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Generic Prozac Was A Downer

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Q. My husband has been taking Prozac successfully for years. He was recently switched to generic fluoxetine. In the last several months he has become much the same person he was before Prozac--angry, depressed and easily irritated.

The pharmacist says the generic is the exact same ingredient. Would it help for him to go back to Prozac?

A. It might be worth going back to Prozac for a trial run. Another reader had a similar experience with fluoxetine: "My husband has taken Prozac faithfully for about three years. We get our prescriptions through a mail order pharmacy.

"He sent in a new prescription for Prozac because all his refills had run out. Four to five days after the new bottle arrived I noticed a lot of his old symptoms reappearing. He said he was taking the medicine but the capsules looked different.

"The bottle was labeled fluoxetine. The mail order pharmacy told him that unless the doctor wrote 'Dispense as Written' they would send this generic.

"The doctor wrote him another prescription for Prozac with a note not to substitute. Within a few days of starting back on Prozac, we both could tell that the drug was working again. While he was taking the generic, it was as if he wasn't taking any medication!"

If anyone else has a bad experience with any generic medicine, please share your story with the FDA. The agency maintains that it really does want to hear about your experience. The best way to do this is via their MedWatch reporting system. You may also want to share your story on our PeoplesPharmacy website.

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My wife has been through the same negative side effects as others here. With all of our technology now, it is a disgrace that people are gouged and treated this way. The name brand is over priced. I realize profits lead to research on new meds. However, the folks do not need to be robbed to do that. It is all about greed. God save us.

Hi, Remember the FDA allows an 80 to 100% bio-availability window for both brand and generic drugs. Taking medicine with cold 10oC water stimulates peristalsis and for capsules that float, they can be moved past the duodenum, surface area 20,000 cm2, into the small intestine, surface area 2,000cm2, and you would loose about 70% of the bio-availability.

Taking the capsule with fluids above 98.6oF would keep the capsules in the stomach longer and allow proper absorption from the stomach to the duodenum. The IR analysis should be the same between brand and generic, ie it's the same medication.

The differences can be in crystal habit and particle size distribution. Using hotter fluids when taking the medicines will help normalize those differences. Remember capsules are made of gelatin (melting point about 92oF) and they don't dissolve well in cold water. The formulation lubricants can also affect dissolution by coating the inside capsule wall and creating a hydrophobic barrier that water doesn't readily penetrate. I hope this helps. Try using the capsule contents on apple sauce too. pg1246 o&o Paul G.

I also have tried generic Prozac (fluoxetine) by 4 different pharmaceuticals. My experience was the same: it didn't work! The cost of the generic versus the cost of the brand name is astronomically different. Why should that be? I wouldn't trust a "brand" Prozac from out of country either.

I had a bad experience with eye drops given in large quantity before, during and after cataract surgery. When I researched online it turned out that the form given me had a preservative in it that was described as "highly toxic to eyes." When I insisted on getting a prescription for the kind without the preservative, the pain diminished and my fading vision returned. I'm guessing that while the main ingredient may be the same, the additives may vary and cause trouble in many drugs. Now that they're mostly made in Asia and Brazil, who knows how long they sit in warehouses.

Well I had the same problem with some cough medicine last month. It cost me $158.00 for it. Yes my insurance company wouldn't pay so I paid out of pocket. Now last year when I had the whooping Cough (get a new vaccine if you haven't already) I had used this medicine and it worked with 15 minutes. Well this bottle of stuff didn't work and didn't taste the same. I took it back.

Come to find out they had given the generic which just hit the market in Oct. This is what they told me. I was probably one of the few that could tell the difference. Well at $158.00 for medicine how many other people are getting something that isn't the same and doesn't work. I called the manufacturer and the pharmacy exchanged the bottle for a smaller one of the real stuff (the real stuff cost $258.00 a bottle) but let me tell you it worked in 15 minutes again and it tasted good like oranges.

So why do generic if they aren't the same. It thought that was the reason for generic the same after the patent ran out and they made up the advertising it was cheaper. Live and learn

I was recently put on a 5mg dose of a generic for blood pressure. The capsule was green and white (I no longer have the bottle so don't know the manufacturer.) It worked. After two months I purchased my prescription through RightSource, a mail order house I've used for several years.

They sent a generic that was a tiny orange pill. This one did not work effectively. I phoned after seven weeks of taking it and requested to speak with a pharmacist. I asked to make a formal statement of concern, thinking the company might have a product review committee of the generic meds it purchases. The pharmacist seemed bored by my concerns and simply said to go back on the capsule if I liked it better.

