[OT] Question about generic medication

Yowie wrote:

I am not a pharmacist.... but I am a chemist.
And pardon if I"m teaching you to suck eggs.

Does this mean "sorry if I'm telling you something you already know"?
That's what it sounds like, although I don't know how to suck eggs.

First all, make sure your *dose* is the same regardless of the quantity of
pills you have to take. For example your previous pills may have had 500mg
of the acitve ingredient in each pill whilst these new ones only have 250mg
of the active ingredient per pill. In that case you will need to take two of
the new pills to have the same dose you previously had.

I suppose there could be a mistake in dosage, but I made a big deal of
telling the doctor exactly what the dosages should be, and repeated myself
a few times to make sure she got it.

Second, make sure that the active incredient is in the exact same form.

How do I do that? The pill bottle doesn't have an ingredients list the
way food does. Several pages of info usually get delivered with the
meds, but I usually shred those as I already know what to expect from
this med. (Well, I thought I did.)

Third, as others have said, the processing will be
different between various manufacturing companies.

Yes, I also said that - it's the first thing I thought of when I realized
my mood had changed just about 10 days after I switched to the new pills.

But the big one is the outer shell if it has one.

This one doesn't have a shell, and neither did the old ones.

You need to back to the doctor and change your script. It could be as simple
as upping the dose of this new medication until you feel OK again, or
reverting back to your old script or, finding a different anti-depressant
now that this one is no longer effective. The change in mood is most likely
do to the change in prescription, but it may be just a coincidence. You need
to go back to your GP, or even better the psychiatrist[1] that gave you the
prescription for the original antidepressants in the first place.

That's not possible because I no longer belong to that HMO (an HMO is a
closed medical treatment plan where the doctors essentially all work for
the insurance company). I can't see someone in the HMO if I'm not a
member anymore. However, I probably could call Kaiser (the HMO) to find
out who their manufacturer is, and maybe the new pharmacy can order their
pills from them.

[1] I am assuming that like here, only psychiatrists can prescibe
medications as they have a medical degree specialising in psychology,
whereas psychologists have a degree in psychology only.

That's right.

Thanks,

--
Joyce ^..^

(To email me, remove the X's from my user name.)

On Dec 8, 4:44*pm, wrote:
This question is especially for people who take generic anti-depressants,
because I'm interested in the effect on mood. But if someone has a
relevant story about a different kind of drug, please chime in!

I've been on generic Effexor for a few years, while I was a member of
Kaiser HMO. Then I left Kaiser and switched to Blue Shield. I got my
first prescription for this medication from my new doctor and pharmacy
about 3 weeks ago.

The first thing I noticed was that the pills looked different from the
ones I used to get from Kaiser. I assumed this meant that the pharmacy
Blue Shield uses gets their drugs from a different manufacturer than
the one Kaiser uses. I wondered if that would make any difference to me,
but then forgot about it.

About 10 or so days ago, I suddenly noticed an abrupt change in my
mood. I stopped wanting to do any work. If you noticed that I was posted
a lot last week, that's why. I simply couldn't get myself to focus
on my work at all. I did get a little bit done, but not nearly enough.
I also sunk deeper into my isolation pattern. I didn't make any social
plans, kept my phone ringer turned off, and hunkered down at home with
my computer, tv, and cats.

I think there's a vicious cycle here because once I start doing that,
I get very depressed very fast. At this point, nothing I used to enjoy
gives me any pleasure - everything feels like a chore. Even my singing
group annoys me. I feel like the director is a bossy clod with no social
skills. This somewhat true of her - eg, she'll give abrupt orders with
no explanation, and the effect is one of "Because I said so" - but usually
I take this a bit more in stride. She's a very decent person, but right
now her flaws are irritating me more than usual.

