Antidepressant medication: Is there a difference between the original and the generic? (Generic Antidepressants)

Are you a person who suffers from depression or is taking medication for depression? If so, you may be familiar with this experience. The medicine that the doctor initially prescribed for you, the 'original' one that we all know, may change at the pharmacy after a while. You may receive the same medicine under a different name and in a different package. This is what we call 'generic' medicine. With this change, do you feel like the feelings of sadness and anxiety that you had before are resurfacing? Or have the side effects that you experienced when you first started taking the medicine reappeared? Don't worry, you are not the only one experiencing these things. Let's be clear about this.

What is the difference between 'brand-name' and 'generic'?

Simply put, a company that invents a new drug gets a patent for it. During that period, only that company can make that drug. We call it a 'brand-name' or original drug . When this patent period ends, other companies are legally allowed to make drugs using the same active ingredient. That's what we call 'generic' drugs .

Major health agencies around the world, such as the Food and Drug Administration (FDA) in the United States, say that there is no significant difference between the two types. Therefore, doctors around the world, as well as in our country, often confidently recommend generic drugs. Because they are considered to be effective copies of the original drug. And they are also much cheaper.

So why does this shift affect some people?

This is the question that many people have. If both drugs are theoretically the same, why do some people feel a difference when they switch from the original drug to the generic? There can be two main reasons for this:

1. Recurrence of symptoms: After switching to generic medication, some patients start to experience their old symptoms of depression, such as sadness, hopelessness, and anxiety, again.

2. Side effects reoccur: For others, side effects such as dizziness and nausea that first appeared when starting the original medication start to appear again when switching to the generic.

Imagine this scenario. A person named Samantha had been taking the original drug `(Paxil)` for depression for about a year and was doing very well. But after the pharmacy gave her its generic version called `(Paroxetine),` within a few weeks she started feeling the same old heaviness and lack of interest in anything. There are even medical reports about such cases. Sometimes, even when switching from one generic to another, such effects can occur.

What is the scientific explanation for this difference?

In most cases, the problem is not that the generic drug is "lesser" than the original. But there may be some very minor differences . Those minor differences can affect some people.

Simply put, a pill is not 100% just the active ingredient. Other ingredients are added to the pill to bind it together (binders), keep the shape of the pill, and put a coating on top (coatings). These are called 'non-active ingredients' . These inactive ingredients may differ between the original drug and the generic drug. This difference may slightly change the rate at which the drug dissolves in the body and the rate at which it is absorbed into the blood.

By law, the level of drug that a generic drug should accumulate in the body's bloodstream is between 80% and 125% of the level that the original drug accumulates. While this may seem like a large range, most people won't even notice this difference. However, for some sensitive people, especially those with other medical conditions or genetic variations, even this small difference can affect them.

The table below can further explain this difference.

What should you do?

Okay, so if you also feel a difference when you switch to a generic drug, don't worry. There are a few things you can do.

Talk to the doctor.

This is the most important and first step . Tell your doctor about any changes you notice, whether symptoms return or side effects occur. Be clear, "Doctor, I've noticed this change since I switched to the new medication." Never stop taking your medication or change the dosage on your own.

Dose Adjustment

Sometimes your doctor may decide to change your medication dosage slightly. For example, if you were taking 20mg of the original drug ``(Celexa)`` and were doing well, you may need to take 30mg or 40mg of the generic drug ``(Citalopram)`` to get the same results. This decision should be made entirely by your doctor.

Switching back to the original medicine

If the generic medicine does not suit you and you can afford the price of the original medicine, your doctor may advise you to switch back to the original medicine.

In conclusion, generic antidepressants are generally very safe and effective medications. They are less expensive, making them more accessible to a wider range of people. But as with any medication, it is important to be aware of how it affects your body and to talk to your doctor about any concerns.