Thanks Paul for informative information regarding pills with cold water versus fluids warmed about 92deg. Something I will try. I too have same issue with generic Prozac versus brand name. It is a shame for a drug that has been on the market so long to still be high in price..

I had the same experience with generic wellbutrin. My experience was several years ago. Since then, after many complaints, the generic forms have improved to the point where I can't tell the generic from the "real thing". It may be just one brand of generic or more than one brand, but try them all.

I had the same experience switching from name-brand Welbutrin to generic bupropion. My therapist explained that every drug has to contain a certain minimum amount of the active ingredient, but the rest can be inactive filler. For example, the FDA might insist that pills contain at least 99 percent of the active ingredient. I believe the generics put in as little of the active ingredient as they can, to save money, while name-brand drugs often contain closer to 100 percent of the active ingredient.

In psychoactive drugs like antidepressants, the brain can detect very minor variations. You may have to have your prescribing doctor adjust the dosage if you take generics.

I respond well to fluoxetine (Prozac), and have taken it since 1992.
When I was switched to generic substitutes some did not work and made me slightly dizzy and drowsy.

In my case, and I do seem to be sensitive to chemicals, the following specific generics do not work for me, and have the adverse effects mentioned:

NDC #:50111-0648-03. White oblong-shaped capsule imprinted with PLIVA 648. Add info: PLIVA 648 on green band
NDC #:00781282310 FLUOXETINE HCL 046213 FLUOXETINE HCL SANDOZ (Canada).

What a relief to read others' experiences with the generic of Prozac. . . . I thought I was going crazy! The horrible symptoms prior to taking Prozac (the name brand) returned when I took the generic fluoxetine. I too am outraged at the over pricing of the brand name Prozac and also at the lack of the standardization of the generic fluoxetine.

I take Fluoxetine every day, and I think it works great for me. But that does not mean it will work that way for everyone else.

I don't normally comment on blogs, but I feel it unjust if I didn't tell you HOW MUCH the information that you provided meant to me. Personally, I've been on ALL of the SSRI's in the last 11 years. I've NEVER had the experience that I've had over the last 4 months after my doctor switched me to the generic Prozac.

I've had classic SSRI Discontinuation Syndrome ( tremors, panic attacks, brain zaps, anxiousness, depression, ect., ect., ect.) EVEN though I HAVE been FAITHFULLY taking 40 mlg. the generic Prozac!!! I've REALLY thought I was losing my mind. I've been through our local Mental Health Department, previous to this experience, and THAT was a JOKE, and I'd asked my medical doctor, AND my pharmacist about these happenings to no avail (They were baffled by it and had no advice.), so I had absolutely NO HOPE when (THANK GOD!!!) I ran across your post. YOU ARE A GOD-SEND!!!

This morning was the first time I actually broke open the capsule and took the medicine (in a shot of warm water, which I quickly chased with a soft drink as it was disgusting, so naturally, I've not felt any changes as that was only like an hour ago, BUT, just to have the hope that I'm NOT crazy, that YOU have given me has helped me TREMENDOUSLY. Already!!! THANK YOU! THANK YOU! THANK YOU!

Wow, I think this is the third time my hospital has switched to another generic for Prozac. I always assumed that generics were just as good as other generics and am so thankful that I found this site. I have been taking Prozac for 15 years or so and things have been wonderful for me.

However something has started to change. I am so easily irritated, get very angry and never feel like doing anything. I just thought my body was changing and maybe that I was having a mental breakdown. Now I really think it may be the generic I am taking. I am still trying to put the timeline together but I really think something began to change when I started this new generic. I have a doctor appointment scheduled for this Friday to review my meds. Thank you for your wonderful website.

Thank you for this web site. Generic prozac has been a nightmare for me. The first one I tried I was so nauseas I was useless. So back to the brand name for 6 months and I felt great. My doc put me on generic and now after just 5 days I an a wreak, obsessive, anxiety driven, tearful, etc. No one seems to believe me that the generic just does not work for me. I don't care what they say, Generics are not created equal!

Never, never, never trust random folks on the internet for med advice. The generic by law has to be the same exact thing, the bioaviailibty, as well as the delivery is also the same. Please dont read advice from nutjobs who have no clue what they are talking about. They allow their subjective feelings to interfere, when in reality, their body doesn't know the difference between the generics and brand name. NONE. It's the nocebo effect.

PEOPLE'S PHARMACY RESPONSE:

Dear MN,

Did you know that when the patent for a particular drug runs out and generic competition is permitted that the delivery system frequently remains under patent. That means the generic manufacturer has to come up with a different system. This is especially true for long-acting formulations.

