Warning About Generic Version Of Anti-depressant

[Flor]

Dear friends,

I just had a nightmare experience switching from brand name Wellbutrin 300mg to the generic "wellbutrin" called Budeprion 300mg (manufactured by Teva), both extended release.

I developed anxiety/depression symptoms at the same time as the celiac ones and have been through quite an "adventure" in pharmacology. But this one merits passing along so no one else has to go through this.

I have no history of suicidality, but a day after switching to the generic I went into a week of steadily rising panic. Then I hit rock bottom this last Saturday. Like some demon took over my body. I wanted to die, felt like someone was holding me by the throat and pressing me against the wall. I was psychotic, self-loathing way WAY beyond anything I have ever experienced.

I made it through the worst of it, called a suicide hotline, took two Ativan, and didn't take any more of the budeprion. The next day I felt much better and today I'm back to my normal self (I'm not even taking the brand name wellbutrin now).

I just saw my psychiatrist (who didn't know I'd been given the generic and hadn't heard of this one) and he says it was almost certainly from a toxic dose of the generic wellbutrin building up in my body. He says many of the generics are not absorbed or metabolized at the same rate as the brand names, so you can get unpredictible effects. This unpredictible effect damn near killed me.

The pharmacists and the drug companies are adamant that the generics are THE SAME. This is, I believe, very wrong, and dangerously so.

I would love to send these budeprion tablets I have to a lab to see what's actually in them and how they might be absorbed the same or differently from the brand name -- anyone have any leads for that?

There are enough stories like this out there now that real studies should be done, particularly for drugs that carry high risks for small overdoses (Wellbutrin can cause seizures and cardiac arrest at doses not much over the standard adult dose)! (if you google "budeprion and problems" you'll find a lot of other folks who have similar stories to tell)

If you have similar stories to report about problems with generics, you can report them at: Open Original Shared Link. They host an NPR program, among other things, and they forward the complaints to the FDA.

Side note: I wonder if people with celiac disease or leaky gut or other associated auto-immune/food intolerance issues might be at particular risk of the damaging effects of the inconsistency in the quality of generics. I may be a slow metabolizer, for instance, which would lead to many drugs at their "normal" doses, not just badly made generics, to accumulate to dangerous levels in my body. There's no easy test for whether one's a poor metabolizer, but the consequences can be quite scary. Anyone know of any research done linking our gut problems with drug metabolism issues?

[blueeyedmanda]

Wow, that's scary. I hope you are feeling better.

[Karen B.]

That's scary!

One of the major benefits of having an "official" Celiac diagnosis from my physician is getting her blurb at the bottom of my perscriptions "BRAND ONLY - MEDICALLY NECESSARY".

I never take generics because today they may be gluten-free and tomorrow they may be stuck together with wheat starch. I still have to struggle with Walgreens and Caremark because they keep shoving generics at me but when I refer them back to the perscription, they relent and give me the brand name drug. I pay brand price ($40 vs $10) but that's better than getting sick.

[ravenwoodglass]

The problem with all generics is that they often are not gluten-free. The binders can change at any time. The reaction you had may have been a reaction to gluten in the drug. My doctor also insists that everything be name brand, that has been the safest way to go. Even then we check the gluten statis.

[mandigirl1]

OMG!!!!!!

Ive been taking brand wellbutrin and generic for about 6-7 years now!!!

Ive had major mood issues, stomach problems, skin, etc. Now Im worried!!! I should really go off the generic just to be safe......i didnt know they can change the formula/binders at any time. Thats scary and should be illegal!!!!!!!!!!!!

Thank you so much for letting us know!!!!!

[holdthegluten]

does anyone know if the generic for prozac is gluten free. And the generic for ativan (lorazepam), and the generic for prilosec. I am worried now!

