The People's Pharmacy® with Joe and Terry Graedon

Search

Generic Antidepressant Raises Questions

Newspaper Columns, Editorial July 16, 2007

The first email message in February piqued our interest: “I have been taking Budeprion XL 300 mg for 3 months instead of Wellbutrin XL 300 mg. I find that I am easily upset and cry very easily. Sometimes I feel aggressive. I also have short stabbing pains in my head.

“Taking the brand name drug (Wellbutrin) helped me feel the best I have felt in 20 years—not depressed and able to enjoy being with my family and friends.”

Wellbutrin XL is a long-acting antidepressant different from Prozac and SSRI medicines. The XL formulation from GlaxoSmithKline (GSK) is designed to be taken once a day to release a steady level of the active ingredient, bupropion, over 24 hours.

The patent on this pill recently expired and a generic version called Budeprion XL became available. Not long after, we started receiving letters and email messages about problems with Budeprion XL. At last count, more than 100 readers have reported their experiences with this generic drug.

One reader wrote: “I just had a nightmare experience switching from brand name Wellbutrin XL 300 mg to the generic Budeprion XL 300 mg, both extended-release. I have no history of ‘suicidality,’ but after switching to the generic, I went into a week of steadily rising panic. Then I hit rock bottom. I wanted to die.

“I made it through the worst of it, called a suicide hotline and didn't take any more Budeprion. The next day I felt much better and today I'm back to my normal self.

“I just saw my psychiatrist who said my reaction was almost certainly from a toxic dose of bupropion building up in my body. He says many of the generics are not absorbed or metabolized at the same rate as the brand name drugs, so you can get unpredictable effects. This one nearly killed me.”

We have no way to verify whether there is a problem with this generic drug. We notified the FDA of the messages we received. The agency assures us that it will analyze the drug and the reports it has received.

Anyone who would like to report a generic drug problem may visit our Web site (www.peoplespharmacy.com) and add comments to the growing list.

We have heard from several people that their depression returned when they started on the generic formulation. Another reader also became suicidal: “The pharmacy gave me Budeprion instead of brand name Wellbutrin. I steadily deteriorated into a suicidal crisis. I had never been suicidal before! My therapist gave me a new prescription for Wellbutrin and within a week, I was better.”

Others have reported side effects: “Soon after starting Budeprion I started having feelings of despair, hopelessness, disorganized thinking and anxiety, and fell into a depression. I have had physical problems as well: migraines of prolonged duration and greater intensity, sleep disturbances, night sweats, rapid weight gain, low energy and abrupt and painful changes in my menstrual cycle.  All of these changes coincide with my taking Budeprion instead of Wellbutrin XL. I have just resumed taking Wellbutrin XL and I am already feeling better and thinking more clearly.”

The FDA assures us that the approval process ensures that generic drugs are as good as their brand name equivalents. Our readers’ reports make us wonder if that is true.

Reader Comments

my wife was switched over to the generic that last week of march. within 4 days she started becoming panicy and had uncontrollable crying fits and was very irritated. She had difficulty getting out of bed and going to work. At work, she could not focus and would at times close her door and put her head on her desk.. for hours. It was terrible
We didn't know what to do. We saw her doctor after a couple of months of no improvement and at that meeting i learned that she had been switched to the generic version. The doctor switched her back to the name brand Wellbutrin and after about 3 days she started getting better and now seems back to where she was before the switch. I was so thankful to read your article in the paper Sunday and she was too. She had thought something was wrong with her. As it turns out, it was the meds.

JUST WANTED TO LET YOU KNOW THAT YET ANOTHER PERSON HAS HAD THE SIDE EFFECTS TO THIS DRUG ALSO. I STARTED TO FEEL REAL DEPRESSED AND UNEASY. I WAS FEELING VERY HOPELESS.

I was taking Wellbutrin XL for almost one year and felt so much better than I had in a long time. I even lost weight. Then my doctor prescribed the generic version and I began feeling depressed again and had many days of feeling like I didn't want to live. I feel nautious all the time, dizzy with strange headaches, my left side hurts and I gained all my weight back. I asked my doctor if I was developing a tolerance to the drug or of the generic might not work like the real thing.