Most people (including health professionals) assume that the generic manufacturer can create an identical copy-cat version of the brand name. You seem to fall into that category. You are mistaken.

You assert that the generic has to be "the same exact thing" as the branded product. We invite you to read the FDA's own report about Budeprion XL 300 compared to Wellbutrin XL 300. You will discover that the FDA permitted a different curve for release of the active drug (bupropion). Here is a link to the data: http://www.peoplespharmacy.com/2007/10/12/generic-drug-eq/

Please do not be so quick to dismiss visitors to this website as "nut jobs." When someone who has been on Keppra for years and successfully controlled his epilepsy suddenly starts having breakthrough seizures after being switched to the generic formulation (levetiracetam), we think there is a problem. That is not a "nocebo" effect. There are many such cases: http://www.peoplespharmacy.com/2010/08/05/trouble-with-generic-seizure-medicine/

Thanks, Peoples Pharmacy for telling,"It like It is". Certain drug companies and their crooked reps will do anything for a buck. It is all about the money. Health concerns of their victims mean nothing to them. We are ALL their guinea-pigs. GOD saves us.

Generic Prozac did not work the same as the name brand. My health insurance does not cover psychiatric drugs so I was forced to buy the generic for $4 at Walmart. The generic helped to make me less irritable but did not stop the depression. After 5 years of generic, I stopped for 2 weeks and started a tea made from 1 teasp per cup of St Johns wort. I drink one or two cups a day and it works well. I wish I had done this 5 years ago.

I, too, have tried the generic of Prozac. It DID NOT work for me. I would prefer the overpriced cost of the real Prozac and not be angry and depressed, which is what I do.

I have been taking Fluoxetine for a little over 2.5 years now. At first, the medication worked great and did exactly what my physician said it would do:

1. OCD (all but disappeared)
2. Panic Attacks were gone
3. Repeated thoughts decreased dramatically
4. Huge weight loss (about 30 plus pounds in about 3 months) mostly due to decrease in appetite and going to gym due to high energy.


Please note that this was generic brand and I was experiencing the positive results and I was taking 20 mg.

About little less than 2 years ago, I picked up my prescription refill and noticed a slip inside the bag that the manufacturer of the medicine was changed, but that the drug was the same. I thought nothing of it and continued taking the 20 mg tablets.

Little by little I noticed that I was not responding well and my doctor gradually increased my doses and I am up to 60 mg per day to see if I responded in a positive way. Result--- I am very sluggish, always tired, depressed and repeated thoughts are back and I have gained 60 lbs from my lowest weight of 221 lbs and now top 280 lbs as appetite is out of control.

I called the pharmacy and they confirmed via phone that the manufacturer had indeed changed and they could not get the previous generic for me. Point is that based on my experience, NOT all generic SSRI's are made equal. For reference purposes, the capsule marking reads "PLIVA 0648" with a green band as another person referenced above. The generic I was on before was, I believe, made by Barr Pharmaceuticals.

Has anyone else had this experience? I am going to appeal to my PCP to see if she can expressly request DAW on the prescription. Price is almost secondary when it comes to sanity, peace of mind, zest for life and a check on appetite.

thank you to all of you - I have had the experience of the pharmacy changing brands and it was a bad - bad time - if you did not have these comments on the web I would have thought it was me - thank you - gb

I used to be on Prozac and it helped me immensely. Now that I'm on the generic Fluoxetine I've definitely noticed a regression. It just isn't the same, I don't care what the doctors and pharmaceutical companies say ...!

I have been through this too. Thanks for letting me know I am not alone. I had a problem with generic fluoxetine by Barr - just didn't seem to work very well. Paid big bucks to use the name brand for years, then tried a generic again when my pharmacy was out of brand but had the generic from Sandoz. Happily, it worked great for $4 a month.

Later, they couldn't get Sandoz, so I tried Northstar. Results were good and my pharmacy was good enough to keep the Northstar brand stocked just for me. Two months ago, they said they could no longer get Northstar. I tried the new generic with no noticeable problems. Then I refilled again and got yet another brand, this time Par. It's been two weeks and I have cried rivers the past two days. I thought my husband had just turned into a major jerk overnight, but guess what? I think it's the meds and not him.

Tomorrow I will find a way to get Northstar or even will go back to paying for brand if I have to. It's so disruptive to have to go through this. It should not be legal. The generics should have to go through clinical trials to prove that they work as well as the brand name before they are sold as "equivalents".

My advice for others though - not all generics are equal. Some may work for you even if some have not, but if you find one that works for you, try your best to stay on that brand.

