Differences in generic brands of citalopram??

[poppins]

Hi all. I'm new here but have a question that I hope some of you can help with.
I have PND, since the birth of my 6th baby just over a year ago. Initially it was quite mild, but gradually got worse and i started on citalopram in Dec last year. This is the second time I have had PND, and the second time I've had citalopram, last time was after baby no 4, 4 yrs agao. Initially the citalopram did help. Side effects were bad, but eased after a couple of weeks. Then after first 2 months I got a different brand of citalopram. Had this one for 2 months and somehow my mood seemed to start dipping again - not sure whether this was just the course of the illness, circunmstances or due to the differing brand.Then last week got another 2 month supply - different brand agai. And now I feel TERRIBLE. LOADS of Side effects (sweating, sickness, totally wiped out, foggy, confused, poor sleep, headaches) Mood also fairly rubbish - but again that could be circumstances as DH is away for a week so I'm on my own with all 6 kids !But these awful SE on top of it all are really getting to me.
So has anyone else noticed a difference between generic brands of citalopram or other Ad? Do you think it is worth going back to GP or shall I give it a bit longer see if my body adjusts?
I could REALLY use some help with this - please
TIA

[winegirl]

Hi Hun

First question, can you explain how they are different brands to me? What does it say on the boxes??

WG xx

[poppins]

Hi,
well they are all citalopram - but made by different companies. The original Citalopram that was made was " Cipramil" which was the only brand, made by same company for a few years, but then after a few years other companies can make it too, so if the GP prescribes "citalopram" it can be made by any company. In theory they should all contain the same active ingredient (so i thought it wouldnt matter!) but after my experiences have been reading round and it seems a lot of people notice a difference. Possibly due to a difference in bioavailability of the active ingredient (how well the body absorbs it) but may be other factors that differ too I think.
Cant remember the first brand I got. Second brand was be "Generics UK" new ones are"Bristoll" all supposedly contain same active ingredient (citalopram hydrobromide) but I can sure notice a difference.
Hope that makes sense - not sure I've explained very well! Hopefully someone wiser than me will come along and chip in LOL

[winegirl]

LOL - well I have a bit of experience with meds and their generic brands, but normally the difference in manufacturers shouldnt make any difference. For example, escitalopram is a generic brand of citalopram, it is pretty much the same with a couple of alterations...

But I have never heard of side effects from the same drug from different manufacturers. However, that is not to say that that isnt what the problem is here...

You can request from your pharmacy for the same manufacturer on your prescription, and if they dont have it go to a larger chemist that may do so.. The problem with these meds these days is money and how it is distributed, phramacies will naturally always but the cheapest brands of the same drug they can get..

Def speak to your GP about it and in teh mean time I will do some research through my trusty meds books x

[poppins]

well you know its funny cause before my mummy days I worked as a psychiatrist so I really should know all this. I know that "techincally" all differing brands SHOULD be identical, and before taking them myself that is what I would have told patients....but having tried for myslf I'm not sure now !
I do think youre right when yousay it all comes down to money! Branded cipramil costs something like 4X the cost of generic citalopram so there ya go! The problem has arisen cause I keep going to different chemists, depending on where I happen to be - will make sure I go to same one form now, and will request the same brand I think.
Would be very interested to hear from anyone who has noticed similar .

[winegirl]

Oh I have argued lots with the medics about the meds and what `should' happen and what actually does. I myself am actually training as a psychiatric nurse, and a lot of what we are told about meds completely differs with my personal experience! I know that I was determined i was going to take escitalopram as opposed to citalopram to try and avoid some of the side effects, but knew i would have a battle on my hands with the GP due to the cost of escitalopram! As it happens, on the day of my appt to discuss the meds I got a locum dr who couldnt give a poo about money so got my own way! LOL.

Yes i found that also if i went to boots for one prescription and then to manor pharmacy for the next i would get meds from differet manufactureres, so now i just stick to manor pharmacy so they are always the same.

I too would be interested to hear if anyone had any experience of side effects from taking meds by different companies. Could even start a poll on it??

WG x

[Veritee]

Hi Poppins

I do hope that things get better for you soon and that you can have the medication that works for you.
I can not imagine being alone with 6 kids and with PNI.

My husband worked away as a merchant seaman when I had PNI and I was alone often for many months. I only had one child and I REALLY struggled when alone with just me an my child.

I wondered if you had also tried counseling or supportive psychotherapy for PNI? As I found that the person centered approach - Carl Rogerian based - really helpful for me when I had PNI

It is interesting that you are a psychiatrist.

You may not now be working professionally now but you have the qualifications and training so even if you never work again professionally as this you are and will always be a qualified psychiatrist and maybe when your children are older you can hopefully use this training again?

if not directly as a practicing psychiatrist perhaps in a related friend or with a charity or other organization that can use your previous experience and training in some other way.

