Switching From Pristiq To Generic Desvenlafaxine (Page 8)

I was switched from Pristiq to generic Pristiq (Desvenlafaxine) which if I understand right, is really Effexor. Is there a possibility this could be causing my severe fatigue? Has this happened to anyone else out there?

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I doubt either Effexor nor Pristiq would ever cause fatigue. The question first must be, How is your Depression, Anxiety, Mood separated as well as you can from the fatigue? As for very bad Fatigue, depending upon how severe and pervasive, it could mean that youre still depressed. When ones depression is well managed, and unless there is,another health problem, one feels well and free to move and accomplish things. So again, how is your depression?

To problem solve thus, Id like to try to be of help as a once vibrant and uniquely qualified and experienced clinician (Now, most ironically disabled ) and as one who has managed severe depressiin and more to a degree which allowed me to function intellectually, clinicallly-professionally and as an innovative thinker, problem solver, instigator for change via entrepreneurial mindset and endeavors. Also as such I worked with clients who had very complicated life, health snd physical/functional conditions via interdisciplinary clinical models. As for meds, over the years Ive needed to change every 4 or so years. Meds that worked excellently for me just dropped me cold as it seemed. Luckily, I always have had a great clinician to know my history and was ready with the next right choice as it turned out! Ive been most fortunate. My case as just another person, patient got complicated first by a TBI, and then I acquired a neuroligical condition which back in 2002 was still very much commonly known by the misnomer of Chronic Fatigue Syndrome. The term CFS and illbess was a disorder for which I was an early and rare clinician to study then little information back in 1990. Neither the TBI nor the onset of CFS, which is now finally rightfully identified and recognized as Myalgic Encephalitis (note, there are some who dont have the myslgia. I dud not have it until the onset of my 3rd "Relapse," which I am certain are actually acute Reactivation or Recurrences of the original, prsumed to be Virus not yet ideantified and also other opportunistic viruses one contracted at the original onset simultaniously. Bad fortune!. A key feature of the illness is an, "Indescribable," "Utter" fatigue and or exhaustion while acutely ill and once contracted, can be elicited, depending upon the staus of ones case and/or conditioning. So thus and as many of my patient clients did also experience varying degrees and reasons of fatigue, I know much about both topic, clinically and personally. I proceed:

Was fatigue a typical part of your depression before, ever, even if this is worse now? Remember the medication most definitely would not cause fatigue. However, if your under medicated for depression or if this has been the wronf antidepressant for you, then depression is still not optimally treated and maybe not at all treated by that medication.

If depression wise, except for the fatigue, youre feeling pretty good, then you must look first for a health/medical or perhaps a psychosocial cause for depression. Psychosocial btw, doesnt mean in your head and therefore less real or valid!. Besides it is well proven that there is no truth to the xoncept of anything atall being only in ones head, brain and all that encompasses. The brain and its chemistry and the body is so very interconnected in many ways! You would be surprised if you were to begin to learn about the concept of, "Mind Body," and Neuroscience and neurotransmitters etc. So im not minimizing your fatigue. Im quite concerned as you are Im sure.

Answer those questions and then not as an active clinician and nor as anything remotely to be thought of as a substitute for your need for medical care, etc..etc, but more as a person or co-sufferer who cares and has unique experience and insights that may or may not aide you in getting yourself to the right clinician. Soneone who might help you to solve your problem. Please respond that you get this. Im not an active clinician. I can only help with promoting you to or offering you some thoughts and point you to resources that could be of help. I like to help and what you shared intersts me and matters to me.
Lastly. Pristiq is not essentially or otherwise, the same as Effexor. Youve miss understood or been mis-led. They are considered to be in the same family or category of psychotopic medications generally used to relieve depression which may or may not also involve anxiety and other symptoms.

