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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Geezer on July 13, 2002, at 18:09:57
Can anyone tell me the approximate bioequivalence of brand name Prozac vs generic Fluoxetine? I had real success with Prozac a few years ago then switched to Fluox. generic (pdocs and pharmacies often do this without much thought), can't remember the timing regarding the change but I went down hill on Fluox. Everyone (including me) assumed "poop out". The jury is still out as to my DX, Unipolar Major Depression or Bipolar II. Currently taking Depakote 750mg and Lamictal 150mg. I really need to add an AD to the mix. I know the FDA , in their infinate wisdom, allows considerable varience with generic drugs. I am looking for the best chance for success and would welcome all experience and comments,
Thanks,
Geezer
Posted by Fuscia on July 17, 2002, at 17:32:03
In reply to Prozac or Generic Fluoxetine?????, posted by Geezer on July 13, 2002, at 18:09:57
Hi,
Something for you to read.
Manufacturers, please
http://www.rxlist.com/rxboard/prozac.pl?read=865I am currently taking Prozac capsule 20mg twice weekly. Working great. I'm still curious as to "rx's" reason that you should not switch between capsule and tablet form. If this is true, then my pharmacist should have made mention of it when I said "Okay" to 20mg tablet Geneva Lab fluoxetine, when I was currently taking 20mg capsule Prozac.
Take care, Fuscia (Nutmeg)
Posted by Geezer on July 17, 2002, at 18:39:48
In reply to Re: Geezer -Prozac or Generic Fluoxetine?, posted by Fuscia on July 17, 2002, at 17:32:03
> Hi,
>
> Something for you to read.
>
> Manufacturers, please
> http://www.rxlist.com/rxboard/prozac.pl?read=865
>
> I am currently taking Prozac capsule 20mg twice weekly. Working great. I'm still curious as to "rx's" reason that you should not switch between capsule and tablet form. If this is true, then my pharmacist should have made mention of it when I said "Okay" to 20mg tablet Geneva Lab fluoxetine, when I was currently taking 20mg capsule Prozac.
>
> Take care, Fuscia (Nutmeg)Hi Fuscia,
Thank you for the link about Prozac/Fluoxetine. I took Prozac for a year (along with a tricyclic AD). I had great results for about a year then the Prozac gave out and I experienced a bad depression. The article by Eli Lilley answered my question....what is the difference in bioequivalence between the two? According to the Lilley statement the variation allowed by the FDA is 80%-125% in the US. I don't have any proof but I always want to be on the high side of an AD and not drop lower. I was changed to generic tablets as well but by that time I was pretty far gone.
I just restarted Prozac 20mg daily with Depakote and Lamictal and will push the Prozac dose higher. Your does is a bit low but the important thing is it is working nicely for you (Fluoxetine has a very long half life - takes weeks to get out of your system completely). As for the difference in the tablets compared to capsules I don't know. I will stay with the Prozac brand this time just to see if I get continued success ( the cost difference is huge).
Now, I don't know if you are in the states. I would contact Geneva Labs. directly to see if you can get an answer. If that fails I would ask the doctor to do it.
Thank you so much for the help.
Geezer
Posted by Fuscia on July 18, 2002, at 12:11:36
In reply to Re: Geezer -Prozac or Generic Fluoxetine?, posted by Geezer on July 17, 2002, at 18:39:48
Thanks, I'll keep that in mind. I am in the states. I'll find their address and inform them of my experience.
I'm one of those that fiddles with her medicine dosage, and have actually done the research first, then asked my doctor if I could be prescribed a certain med., instead of the one he would have liked for me to try. I'm a rebel with a cause ; ) I cringed when one doctor I went to for one visit (boy was he expensive and his style was not for me-too serious.) suggested I try Effexor. No thanks, read too many bad experiences about it.
