Lexapro Brand Versus Generic Escitalopram (Page 2) (Top voted first)

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I have taken 30mg of Lexapro for past 4 years. After the deaths of my son and his wife in a plane crash the depression and anxiety were more than I could bear. This past May I was changed to the generic escitalopram. God Forbid!!!! What a nightmare. Within three weeks I was suicidal, I was going through SSRI withdrawals which are vicious. I am now paying over $225.00 per month for Brand Lexapro as my insurance will NOT cover it even with prior auth or any other reason. My Medicare Advantage plan leaves a lot to be desired even though I pay a $152.00 per month premium. Has anyone else had problems with the generic Lexapro? My pharmacist said I am not the first.

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89

For those of you who are experiencing difficulties in switching from Lexapro to Cipralex/generic rest assured your problems are DEFINITELY not psychosomatic. I too have met with the same results in two separate instances. Since my employer, (Fortune 500 company), is self-insured a separate insurance company and mail-order pharmacy is contracted to manage the health plan and prescription drug program, respectively. Last year, I was initially denied Lexapro and the reasons cited were the same as those listed in the submissions of others at this site. My psychiatrist, however, got directly involved with both the employer's benefits office as well as the mail-order pharmacy and explained to both parties, in-no-uncertain-terms, the liability issues at stake–not to mention my health. Fortunately, the matter was resolved and was able to procure the Lexapro at the rate of $225. per 90-day refill. This year I am faced with the same dilemma and suspect it will again be a tough fight.

If my psychiatrist should not be successful I have every intention of filing a complaint with the state insurance commissioner citing both the mail-order pharmacy and the employer. And, if necessary, I shall retain an attorney and let him/her approach the various newspapers and other media outlets. I'm hoping it will not come to this but these are certainly options well worth considering for those of you being denied the medication you need and deserve to have. My view is such that if the insurance companies want a fight I won't disappoint them.

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16

I've also been on 30mg for about 2.5-3 years now due to GAD and some social anxiety that developed my last year or two of HS (I'm 25 now having just graduated from Indiana University), but anyways this busch light has be rambling ;) ha I recently was switched to the generic as well, and have been going through a semi depressed time which i guess could be related to my having been switched. Also, I decided that it's time for me to start tapering off so I have been taking 20 for the past 3 weeks and am going to try and stay steady at 15 from now on. I'm at a time in my life where I need to be motivated and passionate, and you can't reach peak potential without some stress. So thats my reason for tapering, but I'm happy having been made aware of the different effects from the new generic. Oh and for whoever asked about alcohol, the only thing lex does to me is make me a bit more hyper while out and then make me want to go to sleep earlier than usual, and the memory is definitely not as strong once i start getting sleepy. Enjoy deciphering that ha

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23

Thank you for the link! I just reported ESCITALOPRAM side affects. I have been taking the generic form of Lexapro 20 mg for a about 7 months for social anxiety and panic attacks. I had slight GI issues, but I was feeling SO much better and just dealt with it. I felt I actually had a real life. At work people noticed a difference. I rarely had panic attacks. I refilled early October, 2013 and noticed the pill was a different shape. Have been taking it for a month and had extremely embarrassing GI problems, depression started coming on, insomnia, lost 15 lbs., started becoming unsocial and a recluse again, and headaches. CVS told me they switched manufactures. Today I saw my doctor and we are going to try the non-generic Lexapro. Wish me luck! I enjoyed having a life and want it back!

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24

I also went to the FDA link someone provided above and reported the generic--thank you! Maybe if we all do this and spread the word, something will finally be done.

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26

I had the same problem. After 8 yeasr on real Lex was switched to generic and started having anxiety, headaches, insomnia and realized it started with the Aurobindo (Indian Company) generic Lex. I switched back to real Lex and it has taken 2 weeks to feel almost back to normal.

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37

I was given the generic after eight years of taking Lexapro. Didn't think anything about it and was pleased with the lower price. Then--the headaches, ringing in the ears, nausea, and shaking hands and panic attacks started. I hadn't had a panic attack in so long, I didn't recognize what was happening to me at first. It took me some time to connect my sudden symptoms with the generic. Now I am back on Lexapro, and all the symptoms have stopped.