These meds, both have an impact upon the brain of aiding certain neurotransmitters to be able to do their job. Pristiq targets two of them and Effexor, the first of its kind, aides the effectiveness of three different ones; Serotonin, Dopamine and Norepinephrine. There are many neurotransmitters, each are involved with communicating certain information in certain ways to effect certain mental and physioligical function throughout the body. See...Mind Body Neuroscience proved what clinicians and people who live conscious of and according to the interconnections between the Mind and Body in there too is Spirit and the Energetic or Subtle body. Its not voodoo. Some clinicians choose to ignore this. Many do. That doesnt make them bad clinicians, but maybe on a level not as optimal as they could be. I was not a big expert in these things, much more than other most clinicians. I was Physical therapist and rehabilitation expert. I had a very interesting career and have a great story as to how I became a PT and what I did and my accomplishments. I still hope to see my work to be advanced and reproduced and or to write about it for others to take up. Right now, as my parents caregiver, medical and caregiving manager and as that huge responsibility has affected my health and wellbeing greatly to the negative, Im currently struggling for stability of my moms wellbeing and my own too. I will get better, but expect to be limited. Ive found ways and means to ideally attract, inspire and to influence others to pick up where I left off and now I also have missions to see to actualization in the area and witjin the industries of Senior Living. Parallel to that and to my own needs with respect to getting access to one of but a handful of ME/CFS evaluation, treatment and research centers and to apply my clinical design and evaluation and rx concepts to build a highly reproducible local functional medical and rehabilitation model. This disease of ME is devastating, to a point, it is treatable and can be managed. I believe that if people had access to this care, even it going to them if they are house or bedbound, that they could recover function and health believed to have been lost forever. That a lot for a person who is herself currently mostly housebound and severely disabled/impacted by this disease. Ive to be aided, but it is possible.

TMI, but I have to be a human billboard for this illness and for the causes I so believe in or else none of ehat has happened to me, given my knowledge and expertise makes sense! Or rather, what Ive gained before and after these hardships will go to waste...except of course for any and all whom Ive helped to date. I do have that! I hope Ive helped you. Given you some clues. Ill respond again if you answer those questions. Note, that given my own concerns, that I can be long in respinding. I will though strive to follow up regularly and find you. Either way, good luck. Maybe others will be helped by my long message here. Id love to see any responses!

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Re: Pam (# 121)

Great sharing thank you. I had not heard of the PG...geez I ought to have attended to the anachronism better. I very much heard and felt for you. How crazy it was for esp BCBS to fsil you like that! As a clinician who did innovative ground breaking work, I had to learn ways and means to get paid. Very, very often things can get denied for something as simple as wording and semantics! Also it has much to do with whom you are communicating your need. How did you appeal? Did you do it yourself or did your clinician do it? Most clinicians have clue how to or to whom they must make the appeal. You ought to try again, especially as you have now well-documented proof that the issue WAS the generic Pristiq! Most clinicians will stipulate that a prescription be the name brand versus generic! Most, no all except that one exception that began this exchange, as my clinician had retired and I was dealing with another. Before I even got to get her to change my prescription to decline generic Pristiq, it had become obvious that Pristiq just finally had quit working for me. I changed providers too. Im now on Sevella, which is in the same family of medications. Interestingly, rather than label and market it as an antidepressant, and this may be helpful to you someday, it is marketed as a medication for Fibromyalgia pain!

I have Myalgic Encephalomyelitis which for too many years was known by a misnomer arbitrarily made up by the CDC in 1984, following one of well over a hundred documented cluster outbreaks prior to it in the US Europe and the UK alone. The applied this vaguely defined new label of Chronic Fatigue Syndrome which minimized the illness and set much in motion against this disease getting the recognition, funding and support and validation required to help millions of sufferers in the US and abroad. That enters into a long story not for here. Certain life conditions have caused this to get rapidly more and more debilitating over the last 5 and half years when I would have otherwise been able to manage it. However the Myalgic part of the name refers to painful neurogenic causes to pain. Commonly one will read that we therefore have Chronic Fatigue Syndrome and Fibromyalgia. As a clinician whose specialization was in developing interdisciplinary evaluation, and innovative treatments and attitudes, environments to ever better understand and care for persons with chronic pain from injur(ies) and illnesses, Fibro and CFS among others being often part of a greater picture. I know that ME pain is not Fibromyalgia although there are overlapping similarities.

So once on a therapeutic dose of Sevella, I was astonished, that my depression finally was stable again like magic! While having an open mind, I had no expectations for it, but my pain also was almost just stopped in its tracks and reduced a great deal over the course of about two months! Stress and other types of strain can cause an incident of pain requiring meds. I am very, very impressed.

