Q. I made it clear to my doctor a few years back that the generic brand for Xanax does not work effectively. It is at best 50% effective.
I first realized how poorly it worked about 3 years ago when I was given alprazolam in the place of Xanax. I noticed the different shape of the pill and asked if it was correct and the pharmacy told me it was exactly the same medication in a different design.
My panic attacks came back and I kept thinking I had missed a dosage or simply was having a rougher time. After 3 refills over 3 months and another visit to the doctor I asked him if he had ever heard a patient complain before and he had.
I switched back to Xanax only and it made a noticeable difference. He would have to write Xanax only on the prescription or they’d give me alprazolam.
My insurance company recently stopped allowing this and now I can only take alprazolam. I’m dealing with it and having anxiety/mental health issues. My guess is that the pharmacy/insurance company views any complaint about a difference as a symptom of my problem and not a problem with the medication. Yet, I can assure you they are incorrect.
A. You are not the first person to complain about generic alprazolam:
“One of my family members has been on Xanax for several years to control panic attacks. The medical insurance provider that she is covered by won’t pay for the brand name product anymore.
My relative insists that the generic drug alprazolam is unstable, varies in effectiveness and sometimes doesn’t seem to have any effect at all.”
“My grown dauthter was switched from Xanax to the generic alprazolam. It was almost worthless for her, while the brand Xanax produced positive results in about five minutes.”
“I have taken, on several occasions, a generic version of Xanax by company XXX. It lasts for a very short time, is less calming, and I feel as if I’m going through withdrawal from the medication when taken as ordered by my doctor.
I can take other types of generic drugs, and other generic versions of alprazolam without this problem. I do not believe the company XXX’s version of Xanax meets minimum requirements for generic equivalents.” [Editorial comment: We have deleted the name of the generic manufacturer listed to avoid litigation]
“I did well on Xanax, until the generics came out. I seem to do well on alprazolam made by Greenstone. My Pharmacy switched me to one made by company XXX, which was almost useless. The tablets would not split, they seemed to be made of talcum powder.
If I want Greenstone version of alprazolam I usually have to phone ahead early and the pharmacy will get it for me. My insurance will not pay for any brand name medication if there is a generic available.”
The FDA maintains that all generic versions of all drugs, including alprazolam, are identical to their brand name counterparts. Visitors to this website beg to disagree. When someone suddenly stops taking an anti-anxiety agent like alprazolam, chlorazepate, chlordiazepoxide, clonazepam, diazepam, lorazepam, temazepam, or flurazepam, withdrawal symptoms can occur. They include:
- Digestive upset
- Impaired concentration
- Brain zaps or shock-like sensations
- Tinnitus or ringing in the ears
- Suicidal thoughts
- Seizures have occurred in people with no history of epilepsy
If someone starts experiencing some of these symptoms after being switched from a brand name to a generic or from one generic that is working to one made from another manufacturer, we strongly suspect that there is a problem. By the way, if you would like to know more about discontinuing such drugs, here is a link to a gradual withdrawal process.
Bottom line: you are going to have to enlist the help of your health care providers (physicians, nurse practitioners, pharmacists, etc) if you suspect that your generic medication is not working as well as it should. These people can argue with insurance companies or seek a generic that is more likely to work as intended. Search this website for other generic medications such as antidepressants, anti-seizure drugs or even heart medicine that may not be performing as your prescriber anticipates. Report any problems you have encountered here.
Should you wish to learn more about the generic drug problem in America, here is a link to our latest book: Top Screwups Doctors Make and How to Avoid Them.