To be honest, I don't like anyone. Please don't take that personally,
or yell at me that "No wonder nobody likes you if you don't like them",
as though that will make me like people. I can't help it. Everything
annoys me. I'm not happy in my friendships right now. This one is cold
and unexpressive (she does care about me, but doesn't express emotions
very easily). That one is judgemental. The other one has trouble hearing
about "hard" things and especially doesn't get internal problems like
depression. Please don't say "your friends suck, you need new ones". I
have been having a very hard time even meeting new people, much less
connecting with anyone well enough to want to make friends with them.
Anyway, my friends are all decent people, but right now I'm far more
aware of their shortcomings than anything else. I just feel cranky,
irritable and bothered by everyone.

I also don't feel comfortable with people I don't know very well. Every
interaction I have, even the most fleeting, such as nodding hello to a
colleague in the hall, feels like some kind of criticism or indictment
of me. My thoughts go, "Why did he give me *that* look? Does he think
I'm totally useless here?" I do realize this is totally irrational.

I'm also tired and unmotivated, and when I try to find something to
enteratain myself, I'm bored to death, no matter what I'm doing.

The question is: could this be caused by the change in generics? If
two different companies are making the drug, then it's not unreasonable
to think that they might have slightly different formulas. The main
drug might be the same, but, as someone once put it, maybe the "binding
agents" are slightly different. (Whatever those are.) I'm just thinking
that maybe this formulation might not work as well with my body as the
other one.

Has anyone had any experience with this and noticed a change in the
efficacy of the drug? Note that I'm *not* talking about a change from
name brand to generic. I'm talking about a change from one generic
manufacturer to another generic.

Last, if it's true that my sudden dark mood is caused by this change,
is there some way I could get access to the other ones??

Thanks for any input or suggestions.

--
Joyce * ^..^

This is a difficult time of year for a *lot* of people. The holidays
just aren't what
they're cracked up to be, and we're just constantly bombarded by the
media
fairy-tale "perfect" version of the holidays. It's enough to put a
healthy person
in a funk. Let alone someone who is already prone to depression. Plus,
winter alone
is tough. I really don't like this time of year and struggle with it
every year.
Anyway, I was thinking maybe that is a factor.
If you already know you're in a spiral, don't hesistate to ask the
doc.
Are you required to use this specific pharmacy? Are they customer-
friendly enough
that you might *ask* if they could carry the same generic that you did
well on before?
With our plan, you *can* get name-brand, but it costs a lot more than
the normal $25
copay. Effexor is a really expensive drug, I do remember that from
when Dad was on it.

Sherry

wrote:
This question is especially for people who take generic anti-depressants,
because I'm interested in the effect on mood. But if someone has a
relevant story about a different kind of drug, please chime in!

I've been on generic Effexor for a few years, while I was a member of
Kaiser HMO. Then I left Kaiser and switched to Blue Shield. I got my
first prescription for this medication from my new doctor and pharmacy
about 3 weeks ago.

The first thing I noticed was that the pills looked different from the
ones I used to get from Kaiser. I assumed this meant that the pharmacy
Blue Shield uses gets their drugs from a different manufacturer than
the one Kaiser uses. I wondered if that would make any difference to me,
but then forgot about it.

About 10 or so days ago, I suddenly noticed an abrupt change in my
mood. I stopped wanting to do any work. If you noticed that I was posted
a lot last week, that's why. I simply couldn't get myself to focus
on my work at all. I did get a little bit done, but not nearly enough.
I also sunk deeper into my isolation pattern. I didn't make any social
plans, kept my phone ringer turned off, and hunkered down at home with
my computer, tv, and cats.

I think there's a vicious cycle here because once I start doing that,
I get very depressed very fast. At this point, nothing I used to enjoy
gives me any pleasure - everything feels like a chore. Even my singing
group annoys me. I feel like the director is a bossy clod with no social
skills. This somewhat true of her - eg, she'll give abrupt orders with
no explanation, and the effect is one of "Because I said so" - but usually
I take this a bit more in stride. She's a very decent person, but right
now her flaws are irritating me more than usual.