My insurance won't cover the real Wellbutrin since a generic is available. So, I've been looking online at side effects for the generic and have discovered many blogs with the same experience I have had. I think I am going to go ahead and pay the full price and see if I feel good again.

I have been taking Wellbutrin XL with a very good result for months. Yesterday I took for the first time the generic formula,Budeprion XL, and experienced anxiety attacks and cried all day. I will never take it again.

I have been successfully taking Wellbutrin XL for at least 5 years. As my insurance was changed I was forced to switch Budeprion XL as the name brand was cost prohibitive. Due to a sudden death of a close friend and other mitigating factors, I thought that my symptoms you described were part of a major depressive episode. While I did experience a major depressive episode, after time the major issues of the depression had subsided, but I was still feeling not quite right.

I nearly leapt out of my chair when I read your article about the symptoms others were describing: migraines of prolonged duration and intensity (my topamax was increased to help with this, something I dislike because Topamax in itself makes me feel loopy), sleep disturbances (I sleep for 4 hours, am awake for 2 or 3, then finally am able to return to sleep with weird dreams), night sweats (I thought I was hitting early menopause at 39), rapid weight gain (compulsive eating and not being able to stop), low energy (sleep difficulties I thought were the problem; caffeine intake tripled), and abrupt and painful changes in my menstrual cycle (again thought early menopause).

Thus, I will have to find a way to make Wellbutrin cost effective (lowering dosage on Topamax will probably help). Thank you for getting the word out.

I, too, have been on the "anti-depressant roller coaster" for the past year. The similar side effects your readers are experiencing are uncanny. It astounds me that these drugs are so easy to come by, when their use and dis-use create such powerful changes in one's body chemistry. Yikes! No wonder I liked the old non-generic Wellbutrin from several years ago and not the one I was recently given. Thanks so much for all your wonderful information...Diane

I SWITCHED TO BUDEPRION XL A REW MONTHS AGO AND HAVE NOT BEEN FEELING MYSELF, I CRY EASILY, VERY TIRED AND JUST FEELING VERY LOW. I HAVE BEEN ON WELBUTRIN XL FOR YEARS WITH NO PROBLEMS I GUESS I NEED TO CHANGE BACK! THANKS FOR THE INFO

I have remained stable on Wellbutrin XL for two years now. I told my psychiatrist about my insurance coverage notice. It says anyone who begins taking Wellbutrin will have to use the generic. They haven't said anything about those who have been taking it. My psyciatrist said there was no way he wanted me to risk my stability by taking the generic. When my meds fail, I have ended up having to receive shock treatments in order to get stabilized and after over 50 I have permanent brain damage to my short term memory which fortunately responds to medication. Psychiatric medications are too delicate to be made into generics. The FDA needs to investigate generics much more thoroughly. They're not generics, they're imitations.

I too have had the same effects on a generic Wellbutrin. When I first started having the recurrent symptoms of depression with crying, irritability, etc, I called my doctor and he increased my Wellbutrin to 300 mg. On this medication my symptoms increased to night sweats, sleep interruption, strange dreams, and increased appetite. I appreciate hearing that others have these same results with generic Wellbutrin because I was feeling pretty desperate about how I was feeling-- it has been very scary to be plunged back into the depression I'm having.

I had the same experience with the Budeprion. I took Wellbutrin XL several years ago to quit smoking and felt great. Recently I was prescribed Wellbutrin SR for depression and was given the generic. Within days I was on the verge of tears at any moment, even at work. I felt hopeless and more depressed than I was before I took it. I found myself enraged about the tiniest things, and extremely irritable toward my 5 year old. Anxiety and nervousness much increased. I only took it for two weeks and got the dr to prescribe the brand.

I had been taking Wellbrutin for almost 4 years. My Doc prescribed it for 2 reasons, to help me quit smoking and depression. I have been smoke free for 4 years and feeling fantastic, Oh and lost 15 pds. Now that they switched me to generic Bupropion xl, I stay home and feel sorry for myself, and cry the entire weekend. My kids have not seen me this sad in years and don't know how to handle this. Now that I read your info I will be calling my doc in the morning and finding some other product, but I do love Wellbrutin.

