Lexapro Brand Versus Generic Escitalopram (Top voted first)

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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Hi Lin,

I'm terribly sorry to hear about your situation. From what I can gather, there are a lot of people having negative reactions to Escitalopram. It seems as though many people like yourself prefer Lexapro instead of the generic alternative.

Some of the side effects people have reported while on Escitalopram include but are not limited to: headaches, sweating, heart racing, no sleep or appetite, anxiety, and other withdrawal like symptoms. Your pharmacist is right, you are definitely not alone in this.

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I've been on Lexapro for 4+ years and got switched to generic as well. Initially the generic just didn't work (it was like I wasn't taking the meds...not a good scene in itself), then after a couple of days I ended up with some bloating, GI bleeding, headaches, nosebleeds and wicked headaches. They insist that it's the exact same drug, but when I stopped taking it, the secondary symptoms went away in a couple of days and left me with just the original anxiety issues. Like you, my drug plan won't cover the name brand and I don't want to be screwing around with meds when I know one that works. So, I have to suck up $300+ per refill.

On an interesting note, my drug plan provider, doctor and pharmacist just sort of shrugged and said "yeah...some people have problems with the generics", but they didn't log it, report it or otherwise seem to give a crap. It's "my choice to use the name brand when a suitable generic is available", so I have to pay for it out of pocket ("Suitable", in this case, meaning 'doesn't resolve the primary issue and causes the patient to poop blood'). That's probably why the manufacturers can claim that it's a 1:1 replacement. No reports = no evidence = keep selling meds that are problematic to some patients.

Report your experiences to the manufacturer so that there's at least some record of it not working for you. If more patients do this, maybe the Rx providers will have to acknowledge that generics aren't always viable.

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I'm back on my name brand, but it took a week or more to get back to "normal". I've also tracked down the problem (I think). The generic appears to have a lactose coating that the name brand doesn't use. I'm lactose intolerant and it's never been much more than an inconvenience (though clearly listed in my health profile with my provider). Certainly nothing as severe as my reactions with the generic lexapro. Just as a test, I thought that I'd try an experiment. I had half a glass of milk with my name-brand pill every day and after 3-4 days it was clear that I was starting down the same nasty path that the generic had me on (in addition to the normal GI issues that I have with lactose). Occassional lactose hadn't been a problem, but continual exposure was. I wonder what other "inert" fillers there are that people are reacting to in the generic. I'd also like to know how the providers determine that a drug containing something that I have a confirmed and reported adverse reaction to is a viable medication. Maybe they have a generic version that's mixed with ground glass that I can try? :/

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I just called the FDA's adverse drug effect reporting line. Here is the link to the form to make an official report. The woman I spoke to said that having people make these reports is the only way we can hold the drug manufacturers accountable, and change the insurance companies' policies on coverage of genetic vs. name brand.
accessdata.fda.gov/scripts/medwatch

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You are so right. I would think just like any other medical profession a pharmacist would have to report when a patient has an adverse effect, especially when the patient works closely with the pharmacist as I do. Most lay people don't know to do this type of reporting. Therefore, insurance companies will just continue to deny the brand named meds because of "money". I don't choose to be so terribly depressed, I don't choose to have to take medication. I try to take care of myself, healthy weight and activity for my age. We just don't live in a good world right now. Lots of greed and deception. Guess that's the depression talking. lol

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I wrote earlier on 2/26/13. I had been on the generic Lexapro for one month when my symptoms of depression and OCD returned. I went back on the name brand Lexapro on 2/21/13. UPDATE: It took a full six weeks, but my depression and OCD symptoms have subsided almost 85%. I keep a log everyday and rate my depression and OCD. I also log in any changes in medications. I am certain that the generic Lexapro did not work. I have searched other forums and have ready many other people who claim that the generic Lexapro did not work for them. I will report my experience with the FDA and the drug maker.

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People do not realize, that a generic, might not work the same as a brand name. First, the dose, has to be within 10% of the stated dose. Brand name hit it on the money. Second, the chemical crud left behind, often is lots worse on generics, more side effects. Third they use the cheapest ingredients they can find, often less pure, more problems. Some drugs is is no big deal. Some drugs it is i life changer in very bad ways. report it to the FDA. fourth, each time you fill a script, you may get, a generic make by a dif company. you can tell cause the pills look dif. ALWAYS CHECK you pills before you leave the pharmacy, cause when they make a mistake, if you leave and come back, they will not believe you. In my life of many meds (aids) have gotten the wrong drug, in the right bottle. lots of sound alikes, and look likes, and some just way off.