Just FYI. I have been on the generic buporine XL 150 mg. Then was upped to 300mg. It still did not work. I was suicidal and angry tearful and certainly not myself. I went to another drug in addition to buporine.

Then I read that the buporine xl did NOT contain he ingredient needed. And the FDA did not check the generic. A lot of persons have been experiencing the same symptoms as before. I wish there was something we could do. The current med I am on it Viibryd. I am dealing with side affects just to feel like myself.
You'd think there would be another option.

I have taken brand name Prozac off and on for 10 years. I worked for 23 years and could afford brand Prozac. I recently retired and can no longer afford the over $100/mo co-pay. Since Medicare has become my primary insurance the brand name puts me in the donut hole on my allowable Medicare drug benefits. I was forced to go on Fluoxetine due to the high co-pay after I retired even tho my previous physician of many years took me off generic brand.

My current physician tries to push other antidepressants on me but I am reluctant to try a new drug as I have a low drug tolerance level and feel safe with prozac. The generic brand capsules are not the same. The brand takes the edge off all the reasons I take prozac. I can cope better and am more effective and productive.

On the generic (Pliva 648) I get headaches, light headiness, lethargy and agitation. I have tried the generic for 3 months but am stopping. I don't understand why the brand name is so expensive and the insurance companies will not pay a higher co-pay. Doctors don't want to be bothered with writing letters to justify brand name and even as a Tier 3 drug it is expensive. What can one do?

My depression returned while on several different Prozac generics, i.e. fluoxetine, over the past few years. The worst generic in terms of negative side effects was manufactured by Pliva (a Croatian pharmaceutical). It took me a while to realize my relapses could be related to the generics. My GP was beginning to prescribe additional anti depressants for me because of these relapses. Before I started on yet another medication, I recalled how regular Prozac had worked wonderfully for me many years ago before the generics hit the market and the cost of prozac skyrocketed.

I decided to try the prozac brand name again (paying out of pocket hundreds of dollars) to see if there was any difference. The brand name made a world of difference in how I felt. My depression is gone and that sense of well being is back.

Certain fluoxetine generics just did NOT work. in fact, made my symptoms worse in a number of ways. I will never go back to generic as it's not worth the risk. It's very frightening what is happening to our prescription medications and the lack of regulatory oversight is astonishing. I don't know how I'll continue to afford the high cost of the brand name, but I'll have to find a way.

Same thing with me. I've tried 4 different generics. None work as well as the name brand prozacs I used to take. My pharmacies have a 100, that's one hundred, fold increase in price between generics and eli lilly prozac originals.

There is NO way a product that is supposed to be the same, but has that much difference in price, can be produced without something fishy going on.

I did some research. There can be different quality precursor chemicals used in the manufacturing process.

I'm not sure what it all means but somebody's getting rich while we suffer or are inconvenienced. Our quality of life suffers because of small groups of greedy people. Period.

same is going on with me. the generic is just not working for me.

When I first started taking Prozac, I was taking a generic. I never thought to pay attention to the particular manufacturer, as it wasn't giving me any problems. About two years ago, I decided to try the brand Prozac, since I was having more success with brand Klonopin. So far, so good.

Two months ago, I was accidentally switched to a generic. At first I figured, "No big deal". But it eventually turned out to be a big deal. I felt more depressed than I had in a while. After doing research on sites like this, I realized that I probably was reacting to the differences between brand and generic.

After 6 weeks on generic, I went back to brand. Two weeks in, I begain having what I'm almost certain are side effects from being back on brand. The fluctuation between brand and generic in such a short amount of time, combined with my sensitive body, has produced "classic" Prozac side effects: headache, stomachache, dizziness, increased agitation and anxiety.

I just know that I can't function like this. I'm think that going down to 10mg and working my way up may be the way to go. Going slowly has always been the best thing for my body.

Good luck to all of you who have dealt with varying reations to generic versus brand. I wish for all of us peace and freedom from the effects of anxiety and depression.

Anyone have any experience witb Teva 7198 flouextine? I'm taking 40mg from Walmart pharmacy. Originally I was taking 20mg from Walgreens. Don't know the manufacturer but needless to say I am getting the same benefits. I thought upping the dose would help. It has not. Any advice extremely appreciated. Thanks

The doctor is right. It is my understanding the FDA requires that all generic medicines must contain the same amount of of the drug as the brand name.

What FDA does not control is the fillers that go into the wrapping of the generic drug. In other words, who really knows what is put in the filler.