[tarnalberry]

the main (active) ingredient in generics is the same as the brand name item. but it's soooo true that they are not 'identical' to the brand name, or there wouldn't be any call for many of them. some doctors will recognize this - the slight variances in fillers and binders can affect how it is absorbed and affects the system. (actually, it seems this phenomena is relatively accepted when it comes to asthma inhalers, for instance.) ironically, prescription naproxyn sodium kills my stomach (two manufacturers), but the same dose, in the over-the-counter aleve is just fine for me.

[DingoGirl]

Oh my god.

First, I must gently correct your spelling of the generic. It's BUPROPRION. Just so everyone knows.

And oh my god, in the fall of 2004, I was stricken suddenly and abruptly with a horrible terror, I can only compare it to the feeling you'd have if you awoke to see a man with a hockey mask and knife standing over your bed......that acute panic stayed with me for a solid three months. I wasted away, and got sicker and sicker......we all only know to call it a "nervous breakdown," and guess what, I was taking the generic for wellbutrin. Doctors put me on more and more drugs, at higher dosages.....and I got worse and worse. [may I also mention that I was eating an enormous amount of carbs to try and put on weight - - - undiagnosed Celiac at the time.] So.....when we switched antidepressants, I was nearly back to normal within three weeks, and moved home from my parents' house....

this is astonishing.....you are quite fortunate to have discovered the problem so quickly!

Thanks for the information.

[Karen B.]

does anyone know if the generic for prozac is gluten free. And the generic for ativan (lorazepam), and the generic for prilosec. I am worried now!

You can not be sure if a generic is safe because there may be multiple manufacturers of generics for any drug and your pharmacy may not even know when the manufacturer changes because the supplier may stay the same.

QUOTE:

Open Original Shared Link

Generic companies from all over the world (Israel, India and Brazil) are vying for market share. Price is often the deciding factor when wholesalers and hospitals decide which generic drugs to buy.

END QUOTE

"The Gluten Free Bible" by Jax Peters Lowell has a very handy list of popular drugs that are and are not gluten-free. That's when I found out my favorite antibiotic, Z-pak, is not gluten-free. I always blamed the stomach upset on the fact that it was an antibiotic.

I consider myself fortunate to have broken out in my first case of DH when I had been gluten-free for awhile and was given a generic of Allegra. It could have been a much harder lesson. Considering the brain fog and depression that can accompany a gluten exposure, you are VERY lucky to have discovered the problem so quickly. Generics are dangerous for Celiacs (IMO) because you could be dealing with the problem of not getting the medication you needed in the first place, complicated by the idiosyncratic reactions we all have when we get a gluten exposure.

[gfp]

Generic or not physcotropics are dangerous....

I would really be adverse to using them myself after readong so many horror stories...

I do have a friend who is a qualifed physchiatrist who doesn't practice (not so well paid here in France) and he is avidly against use without medical monitoring....

That said there are so many and some are far safer than others....

suicidal feelings in people who were "just depressed" (sorry not trying to trivialise that) are quite common...

Recently one got taken off the UK list for under 18's after the amount of suicides was actually studied... but please everyone do your OWN research... one reason there are so many is because they all have different bad side effects... so they keep trying new stuff..

catesfolly: this is just speculation but it is possible your physciatrist is CYA.... I would ask them if they might suggest a different one ... make it clear your not after them in a subtle way... but I woulkdn't want to rely on the non generics actually not being bad for YOU either...

[chrissy]

susan---catesfolley was correct in her spelling of the generic name of wellbutrine. it is BUDEPRION, not BUPROPRION. i'm glad you shared your story about the problem with the meds. i know they help so many people, but people need to be aware that when the meds aren't working, or the symptoms are getting worse, that maybe the meds could be part of the problem. sometimes a switch in meds can make a world of difference---we just forget to consider that sometimes.

[gfp]

susan---catesfolley was correct in her spelling of the generic name of wellbutrine. it is BUDEPRION, not BUPROPRION. i'm glad you shared your story about the problem with the meds. i know they help so many people, but people need to be aware that when the meds aren't working, or the symptoms are getting worse, that maybe the meds could be part of the problem. sometimes a switch in meds can make a world of difference---we just forget to consider that sometimes.