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I have been on the name brand Lexapro since May 2012. Just started the generic January 2013. Just after filling my first refill of generic, I was back into depression and OCD. I immediately have switched back to the brand name, hopefully with good results. Will be one week of the brand name on 2/28/13. Has anyone who went back to the brand name have good results?

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Ok Yes, the Lexapro brand was so very much better than the generic. But, I just could not afford over $220.00 per month. It came to a point of either having to go off cold turkey or do some research to find out what I could do. I found out very quickly that drug companies are not in the business to "Help Others". I narrowed down Celexa vs Lexapro (same company) It seems they merely tweaked the Celexa since they were no longer making millions from the Celexa when the patent ran out. Very little differences in the meds. hence the names CeLEXa and LEXapro or citalopram and escitalopram. After meeting with my P doc, I went from 30mg Lexapro a day to 40mg of Celexa a day which we can increase to 60mg. The switch was very easy with absolutely no withdrawal symptoms at all, after the first three days, I actually had more energy and the 5th night I slept from 11pm until 6am, something I had not done in many months. I have had no adverse effects and am actually more improved than ever with more motivation, less isolation and a much better outlook. Now for the cost: I bought 30 of the 40mg tablets at Kroger pharmacy off of the $4.00 list but it was actually cheaper through my insurance company at $3.16. So far so good. I always have the option of going back on the Lexapro but I am going to ride this blessing for as long as it works. Maybe it was just time for a change. The body needs that every now and then. Many of us are very concerned when changing these delicate meds as it affects every aspect of our lives. I was very resistant at first but now am very glad I gave it a try.

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Same issue.... as soon as I switched it was like being on a sugar pill....How can they get away with this...
Insurance wants $250 month even though we pay over $600 month premiums to blue cross,,,,something has to be done.
People like us are suffering and being tortured.....

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I've been taking Lexapro, or the generic escitalopram, for several years. Although I suspected the brand name medication worked better for me, I never made a fuss since we are told generics contain the same active ingredients.

Several weeks ago I began having nighttime panic attacks. While I have experienced this phenomenon sporadically throughout my life, I was disturbed to find they were showing up every night--full-blown panic episides--and they were increasing in intensity.

I chalked this up to life stressors, but my life was going fairly well. I was eating clean, exercising, and forgoing alcohol. Still, my nights were terrifying and I grew increasingly distracted day by day.

After a week of hell, I began to retrace my steps. The only event that corresponded, generally, to the beginning of my attacks was a trip to the pharmacy to refill my escitalopram prescription. I had heard that switching to generic from brand could cause issues, but I had been on generic for many months.

Another week passed, and my panic attacks persisted. They began to seriously interfere with my life, and so I made an appointment with my psychiatrist. However, three days before the appoinent I couldn't take it anymore and went to an urgent care facility. I explained my problem, and they took mercy on me by writing a prescription for clonazepam. The idea was that this should suppress attacks and help me sleep. I was grateful, but I still needed to know why the attacks were happening in the first place.

We went to fill the clonazepam prescription, and I decided to take a chance and tell the pharmacist my problem. I told him I knew it sounded crazy that picking up a refill of my current medication should wreak havoc on my body, but I wondered if anyone else had complained.

The pharmacist hadnt heard of any problems, but to my surprise he began researching my escitalopram. It turns out Walgreens had ordered from a new manufacturer (Camber), and the timing corresponded to my refill. He explained that these negative experiences were not uncommon with this type of medication, and that I should check into having my doctor write for Lexapro. In the meantime, he let me get a handful of Lexapro at full price, a step I was happy to take if it meant relief.

One day later, I have experienced my first restful night in weeks and appear to be on the mend. I meet with my psychiatrist on Monday, and will work with him to fine tune my prescription to avoid these problems in the future.

Generic vs. generic: Who'd have thought? This experience was a good reminder to trust my hunches and question everything!

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Well...I got a few good months out of my name brand at $300+ per refill (see my February posting) and then I noticed that this last refill wasn't working so well. I didn't have the black stool, but I did have the headaches and it felt like I had forgotten to take it on some days (to the point where I put up a calendar to make sure that I wasn't missing any). After a few weeks of this, I finally thought to check the prescription and, sure enough, they tried slipping in a *different* generic (Teva this time) despite a script on file that explicitly says "dispense as written" for Lexapro. Apparently, since they also had the old one on file that didn't say that, they felt they could pick and choose.