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42

I was taking Lexapro 10mg for 11 years. I went through yer of my young daughter battling cancer, and didn't suffer depression that time. Anxiety, but not depression, think God. Lat year I also was switched to th generic brand. My stressor were nothing compared to my past, yet I became so mentally debilitated, I thought I would die. I am an RN,and couldn't work for 6 weeks. I couldn't get out of bed. My family had an intervention, I tried to tell them it was the meds. My Dr. Told me that FDA allows 33% LESS efficacy of all generics! They are also thickly coated, so they dont dissolve in the small intestine where most absorption takes place. I am on brand again. Was $110/ month, now just increased to $155. ALL my generic drugs had to be DOUBLED in the dose to work!!

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52

Hi Lin,

I did not read the whole row of replies, but your complaint is anything but bizarre. Unfortunately, the 'all generics are created equal' concept is, in all almost all cases, as flawed as the notion of 'there's nothing that can be done' regarding the problem. Most likely you do not have to pay out of pocket. There are actually assistance programs that actually work - it might sound like a fairy tale, but it's more common than you think. No one is going to go on the internet and post about how comfortable they feel now that their medical issue is solved and problems dominate most of the stuff we see written. FURTHERMORE YOUR DOCTOR CAN REQUEST AN AUTHORIZATION FORM, the concept of 'prior authorization' is another one of those things that seem to be possible only 'elsewhere', 'a long time ago', or 'for other people but not me'. This is false. If your doctor devotes more time to working with your insurance and less time shrugging his shoulders and telling you about the FDA guidelines about generic drug approval and the rigorous demands that need be met before a generic makes it out onto the market etc, you will most likely get your medication, whether it costs $200 or $200,000, insurance companies usually have the means to cover their patient base a hundred times over, and there are plenty of people taking medications which cost more per tablet without a generic equivalent therefore covered by most insurance, than you pay yearly for your escitalopram. 1. call your insurance company or the number on the back of your card, so you can speak to a person/human being, recovering claims and coverage. 2. tell them or if applicable, write them, and explain how you have been taking escitalopram from the same manufacturer for years etc, and indicate that you encountered severely disturbing symptoms/adverse effects around the time that you noticed by accident that the tablets look different. 3. DO NOT SAY THAT THE GENERIC IS BAD , merely word things in such a way your statement makes it obvious to the person on the other end that it's possible the switch from one manufacturer to another caused some sort of anomaly. IF you complain about the poor quality of the generic, you will be heard and 'the situation will be looked into' but since most anti-generic complaints are the result of placebo effect (this much is true, and I am not insinuating this is the case here) you will be taken as seriously as the rest of the thousands of people who call in daily to complain - meaning absolutely nothing will be done and you will also most likely be marked so that any future attempts to complain or otherwise intervene, will be automatically rescinded. 4. You are taking a psychotropic medication. You have to realize you are often going to be treated as a 'psychiatric patient' especially when you complain. Not only does this save an insurance co money it also allows them to justify their negligence. 5. After you complain you will (almost always) be given the code to obtaining the authorization form - typically this involves your doctor calling a number and ordering a form. Filling out this form might take as long as ten minutes and might ensure in as much as 4 phonecalls in the span of a month, so if your doctor simply disagrees, consider going to another doctor - depending on the area where you live, the more 'metropolitan' the area, the more common it is for these grueling prior auth. processes to take place. It might prove to be cheaper seeing a specialist once every three months or even less for your Lex, instead of paying out of pocket. So please find out from the back of your card about the prior auth. process. Your doctor doesn't HAVE to do this, but if you are very calm and persistent and continue to complain, do not be afraid to ask him WHY he simply declines to take part in the process. Most doctors will refuse to, but most doctors also want to help their patients, and if your distress is real and this much is evident, your doctor will understand that you are not simply buying into hype you read on some forum somewhere but are actually having an issue. At this point your doctor might take action because though he does not HAVE to do a PA for Lex, he does have to follow a certain code of behavior, and ignoring endless complaints from you would make that an issue should you be willing to take it to court. I am not saying you should threaten your doctor with legal proceedings, but I am saying that no doctor or any other person in their right mind, for that matter, wishes to go through the court system if the issue can be resolved by a phonecall and something that culminates in ten minutes of frustration in the worst case scenario. So be persistent and ask for a prior auth. which will make your insurance look into covering the costs of the non generic escitalopram hydrobromide, including doing so at a dose that is 'above normal' (another issue you might have to tackle). At the same time go the manufacturer's website, call Forest labs, they are very polite on the phone and will listen - there is no guarantee they will do anything - but they will definitely listen. If your income is too high or if you simply fail to establish that the manufacturer helped you but the generic substitute has ruined your life, it is in the interest of the manufacturer to assist you by covering costs either fully or partially, because this is a good thing on their record in at least two ways - it establishes they are sympathetic and their humanism goes beyond pressing tablets and launching ad campaigns - it also becomes 'evidence' if you will, that they can use to help assert that their formulation is superior to any other [generic]. So essentially by getting coverage from the manufacturer [forest labs will not go hungry, I promise, for covering your expenses] you are helping the manufacturer make money. It is in their interest, and you're not asking for handouts. Furthermore they actually work with your insurance and your doctor in establishing all this, so it's not that they simply send you a coupon in the mail, they actually stir things up before they start paying themselves, should that be the case. Please don't sit there and take it. It's easier to do and takes less time than it took me to write this. A shame this is so anonymous or I'd gladly leave my email to help you out with this - it's an absurd problem that should not even exist, and the lack of knowledge is astounding, regarding prior auth., discounts, and also manufacturer-patient assistance programs that have nothing to do with any insurance. Best of luck - it's NOT IMPOSSIBLE IF YOU STICK TO IT, I cannot stress that enough. Otherwise, take comfort in the fact that Lexapro went generic fairly recently, so as more manufacturers roll out their version of escitalopram, the problem will [as in the past] eventually fade away or just fade out. But that can take forever. So be persistent.