To be honest, I don't like anyone. Please don't take that personally,
or yell at me that "No wonder nobody likes you if you don't like them",
as though that will make me like people. I can't help it. Everything
annoys me. I'm not happy in my friendships right now. This one is cold
and unexpressive (she does care about me, but doesn't express emotions
very easily). That one is judgemental. The other one has trouble hearing
about "hard" things and especially doesn't get internal problems like
depression. Please don't say "your friends suck, you need new ones". I
have been having a very hard time even meeting new people, much less
connecting with anyone well enough to want to make friends with them.
Anyway, my friends are all decent people, but right now I'm far more
aware of their shortcomings than anything else. I just feel cranky,
irritable and bothered by everyone.

I also don't feel comfortable with people I don't know very well. Every
interaction I have, even the most fleeting, such as nodding hello to a
colleague in the hall, feels like some kind of criticism or indictment
of me. My thoughts go, "Why did he give me *that* look? Does he think
I'm totally useless here?" I do realize this is totally irrational.

I'm also tired and unmotivated, and when I try to find something to
enteratain myself, I'm bored to death, no matter what I'm doing.

The question is: could this be caused by the change in generics? If
two different companies are making the drug, then it's not unreasonable
to think that they might have slightly different formulas. The main
drug might be the same, but, as someone once put it, maybe the "binding
agents" are slightly different. (Whatever those are.) I'm just thinking
that maybe this formulation might not work as well with my body as the
other one.

Has anyone had any experience with this and noticed a change in the
efficacy of the drug? Note that I'm *not* talking about a change from
name brand to generic. I'm talking about a change from one generic
manufacturer to another generic.

Last, if it's true that my sudden dark mood is caused by this change,
is there some way I could get access to the other ones??

Thanks for any input or suggestions.

It might be , that even though the new med works, you get
withdrawal symptoms from the old one.
Try to stop both for a week, or so, and then restart with the
new one , to see whether it is working.

Speaking from personal experience, the medication you were taking as brand
name effexor can be just enough different that for some people it's efficacy
if affected. If you are learning that this generic is not working for you,
you need to talk to your doctor about signing the "no substitute" line on
the prescription pad. I have to do that for several of my medications
because I have to get blood levels and there is a distinct difference in how
how high my levels are depending on brand vs. generic. It isn't supposed to
make a difference, but it does.

Go back to your prescribing doctor and explain the difference and explain
you want a new script with "no substitute" signed. It may require a prior
authorization, but your pharmacist will tell you what has to happen then.
Usually at that point it is all between the doctor, pharmacist and insurance
company - and as long as you have documented things with your doctor, it
should be no problem.

Bridget


wrote in message
...
This question is especially for people who take generic anti-depressants,
because I'm interested in the effect on mood. But if someone has a
relevant story about a different kind of drug, please chime in!

I've been on generic Effexor for a few years, while I was a member of
Kaiser HMO. Then I left Kaiser and switched to Blue Shield. I got my
first prescription for this medication from my new doctor and pharmacy
about 3 weeks ago.

The first thing I noticed was that the pills looked different from the
ones I used to get from Kaiser. I assumed this meant that the pharmacy
Blue Shield uses gets their drugs from a different manufacturer than
the one Kaiser uses. I wondered if that would make any difference to me,
but then forgot about it.

About 10 or so days ago, I suddenly noticed an abrupt change in my
mood. I stopped wanting to do any work. If you noticed that I was posted
a lot last week, that's why. I simply couldn't get myself to focus
on my work at all. I did get a little bit done, but not nearly enough.
I also sunk deeper into my isolation pattern. I didn't make any social
plans, kept my phone ringer turned off, and hunkered down at home with
my computer, tv, and cats.

I think there's a vicious cycle here because once I start doing that,
I get very depressed very fast. At this point, nothing I used to enjoy
gives me any pleasure - everything feels like a chore. Even my singing
group annoys me. I feel like the director is a bossy clod with no social
skills. This somewhat true of her - eg, she'll give abrupt orders with
no explanation, and the effect is one of "Because I said so" - but usually
I take this a bit more in stride. She's a very decent person, but right
now her flaws are irritating me more than usual.