So I do hope that after PNI and when your children are old enough you will be able to resume your career in some way .............. even if in a voluntary capacity if you do not want the stress of such a pressured job.

As in my opinion the profession needs those who understand from direct first hand experience what it feels like to suffer from such mental distress. And also to know from first hand that you can recover from many forms of mental distress or illness.

As in my experience far too many people, including professionals in the field, view any metal health issue as a lifelong thing and an illness that prevents you ever pursuing a professional career of being a useful member of society.

We have in fact over the years had doctors, midwifes, Health visitors, social workers and even one other psychiatrist on this forum as PNI sufferers.

Which just disproves the common public 'miss assumption' that only 'inadequate' and economically, educationally and socially 'deprived' women get PNI or as more popularly known, PND.

However while some of us here might have medical training or other relevant professional backgrounds, we are a self help and mutual support group and anything we say here is only our opinions based on our own person experience.

As to generic medicines not being the same in terms of side effects

I can not speak for Anti depressants as I have not taken them since a young girl of 17 and did not take them when I had PNI in my late 30s.

However I am now at 56 on constant medication for another - physical - and lifelong condition. And I have found that drugs containing the same active ingredients but made by different manufacturers certainly have different side effects.

They all do the same job in terms of dealing with my condition/illness but it is the side effects that are different.

One I take in combination is known to have Central Nervous System and mental health effects in some which is not part of what the drugs are supposed to do but an unwanted side effect which for a few is so extreme - as it can ever cause psychosis - that some patients have to stop taking them.

I am lucky in that they never have any undesirable mental effects on me. However if I take the same drug but by one manufacturer it makes me euphoric and feel slightly drunk!! which is not undesirable but it is a side effect.

But the same active drug by a different manufacturer does not do this but tends to make me suffer more nausea!

The difference between one manufacture and another of the drugs I take is quite marked for me i.e the one who is taking them, but I can not get my consultant to accept that this is actually the case and not my imagination.

So I am sure that genetic drugs will have different side effects from others and may vary between all manufacturers of the same active ingredient.

This does not mean that they do not work for what they are intended for, but I do think that you are right.

With my current medication regime for my physical illness I always insist I am prescribed the medication made by the manufacturer that suits me best, whatever my consultants opinion on it being my imagination or not.

So with citalopram I can only suggest that you do the same? I am sure that especially with your background you will be able to get this? So I feel it would be worthwhile to go back to your GP and try to arrange to have your medication only made by the manufacturer that suits you the best.

If it does not help at least you have given it a try and put your mind at rest that you have done your best.

However I think that from what you describe it probably will be helpful.

All the best to you and if you are alone and coping with 6 children I think you are doing a marvelous job, with or without PNI.

Veritee XX

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[poppins]

Thanks for your reply Veritee. The actual experience of mental illness and medications is SO different form what the textbooks say it should be LOL
I went and forced my clueless GP to give me a new prescription today so I can at least get the brand I had before. I am fairly sure that my current side effects are caused by the new brand whatever the books say should happen!Not sure if I'll go back to my career - cant think that far ahead at the moment, but will definately be involved in Mental Health in a voluntary capacity at some point in the future.
WG You made a good decision asking for escitalopram I think - wish I had done that actually, may discuss it with someone if I ever get to see someone who knows what theyre talking about!

[winegirl]

LOL - poppins - yeah I just sort of demanded it hun. Turns out i knew more about the meds and MH in general than my GP so i bullied him in to it xx

Here's hoping the new prescription helps hun xx

WG

[louloubexsguest]

Hi

Poppins I am also on citlopram and I was orginally prescribe cipramil the orginal one the one that is most expensive, and I was fine whilst taking this. Then when I went to see my Gp for a repeat prescription as my psychiatrist did my first prescription, he just put down citlopram which means ANY of the generic brands...which gave me tremors, sweats and generally feel unwell. I then went back to my gp and insisted he gave me the orginal one as I was suffering side effects. I managed to persuade him....put your foot down as I believe the different types make a difference.

Hope this helps

Lou xx

[larsbars]

Hi Poppins,

I was prescribed citalopram about a year and a half ago. After a feww changes in dose I started to feel a lot better. Since January time, and in combination with my son being quite ill, I have been feeling very low again adn unable to pull myself out of it. I guess that the circumstances could well be my problem but I have changed the chemist that I get my meds from on a couple of occasions each time with a different manufactured drug so I am going to go back to the original chemist and try and get that original ones that I felt ok on although I can't remember which one it was so this may be a wasted exercise anyway!! I definitely think there is something in what you say though. I will report back here and tell you how I get on.