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58

On Lexapro for almost 10 years, no problems. Generic had me in fits after 2 weeks.

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66

I was on Lexapro 10mgs. for several years before my insurance company switched to Generic Lexapro (TEVA) in the fall of 2013. At that time I was only paying $5.00 for the Generic. I went 11 weeks in 2013. Then backed off for the Summer thinking something was not right with this generic med. I just went on again in September 2014. I'm convinced it is not working. headaches, diarhea, crying or being sad, not wanting to socialize are all symptoms I never had when on NON-GENERIC Lexapro after 2-3 weeks that's when I called my Doctor's office. They changed my script to read(dispense as written). I also called my Insurance company Independent Health. They said they would note my concerns and finally approved the change. To my surprise the Co-pay is now $60.00. I also filed a report with the FDA. I also feel a legal suit may be coming in the future. Please take the time to do this. It may help all of us. Here is the link:

accessdata.fda.gov/scripts/medwatch/index.cfm?action=consumer.reporting1. Keep This Forum Going!!

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68

After being on Lexapro for six years, my insurance company switched me without my knowledge to the generic when it became available. The symptoms I had were so much worse than my pre-Lexapro anxiety and depression. After about a month on the generic, I discovered that I was no longer taking Lexapro and immediately knew what the problem was, so immediately I went back on the Lexapro brand.

From Sept '13 until May '14, I tapered off of Lexapro and have had horrible "discontinuation" symptoms that my psychotherapist has actually identified as withdrawal. I am now wondering if what I was actually experiencing when I abruptly stopped taking Lexapro and started the generic may have actually been withdrawal from Lexapro. I am certainly not defending the generic, because my body definitely recognized it as a drug different from Lexapro, so it is clearly NOT THE SAME DRUG.

The second stage withdrawal symptoms I am experiencing are insomnia (which I have never had -- ever, stress that is unlike any stress I have experienced -- it actually induces panic attacks, which I have never had in my life and weird bouts of dizziness.

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78

Did you say you are NOT back on it or was that a typo? If you ARE back on, you should start to see some improvement by two weeks. For some it is sooner, some later but it seems generally you would notice positive mood changes by two weeks.

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79

Taking lexapro generic is like taking a placebo for me!!! I pay for the brand and it is also not covered. I am a pharmacist and I will tell you we are not alone on this. I have met others that pay cash for the brand.

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82

Report it to the FDA. This is the only way we can get help.