To be honest, I don't like anyone. Please don't take that personally,
or yell at me that "No wonder nobody likes you if you don't like them",
as though that will make me like people. I can't help it. Everything
annoys me. I'm not happy in my friendships right now. This one is cold
and unexpressive (she does care about me, but doesn't express emotions
very easily). That one is judgemental. The other one has trouble hearing
about "hard" things and especially doesn't get internal problems like
depression. Please don't say "your friends suck, you need new ones". I
have been having a very hard time even meeting new people, much less
connecting with anyone well enough to want to make friends with them.
Anyway, my friends are all decent people, but right now I'm far more
aware of their shortcomings than anything else. I just feel cranky,
irritable and bothered by everyone.

I also don't feel comfortable with people I don't know very well. Every
interaction I have, even the most fleeting, such as nodding hello to a
colleague in the hall, feels like some kind of criticism or indictment
of me. My thoughts go, "Why did he give me *that* look? Does he think
I'm totally useless here?" I do realize this is totally irrational.

I'm also tired and unmotivated, and when I try to find something to
enteratain myself, I'm bored to death, no matter what I'm doing.

The question is: could this be caused by the change in generics? If
two different companies are making the drug, then it's not unreasonable
to think that they might have slightly different formulas. The main
drug might be the same, but, as someone once put it, maybe the "binding
agents" are slightly different. (Whatever those are.) I'm just thinking
that maybe this formulation might not work as well with my body as the
other one.

Has anyone had any experience with this and noticed a change in the
efficacy of the drug? Note that I'm *not* talking about a change from
name brand to generic. I'm talking about a change from one generic
manufacturer to another generic.

Last, if it's true that my sudden dark mood is caused by this change,
is there some way I could get access to the other ones??

Thanks for any input or suggestions.

--
Joyce ^..^

(To email me, remove the X's from my user name.)

It might be , that even though the new med works, you get
withdrawal symptoms from the old one.
Try to stop both for a week, or so, and then restart with the
new one , to see whether it is working.

Wow, this is not something you want to do without the doctor being
consulted. Some types of medication, including Effexor, can have
serious withdrawal symptoms, and a patient must be weaned off them.
Missing one dose can cause mild symptoms, and according to the link
below 78% of people discontinuing this medication experience some
symptoms. Simply stopping the medication without being weaned off can
have what the FDA considers 'serious' symptoms including
hospitallization, cancer, permanent disabilty and even death.

http://www.join-the-fun.com/effexor-withdrawal.html

"Sherry" wrote in message
...
On Dec 8, 4:44 pm, wrote:
This question is especially for people who take generic
anti-depressants,
because I'm interested in the effect on mood. But if someone has a
relevant story about a different kind of drug, please chime in!

I've been on generic Effexor for a few years, while I was a member
of
Kaiser HMO. Then I left Kaiser and switched to Blue Shield. I got my
first prescription for this medication from my new doctor and
pharmacy
about 3 weeks ago.

The first thing I noticed was that the pills looked different from
the
ones I used to get from Kaiser. I assumed this meant that the
pharmacy
Blue Shield uses gets their drugs from a different manufacturer than
the one Kaiser uses. I wondered if that would make any difference to
me,
but then forgot about it.


First thing I'd do is make absolutely sure the medication you got is
the right one and the right strength.

Then I'd let my doctor know that at least for right now, it isn't
doing the job, at least not all by itself.

This is crash and burn season for me. Shortly after Thanksgiving, no
matter what the weather or where I live. Who I'm around and what I
have to do can make it a little better or a little worse, but it is
always there. The valley getting fogged in for days running is the
icing on the rotten cake, but I get there even if the sun is shinning
brightly.

I have to be especially sure now that I take all my medicines exactly
as I'm supposed to. One missed day can be a disaster.