I am so glad I found this website. I just got a new psychiatrist 2 months ago and she re-prescribed me on Welbutrin, well I thought she did. I saw that I got the generic and ended up taking it anyway. Well after I should start feeling better I still felt bad and sometimes worse than I had when I wasn't even on an anti-depressant. I hate to admit it but even my sex drive has gone completely out the window. I don't know how to make the FDA do further testing of generic perscriptions but they should.

I've been taking Zoloft for many years and had been doing fairly well. Then I switched to the generic version of Zoloft and have not been doing so well. I never thought about a possible link between my falling back into depression and the fact that I was on a generic for Zoloft.

Has anyone else experienced a problem with Zoloft? I see that many have found a problem with generic Wellbutrin, but wonder if there are similar experiences with Zoloft?

Thanks for your input.

I was taking Wellbutrin XL for almost 2 years after the birth of my 2nd child. Before I had kids I had mild to moderate depression manefesting mostly as anger, irritability and anxiety.

I had post-partum depression (PPD) with kid #1 but I never sought professional help. The PPD made me worse than normal. I felt confused and chaotic and was very impatient and irritated, to say the least.

When kid #2 was born the PPD was worse and my moods were worse and more extreme. My kids were paying the price, mostly kid #1. I didn't want to make the same mistake again so after describing my symptoms to my dr. he called my pharmacy right away and got on Wellbutrin XL that same day. My life changed dramatically almost instantly.

WhereI had an almost impossible time looking at the bright side, I now was hopeful, positive, energetic and enthusiastic about being a new mom again. Problems got solved without the anxiety and mental chaos. I felt great - I felt normal.

I got pregnant with kid #3 and stopped taking the Wellbutrin. Fortunately I had THE BEST ob/gyn to help me through the pregnancy chemical-free. He kept a close eye on me, was very supportive and gave me lots of positive reinforcement about all that I was doing good.

After the baby was 8 weeks and since I was nursing, I got the ok from my baby's pediatrician to go back on the Wellbutrin/c I was crying all of the time and had deep feelings of sadness and guilt over not having time for my older kids. I had a bottle at home from before that I filled but never took b/c I got pregant. And once again I started to feel normal again.

I was still tired and emotional but I was able to enjoy the challenges of being a new mom. A month later on 7/4, I refilled again and was given the generic. I noticed it looked different but didn't think anything of it until I started feeling like I wasn't taking anything again. I feel out of control, chaotic, angry, impatient with my kids (5 & 3), and today I just lost it. I'm screaming at my kids and crying over the guilt. I feel worthless & hopeless. I'm a mess.

Last week it even crossed my mind that the pharmacy may have given me the wrong rx. So I got online to verify and discovered that I'm not alone!! It wasn't doing anything to help me, rather it was making feel the worse than I've ever felt.

My experience for the past 2 years and the previous month were positive. When I am taking Wellbutrin XL, I don't even think that I have a problem with depression and anxiety. Life is good. I could take the good with the bad. I found humor in my kid's bad behavior and the patience to correct them in a positve and nurturing way. On the contrary, in the past few weeks I just kept thinking that I was feeling like I felt when I wasn't taking anything.

This generic may have the same ingredients but it's not getting into my system the way it needs to in order to be effective. This is really bad right now b/c when I wasn't taking anything I had lots of people looking out for me. My mother practically lived here, my friends and family came by regularly and when I started back on the medicine, I sent Mom home b/c I was smooth sailing, handling everything and didn't need anymore help.

I shouldn't have been by myself with my kids in this mental state. My kids have not deserved the mommy they've had in the past 3 weeks. This drug is NO GOOD and is causing more harm than anything else.

I had been on Welbutrin for a bout a year before switching to a generic. During the three months I was taking the generic, I felt like it was not working for me at all. All my symptoms that I had been prescribed Welbutrin for had returned.

I switched to another pharmacy which had another brand of the generic. And then I went through a two week difficult period where my body had to readjust to the drug again. It seems like the former brand was not working for me at all. I don't remember the brand that did not work, but I am using the generic made by Watson and it is working fine for me.

I was on Wellbutrin twice a day for a few years, and I felt great! Then I tried the generic. I felt horrible for the first month, told my doctor, and she said I should try another month and see what happened. I gained weight, lost track of friends, no yard work was getting done, no house work was getting done.