As for appealing your coverage determination. Demand that it be reviewed by their medical review board. As for a nurse case manager. Hope for a good match, ie one with whom you can have functional, reason based dialog and know that youve been heard and cared about in your concerns. Reps and the first, even second tier of typical contacts, supervisors have little to zero license to apply principles to written rules and guides. So they deny anything that doesnt match up to their cookbooks essentially verbatim. They dont interpret rules or examples. They also have low educational requirements to be in their positions and certainly no medical education and background. It vehooves the company as a whole to resolve your problems esp so simple as granting your ability to have the medication you need to feel and be stavle and as well as possible. For this clearly saves the greatest dollars...not refusing prescription for which they likely pay leas for than anyone.

Use the COPD symptoms...i say COPD especially if youve no presdisposing causes for it. You didnt mention any, and for the symptoms to go away with the right medication suggests a possible misdiagnosis and also that not having rx put you in the way of developing it! Think of the costs to sn insurance company for a whole new diagnosis of any kind. First a new doctor has to start following you, next there are wgile varries of testing much of which has to be remeasured every visit, plus O2, and medications. You didnt say the COPD went away or not. Even if only greatly improved which you did indicate at least, they are way way better of immediately and long term. Make your argument in these sorts of terms think as they do...well those there paid to think and to project. I guarantee that above all the company does want to serve well and optimally as doing so saves and makes them more money than stupid piddly denials of the sort you got. Someone(s) there higher up do care about that which makes sense.

Approach it as if you're helping them by sharing your story. Detailed enough with the facts and documented costs and effects upon your health and well being. Pitting you see you without it covered vs you with it. Day and night. Offer yourself even as a resource if so inclined. It works. And for little effort and time and persistence. Be a SQUEEKY wheel. Dont whine about what theyve done to you. They are whine and complaints deaf. Educate help them to see what is obvious. Research some helpful facts and data with references. Send your support documents or copies of them. Keep records of every contact by letter or phone. Alway with the day date and time start and end and with first and last names involved then summarise the communication and with as detailed notes, subtly let them know that youre keeping record. Drop without threat, innocently verbally and in writing on a cover letter to start and if recontacting and more and more requirements demands of your time energy which is something to bring up along with how long you so obviously suffered needlessly that not paying for this in light of the information shared and sent in "seems or feels like bad faith on their part and senseless." Ask for reimbursement separately for your costs to date with reciepts. And time extra spent on learning about researching other ways to get the meds and, what your time is worth in general and conditional terms if not work hourly rate. Lost time from work and or quality of life. Ive not shared this, very unorganized, sorry about that for i ought to have been asleep about 4 hours ago.

Things are coming to mind as I have gone. The simple words 'bad faith' mean just that to us, but as a legal term it is a big big big deal. Basically a decision that saved them a few hundred per month. A Bad Faith legal claim can cost an insurance company in millions if lost and dep upon other factors. But you dont want to barging him nostrils flaired, blood and green in your eyes, in twirling pistols in the air and threats sputtering out you mouth. Get it all...my meaning? Give them good reasons to just do the right thing via reasons to which their minds are set to think...facts and figures. their language and a subtle reminder not a threat you dont want this either youre using the as if blind to the meaning an innocent statement that just happens to make their butts pucker a bit. You most importantly from the get go want the medical review board to love your attitude, respect for their difficult jobs. They too need to feel understood and not as if all see them as cruel baby killers etc. Get my drift? Definitely do all you can to make a direct contact by phone with someone on this board. Be firm but pleasant, ask if they got the info they needed how or what is lacking. Ask the person to explain the situation and point on with merit will be made. Sounds like a lot but ive been redundant.

Bon chance! (GOOD LUCK)

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Re: Kate (# 142)
Thank you Kate. I have appealed it myself and it is still a no from the insurance company. What I have done is through Canada drugs I get it from Australia. And although it looks exactly the same, and I'm going better on it than I did the generic, I'm still not satisfied I feel as good as I did with the brand name Pristiq from the US.

I take Pristiq for Persistent Genital Arousal Syndrome which began in 2008 after menopause. I was suicidal over it and my doctor just happened to do his research and found Pristiq as a drug prescribed for fibromyalgia, so knowing my nerves were misfiring, we tried that. It worked beautifully.

I explained all this and they still denied it. My other doctor retired and the punk I have now is not willing to go to bat for anyone, I have to fight with him for any treatment. My pulmonary doctor is better, but he doesn't prescribe this sort of drug.

I wonder if getting a lawyer would help?

