Drug switch not OK
Pharmac insists generic switch is safe but depression sufferers say it just makes them worse. Simon Maude reports.
Some depression sufferers are warning that a generic antidepressant substitute is worsening their struggle with the condition.
However, after Pharmac withdrew its subsidy for EffexorXR, the government’s pharmaceutical agency insists that its replacement drug, Enlafax-XR, is safe.
But Heather Williams and Sarah Macrae both insist the new medication is in fact hindering their battle with depression rather than helping combat it.
Both women say they sunk back into depression within weeks of being dispensed the new medication by their pharmacists.
Williams, 33, says the substitution left her feeling suicidal. Macrae, 40, was left ‘‘incapable’’ of caring for her four toddlers.
Both women were long-term Effexor users and, after insisting that no new stresses were introduced to their lives, are adamant that Enlafax caused their struggle with depression to deepen.
‘‘Hundreds of people have had bad reactions [to Enlafax],’’ Palmerston North resident Williams claims.
The Centre for Adverse Reactions and Monitoring (CARM) – run by the University of Otago – reports that 161 people have contacted them complaining of the adverse effects of Enlafax-XR.
Williams and Macrae are two of them.
A popular mental health support page on Facebook, The Nutters Club NZ, catalogues several page members’ travails after undergoing the same medication switch.
Government medicine agency Pharmac introduced its subsidy for Enlafax in April, 2017 and removed Effexor’s subsidy in September, 2017.
‘‘There is a problem with Enlafax but Pharmac continue to deny it,’’ Williams claims.
However, Pharmac insists that Enlafax is safe, and chief executive Sarah Fitt defends the agency’s funding decision to make the switch.
She says that generic medicines are widely used and accepted internationally, adding that New Zealand’s ‘‘pharmacovigilance’’ system meant adverse reactions are closely monitored by itself and Medsafe.
Pharmac saved $5 million annually by switching its subsidies from Effexor to Enlafax, Fitt revealed.
‘‘Generics offer Pharmac the opportunity to obtain significant price reductions, allowing us to widen access to existing medicines and fund new treatments, while continuing to provide New Zealanders with funded access to safe and effective medicines.’’
Enlafax contains the same active ingredient as Effexor – venlafaxine.
To be considered an approved generic equivalent by Pharmac, the replacement drug must equate to the same dosage delivered in the same way by the original brand.
In an earlier email to Williams, Pharmac told her, ‘‘Enlafax has been thoroughly evaluated by Medsafe to ensure it’s safe and works the same as other brands.’’
‘‘While the pill may be a different size, or shape, or colour, that doesn’t affect the way it works inside the body.’’
However, Williams remains adamant that Enlafax has only worsened her condition.
‘‘I’d had other medication changes without any problems, I thought Enlafax would be the same.
‘‘Last year when I went to pick up my medication in May I was told ‘there’s been a brand change’ and I thought, that’s fine, and the pharmacist went, ‘Yeah, it’s the same.’’’
Days after switching to Enlafax Williams said she started to ‘‘feel a bit off, but didn’t recognise why’’.
‘‘Over the next two weeks I began feeling very angry to the point of being violent and I became suicidal – I just couldn’t function at all.
‘‘It got to the point I just couldn’t manage and I went to the acute, after-hours doctor and they said I could go back on Effexor,’’ she said.
Some of Williams’ symptoms have gone away but nine months later she’s on the ‘‘maximum dose of Effexor and I’m still not back to how I was prior to going on Enlafax’’.
Like Williams, Macrae is back on an increased Effexor dose after her troubles with Enlafax.
The Te Awamutu stay-at-home mum said Enlafax ‘‘left her incapable of looking after her kids’’.
Macrae believes that after she stopped using Effexor and started using Enlafax she went into a ‘‘withdrawal’’ state causing mood
changes and disorientation.
‘‘During that time I felt awful. I was just so upset, crying at the drop of a hat. It must have been horrible for [my kids] to see mummy out of control.
‘‘I got vertigo, dizziness, my head always felt like it was in cotton wool, your spatial awareness is just gone.
‘‘I pranged the car once on the side of the house, once at K Mart and once on the pillar by the footpath, I’ve never done that before. It really scared me that I was probably incapable of driving and had the kids in the car with me the whole time.’’
Both Williams and Macrae also believe that the Effexor/Enlafax medication change has put financial strain on them.
Both Williams and Macrae want Effexor re-subsidised by Pharmac.