Document Detail


Loss of response after switching from brand name to generic formulations: three cases and a discussion of key clinical considerations when switching.
MedLine Citation:
PMID:  20216221     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Generic formulations of medications are marketed as therapeutically equivalent and less expensive than branded ones. Multiple studies and case reports have described relapses and worsening clinical outcome in patients after a switch from a brand name to a generic medication. Recent studies have shown that generics do not always lead to the expected costs savings, reducing the impetus to proceed with compulsory generic switching. We report on three patients who experienced clinical deterioration after commencing the generic formulation of their previous brand name psychotropic medication. We discuss key clinical differences between original and generic formulations of the same medication. The use of bioequivalence as an indicator of therapeutic and clinical equivalence, the lack of appropriate studies comparing generic and brand name medications and differences in excipients are some of the factors that could explain variation in clinical response between generic and brand name medications. Generic switching should be decided on a case-by-case basis with disclosure of potential consequences to the patient.
Authors:
Howard C Margolese; Ya?l Wolf; Julie Eve Desmarais; Linda Beauclair
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  International clinical psychopharmacology     Volume:  25     ISSN:  1473-5857     ISO Abbreviation:  Int Clin Psychopharmacol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-13     Completed Date:  2010-07-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8609061     Medline TA:  Int Clin Psychopharmacol     Country:  England    
Other Details:
Languages:  eng     Pagination:  180-2     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, McGill University, Montreal, Quebec, Canada. psychopharm.unit@mcgill.ca
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MeSH Terms
Descriptor/Qualifier:
Drugs, Generic / therapeutic use*
Female
Fluoxetine / therapeutic use
Humans
Male
Mianserin / analogs & derivatives,  therapeutic use
Middle Aged
Recurrence / prevention & control
Therapeutic Equivalency*
Valproic Acid / therapeutic use
Chemical
Reg. No./Substance:
0/Drugs, Generic; 24219-97-4/Mianserin; 54910-89-3/Fluoxetine; 61337-67-5/mirtazapine; 99-66-1/Valproic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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