Ingredients

I looked up the inactive ingredients in the generic “equivalents” I had been taking and compared them to the brand name drugs I was prescribed. In the table below, I organized the inactive ingredients list to clearly show which ingredients are shared by the different medications (Zoloft, the generic sertraline HCl I was taking, BuSpar, and the generic buspirone HCl I was taking).

I suspect that ingredients in italics are essentially the same chemical, but with slightly different names. There may be differences between them, but I’m inclined to think that any differences in their biological effects are relatively insignificant.

The ingredient in bold is only present in one medication; interestingly, the medication in question is the generic buspirone HCl. The only explanation I can come up with for why they’d randomly add sodium lauryl sulfate is because they need it in order to get the anhydrous (condensed) lactose to behave similarly to non-modified lactose during production. I find the presence of sodium lauryl sulfate in my medication disturbing, but haven’t found any information to suggest that it might’ve been interfering with the effectiveness of the medication or having noticeable adverse effects.

Ergo it seems likely that if inactive ingredients were limiting the effectiveness of my medications, switching from generic to brand wouldn’t help me much … unless differences in amounts or proportions are significant. I have no idea whether the amounts of the ingredients are the same across the included medications, but each medication had them listed in a different order.

Wakana sat me down at her computer, worked with me step-by-step to find a psychiatrist within reasonable driving distance who takes my insurance, and insisted that I call to make an appointment. I had to leave a message – to which I have yet to receive a reply – but at least I did something. I felt like a huge weight was lifted from my shoulders. And maybe finding out information about other organizations / programs that could help me will be similarly painless … especially if I can do a lot of it online.

One thing I’ll definitely be looking for as I conduct my search for a new psychiatrist will be strong knowledge of how inactive ingredients affect one’s response to a drug, particularly when that may cause significant differences between brand and generic. I need a psychiatrist who will take this concern seriously and be willing to fight to gain me access to the brand drug ze’s prescribing (instead of a generic “equivalent”) if necessary.

UPDATE: I’ve color-coded the inactive ingredients list to indicate possible concerns raised by Disorderly Chickadee in Generic Versus Brand: What’s In That Pill? Part Two. Many thanks once again to DeeDee for compiling the information. Trying to do so myself has been very difficult and frustrating.

Coding scheme:

  • allergen
  • carcinogen
  • toxin, irritant, or other health risk
  • animal product
  • restricted by some religions

Zoloft (50mg)

Sertraline HCl (50mg) Camber Pharm.

BuSpar (15mg)

Buspirone HCl (15mg) Mylan Pharm.

Dibasic calcium phosphate dihydrate Dibasic calcium phosphate dihydrate
FD&C Blue #2 aluminum lake FD&C Blue #2 / Indigo Carmine aluminum lake
Hydroxypropyl cellulose Hydroxypropyl cellulose
Hydroxylpropyl methylcellulose Hypromellose 3cP & Hypromellose 6cP
Magnesium stearate Magnesium stearate Magnesium stearate Magnesium stearate
Microcrystalline cellulose Microcrystalline cellulose Microcrystalline cellulose Microcrystalline cellulose
Polyethylene glycol Macrogol / Peg 400
Polysorbate 80 Polysorbate 80
Sodium starch glycolate Sodium starch glycolate Sodium starch glycolate Sodium starch glycolate
Titanium dioxide Titanium dioxide
  Colloidal silicon dioxide Silicon dioxide
  Lactose Anhydrous lactose
    Sodium lauryl sulfate

Prescription by Dr. Ziya

WARNING: This is a (potentially risky) decision I have made for myself. It does not take the place of medical advice by a qualified mental health professional.

Today I had a conversation with 2 friends that confirmed a few thoughts I’ve been having:

  1. I will not go back to Psychiatrist B under any circumstances.
  2. I need to stop taking my current medications.
  3. Listening to music daily will improve my mood and possibly also my brain’s functioning.
  4. I need to be honest and talk about my disorder more often.

