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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  1. Caromeo

    I am a PDoc as well and make no mistake, there is a huge difference between generics (Prozac, all psych meds, and all meds) – not just with regards to efficacy, but also weirdo side-effects all over the map for patients on some generics. Fluoxetine (generic for Prozac) is one of the drugs I commonly prescribe that has the most variation between generics. About 3-4 years ago, a bunch of my patients stabilized on Prozac x years, started relapsing. One of these patients (with OCD, the worst anxiety disorder) did her own homework and realized her Walgreens had been giving her Sandoz (high quality US manufacturer of generic psychiatric medications that does its manufacturing in US not India/China). After that, I started specifying Fluoxetine (Sandoz generic only) across the board – everything was consistent and good for my patients on Prozac while I did that 1-2 years. Unfortunately, Sandoz stopped manufacturing Fluoxetine last February, and most pharmacies reserves have dried up at this point. The old trick of prescribing Prozac tabs no longer works because horrible-quality companies like Mylan are now in the fluoxetine-tab manufacturing business. So, after researching the matter at length today, I decided I will start specifying TEVA/PLIVA fluoxetine only. Pliva is a well-regarded pharmaceutical company in Croatia, whose claim-to-fame is not generics, but Pliva scientists developed Azithromycin, which was a game-changer in antibiotic pharmacology. Pliva was acquired by TEVA (Israeli) who in my opinion is the best generic manufacturer for psych meds and has often the first generic when a brand med first goes generic.


  2. Dianne S

    Why are the tens of millions of people including kids being put through this mental health nightmare? Why do pharmacy benefit managers, pharmacists, and those medical personnel all ” believe”
    generic pharmaceuticals for brain functioning are identical to Brand medications? People living with mental illness should ne able to purchase at a reasonable price the medication that keeps us whole. We know more about the origins of our food than our medications.

    If in fact a generic for the brain is developed standards must be set including hygiene, for each specific CNS medication. I will buy brand cymbalta from a Canadian pharmacy. We are stronger together.

    • Sarah
      USA southwest

      I was happy to read this, as I have recently been having major panic attacks and anxiety. I was on Sandoz for 17 years and when they finally couldn’t get it anymore I was switched to alembic , which made me feel as if I have a knife in my stomach all day…. then I got switched to Mylan tablets, which have made me have the worst panic attacks I have ever had in my 47 years….. I feel just awful…… 2 days ago I switched to the Teva brand and I pray it works for me, because I cannot live like this…..

      • Michele

        How has the Teva brand worked for you?

  3. alondra
    northern california

    I don’t think generic is the same at all (Prozac). I also think it’s a shame how we the people have to accept the switch from one generic to another. These so called “non profit organizations” that print “because we pay for your medical, we have the right to choose what medical service is best to suit your needs or wants” . I have never seen any one writing a check or pulling out their wallet and paying for anything for me. These medical “non profit” places are evil and rather scary, and have no “By Laws”. I am a avid reader and spend a lot of time gathering info for my own personal use, and reference. If folks realized that we are being farmed out like cattle instead of being treated like individual persons with, in some cases, very serious conditions and/or needs.

  4. Dr. Chris

    I am a PDoc, who also suffers from Major Depressive D/O. I have 2 bad days per month still, but the medication has saved my life. I went into psych because I knew firsthand how painful depression can be. I literally have had periods where I can barely function, yet somehow I managed to get through school, and have been doing psych now for 20 years. I can tell you this…. there IS a BIG difference between generics. Avoid like the plague any generic made in India/China. I ONLY order for my patients on Fluoxetine, the generic tablet form, which is available at Walgreen’s. Your prescription must say “Tablets Only” It is very close to the pure Prozac. Other pharmacies can order it for you, but it will cost about $30 for #30, 20 mg tabs, versus $4 for #30, 20 mg capsules. Hang in there.

    • Grateful for the help

      Dr. Chris, thank you so much for your info. I believe there are several manufacturers of the tablets. Which manufacturer are you referring to as your preference for fluoxitine tabs?

    • D

      Thank you so much for the information. I wish all doctors were as thoughtful and concern as you. It will help many if you would provide the manuafacturer’s name of the Fluoxetine tablet that is sold at Walgreens. After investigating, Walgreen’s pharmacist stated that they sell Fluoxetine tablet made by the manufacturer PAR. The company is based in the USA 🇺🇸

      More importantly, prayers and Christian counseling have a tremendous positive effect on human behavior.

    • Di
      United States

      Walgreens no longer carries Sandoz. Sandoz quit making it February 2018

  5. Susanne

    I was taking brand name Prozac and never had a problem. I was then switched to generic Prozac and it seemed to working fine until about 6 months ago when the manufacturer had been changed. I went through living hell and suspected that the generic I was taking was bad. I got on the internet and found out this same thing was happening to many others taking this generic. I did some researching on the manufacturer Aurobindo in India and it is not good. They were approved by the FDA for manufacture of drugs in, I think 2011. And there have been many, many, many violations of manufacturing practices since then. In one of them I read, the sinks were connected to sewage lines. Here’s another warning from the FDA from 2011 I found. https://web.archive.org/web/20150205110520/http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm256861.htm

    FACT: You cannot depend on the quality of generics any longer mostly because they are being made in India. The reports of problems are staggering. One plant in India produced capsules with no medication in them. They were empty. One factory altered ingredients required for proper time release of a drug and way too much medication was released at the onset making people ill and then without relief for the remainder of the time . These are only a couple I happened to find.

