regulation of hormone systems.
Is there anything which could have been affecting your hormones?
How long has this recent sudden drop been going on?


(and now I want to tell my dear old Dad's bad joke:- Apologies in advance. I do not expect this to cheer you up or even raise a smile. But I miss my dear old Dad, and I even miss his bad jokes, so here it is.)

Q. How do you make a hormone?

A. Refuse to pay her!
(whore moan....)

Nice joke I've had adrenal problems for a long time. They are most likely from Lyme since I was bitten by a tick 18 years ago. I probably had mild depression before that and maybe even some adrenal issues, but it got a lot worse afterwards. A year after my depression got really bad I started having hypoglycemic symptoms, nausea, and a heightened stress response. I believe all of these were caused by malfunctioning adrenals. I've only had my cortisol and DHEA tested so I don't know the full extent of my issues, but cortisol was outside normal range (both high and low). I don't know about my thyroid. My TSH and T4 were normal, but I haven't had any other thyroid tests. It seems more likely that it's the adrenals, but I know very little about this subject. I made a recovery last year by consistently getting enough sleep (10+ hours) and limiting activities and sources of stress. For me limiting activities meant staying in bed most of the day. Since I didn't have much social interaction limiting sources of stress meant that I stopped watching TV and movies. I also stopped following politics and reading fiction novels. I also ate healthy and took a lot of supplements, but I believe the other things made the most difference. I actually was depressed during that time because I wasn't taking SSRIs due to acid reflux and the other medication and supplements I took for depression didn't help much. However, many of my other symptoms got much better to the point where I was working out at the gym last summer. I had to stop exercising altogether because I got worse after that. The most likely cause of my recent depression seems to be from my body fighting Lyme or some sort of virus, but even this theory is hard to know for sure.

 

[Lotus97]

It seems that it was the probiotics which were causing the depression. I don't know why. It seems that the most likely reasons are either that there is some sort of pathogen that is reacting to the probiotics or that the probiotics are triggering a Th2 response. It could also be that the Th2 response is due to the pathogen. If anyone has any suggestions I'd like to hear them, but the main reason I'm posting this update is to let people know that there doesn't seem to be a problem with Aurobindo's Prozac/fluoxetine. I would have just update my original post, but it seems I can't do that.