Why Do We Hesitate To Use Generic Drugs?

I caught a recent column by Joe and Terry Graedon in which some people complain that generic version of Wellbutrin does not work as (or as well as) Wellbutrin does. Have you heard anything about it?

Might want to change "dugs" to "drugs" in both your title and the link.

My wife insists on brand name... Can I tell her she's crazy and she MUST only use generic's?

I worked in hospital pharmacy for 18 years (in Canada) and we always used generic drugs where available. Cost was the big consideration and if there were more than one company making a generic drug they would bid to get the contract to supply the hospitals for the whole province. It was rather funny too because the original patent holder company often began marketing a generic equivalent very cheaply as soon as the patent ran out so they could still keep some market share.

I think people look at the price compared to the brand names and conclude it is too good to be true

Bora,
Thanks for informing me about Joe and Terry Graedon's article. In response to one reader's complaint that generic Wellbutrin (Budeprion XL) was not as effective they say "we have no scientific evidence that there is a difference between the brand name and the generic. Nevertheless, so many reports convince us that there should be an investigation." It seems they are now working with the FDA to analyze any generic pills that their readers suspect are not equivalent to their branded counterparts. The results they uncover will be interesting.

Kevin W. Parker,
Thanks for the correction.

I also had problems with the generic for Wellbutrin XL. I have taken Wellbutrin for a few years and my depression has been treated. My mail order pharmacy substituted the generic in November. I combined the trade with the new refill of generic tabs. Out of 100% compliance with the drug - 76% of that was taken of generic. Over the last 3 months I had increasing depression symptoms. I can't believe that the efficacy of this generic is equal to the trade.

When thinking about the equivalency of generics and brand names, I think about two things: one is the active ingredient, the actual drug. If you have the same chemical, the same amount, you are delivering the same dosage of active drug in a pill whether it has a brand name stamped on it or not. But the other part is, what are the inactive ingredients? In other words, what are all the binding agents, the drug delivery vehicle? Inactive ingredients are supposed to be just that, inactive, but you may know from experience that if you take an over the counter drug in a tablet form versus a time-release capsule that you have a different response time - and thus a different sort of effect from the active ingredient.
Generics aren't supposed to differ all that much in binding ingredients and indeed some of them come off the same production line as the brand name drug. But some have different inactive ingredient formulations and some people (including me) think that these differences can affect the way you metabolize the drug, and thus your body's response to the drug.
There's also the possibility of the placebo effect. For example: I have been taking Zocor ever since April of 2003, right after I had a stroke. Did not have high cholesterol, but my doctors wanted to lower my cholesterol even more below normal, as prophylaxis against a future second stroke. In my mind, Zocor is part of my armor keeping me healthy. Recently, Zocor went generic, and when I got my first bottle of generic Zocor I experienced a brief moment of panic because it wasn't the shape and color I was used to. It didn't "look like" Zocor, and Zocor is part of my armor. Would I be as well protected? Well, the science-y part of my mind says to me, yes, I'll be just fine, but the frightened part of my mind that is a stroke survivor says "I want my old Zocor!"
If that part of your mind predominates, you might experience a reverse placebo effect with your drug, leading to it being less effective.