Anyway, I read on Dr. Bob's tips that there are those that take Prozac twice weekly and even once a week, and I'm not talking about the Weekly Prozac, but regular 20mg capsule here. From what I've asked a pharmacist, he said that the major metabolite in Prozac lasts 100 hours, and its secondary metabolite can last roughly 5 weeks in the body. That is a l o n g half-life. So, I started taking Prozac originally daily, then after a month plus, I started taking it every other day, then a month later twice weekly and it is working great. I may have either borderline personality disorder or bi-polar, but I seem to lean more toward the BPD. I have six older brothers, the third from oldest has schizophrenia disorder and most of my other brothers have problems with anger control, drug addiction problems, and three should never drink alcohol, but do so when life gets frustrating for them, and they stops eating, and becomes hypoglycemic due to a diet of alcohol. My dad had anger control problem big time, but as for any relative having bi-polar illness, I can't really say that they did - just anger problems. My father's mother may have been bi-polar, from what I've heard of her personality, but I don't know. My mother's father had drinking and anger problems. That's another reason I don't think I am bi-polar for I do not think any of my close relatives have had this illness. I also need my 9 hours of sleep!
I buy my prescriptions from a Canadian pharmacy and their price is even less expensive if not the same as what I can buy the generic for from my local pharmacist. But, I have to wait 2 - 4 weeks for it to arrive, which is only a problem if I forget to get it refilled in time. I buy in volume to get the savings - can hit your wallet if you end up discontinuing the drug due to side effects or it not working, but that is why I wait to order from them after I've been on the drug for a month at least before I buy in bulk. But, the Canadian pharmacy I order from also sells fluoxetine, besides Prozac, but I think it is from another lab and not Geneva. I'll have to inquire from them about this.
Yes, the twice weekly is working so far so great that I am going to stick with this for at least 3 months before I start fiddling again. I'm a doctor's worst patient - I enjoy experimenting to see what works the best for me, and I tend to be skeptical for I know that even in the world of pharmacopiea that it can be a Barnum and Bailey world, and the consumer must beware for sometimes greed gets in the way of the hypocratic oath, that, "one - do no harm to the patient". After learning about fluoxetine's half-life characteristics, it only made sense to me to try skipping a day. This floats my boat. It works great for my anger outbursts, for I can get easily frustrated and lose my temper quickly - a chip off the old block. My dad tried to strangle my mother twice during their marriage from his temper problem, he was much like Archie Bunker and Scrooge rolled in one - so I am thankful for Prozac working on this problem for me. Some people choose to lower the dosage quite a bit and take that amount daily (such as 5 or 10 mg).
I think also what has helped me recently is to stop drinking any amount of alcohol. I was drinking a half pint or a glass of red or chardonnay wine in the evenings daily for that is the time of day that I am anxious or nervous. The alcohol did wonders for this and my psychiatrist said a glass or two shouldn't hurt as long as it isn't distilled alcohol. He probably would have had felt the need to prescribe me a benzo drug if he said no to the alcohol. But, recently I noticed I wasn't sleeping well, so I figured I better try stopping the alcohol. Beer and wine contain tyramine which is a precursor to nerepinephrine, which has stimulating effects. Sure, I'd fall asleep, but I would be wide awake in the middle of the night, not to mention experiencing false hunger pangs due to hypoglycemic reaction. So, for the past few days I've been drinking catnip tea in the evenings and this has a relaxing effect on me. I also have a combination herbal supplement hops/valerian that I take now and it worked great last night at making me relaxed and sleepy by bedtime. I slept all the way through, except for having to get up at 5 to let our pup out to go toilet. I went back to sleep easily. It can be tempting to join in when my husband pours himself a glass, but now I find that I prefer a good night's sleep instead.