To be fair, the Teva version did seem to help *sometimes*, but it was really hit or miss. I don't know how the same active ingredient can be absorbed or processed differently, but it is.

I can't keep playing these games, so my MD is going to give up on Escitalopram and try a completely different drug. It's a shame, because the Forrest Lexapro was a life changer for me. I wish that they could just slap some food coloring in it or something and call it a new drug so that there wouldn't be a generic equivalent.

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I have had this same issue and it is very frightening b/c I really can no longer afford the medication at all, yet, if I go off, I know I will soon be suicidal. I found a non-profit organization that I thought was going to help me with the cost but it turned out they only provide the generic--grrr!! I am at a total loss and don't know where to turn. If anyone has any solution to this, please post here!!! And no, the pharmacist and doctor made no attempt to report the problem, though they readily acknowledged it was common!!!

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Actually there are some very specific differences between lexapro and celexa and it is not simply a tweak. there are two different orientations of the molecules that make up the drug (way they are arranged in space). One of the orientations is more responsible for the beneficial effects and the other is more responsible for some of the side effects. Celexa contained both enantiomers while lexapro has been manufactured to have only the beneficial enantiomer. Many people tolerate celexa really well with minimal side effects while some people have side effects and can switch to lexapro and maintain the beneficial effects. this is why prior to the generic lexapro, most insurance companies insisted a patient try celexa (which already was generic and so cheaper) before trying lexapro. the issue with generics is very different. I have been on lexapro for at least 10 years. cleanest anti-depressant i have ever been on (and i have tried pretty much every class). i was thrilled when i picked up my last refill and found generic (and a cheaper copay). unfortunately like so many others, i am not finding it as effective. in particular i am having the terrible spinny vertigo like withdrawl feelings if i am the least bit late in taking it. it has long been known that generics and brand are not equivalent. how a drug is manufactured changes its absorption. It has also long been known that not all generics are equivalent. Ask anyone on thyroid medication. i would suggest if you can find a generic that works, try and find out who makes it and then try and keep that constant. unfortunately pharmacies change manufacturers frequently. you just have to look at all the drug shortages to know that if a company can't make money on the drug, they won't make it. this includes many very very important cancer drugs.

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Yes, I posted the FDA thing a while back and some of us have already filled that out but it needs to be filled out by all of us. I wish a lawyer would take our case and get this situation remedied.

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Hi Stressed. Nice to meet you. I DO feel your pain. Today I have to go for a refill on the Lexapro. I found a coupon on rxreliefcard.com for "take UP to 75% off your next prescription for Lexapro 20mg. I printed it off and will try to use it. I did find out that my insurance will cover the liquid brand Lexapro 5mg/ml. I am going to call them today and ask WHY if they will cover the liquid they will NOT cover the tablet. C*R*A*Z*Y, greedy, money-hungry. If they won't provide coverage, I will just have the p-doc change me to the liquid. The co-pay is only $95.00 per month. A lot cheaper!! Might taste nasty but they can add some kind of flavoring at the pharmacy. lol Will also put me in the Medicare Coverage Gap in a few months then I am back to paying full price again. No win situation!! {edited for privacy}.

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Also, if anyone has experience trying to get it from Canada, please share! Thanks!

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I had the EXACT same issue of horrible nighttime panic attacks when I switched to the generic. As soon as I switched back to the namebrand, and it remetabolized in my system, boom, panic attacks gone.

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My doctor explained this to me. The generics are the same active ingredient, but the different binders can affect the bioavailability (the rate and extent to which a drug makes it into your system). It can also impact where in your system and how the drug is absorbed. (eg: Acidic drugs are apparently absorbed in the stomach and basic drugs are absorbed in the small GI tract.)

So despite what the drug companies would have you beleive, the active ingredient isn't the entire story. If it was, there would be no reason to include the variety of different binders and fillers that they use.

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I have been on Lexapro 20 mg since it came out on the market. When it went generic I started taking escitalopram. All my anxiety, anger, depression came back in full force. I could not understand what was happening until my husband pointed out it all began when I switched to the generic. I now pay thru the nose for the brand, but it is a necessity for survival. I am a pharmacist and have heard from a few patients that this is the case for them too.

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