Psychiatrist B didn’t take my thoughts about harming myself and even committing suicide seriously, despite the fact that the drug he was prescribing me can cause such thoughts. He also needed assurance from me that it was worth gaining weight to have the possibility of recovering from a disabling disorder; that my mental health is more important than my appearance! (He also made the typical assumption that fat = ugly, which I have no desire to perpetuate.) As one of my friends put it, there’s a significant risk that if I keep going to this doctor, his problems will have a negative impact on my well-being. It also certainly doesn’t bode well that the “clinic” hasn’t made any attempts to contact me about rescheduling the follow-up appointment I canceled nearly a month ago.

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long-white-pillsRegarding my medications, the bottom line is: they’re not providing the relief I need. Regardless of whether they’re helping “somewhat,” the fact remains that they are not helping enough. And there’s the possibility that they are causing or contributing to some of my more disturbing symptoms. I haven’t been taking them for the past few days and to be honest it’s been a very rocky road. At this point I’m unsure whether I should hold my ground until they’re completely out of my system – or start taking them again in smaller and smaller doses until it’s safer to stop completely (or I run out). Everyone seems to think it’s better to wean myself off them slowly, but I’m concerned about what might happen if my levels spike again after being so low for the past couple days. It’s also a lot easier to just not take them than to try to figure out what doses would be appropriate and remember to take them regularly.

It’s recently come to my attention that I’ve been doing my readers and the companies that make certain brand-name drugs a disservice. I’ve been taking generic “equivalents” of Zoloft and BuSpar (sertraline HCl and buspirone HCl, respectively); prior to beginning this blog I was taking bupropion in place of Wellbutrin. Anyone reading my blog would think I was taking the brand-name drugs and that they were causing or contributing to the undesirable effects I’ve described. This is most certainly not the case. In Generic Versus Brand: What’s In That Pill? Part 1, Disorderly Chickadee sheds light on how generic formulations of brand-name drugs often are not as effective as the brand-name version; in some cases the difference in functioning one experiences can be “like a brain transplant.”

Most notably, there is a huge difference between Wellbutrin and generic bupropion, enough so that one generic formulation was recalled. It’s not the one I was taking, but it still raises some suspicion that I might have done a lot better if I’d taken actual Wellbutrin instead. I’m also wondering whether brand-name Zoloft and BuSpar would be more effective (and safer!) than the generic sertraline HCl and buspirone HCl I’ve been taking.

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bob marleyI don’t usually listen to music, unless you count the background stuff in Oblivion – which either alerts me to the presence of enemies or puts me to sleep. Yesterday I had the very pleasant experience of listening to some of the more upbeat tracks on a CD of instrumental Celtic music. The bass and percussion were very grounding and calming, helping me to feel safe … while the foregound instruments were lively and played complex melodies in compound meter.

MeterI had a lot of fun listening to the music, felt calmer and happier, and thought it was having a desirable effect on my brain. It required enough of my attention that there was little to no room left for disturbing thoughts, and it seemed to help organize my brain. My hypothesis is that the regular firing of neurons involved in listening to the music (which are located throughout the brain) may have provided the stimulation, serotonin, dopamine, and information pathways my brain needed to function more effectively. I might need to experiment a bit to figure out how many times per day and for how long I should listen to music, as well as what types of music will provide the best effects … but overall I’m optimistic that listening to music regularly will help – a lot!

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meep-and-lolz-cropFinally, it felt really good to be honest about what I’ve been struggling with and have my friends accept my reality. They listened and shared their own related experiences, which helped me feel less alone in my struggles. They offered advice – some of which I found helpful – but more importantly demonstrated that they support me in my efforts to take care of myself. “You know you can call any of us any time you need to talk, right?” Yeah, I do; I just need a reminder that there are people who want me to reach out to them in my times of greatest need, when I feel like I’d be doing everyone a favor if I just ceased to exist.