She put me on Welbutrin XL (not generic at that time) once a day… and my life came back within a week! I felt great again!

Then a few months ago, I picked up my prescription at the pharmacy, and it didn't look the same. When my doctor renewed my prescription, she'd made it generic.

I called my doctor, and she said over and over again that there is NO DIFFERENCE between the name brand and the generic, and that the insurance companies were *making* doctors prescribe generic.

Well, I know what my body feels like, and it feels like crap! I told her I was scared to try the generic again, because I'd hated it the last time, and my workload has been doubled at work, and I just didn’t have the time to play around with it. She asked me to try it for a couple months and let her know.

Now we’re at a couple months. I’ve gained 15 lbs, have headaches all the time, am falling behind in house work, yard work, work, and finding excuses to not answer the phone or see friends!!

I understand that the drug may have the same ingredients, but is it the same release time? WHATEVER is different… it's terrible! I take generic versions of other drugs without problems… this Bupropion just doesn’t work!

Anyone know of anything that they’ve replaced Welbutrin with that has worked? Another brand of drug?

I took Wellbutrin XL 150 mg for a month. Since everything had worked out fine, I knew I would be switching to the 300 mg prescription. I was aware of having to switch to generic because I work for the company that designs my plan.

After reading about so many people having trouble with the generic, though, I decided to pay the extra costs for the name brand, as my plan does provide for it, but at a higher co-pay plus the difference in the drug prices.

My doctor, however, advised that while there ARE certain medications for which you do NOT want to take the generic version, Wellbutrin XL is not one of those. So I got the generic prescription for these HUGE, clunky, NON-COATED pills.

I had headaches with the Wellbutrin, but my headaches were pretty instantaneous with the generic. I assumed this was because of the dosage. But the real problem is that ever since I have been on the generic, I have cried my eyes out EVERY single day.

After reading the posts on this site, I know that I am not crazy. I refuse to take the generic anymore, but it just frustrates me that the government thinks they have to make a generic for EVERYTHING, and that consumers aren't really given a choice in the matter. Who cares if these drug companies make billions of dollars! Generics should not be forced upon people who do not want them.

Why can't the prescription companies negotiate lower costs with the original distributors? I mean, samples are given out quite frequently! So why not limit the samples and decrease the costs of the drugs for the stingy prescription companies?! AND most of the original distributors end up making generic versions anyway, so why not just lower the costs in the first place--stop the generic reproduction of certain drugs and make everyone happy.

I just believe that there HAS to be a better way.

This Budeprion XL stuff is not good! I am really, really angry that it was substituted. Someone needs to contact the Food and Drug Adminstration and ask them what in the world did they do in evaluating this drug. Everyone go back to Wellbutrin.

I was put on Wellbutrin XL 300 by my doctor on July 9, 2007. I was given 10 days of free samples of the brand name, and then given a prescription. I could see a difference overnight with the Wellbutrin. I had energy and the strength to get out of the house. I no longer felt like I was in a bottomless pit of despair.

I started taking Budeprion XL 300 on July 19. I was fine for the first week, but on week two I started having symptoms.

I started crying for no reason. I had angry outbursts and was irritated all the time. I started sleeping 12 hours or more a day. I had a lot of nausea and stopped eating so much...but I started gaining weight for no reason. I had 'lightning headaches' in the left side of my head which were so instantaneously painful that I would almost vomit. I had sexual side effects.. I sank back into the darkness and started contemplating suicide. I was completely irrational and just didn't want to exist anymore.

At that time, I had no idea these symptoms could be drug related. Especially since the Wellbutrin had worked so well in the beginning. I thought I was just sad because I wasn't coping well with my life.

I told my doctor about my symptoms and her solution was to put me on the mood stabilizer Depakote. That worked wonders for me as it gave me the same flicker of hope I had during the ten days of Wellbutrin use.

Only when I got my prescription refilled and they gave me BuPROPion HCL instead of Budeprion did I start to question the medicine. I was nervous because they were so different in appearance (BuPROPion looks like Wellbutrin, Budeprion looks like a horse tablet). I had a really bad experience with Paxil in 2002 where I went bonkers and fantasized about suicide 24/7. So, I started doing some research.