I have tried several different types of generic prozac hoping to they would work for me due to the exorbitant price of the brand. I can tell you that I had the same side effects as your husband on the generics. I had to go back to the generic brand and had absolutely no negative side effects except being a little bit more sensisitve to heat especially the sun which is not a big deal for me.

Fluoxetine is horrible. going back to brand Prozac. infuriates me that we have generics shoved down our throats by ins companies. I don't believe for one minute that brand & generics are the same. If so why such a big price difference.

Dear, Karen. I do not need to take anything. However, I know lots that take this med about 1 in 10 go back to the brand name because this generics doesn't work for them. Joe and Terry have indicate practically the same and that the brand name is better absorbed. I believe your decision will be the best by what I know. Good luck.

Please re-read what you wrote; your comments evidence a clear disregard for others. What is your motive for responding to this forum? As an outlet to disparage others? There is no need to be cruel. We all know that everyone is different. We are attempting to help one another here. I also ask that you please look into the subject of pharmacokinetics and to reiterate, please re-direct/manage your anger (unsolicited advice: exercise, martial arts and the like). Thank you.

I had the same experience, there is a huge difference between brand and generic and I now realize this more clearly when I look back. I got back depression when getting my supply from US, and got well each time I supplied from abroad during my visits home, where only brand is available. This time I tried each in consequent days and there is an unbelievable difference between taking each. Pliva 648 has been worst for me. I may report this to FDA and other websites. This is deceiving and harms people.

I've experienced a similar phenomenon: when taking the generic Fluoxetine by the manufacturer Northstar, I did GREAT. My pharmacy changed suppliers twice (to Pliva & Aurobindo) and both times my depressive symptoms re-emerged almost immediately.

My point here though is that one specific generic brand has actually worked incredibly well, so it's not just the difference between brand name & generic. My pharmacist said it's common to have a reaction since each manufacturer has their own process and sources. They special order the kind I need now.

Don't be afraid to ask for what you need! I was initially afraid to speak up because of the stigma attached to depression. I was convinced they would tell me it was "all in my head" but my pharmacist surprised me & has been very supportive.

You can usually get the Northstar brand of Fluoxetine at Target for $4/bottle versus the ridiculous price of Prozac.

Haven't read through these comments yet. Just briefly scanned through looking for Pliva 648 because I'm having an adverse reaction to it for the second time in the last two years. When I take this medication I experience anxiety, increased sadness with sudden waves of extreme unhappiness accompanied by a loss of hope.

That's the best way I can describe it. I've been taking prozac since 1990 or so, and over the years I have gone off of it for long periods (3 pregnancies, nursing babies, forgetting to take if for several days, etc). Going off of prozac entirely does not create the symptoms that Pliva 648 is creating.

In other words, no anti-depressant at all is preferable to Pliva 648. It is INCREASING anxiety and depression, not alleviating it. This is a bad drug.

I would very much like to be part of the solution here, so tell me who to contact and I will be writing letters and making phone calls before the day is over. I have a happy life, but this drug is taking me back to my days of suicidal ideation. Very bad.

I have been on prozac many years. when I was on brand I felt great. I go to kaiser and pay for a drug plan and they can not give me anything made in America. I took northstar but they said they couldn't order it. You can not even get the generic you want. Pilva is the worst. Waiting for that one to be pulled by FDA. I used to get Eli lily but now it's like 1000 dollars a month.

So you really think India and China are as good. It all about money. Shame on kaiser you should sell better anti depressants. Like made in USA

Does anyone have any experience with MYLAN brand fluoxetine (red capsules). I was on prozac for about 20 years for major depression episodes lasting several months each, several brands of generics worked fine, sometimes there was a little adjustment period when my pharmacy switched manufacturers but they all worked fine until they switched to PLIVA brand I had dramatic mood swings, a couple of short hypomanic episodes (NEVER HAD THESE IN MY LIFE BEFORe), stomach problems and an overall bad feeling, not major depression but chronic low level depression.

Kaiser would not offer another brand so my doc switched me to generic celexa, depression is back under control but I've gained about 15 pounds in the last year. Kaiser switched to MYLAN fluoxetine so I'm going to give it a try. Anyone have any experience with this brand?? Thanks for this site and the info confirming that it's just me having problems with PLIVA.

I too have had a difficult time with generic Prozac. Fluoxetine does not provide the same relief for me. Single payer, healthcare for all, would be a civilized solution for all of us.

Try the generic made by Sandoz. It's available at Walgreens. I have found it works very well, and I cannot tell the difference between it and brand. I can't afford brand name anymore.

Btw, Pliva was the absolute worst generic I used. It did nothing.

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