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Finally back on brand Pristiq for two weeks and what a difference. Never again will I go on the generic but had to try. My Dr said I had to or else the insurance wouldn't pay.

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Re: dobbs (# 144)

A few questons for you if you don't mind

did your insurance cover the name brand then? did you have to call them to make sure they do? was the copay "reasonable" for name brand? it's a rather high copay for me for name brand - like $280 for 30 pills. :(
I HAVE to figure this out. I really need to get back on name brand.

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Re: DebA (# 139)

Suz, do you have a link for that online application by chance?
thanks

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Re: preska (# 145)

I did call my insurance company to find out if it was okay to switch and if they would pay for it and they told me they would. I have Aetna PPO. My doctor just wrote brand on the new script. I do not have a copay and I get it through Aetna home delivery. A 90 day supply for $15.

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Sorry...I made an error in my last message. My copay is $15

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Re: Suz (# 7)

Generic Pristiq is awful. I was on it but had to go back to the brand.

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Re: Maria (# 4)

I switched to generic also. Was on it for 3 months and my depression came right back. My doctor put me back on the Branfs and I am fine now.

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Generic Pristiq has not worked for me either unless it was from Greenstone Labs. That’s because Greenstone is Pfizer’s generic lab. When a generic is made they reverse engineer the drug. Greenstone Labs has the exact formula and ingredients because they are Pfizer. Problem is as others have figured this out Greenstone Labs is always in back order. I am attempting to get CVS Caremark to switch me back to name brand but it’s not easy. At my doctors office now getting them to fill out form and send it into CVS Caremark then wait 3 days for them to decide. Been on 3
Different genetics besides Greenstone none woek

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After days of research, ask your doctor to write your prescription for Desvenlafaxine Succinate ER, dispensed/manufactured by Greenstone LLC. This company is related to Pfizer who manufactures the brand name Pristiq ER. It is the exact same Active and Inactive ingredients. It is Pristiq. This is called an Authorized Generic prescription, and should be covered under your insurance as the generic. As someone who has been on brand name Pristiq for over 8 years and had 0 problems, when I was sent the generic and immediately had problems. This is a huge relief. Both for my state of mind as well as my wallet!

[1] greenstonellc.com/sites/default/files/pdfs/Factsheet/_DesvenlofaxineFactSheet.pdf

[2] fda.gov/drugs/developmentapprovalprocess/howdrugsaredevelopedandapproved/ucm126389.htm

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Re: SMS (# 152)

Neither Pristiq or the generic is Effexor. I had been on Pristiq for 8 years when I was changed to the generic. Don't know if it was Greenstone. I had trouble with the brain zaps like if I didn't take my medication, but it was just that the generic was wearing off too soon. I didn't notice any other difference from Pristiq. However, I suffer from fatigue terribly. I keep wanting my doctor to raise my thyroid meds, but my TSH is as least in the ball park. I am also having a terrible time trying to lose weight. Part of me wishes I had never started antidepressants, but then I hit a streak of anxieties and I remember why. Most of the time I can live. My insurance Aetna has been excellent with covering non-generic Pristiq.

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There should be no difference between brand name and generic. If you feel anything its placebo. Effexor is a completely different drug of the same type. They are not the same at all, they just work in the same manner

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2 different but similar drugs.

Pristiq = Desvenlafaxine

Effexor = Venlafaxine

If you've been switched from one to the other your mileage may vary. If you are just going from the brand to the generic, differences "should" be negligible. I say "should" because I've read lots of anecdotal reports on this and other sites from patients switching generic manufacturers with bad results.

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Re: Steven (# 154)

My generic was NOT placebo and it didn't make a difference which company made it. Once back on brand Pristiq all went back to normal. NONE of the generics work for me so my Drs always prescribe brand so it's not possible all these generics I've tried in different meds are placebos.

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I've been paying full price up to $600 for pristiq for years because I don't have good insurance and can't afford it anymore. Pristiq worked perfectly and I was a normal person again. Didn't want to die all the time anymore. I had the Pristiq Co pay card but that only brought it down to three something. I went on the generic because it's seventy something which is better but I've been severely depressed again and borderline...well it's only been a week, will it get any better??? Why is Pristiq so expensive, people can die without this stuff!!! Will this get better if I stay on it? Not that I have a choice with no job anymore.

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