Lo and behold, I found this site, and dozens more like it, talking about the problems people were having with Budeprion. I am still in utter shock. Budeprion almost killed me...and I didn't even see it coming. I just thought something was wrong with me.

Two days ago I started taking the BuPROPion. I can already tell a world of difference. I have tons more energy and don't feel like I am in a pit of doom.

If this is happening to us, how many more people is it affecting? How many more people don't know the generic drug might be harmful because they started on the brand name and everything was fine? How many people have attempted to take their own life because of this? How many people were successful?

We need to unite to get the word out. I, like many others, cannot get Wellbutrin XL 300 because my insurance no longer covers it. Is anyone else terrified at the thought of the medical repercussions of Budeprion?

Me too! After being switched to generic last year, my dosage was increased and increased--and I was still mildly depressed (was up to taking 400/day!). I have been back on brand for two days, and I feel upbeat and even wired, so hopefully my dosage will come down a lot! I can't believe it! I feel relieved.

I've been on Wellbutrin for six years. Since I've been put on the generic, I just haven't been the same. Now I don't feel so alone by finding all these other poor victims. I am tired all the time. And yes, my moods are unstable. I cry all the time for long periods of time that I can't stop.

My biggest nightmare was when I got my refill and the generic was different then usual. Several different companies can make the same generic drug--what an even bigger mistake. I saw the pills were shaped differently. So I double-checked the bottle, and it was the same drug, just a different manufacturer. And instead of being listed as BUDEPRION it was listed as BUPROPION HYDROCHLORIDE. So I checked on the computer. It was considerd the same drug.

Anyway, after the first day I felt like I was taking valium and being slighltly paralyzed. At first I did not realize it was the medication. I couldnt' figure out what was wrong with me. I take my meds at night. Right after the second night I stayed up late. It was worse. My motor skills were not normal, my gate was completly off, and I kept banging into things. Also, my vision was slightly distorted. By morning things were not much better.

Now I was getting scared, so I took the pills to the pharmacist. When I explained all of what was happening, he told me A LOT of people respond to generic Wellbutrin in that way . He would also make sure that I get the original generic I was getting, and if they did not have it, they would give me the brand at no extra cost.

I could not funtion, my motor skills were completley off, my vision was blurred, and I could not stay awake. I felt like i was drugged out of my mind. The kicker is I am not overly sensitive to ANY medications. On a regular basis I take Topamax, Vicodin hp. fiorecet/codien, singulair, atenonel, daypro, singulair, Proair and MANY OTHERS.

I have been on two different generic in two months for Wellbutrin XL 300. Right now (this month) I am on Bupropion. I am having swollen lymph nodes in my arm pits. They swell and are painful then go back down every few days. They come up in various spots in my arm pits. I kept trying to figure out what I might be allergic to or if I have cancer or something and now I am thinking it might be this dang generic. On the other generic I had huge swollen lymph nodes and a horrid rash but it went away with zinc oxide ointment. My sleep has been not as sound and the top of my right leg (near groin) has been throbbing a bit at night. I hope I can get in to see my doctor soon- I have no insurance and this is very disturbing to me.

I took Wellbutrin last year for depression as well as to quit smoking. It worked great and I really did feel better. Stopped taking it in November/December 2006 since I thought I didn't need it anymore. I got back on it again in July this year when I realized that the Wellbutrin had made a difference.

Anyway, my insurance naturally made me get the generic Budeprion XL. I have not had a good night of sleep since. I either cannot fall asleep, or when I do, I am awake after 2-3 hours and cannot go back to sleep. I have had dizziness, weird tingling sensations in my head, and I am more depressed than ever. I attributed all of this to me. Except, I kept thinking maybe it was the generic since the pill was so very different than the original.

When I found these comments last night, I was very relieved to know that it is not just me. I called my doctor this morning to get a prescription for the Wellbutrin. I hope the FDA pays attention to this. Something is seriously different/wrong about this generic.

Share Your Experiences

Do you have personal experiences related to this article? If so, we want to hear from you! Let us know your thoughts:

(If you haven't left a comment here before, you may need to be approved by the site owner before your comment will appear. Until then, it won't appear on the entry. Thanks for waiting.)





Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site: www.PeoplesPharmacy.com.

© 2007 King Features Syndicate, Inc.