Please help...8 weeks in and its worse !

Thanks so much David - appreciate this reassurance. It's frustrating when drs. say you will be better in 6-8 weeks ! I exercise and take it at the same time yes. My blip seemed to creep in when i changed from my usual brand to 'Accord' to a new one - 'Sovereign'. Feels silly to attribute it to that but its all that I can think of. Again thank you.

Hi Felixe,

I have written about brand changes on this forum before but it's hidden away in other threads so not easy to see.

Like you, I had a brand change of my Citalopram and blipped massively. For two weeks I sunk into a massive hole and my anxiety was on a whole new level. Accord is the brand I use now and I will only use this.

I've worked in pharmacy in the past and the line we are told to tell people is that all generic drugs are the same - and we believe this as truth when we learn it. However, there is a thing called bioequivalence, which means generic drugs have to have a bioequivalence of the original patent of the drug, however the swing in this bioequivalence is from 80%-125% of the original, meaning you could get one generic that is 80% the equivalent of the original, and another that is 125% of the original, giving you a potential difference of 45% between generic drugs. Of course, the drugs are also made with different excipients and coatings which also affects the rate of metabolism in the stomach, something which is massively important but often overlooked.

What you could be experiencing is a readjustment to the new bioequivalence of your new brand of citalopram and you will go through the motions of starting the drug all over again. When I went back onto the Accord brand, the difference was like night and day and I picked up instantly, although did experience things like dry mouth, fatigue etc again with the brand switch. I also spoke about this with my psychologist who has told me it's a common issue with citalopram and staying on the same brand is always something she recommends. There are a few papers on it, too.

So, my advice to you would be to go back onto the Accord brand and stick to it - the price difference between brands will be pennies and you can ask your pharmacist to note it on your patient file. If they are funny about it, just ask your GP to state the brand you want on your prescription.

I hope this helps and I hope you pick up soon - I know how rubbish blips are whether they are caused by things like this or just the naturally occurring ones that we have to ride out.

Amy x

I appreciate this so much thank you - yes I really think it could be this.

I told my dr. but she said there is no link and said I should think about increasing dosage. Which just seemed rash because 1st time round I was great on 10mg. Thank you for not making me feel crazy ! I'll ring again and really try to be stubborn about it - at least just for my peace of mind.

Thanks again!

Felixe x

Hi Felixe,

I did reply yesterday but I attached links into the reply and I think it's still waiting to be moderated. It was links to the paper I read about brand changes and the findings, as well as a link to a clinical psychiatrist on Youtube who discusses generic brands. It's all very interesting.

Unfortunately, it's not something that is well studied but it is a very real issue. Of course, some people are fine with brand changes, but others are sensitive to it for whatever their metabolic reason is and if you've had a dip and it's coincided with a brand change, I'd say revert back to the original. Of course, these blips can happen out of nowhere and it's part of recovery like Katcogs teaches us all, but I always eliminate the other factors and then you know where you are standing.

If your doctor is funny about it, speak to your pharmacist, I just asked my pharmacist and he changed it no problem on the spot. I used to be a pharmacy technician and the difference in generic brand cost is literally a couple of pence, so it's not a big deal for the pharmacy usually as long as they have your brand in stock. If not, they could order it - they do two orders a day, one in the morning which comes in the afternoon and then an end of play order which comes in the next day, so it's not a big deal.

Amy

Hey Amy,

Dr wasn't super helpful but took your advice and phoned around different Pharmacies and 3rd time lucky - they stocked it! Got dry mouth pretty soon after taking Accord but fine other than that. Thanks so much. I hope to write an update on this message board of me feeling better in the future.

Felixe x

hey David thanks for your post its given me hope! I'm 2 weeks in for the second time and had horrendous side effects, had a couple of better days and thought I'm on my way. then yesterday and today I feel like I'm back at the start! questioning everything!

Hi, thank you for the above post regarding brand changes. Ive done a bit of reading myself and know although the active ingredients may be the same, it's the non active that can cause problems. My GP doesn't agree with me!! I was on Accord Citalopram 10mg for about 7 weeks, my GP upped the dose to 20mg. Seemingly Ive been told Accord have stopped manufacturing Citalopram in 20mg tablets?? Do you have any knowledge of this? Im using Medreich 20mg tablets at the minute and so far had no nasty side effects, but my new prescription has changed brands yet again, I'm due to start taking them on Tues and feeling apprehensive, my pharmacist doesn't seem to agree either about different brands and side effects. It's a minefield and its us that has to suffer not the GPs or pharmacist 😡😡

It should pass in time.

You've just increased your dose which will bring on side effects again.

How long have you been having the palpitations?

Hey!

I'm feeling alot better since sticking to the one brand of citalopram for sure. But deffo still wobbly.

I wonder because its our second time round we sort of view our first time with rose tinted glasses as the time frame of recovery seems shorter when you look back!

I also think because it worked for me before i'm constantly comparing with super high expectations! I've tried to stop that and I do feel slightly better.

Plus last time on citalopram I wasn't in a pandemic ! I'm sure that correlates to recovery time too.

Wishing you all the best - its so good we can reach out this way. I've had a string of not so great Dr.'s who make me feel way more isolated in my experience - thank god for this site!