I've tangeteted as usual. I hope the Prozac keeps working for you, as well as the other two drugs you are taking for Bi-polar. Keep in mind it can take some years to properly diagnose bi-polar disorder. Try eliminating as much as you can the following that can cause similar symptoms: sugar, white flour products (replace the spongy Wonderbread for a complex carb bread like Health Nut from Oroweat), white rice (eat brown rice instead), salty snacks like Fritos, Cheetos, and potato chips. Instead eat almonds or peanuts, or homemade snacks made with whole grain cereals that you season and bake in the oven. Add oat bran to waffle batter-the fiber slows down the breakdown of the simple carbs in the white flour and syrup), limit or avoid caffeine, especially none after lunchtime. Eat WASA crackers (you can buy them from most grocery stores in the condiment or health food section). These whole grain crackers have little or no salt and are full of complex carbohydrates. I like the Fiber Rye best which contains toasted sesame seeds. Eat one of these spread with peanut or other nut butter or cottage cheese in between meals to keep your insulin levels even. Also good as a mid-evening snack to help release serotonin for a good night's sleep. Another good choice for this is a handful of shredded wheat cereal, or homemade popcorn made in olive oil with minimal salt. Eating a carbohydrate snack in the evening will help release serotonin that can be calming and help you get a good night's sleep.
Take care Geezer, Fuscia
Posted by Geezer on July 18, 2002, at 15:13:29
In reply to Re: Hi Geezer-cost difference, and etc., posted by Fuscia on July 18, 2002, at 12:11:36
Hi Fuscia - very glad to hear from you. Like you, I am an "rx" fiddler, have also done the research. Must admit, however, I am not nearly as knowledgeable as many on the board who are well versed in neuro. chemistry. Also agree on the Effexor - three different pdocs have tried to get me to take it....I would rather take Drain-O! I did question one pdoc (researcher with the Stanley Foundation) about the terrable withdrawal symptoms of "Side-Effexor" - he agreed the symptoms were probably due to serotonin changes and the way to get off it would be slowly decrease then substitute Prozac for the long half life benefit.
Your titration schedual for Prozac is very, very interesting. Most pdocs would automatically increase dose rather than decrease.....I will go over to Dr. Bob's tips and read that.
Your family history is also fascinating. Lots of anger problems there. Is it possible the anger results from depression or does it look more like an impulse type of reaction? In any case it must be one hellish problem to live with. I believe my mother is Unipolar/Major/Recurrent, with mild somatic delusional symptoms that occur with the depressive episodes. She is on maintenance dose Depokote, Trilifon, and Celexa. She has EPS (hands only) from the Trilifon. My younger sister is Unipolar/Major/Recurrent with mild persecutory delusions when depressed, she is in complete denial and untreated. I have been treated since 1962 for Unipolar/Major/Recurrent - have never been told I have delusional symptoms, never suggested I take AP's but I did have an anger problem like your family. It was the rising anger that led to my complete disability in 1998 - scary stuff when you think you might loose control of anger I had also been hospitalized 9 times. My DX....who knows; I have seen 4 pdocs in the past year 2 say Unipolar/Major /Recurrent and 2 say Bipolar II/Depressive/Atypical. I have had bad substance abuse problems but clean and dry since 1985.
On the issue of Prozac cost. I am 58 (thus the name Geezer) so I qualify for AARP discount med. plan. AARP sells Prozac 20mg caps #90 cost $238, for Fluoxetine 20mg. caps #90 cost $63.00. They don't show prices for tabs. but I have taken them too. My wife is buying meds from a Canadian pharmacy but they don't supply anthing I am taking.
Your comments "pharmacopia......Barnum and Bailey world.......physician do no harm", all brought a warm smile.
Thanks so much for your kind words,
Geezer
P.S. If I repeated myself from my previous post please forgive.....still a little foggy.
Posted by Fuscia on July 19, 2002, at 22:21:44
In reply to Re: Hi Geezer-cost difference, and etc., posted by Geezer on July 18, 2002, at 15:13:29
Hi Geeze, (the format is a bit screwy - I saved this post because a t-storm forced me to log off.)
