New anti-de­pres­sant like ‘poi­son’ for users


Phar­mac’s switch to a generic anti-de­pres­sant brand is caus­ing con­cern as more Kiwi de­pres­sion suf­fer­ers warn the change may be do­ing more harm than good.

Fol­low­ing the death of her hus­band in 2008, Christchurch woman Marise Jose, 54, be­gan tak­ing ven­lafax­ine med­i­ca­tion Efexor XR to treat her de­pres­sion, anx­i­ety and panic at­tacks.

She was told by her phar­ma­cist in Septem­ber that she would now have to pay for the med­i­ca­tion as Phar­mac had switched its fund­ing to a generic brand.

Jose tried the new funded med­i­ca­tion, En­lafax, three times, but ex­pe­ri­enced rashes, sui­ci­dal thoughts, para­noia, mood swings and se­vere stom­ach pains.

‘‘This [generic] stuff is poi­son. It’s not the same. We’re be­ing used as guinea pigs,’’ she said.

The for­merly funded ven­lafax­ine brands – Ar­rowVen­lafax­ine XR and Efexor XR – were changed to En­lafax by Phar­mac in April last year. En­lafax be­came the coun­try’s only funded brand of ven­lafax­ine in Septem­ber. The orig­i­nal ven­lafax­ine brands are still avail­able in phar­ma­cies at the re­tail price.

Jose, who is on the in­valid’s ben­e­fit, re­turned to the orig­i­nal med­i­ca­tion. She re­ceives Work and In­come sup­port to pur­chase it but still strug­gles to pull to­gether the $30 a month needed and is cut­ting her dosage to what she can af­ford.

‘‘[Efexor XR] wasn’t a cure but it did help a lot,’’ she said.

An on­line pe­ti­tion fight­ing to bring back Efexor has gained nearly 5000 sig­na­tures.

Phar­mac and Med­safe agreed the brand switch was safe for the 45,000 peo­ple pre­scribed ven­lafax­ine each year, Phar­mac chief ex­ec­u­tive Sarah Fitt said.

The gov­ern­ment drug­fund­ing agency saved $5 mil­lion a year by switch­ing to the generic brand, she said.

‘‘We un­der­stand change is­sues are real for peo­ple. Phar­mac will be guided and take any ac­tion de­ter­mined ap­pro­pri­ate by Med­safe.’’

More than 150,000 pub­liclyfunded prescriptions for ven­lafax­ine were dis­pensed at com­mu­nity phar­ma­cies na­tion­wide in 2016, Med­safe man­ager Chris James said.

’’It is ex­pected that ap­prox­i­mately 1 per cent of pa­tients will ex­pe­ri­ence prob­lems with a brand switch,’’ he said.

James said it was ex­pected some peo­ple would have side ef­fects, but Med­safe had not iden­ti­fied is­sues with the qual­ity of En­lafax and nei­ther had medicine reg­u­la­tors in other coun­tries.

For a generic medicine to be dis­trib­uted in New Zealand, it must con­tain the same ac­tive in­gre­di­ent re­leased in the same way as the orig­i­na­tor brand – Efexor, in this case.

Med­safe act­ing group man­ager Ali­son Cos­sar said both En­lafax XR and Ar­rowVen­lafax­ine con­tained the same ac­tive sub­stance (ven­lafax­ine), in the same salt form (as hy­drochlo­ride) and amount as the orig­i­nal brand.

Sara Smith, who did want her real name pub­lished, spent six months tak­ing En­lafax af­ter the orig­i­nal brand – which she had used for 15 years – stopped be­ing funded. She said she ex­pe­ri­enced se­vere mood swings, stom­ach pains and sui­ci­dal thoughts, and swore she would never try it again.

How­ever, dur­ing her re­cov­ery from quadru­ple by­pass surgery af­ter a heart at­tack, she was put back on En­lafax while in hospi­tal.

‘‘Within two days I started to feel re­ally, re­ally hor­ri­ble, I was re­ally strug­gling. I felt like I was go­ing mad ac­tu­ally.’’

She pleaded with her doc­tors and was pre­scribed Ar­row-Ven­lafax­ine again.

‘‘Af­ter 20 years work­ing in the men­tal health sec­tor, I’m very good at ad­vo­cat­ing for my­self, but I kept think­ing, ‘what hap­pens for other peo­ple?’’’

Christchurch-based Sig­jaw Trust con­sumer ad­vo­cate Gary Watts said about 25 of his 150 clients around New Zealand had reached out to him for sup­port af­ter ex­pe­ri­enc­ing ad­verse side ef­fects fol­low­ing the brand change.

‘‘Ven­lafax­ine generic drug change is caus­ing mas­sive prob­lems through­out the whole coun­try, it’s quite wide­spread,’’ he said.


Marise Jose’s de­pres­sion wors­ened af­ter her anti-de­pres­sant was changed to a generic brand.

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