In a previous post Are Generic Medicines Just as Good?, I made the point that I thought in general, generic drugs are just a good as the brand name drug. I still believe this, however, the key phrase here is “in general.” I have seen a few medications that result in different side effects when patients took the generic drug. For example, Lamictal is known for possibly causing an allergic rash. Now that we increase the dose over six weeks, the incidence of the rash has significantly decreased. I have seen some patients develop the rash at low doses when they took the generic.
Similarly, a common side effect of Wellbutrin is increased activation or agitation. Many patients can take Wellbutrin without this unwanted side effect, but I’ve had some patients feel increased anxiety or agitation when they switched to generic Wellbutrin.
This is all antedoctal, that is, it’s not based on a head to head study of the generic medication versus the brand. Nevertheless, in my experience, it’s happened enough to take notice. Does this mean that the generic lamictal or generic Wellbutrin are not as good? No. It just means that the different generic manufacturers may have different inactive ingredients that can affect you differently. You don’t know what manufacturer you local pharmacy will use, and they may use a different company the next time you refill. The only way to insure consistency is to use the brand because you know what you will get each time.
For the many people who notice no difference when they take the generic drug, then by all means continue to save money by taking the generic drug. But for those who may be more sensitive to medication side effects, you may need your doctor to write “brand neccesary” on the prescription to avoid an unnecessary substitution to the generic drug.
I fully concur with all your comment here. Having a scientific background, I am not one to be overly influenced by anecdotal or hysterical claims, but I recently encountered side effects with a Fluoxetine generic which has made me revert to my original medication. A very serendipitous consequence of my original medication was that, from day one, it totally quelled my almost constant AF and arrythmia which seemed to emanate from me being in “a panic state” most of the time. After two weeks on the generic, I have noticed the insidious return of the symptoms. Of course, I realize there could be other explanations, but I have been warned by a family member who works in psychiatric nursing that she (personally), as well as many of her patients had experienced problems with generics for fluoxetine.