Thanks for the feedback on your family. I have wondered if some of my
relatives have had undiagnosed bi-polar, but it's difficult to say for
back in the 30's through 60's you tended to not want to talk about such
things, and not want to go for help for such things, unless you were
forced to the hospital.I think the anger was a result of frustration at not getting one's way,
so that would be an impulse-type reaction. For my family, we were not
taught patience or to be responsible - we were simply spoiled kids. My
mother is naive and gullible, and spoiled us rotten by not expecting us
to help out by having certain responsibilities - we were and still are
her babies, and she won't ask you to do anything. She also worries
relentlesly about us to this day, and thinks that if each of us one a
million dollars all of our troubles would be gone.My dad wasn't around much when I was growing up since
he was an engineer going from one job to another, which meant we would
see him on holidays, and in between jobs. He enjoyed being by himself,
and doing his own thing. The first time he lost his temper big time with my mother
was about 2 years after they got married in '49. He was in the army at
the time. While in Japan he had an affair with a local girl (she became
pregnant and asked my father what should she do - she later had an
abortion according to the girl) there and my mother found the girl's
love letters in his coat pocket. The girl had became pregnant and
asked my father what should she do. My mom was upset, but he was even more upset about being caught, and she said he had the look on his face like he wanted to kill
her as he stood with his arm over his head leaning against the cupboard
looking down at her. If looks could kill. My dad never did have any
substance abuse, just a short temper when things didn't go his way. His
mother had a problem with her temper. My dad had a difficult time
showing love, and would vocalize his hate for us instead on occasion.
My brother's schizophrenia episodes started when he was about 18 and at
the time was just starting to experiment with drugs like shrooms,
marijuana, and I don't know what else. It was scary for everyone when
he went throug his episodes. I must say that things have gotten better
as we have gotten older, at least for some of my brothers. One used to
be like a human tornado when he would lose his temper - you could see
the trail of debris after he would get frustrated while working on his
car - explosive is the word. He hasn't lost it like that in many years.
We were never taught how to handle dissapointment or to be patient -monkey
see monkey do, we learned much of it from watching how my parents handled
life's obstacles.Back to Prozac. I paid $2.96 for Prozac 20mg capsule from my local
pharmacist, and $1.90 per capsule (including S&H) from a Canadian pharmacy.
The Canadian pharmacy that I order from also sells Depakote in generic form,
and they sell Lamactil, besides Prozac. Send me an e-mail if you want
there address.
I'm sorry to hear about the hand tremours that your mom is experiencing
from the Trilifon. I've never heard of that, I assume it is an
antipsychotic. It bothers me that this is a side effect that can last
even after the medicine is discontinued, and it effects women more than
men. I always suggest folks with this problem to try taking Brewer's
yeast or Nutritional yeast since this product contains many of the
essential amino acids and a nice balance of the B vitamins. The amino
acids and B vits could help relieve the hand tremours. I'd suggest
taking it daily for a few weeks to see if it helps if she does try it.
I like the taste of Twinlabs brand, called Natural Nutritional Yeast. I
take it a half hour after a carbohydrate-type breakfast of cereal or
bagel.The only thing that I can see would describe bi-polar for me (and I have
yet to learn all of the types of bi-polar illness, boy so many
catagories-you are more up on it than I am), but I have a problem
with spending, but this could just be a sign of the times and never
being taught to be responsible. I get this awful urge to go out and
spend, and it is usually on stuff we don't need and find it difficult
to stop. Only until it is over and done to I realize I've done a no-no,
and hubby has me return some of the items.I get depressed more times than not when September comes, and by the time
May comes I am going full blast with gardening, and feeling very up and
elated like nothing can stop me. It's a great feeling. I overdo it
physically during the warmer months without any exhaustion. I can use our
gas-powered weed eater/brush cutter with 3 refills of gas on a hot steamy
day. But, hey, I got the weeds chopped, so I accomplished something
for this "mania". I'm slow to get started in the mornings and go full
blast by afternoon into evening and most times I do not feel like
preparing meals for I have no appetite. I believe this to be a side
effect of SSRI's, for since I've started taking them I have hardly an
appetite. I was bulimic for years and then stopped a few years ago
and just did the sneak-eating and binging, but I never would get overweight
for by the time spring arrived I would burn it all off from over-exertion.
