What to know about generic medications for bipolar disorder, how they compare to brand names, and tips for managing changes.
If you or your loved one has been switched to a generic medication for bipolar disorder or are considering making the change yourself, it’s natural to feel unsure. You might wonder whether these more affordable options can truly match the brand names you’ve relied on — especially with all the mixed messages out there.
I’ve been through this myself when my pharmacy replaced my Lamictal with generic lamotrigine, and I understand the anxiety and disappointment that can come with such unexpected changes. Let’s dive into the details of brand names and generics.
Unraveling the Generic vs. Brand Mystery
In 2008, I did some heavy research on the topic of brand name versus generic medications when my brand name Lamictal medication was switched to generic lamotrigine. It was very obvious within the first few weeks that the medications were not the same.
I naturally asked my pharmacist and colleagues, “Why does it feel like the generic medication I just tried is not working as well as the brand name medication?” Their responses varied widely, and no one really had a clear answer. I was told, “The pills should be the same.”
As a person who has bipolar disorder and a psychotic disorder, I could physically tell that this newly approved generic (lamotrigine) was not as effective as the brand name I had been on for more than a year. This was in 2008 when GlaxoSmithKline’s Lamictal lost its patent, and the generic drug (lamotrigine) became available.
I knew there was an answer, so I started digging. I had many resources at my fingertips. I was a regular presenter at a well-known pharmacy school and could also talk to my psychopharmacology expert and coauthor, John Preston, PsyD. I even had contact with sales reps for GlaxoSmithKline.
But despite all these resources, I received different answers.
I eventually found an answer that everyone agreed with, and I share it with you now as a change to generic medications affects so many of us who live with or care about someone with a brain illness.
I’ve since tested this information with many of my clients whose loved ones faced a change from a brand name to a generic medication and have found the following to be a safe approach to the topic.
What’s the Main Difference Between Brand Name and Generic Medications?
Here is the short answer: Medications have two components — active ingredients and the vehicle used to get these ingredients into your body. The active ingredients are the original chemical compounds that make the drug effective. The vehicle is added to deliver the active ingredients into your system and can be in the form of a pill, cream, or shot. When you take a brand name medication, both the active ingredient and the vehicle are consistent with each prescription. For generics, the active ingredients must be the same worldwide, but there are no regulations for the vehicle. This is where there can be problems.
The main difference between generic and brand-name medications is how the active ingredients are delivered into the body using a vehicle.
Active Ingredients Are the Same in Brand Name and Generic Drugs
- The term active ingredients refers to the original chemical compounds that make the drug effective.
- According to the U.S. Food and Drug Administration (FDA), the active ingredients in a generic medication must be the same as those in the brand-name equivalent.
- These active ingredients are proprietary in the United States for up to 20 years under a patent.
- When the patent expires, the drug’s active ingredients recipe becomes available for use in generic medications.
The Vehicle Can Differ Widely Between Brand Name and Generic Drugs
- The vehicle delivers the active ingredients into the human body.
- The vehicle includes added ingredients that are combined with the brand name active ingredients to create a usable pill, capsule, shot, cream, or suppository.
- Also known as carrier systems, vehicles play a crucial role but are not regulated as strictly as the active ingredients.
- This difference in regulation can lead to variations in how generic medications perform compared to their brand name counterparts.
Strategies to Manage a Change to Generics
Here are some practical tips to help you or your loved one adjust to a new generic or determine if you need a medication adjustment from your prescriber:
- Chart the reactions to the brand name versus the generic medication. Always carefully chart new medications, especially any change from a brand name to a generic. If you or a loved one isn’t doing well on a generic that is the same dose as the brand name, use the information in this article to get the help you need.
- Give generics time. It may be that the medication needs more time to get into the system.
- Use a different generic manufacturer. The pharmacist can help you find the country of origin and choose a different producer of the same generic.
- Talk with the prescriber. If there is still a consistent problem with the generic, petition the insurance company or disability service and explain the situation in order to return to the brand name or try a different medication. After a year of the generics being on the market, you can try the generics again.
Both of this author’s books, Take Charge of Bipolar Disorder and Loving Someone With Bipolar Disorder, have medication chapters that offer more information on how to create a management plan so that lower doses or even a different medication can be used.
Figuring out bipolar medications takes time and requires a lot of support. Still, ultimately, the goal is to manage as many symptoms as possible using behavior and lifestyle changes so that medications can be taken at lower and more sustainable doses.
For now, start by charting the dosage and source of medication, and if this changes in any way, carefully note any changes in symptoms. It’s much easier for a caregiver to notice changes than the person who is ill, especially if a generic isn’t working, as well as a brand name for mania or psychosis. You can then use your observations to help a loved one get the medication support they need.
Overall, generics are far more economical than brand name medications, and if this means they can offer more access to those who need them, generics are a positive in our bipolar world.
By understanding the full scope of how medications are created and regulated, we empower ourselves to make informed decisions that enhance our health and well-being.
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