The other problem is of course we just want to feel better!

The MD and shrinks however are more worried about being sued....

If they change a med after you have a bad reaction then .. well it looks like their meds are to blame...and indeed they might be but they might be retiscent to change them immediately ....

If YOU suggest the change then at least they are not playing CYA so much!

[tarnalberry]

"The Gluten Free Bible" by Jax Peters Lowell has a very handy list of popular drugs that are and are not gluten-free. That's when I found out my favorite antibiotic, Z-pak, is not gluten-free. I always blamed the stomach upset on the fact that it was an antibiotic.

Actually, many of us have called on the Z-pak. It is gluten free. This, along with other information in her book, is incorrect. Zithomycin can cause stomach upset all on its own.

[DingoGirl]

susan---catesfolley was correct in her spelling of the generic name of wellbutrine. it is BUDEPRION, not BUPROPRION.

I am confused - - does it go by two names? read first paragraph in this link - -

Open Original Shared Link

[DingoGirl]

wait a minute - - - it DOES have two names! look at this one - -

Open Original Shared Link

[Karen B.]

Actually, many of us have called on the Z-pak. It is gluten free. This, along with other information in her book, is incorrect. Zithomycin can cause stomach upset all on its own.

Maybe they got a clue and changed something? After I told my doc, she confirmed that it wasn't gluten-free but that's been a few years. I'll check again for more current info because it really was my antibiotic of choice. What other info have you found to be inaccurate in the book? I found it to be quite a resource and have recommended it to several new Celiacs. I'd like to know if I need to caveat some of the info.

[jerseyangel]

I called Pfizer about a year and a half ago, and at that time I was told the Z Pack was gluten-free.

The Gluten Free Bible lists one of the blood pressure meds I take daily as being not gluten-free. A call to that manufacturer informed me that it was indeed gluten-free--they even told me the starch used was from corn.

[chrissy]

susan---i'm guessing that it is because of the "SR". the generic name of the med is still buproprion, but when the generic med is made into the "SR" form it gets a different name. that is probably why there are two generic names----did that make sence?---i know it did in my head!!LOL!!!

hasn't the "gluten free bible" been around for awhile----that would explain the discrepency. we've come a long way in the last 5-10 years when it comes to celiac information.

[tarnalberry]

Maybe they got a clue and changed something? After I told my doc, she confirmed that it wasn't gluten-free but that's been a few years. I'll check again for more current info because it really was my antibiotic of choice. What other info have you found to be inaccurate in the book? I found it to be quite a resource and have recommended it to several new Celiacs. I'd like to know if I need to caveat some of the info.

I think it was primarily the drug list - something that is *easily* incorrect. (It's just not something to publish in something as static as a book... pet peeve...) I called as long ago as four years, when I first went gluten-free, and it was gluten-free that long ago, and I've called twice since then.

As I recall, this is the book that says it's ok to eat the filling out of a cheesecake or pie (it's not), that says you can take the fixings off of sandwhich bread and be safe (you can't), and has incorrect address information as well as product information (besides medications). (There are old threads on the board from when the book came out - not the original 'Against the Grain', but this specific update 'Gluten Free Bible'.)

I understand there is good, useful, information in it. But plenty of use for caveats as well.

[Karen B.]

I think it was primarily the drug list - something that is *easily* incorrect. (It's just not something to publish in something as static as a book... pet peeve...) I called as long ago as four years, when I first went gluten-free, and it was gluten-free that long ago, and I've called twice since then.

As I recall, this is the book that says it's ok to eat the filling out of a cheesecake or pie (it's not), that says you can take the fixings off of sandwhich bread and be safe (you can't), and has incorrect address information as well as product information (besides medications). (There are old threads on the board from when the book came out - not the original 'Against the Grain', but this specific update 'Gluten Free Bible'.)

I understand there is good, useful, information in it. But plenty of use for caveats as well.