    We are now EXPECTED to take generics which are owned by the same drug companies that made the name brands. Insurance companies are either refusing to cover name brand drugs or raising the cost of them to such exorbitant costs that you cannot afford to buy them. One common drug I have taken went from a couple hundred dollars per month to $5,000! We have a big, big problem in this country and something needs to be done now. People are suffering, getting ill or even dying from being forced to get drugs that do not work.

    • Sherry Lundie
      Louisville Ky

      I am taking name brand Prozac for 20 years..I have tried generic brands but my OCD comes back. I pay $3000.00 at the first of the year to make my copay the it is $250.00. It I hate paying that. My husband is retiring next year and $3000.00 would be a nice weeks trip somewhere. I read your posting. I called Walgreens and they carry the 20 mg tablet mfg by Mylan…So my question to you do you still believe in the tablet generic Prozac.

      Thank you

  6. Dave

    I’ve worked in formulation development for drug products for almost 15 years. As far as generics go, yes, it is the same ingredient but not the same quality. The original branded drug products usually cost more because the ingredients to make them cost more as well. Don’t get fooled when they say “it’s exactly the same ingredient” as the branded product. Better question would be, “what is the brand of the ingredients” — good luck!

  7. Sawyer Rice

    All I know is that I Pliva has worked for me before and was working again until I switched to Sandoz and 3 weeks later I have many of the same symptoms.

  8. Don
    Lawton, OK

    I am crazy.

  9. Nikki
    Los Angeles

    I am so relieved to have found this forum. About two weeks ago, my pharmacy switched me to a new generic, and it’s like I’m taking sugar pills. All of my symptoms are returning. I couldn’t even go to work today. I’ve left my doctor a message (I tried dealing with the pharmacy, but they just gave me the same brand again). I had Mylan and Teva before. Now they are giving me Sandoz, and it’s like taking nothing at all. Thanks for sharing your stories. It gave me the courage to pick up the phone and ask for something different.

    • Sawyer R.

      My prescription also moved to Sandoz and it seems as if I am taking nothing at all, as you said.

    • Sawyer Rice

      Nikki, did you feel better after returning to your original medication?

  10. Mary

    I just learned that Par stopped making Fluoxetine in July 2014. So now we’re torn with how to proceed.

  11. TR

    I have been taking generic Prozac for years upon years with no problems until about two years ago (?) I picked up my refill and right away noticed that the capsules were different in color, but the strength had not been changed and the pharmacist explained that it was a different manufacturer but same product. Also, my public medical assistance would not cover that manufacturer and I had to pay a higher amount, although it was a discount price from WalMart, so it wasn’t that much more. Anyhow…several days later it was as if I were not taking the drug at all! I was a “basket case.” Then I remembered the change in manufacturer and came looking on the internet and found people with similar problems. I got the pharmacy to re-refill my script when they got more of the one I had been getting….and I was back to “normal” pretty quickly. At that time, I had been taking Pliva and was switched to Northstar.
    Everyone here seems to react differently to the generics…many saying that Pliva doesn’t work as well for them. Not for me; it is what I need, and is now TEVA. Just this past April, my dosage was changed from 60 mg. to 80 mg. At first, I took four of my 20 mg. capsules instead of three until I got my new script filled. The new 40 mg. capsules were different color and I thought it was due to different strength…until I crashed and had a very bad, very dark experience several days later…and remembered the previous change in manufacturer – checked the bottle and these were BARR. Spoke to the doctor and got her to write “fill with TEVA/Pliva only” on the script.
    I had trouble getting this filled correctly and consistently – was filled with other brands even though it was written for TEVA… I finally called around and found that the new drug store in town – Walgreen’s – could order it for me and would order it for me, even though it cost more for them to get it.
    I got a refill last week and for a couple of days I have been feeling like it is not working…agh! I called TEVA and they were very nice about checking for any changes to the “inactive” ingredients. The only change was a different brand of imprinting ink in April. It is doubtful that would be the cause of my symptoms, but the representative is forwarding my information as a product “problem” to be checked into. Meanwhile, I will have to wait and see and try to think of any other cause for the way I am feeling.
    Best wishes to all of you…depression and anxiety are hard enough to cope with, but we will be okay despite these challenges!

    • Mary

      My 11-year old son started taking Fluoxetine 10 mg in July and did wonderfully. He went from having suicide ideology to being happy and braver than ever. However, when we went to pick up the generic prescription last month. it was a different color and shape. I didn’t think much of it until he did something really out of character and quickly spiraled downward into depression. He started taking the new pill 2 weeks ago and then this behavior occurred. I told his psychiatrist who said it’s not very common, but it could happen that he reacts differently to a different generic.
      I come to find out the new pill is made by TEVA. The old pill was PAR. And the pharmacist thinks that PAR may be discontinuing it. Does anyone know anything about this? I am afraid to have him on another generic but I also can’t stomach the $300 for 30 days of Prozac.

    • Sawyer Rice

      TR, did you eventually feel better after resuming the original medication?

  12. Susan

    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.

  13. Allwright1

    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.

  14. PP50

    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.

  15. LS

    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

  16. EG

    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.

  17. ML

    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.

  18. P

    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.

  19. mh

    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.

  20. Noah T.

    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.

  21. Karen O.

    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.

  22. mistyrose2

    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.

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