Generic vs. Original Fluoxetine

OB/GYN News, May 1, 2002 by Sally Koch Kubetin

Leaders in the field of psychopharmacology are receiving widespread anecdotal reports that generic versions of fluoxetine may have diminished bioequivalence, compared with brand name Prozac, said Dr. Alan J. Gelenberg of the University of Arizona, Tucson.

Generic versions of fluoxetine hit the market in August 2001, and according to some reports, as many as 80% of Americans taking Prozac quickly switched to the generic version. The Food and Drug Administration allows generic medications to have a bioequivalence ranging between 80% and 125% of the brand name medication.

Dr. Gelenberg, speaking at a psychopharmacology conference sponsored by the University of Arizona, said that several of his own patients had experienced decreased efficacy with the generic version.

"What I advise the patient is, if the product looks different, keep an eye out for either increased side effects or decreased benefit," Dr. Gelenberg said. In the case of decreased benefit, "We need to either increase the dose of the generic or start switching them back to the brand name, with all the hassles that entails, including increased copays," he said.