Curious. I don't remember seeing that in the book but yes, that would be bad information. When the author spoke to our Celiac group, she mentioned people that would call you picky and wouldn

[darlindeb25]

Generics are fine, but, you must all the manufacture before taking any drug, just to be sure it's gluten free. I take Celexa which is made my Forest Labs, the generic brand is Citalopram HBR, which is also made my Forest Labs, at least here on Long Island, it is. My pharmacist calls and makes sure meds are gluten free before he will let me have them, isn't that great. Even when I knew the generic for Celexa was the same brand I had been taking, he called them before he let me have them.

Generics are great, you just have to check them just the same as the name brand.

[Flor]

Hi you all, wow, thanks for the replies here. I hadn't been checking in so just now got caught up on all this conversation.

A few more tidbits:

1. On the name: if I understand this correctly Budeprion (which I took) is the NAME of the generic version of wellbutrin that is manufactured by Teva. Bupropion, I think, is the generic CHEMICAL name of Wellbutrin regardless of who manufactures it. So, Budeprion might more accurately be called a "knock-off" of the main Wellbutrin brand.

2. On my caution about it: I think it's a good point that the potential presence of gluten might affect how it's metabolized by people who are gluten sensitive (which I am). BUT, if you Google "Budeprion and problems" there are so many people with the same horror story I had that I don't think all of them are probably gluten sensitive. They might be, but I think it's just as likely that there's a separate issue of the generics not being of the same consistent quality as the brand names.

3. About CYA: of course ALL doctors do this and absolutely we all need to do our own research and all these pretty serious drugs are prone to affect people very individually. At the same time, I was really comforted by my psychiatrist's response -- and that he'd seen similar problems with generics among his patients before. I don't think he's vulnerable here because it was the pharmacy that gave me the generic. Side note: I have been unable to get a Lot number for the budeprion out of my pharmacy -- which I think is unbelievable given that regular food in the supermarket (other than produce) all has lot numbers printed on it in case you have a bad reaction. I've talked to folks at the FDA about this and they say that the pharmacies "should" be able to track down the lot numbers, theoretically. I found this very reassuring! Oh, and on the FDA: their website has a "MedWatch" link where you can directly report any adverse reactions to any drugs -- it's a lot more methodical and comprehensive than the People's Pharmacy one. Not that anyone actually reads them since they are so pathetically understaffed.

4. Sorry to ask again -- does anyone have any more info about this "slow metabolizer" stuff?

5. By the way, I'm now off all medications and feel SO MUCH BETTER. Although, ironically, while I was on the wellbutrin (or budeprion) I wasn't having diarrhea (constipation is a common side effect so I think it made me more "normal") -- but now I'm back to diarrhea. I'm taking more fish oil now and 5-HTP -- no gluten in either of them, though -- have any of you noticed the big "D" in reaction to either of these supplements?

6. Okay, really, last thing -- and from this one, you'll know for sure I'm nuts: I know this is a little weird, but I've been having recurring dreams since developing gluten-related symptoms that I think are "health warning" dreams of various kinds and was wondering if any of you have had similar kinds of dreams. In fact, when I first heard the term "celiac disease" last November, it was in a dream in which I was "diagnosed" (by our veterinarian, no less) with celiac disease -- I had no idea at the time what celiac disease was, but had been having bad gut problems for over a year and had been trying to figure it out. As soon as I woke up I ran to the 'puter to find out what celiac disease was. I stopped eating gluten that day and within a few days most of my symptoms were gone (though some of them have come back). I've also had a lot of leaky-pipes-in-the-house dreams, which I now wonder whether they might be "leaky gut" dreams (I've been reading about rheumatoid arthritis, which I have, and there's a lot of stuff there about gluten and lectins causing stuff to leak out of the gut that then inflames the joints). I also have occasional dreams of eating wheat. Like last night I ate a big plate of mac and cheese in my dream and said to someone "oh, man, this is really going to kill me later." These wheat-eating dreams often happen when I'm particularly symptomatic and so I wonder if it's my body's way of telling me that I got glutened somehow. Anyone else have these kinds of dreams? I'd love to hear!

Best to you all!