I think what we eat and how much activity we have can also affect how
we metabolize medicine. A vicious circle, if we get sluggish, maybe
we don't metabolize it the same way. If we eat differently than usual
or take it at a different time, it gets into the blood stream more or
less, or at a different point in digestion. Lots of things can make a
difference.

Remind yourself it isn't just you. You aren't alone. And its a
cycle. It will swing the other way. If you notice that you feel
really down now, that means you must have felt noticeable better
before, and you will again. Be patient with yourself and work on
things that help you to feel better.

Also hug your cats, and try to get outside in sunlight or at least
bright light for even ten minutes in the middle of the day.

If all else fails, remember at least here we don't have to deal with
snow and slush, and we get spring first.

Jo

On Mon, 08 Dec 2008 21:17:59 -0800, Jofirey wrote:

I think what we eat and how much activity we have can also affect how we
metabolize medicine. A vicious circle, if we get sluggish, maybe we
don't metabolize it the same way. If we eat differently than usual or
take it at a different time, it gets into the blood stream more or less,
or at a different point in digestion. Lots of things can make a
difference.

Certain foods can interact with medicine. For example, if you are on
various cholesterol-treating medications, you aren't allowed to eat
grapefruit or grapefruit juice. A chemical in the grapefruit will bind
to the medication in the digestive tract, keeping the body from absorbing
the medication.

--
John F. Eldredge --
PGP key available from http://pgp.mit.edu
"Reserve your right to think, for even to think wrongly is better
than not to think at all." -- Hypatia of Alexandria

Bridget wrote:

Speaking from personal experience, the medication you were taking as brand
name effexor can be just enough different that for some people it's efficacy
if affected. If you are learning that this generic is not working for you,
you need to talk to your doctor about signing the "no substitute" line on
the prescription pad. I have to do that for several of my medications
because I have to get blood levels and there is a distinct difference in how
how high my levels are depending on brand vs. generic. It isn't supposed to
make a difference, but it does.

No, no - I did not switch from brand to generic. I switched from one
generic to another. I know that a lot of people have to have the brand
name drug because the generics don't work. But I'm wondering if there
is any significant difference between two different generic versions
of the same drug, made by two different manufacturers.

wrote in message

**Note that I'm *not* talking about a change from
name brand to generic. I'm talking about a change from one generic
manufacturer to another generic. **

Thanks,
--
Joyce

Steve Touchstone wrote:

It might be , that even though the new med works, you get
withdrawal symptoms from the old one.
Try to stop both for a week, or so, and then restart with the
new one , to see whether it is working.

Wow, this is not something you want to do without the doctor being
consulted.

Don't worry, Steve, I wouldn't even consider going cold turkey on
this one!

--
Joyce ^..^

(To email me, remove the X's from my user name.)

Sherry wrote:

This is a difficult time of year for a *lot* of people. The holidays
just aren't what
they're cracked up to be, and we're just constantly bombarded by the
media
fairy-tale "perfect" version of the holidays. It's enough to put a
healthy person
in a funk. Let alone someone who is already prone to depression.

It could be, but if my depressed mood is caused by environmental
factors, I think it's more likely the opposite. We're hearing about
all this horrible stuff all the time and it's overwhelming. Global
economic crash, global terrorism, global warming - the globe is in
trouble. I try to block it out, but with people all around me getting
laid off, it's hard to ignore.

Are you required to use this specific pharmacy? Are they customer-
friendly enough
that you might *ask* if they could carry the same generic that you did
well on before?
With our plan, you *can* get name-brand, but it costs a lot more than
the normal $25
copay. Effexor is a really expensive drug, I do remember that from
when Dad was on it.

I thought about that, too. I did pretty well on the name brand, back
when I was taking it. So if the generic I got from Kaiser isn't available
to me now, I will look into that. (And yes, I know how expensive that
drug is - I was paying for it, full price, out of pocket in 2004 when I
had no insurance!)

Thanks for your thoughts.

--
Joyce ^..^

(To email me, remove the X's from my user name.)