[Cole Thornton]

My wife (type 2 rapid cycle) has been very stable since diagnosis in January 2008. About a month ago she really lost it. She was extremely manic, doing things she has not done since pre-treatment (crushes on people from the past, extreme anger, hypersensitivity and paranoia) and was at the point where she wanted me to take her to an emergency room the next day if things did not change.

We started looking for triggers and narrowed it down to a change to a generic equivolent for Depakote. She called the pharmacist to ask why she had been changed and the pharmacist told her that he took it on himself so as to save her a wopping $2.00 co-pay.

She told him that the generic was not working and demanded an exchange for name-brand Depakote. The pharmacist was ademate that there is no difference, but reluctantly made the exchange. Only 4 hours after taking the name-brand, she was stable and has been so for the last 4 days.

Watch those generics! They may be the cause of a problem! We were on the path to a seperation and probably divorce because of them.

[BlackPup]

Glad you were able to sort out the problem and that your marriage is better now.
Some generics are ok and save lots of money, but you are right that it is a problem sometimes. I take generic lamotrigine and it has been fine.

Definitely agree - I always try to take the brand when i can afford it - noticed a big difference in certain meds, especially psyche meds....even my dr told me for the last sleeping pills she gave me to take brand if possible.

Problem with generics is that they are "almost" as good but wherever you are getting them from, Walmart, Walgreens, private pharmacy....they are all getting them from different manufacturers, who are using different machinery, creating slightly different dosages. Nothing is uniform the way it is in a major drug manufacturing company. One Pharmacist told me she has dr's tell her patients to take extra or write a higher dosage of generics to compensate.

Right now my insurance is horrible so i take generic everything, so my dosages had to be adjusted for me to feel right. Both Wellbutrin and Lamictal were altered.

[Direction]

I would also keep a window open for other things that might be happening...to see that much diffence after taking 1 dose of the name brand seems a bit surprising to me...

[Yoda]

In the USA pharmacists are required to fill Rx with generics unless the physician writes brand name necessary on the Rx.

[Cole Thornton]

Direction-
That is a good point, and we have both been watching closely. She has been very stable for several days now. The difference is extremely significant. Interestingly, I found information from people using Depakote for seizures who have experienced the same immediate relief by going back to the name brand.

Yoda-
Written for name brand the script was. (How's that for "Yoda-speak"?) The pharmacist took it upon himself to fill with generic after all this time in the interest of saving us $2.00. I think there is another reason, such as a better profit margin for the pharmacy. We have filed a complaint with the pharmacy and may file one with the state board, as well.

[Giomanach]

Originally Posted by Cole Thornton

I found information from people using Depakote for seizures who have experienced the same immediate relief by going back to the name brand.

This is true with lots of anti-convulsant drugs (most double as an anti-psychotic, anti-anxiety or bi-polar med). Im sure this is the case with alot of other types of prescription medications.

This is because the brand name drug is one specific recipe made the same each time. With generic drugs, there is room for slight changes, even within the same manufacterer. They get by the FDA on a "me-too" rule (basically saying if you can prove that your drug does the same thing as something else already approved, you get approved) A generic drug MUST be different than the brand name as the brand has a patent on the recipe. This could be something like a different binder, a different amount of binder or filler. This does change how the drug is absorbed and how well your body responds. Generic drugs formula can change within the same maker and from different makers.

In someone with epilepsy (im not sure on other people) the drugs have to cross the blood/neuron barrior delicately and at the same levels constantly. any change in this can cause a seizure or unwanted side effects. Im sure the same thing goes with someone who is trying to avoid a depressive or manic state.