So, my doc says maybe a bit of seasonal affective disorder thrown in.
He also thinks I may have borderline personality disorder for I used
to self-inflict pain to myself by hitting my head very heard with my fists.
Low self esteem, self-hate. It would make me feel good just to do this.
Kinda like you feel after vomiting due to nausea - you feel exhausted,
tired, and drained. This feeling would be what took the place of the
anger and frustration I would feel prior to losing my temper with
myself. I would then cry very hard and fall asleep. I haven't done
this in a few years, though, so that is good.When all is said and done, my brother with schizophrenia is one of my
favourite brothers for I love his wit, and I got my love of the
outdoors-hiking-and gardening from my dad.Okay old man, you can call me Granny for just last year I had to get
prescription glasses to help me read the fine print. Turned 39 this
year - boy, get me my Zimmerframe........Thanks for "listening" and sharing.
Fuscia
Posted by Geezer on July 20, 2002, at 14:36:38
In reply to Re: Hi Geezer-cost difference, and etc., posted by Fuscia on July 19, 2002, at 22:21:44
Hi Fuscia,
Can you tell me how to send you an email? RE: your last post? I am not good at this computer stuff - really don't understand how to do it. I don't want to infringe on your privacy either.
We could go to Socialbabble if you prefer but I don't want to get into a lot of stuff over there. Don't think we should stay on this board since I don't have much direct drug info. to give.
ThanksGeezer
Posted by Fuscia on July 21, 2002, at 16:32:36
In reply to Re: Hi Geezer-cost difference, and etc. » Fuscia, posted by Geezer on July 20, 2002, at 14:36:38
Hello,
I didn't post the website url to the pharmacy in case it was against Dr. Bob's posting rules. Once again, this is typical of me, trying to outhink someone in advance. I did post access to my e-mail with my second post to you, but not the last post - oops. You wouldn't be infringing on my privacy. Remember, one can always hit the Delete
button ; )
If my name is highlited then it is e-mail address link accessible. I see your name is a link. I'll post my addresss here as well:
hey_hullo@boardermail.comIf this is against the rules, then I'm sure Dr. Bob will delete this - but this is a required prescription pharmacy, not like some of those overseas pharmacy websites where no prescription is required. I'll see you here, at the social board, or in e-mail - either place, you do offer valuable insight. Thanks!
Here is the link:
xxxHave a great day, Fuscia
Posted by Dr. Bob on July 21, 2002, at 17:36:30
In reply to Re: Hi Geezer, posted by Fuscia on July 21, 2002, at 16:32:36
> If this is against the rules, then I'm sure Dr. Bob will delete this - but this is a required prescription pharmacy, not like some of those overseas pharmacy websites where no prescription is required...
It may not be one itself, but it links prominently to some, so I did delete it.
Bob
Posted by McPac on July 23, 2002, at 16:40:16
In reply to Prozac or Generic Fluoxetine?????, posted by Geezer on July 13, 2002, at 18:09:57
GEEZER
"The jury is still out as to my DX, Unipolar Major Depression or Bipolar II. Currently taking Depakote 750mg and Lamictal 150mg. I really need to add an AD to the mix. I know the FDA , in their infinate wisdom, allows considerable varience with generic drugs".>>>>>>>>>The jury has been out on my diagnosis on EXACTLY the same possibilities as yours for about 20 YEARS! As for the FDA..allowing cons. variance...w/generic drugs.......I thought that generics, by law, had to be the same? Doesn't it state they are the SAME at every drugstore? If not, that sucks.
Posted by McPac on July 23, 2002, at 17:11:41
In reply to Re: Prozac or Generic Fluoxetine?????, posted by McPac on July 23, 2002, at 16:40:16
Just got the info. posted by Fuscia.
This is the end of the thread.
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