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Thread: Pharmacy gave me different medication brand...

  1. #1
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    Pharmacy gave me different medication brand...

    Hi all,

    I've been on Sertraline (brand Sandoz) 25mg (low dose) for half a year and it works wonders.
    A few days ago the pharmacy gave me Sertraline brand Mylan, instead of Sandoz.

    It seems since then my anxiety has gotten worse and i feel a little off... Can this just be me overthinking it or?? Like placebo effect?

  2. #2
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    Re: Pharmacy gave me different medication brand...

    yes, you are overthinking things. your subconscious is thinking that as it is a different make of the same sertraline then it isn't the same med..... but it is
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  3. #3
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    Re: Pharmacy gave me different medication brand...

    I've found that if they give me a generic Lexapro my anxiety increases.
    I took one lot back and now I make sure I get the right one.
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  4. #4
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    Re: Pharmacy gave me different medication brand...

    Hi

    This is just a courtesy reply to let you know that your post was moved from its original place to a sub-forum that is more relevant to your issue.

    This is nothing personal - it just enables us to keep posts about the same problems in the relevant forums so other members with any experience with the issues can find them more easily.

    Please also read this post:

    http://www.nomorepanic.co.uk/showthread.php?t=213239
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  5. #5
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    Re: Pharmacy gave me different medication brand...

    Quote Originally Posted by Panda22 View Post
    I've been on Sertraline (brand Sandoz) 25mg (low dose) for half a year and it works wonders.
    A few days ago the pharmacy gave me Sertraline brand Mylan, instead of Sandoz.

    It seems since then my anxiety has gotten worse and i feel a little off... Can this just be me overthinking it or?? Like placebo effect?
    Mylan is part of Viatris which is 47% owned by Pfizer Pharmaceuticals the developer of sertraline so I doubt there is a problem with the tablets you're taking. So it is probably the loss of whatever benefit you were getting from placebo. There was a study done about 20 years ago which found that the brand name on the box increased the effectiveness of an AD by about 14% compared to generics.

    You are on what is a sub therapeutic dose for most. Ideally, you should be taking at least 50mg of sertraline and most need to take 100-150mg for good results. Taking sub therapeutic doses for extended duration may increase the risk of the AD pooping-out.
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  6. #6
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    Re: Pharmacy gave me different medication brand...

    I was on 50mg for years
    Worked well.
    Dr wanted to increase but I said no.
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  7. #7
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    Re: Pharmacy gave me different medication brand...

    Yes i have actually been thinking of upping to 50mg and my doc said i can if i want to. 25mg has been working so well i think i'm quite sensitive so a low dose seems to work, but i read a few times that 25mg is too low?

    Problem with this new brand is that they're 100mg pills so i have to cut them in 1/4's which is really difficult. Does it matter if i take like 20mg one day and 30mg the next? (as cutting the quarters doesn't go exactly equal)

  8. #8
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    Re: Pharmacy gave me different medication brand...

    Everyone is different.
    If it works for you stick with it.
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    Don't believe everything you think.

    Don't be afraid that your life will end, be afraid that it will never begin.

  9. #9
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    Re: Pharmacy gave me different medication brand...

    Quote Originally Posted by Panda22 View Post
    Yes i have actually been thinking of upping to 50mg and my doc said i can if i want to. 25mg has been working so well i think i'm quite sensitive so a low dose seems to work, but i read a few times that 25mg is too low?
    For most serotonergic ADs the dose needs to be high enough to saturate about 80% of the serotonin transporters in order to initiate and sustain neurogenesis (see below). The recommended minimum dose has been shown to achieve this in even fast metabolisers. It's possible that a lower dose will suffice for you, but unfortunately there are no diagnostic tests to determine this in individuals. Sensitivity to drugs isn't a good guide to med effectiveness because it is most often about side-effects and anxiety, not efficacy. It is even less useful with ADs because of the way they work.

    ADs have no direct effect on anxiety, or depression in the way say aspirin has on a headache, or diazepam on anxiety. They work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly. For more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF) and How antidepressant drugs act.

    The problem with taking sub/borderline therapeutic doses is neurogenesis may be interrupted whenever AD plasma levels drop below the amount needed to sustain it which could lead to the second issue, the growing evidence antidepressants become progressively less effective every time they are stopped and restarted. Two studies, Amsterdam JD, 2016 and Amsterdam JD, 2009 found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Bosman RC 2018; Amsterdam JD, 2009; Leykin Y, 2007); Paholpak S, 2002). Taking a low dose for months may create a similar situation as stopping and restarting the med. While the neurogenesis interruptions may be only of short duration, they will probably occur much more frequently.

    Problem with this new brand is that they're 100mg pills so i have to cut them in 1/4's which is really difficult. Does it matter if i take like 20mg one day and 30mg the next? (as cutting the quarters doesn't go exactly equal)
    Most pharmacies sell pill cutters which usually make it easier to accurately cut tablets. Generally, the best method is the make the first cut at right angles to the score line and then use to score to line up the blade for the second cut. However, some meds crumble at the cuts leading to inaccuracies even with pill cutters.

    Taking slightly different doses isn't ideal, but if it's your only option then it will have to do. But I'd insist on getting 50mg tablets next time if you decide to remain on 25mg.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

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