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87

I have been paying a fortune for brand lexapro so I decided to try the new SSRI made by Forest Labs, (Forrest Labs?) which is the same manufacturer of Lexapro. They came out with Viibryd as soon as Lexapro went generic. I am giving it a try as my insurance will cover viibryd and there is a coupon online at the viibryd webiste which makes it very affordable. I got the starter pak from my doctor and I am liking it a lot. The only thing I noticed was that during the titration period I did cry twice, something I haven't done in years, I am now on the full dose and like it, except that it also makes me a little absent minded. The absent mindedness was one of the first problems I faced when I started Lexapro and then I got normal. I hope Viibryd is the answer for me. Generic lexapro is not worth the 5 dollars I spent on it. I could tell the generic was not working as I was getting very bitter against my husband which is a sure sign for me when the meds are not doing their job. Hope this helps.

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100

Amber, that may be a bit of an overreaction. Generics, overwhelmingly, are not toxic. There are some unscrupulous manufacturers, but they're exceptions and not the rule.

The problem with generics is that the active ingredient is exactly the same, but the formulations change how some people process it. For the majority, it's a non-issue. But for some of us, it's the difference between "works" and "doesn't work" or even "works" vs. "does harm". We need the FDA, drug companies and Health Care Providers to acknowledge that there are individuals that have legitimately and fundamentally different reactions to different formulations and can't tolerate specific generics.

Trying to make the case that all generics are evil is swinging the pendulum too far in the opposite direction and distracts from the very real problem that, while generics do work for most people, they can be very problematic for others.

I take generic anti-inflammatories, use generic cough medicine and anithistimines, apply generic antibiotics to cuts and cover them with generic bandages. None of these have caused any problems. However, the only escitalopram that has ever worked for me is the one from Forrest Labs and the other manufacturers have ranged from "doesn't work well" to "causes internal bleeding". That doesn't make the other products bad, just bad for me.

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101

I worked in the Pharmaceutical industry. Your safest drug with the least health affects is the Brand name! I know all you are talking about but the industry continues to makes more generics that are creating health problems and expensive hospital visits and then people people find out the WHY'S of their issues and health problems with generics. I am not overreacting! I have seen the hell that some people go through vs using the brand drug. Its all about making money not well being!

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123

I have been on Lexapro off and on over the last 8 years. Has been very effective for me. I was taking 5mg as maintanence for he past year and a half without issue. Then a new job with new insurance and they wanted me to switch to the generic.

I figure I had been on Lexapro for several consecutive years without incidence. Starting at 20mg for a couple years then down to 10 then to 5 for maintenance. I figured there will be little harm in switching at 5 between the two.

I switched a month and a half ago and the only thing of notice is I felt maybe more apathetic. Figured maybe a side effect that will pass. I just seemed as each week went on I was just more blah and less motivated.

Then last week I started to feel a little subtle anxiousness/nervousness as well so I started to increase the dose. Then last night while trying to go to sleep I experienced a panic attack and a increased level of overall anxiety in general that has stuck around since. Needless to say, I immediately went to my pharmacy this morning and paid out the nose for the Lexapro. So now the wait and see and pray that switching back to what was working in the first place will still work.

There is a whole lot wrong with the whole generic and insurance industry game. The choice should be our own weather we take a brand name or a generic. I logically cant see how anyone can say the two are the exact same. Same active mechanism but completely different makeup with fillers and binders. If a person starts off on the Generic, I'm sure they probably have some success on it but for those taking something currently that is already working then being asked to take something that is similar but not exactly the same in makeup. Is most likely going to have a different effect on the individual.

Insurance companies ask us to defy our own common sense to take, in some cases, very inferior quality of medications.

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125

I too had been on Lexapro 20 mg for about 4 years, until my insurance decided that they no longer would pay for the brand name. I was sent the generic which I took only for 1 week and was a raging maniac and yelling at the world. called my doctor and demanded the insurance to put me back on the brand name. Which they complied to do at over 500.00 for a month supply, which I decline to buy for that price. Doctor changed me to another depression medicine which I am tolerating just fine. Generic Lexapro needs to be pulled from the medicine list. The pharmacist tried telling me there is no difference in generic and brand but for the price, They are wrong!!

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127

Yes! Lexapro worked wonders and the generic was awful. I tried to tell my doctors but they kept saying it was the same, but it's not!

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