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Generic Antidepressant Raises Questions

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.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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