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Suggest Treatment For Depression And Anxiety

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Posted on Thu, 18 Sep 2014
Question: I have been switched to generic Cymbalta for the last month and I started to experience the same symptoms that I went on Cymbalta for ... anxiety depression and uncontrolled crying with thoughts of suicide ... I had my doctor switch me back to Branded but my insurance company will not pay anything towards the branded version ... interestingly they will cover Synthroid for my hypothyroid issue .. maybe a higher copay but at least covering ... the generic Cymbalta is not the same and I understand how generics work and that they are not 100% ... 20% difference is too much for some including myself ... I have written a letter to my insurance company do you have any other information that would be useful??? Much thanks!!! Cymbalta when I started it about 6 years ago changed my life and saved it ... is that not enough????
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (30 minutes later)
Brief Answer:
Dose of generic can be increased

Detailed Answer:
Hello,
Thanks for using healthcaremagic.

I read your query and understand your concern. What you experienced is quite rare as even the generic medicines also have to go through strict quality control.

Writing a letter to insurance company to provide cover is one important thing but before that it was better to try the higher dose of generic duloxetine when the equivalent dose failed to work.

Secondly there are other anti depressants which can be tried. Most of the SSRI group of medicine are quite cheaper than Cymbalta and in case there is problem with affordability they are the much better choice.Discuss about this your treating doctor.

'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (16 hours later)
Thank you kindly for your response Dr. XXXXXXX ...

I have suffered since I was 24 to find the right combination of resources for me to use to combat my battle with depression and anxiety ... I have tried almost every other SSRI that was out six years ago when I finally tried Cymbalta and had amazing results!! I no longer have night terrors and extreme anxiety as well as thoughts of suicide ... I understand the use of generics when they are a valid option and save money but when it comes to my mental health and getting so low that I felt as I did prior to trying Cymbalta ... I am not ok with just trying higher doses of a generic ... I am not alone in my symptoms and do not feel that what I have experienced is rare based on the results of many who posted on your blog that have had the exact same experience as I ... can you offer any other suggestions as to why a healthcare company will deny a patient a Branded drug if the generic fails??? Much thanks!

XXXXXXXX
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (7 hours later)
Brief Answer:
I think nothing more than saving money

Detailed Answer:
Dear XXXXXX,
Welcome again to healthcaremagic.

I agree that you are not only one who encountered problem with generic version of a medicine. I suggested higher doses of generic because there is 20% +_ difference in generic and branded medicine and that is acceptable to regulatory authority (FDA). Although they say only 20 % but if we compare response to a particular patient there is huge differences. In case of poor response to generic in my clinical practice I suggest higher doses of generic molecule hoping that 20% will be no more with high dose and many times I got positive results.

I do not find any reason for an insurance company to not cover the branded medicine when it was highly effective for a particular individual. Ethically that should not be done but I guess like me or you these insurance company insert one or another term to save money.
Courts had given many landmark decision and in case they do not respond to your letter or respond negatively than taking help of court is viable option.

"If you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health".
Thanks and regards
Dr Ashok
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3355 Questions

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Suggest Treatment For Depression And Anxiety

Brief Answer: Dose of generic can be increased Detailed Answer: Hello, Thanks for using healthcaremagic. I read your query and understand your concern. What you experienced is quite rare as even the generic medicines also have to go through strict quality control. Writing a letter to insurance company to provide cover is one important thing but before that it was better to try the higher dose of generic duloxetine when the equivalent dose failed to work. Secondly there are other anti depressants which can be tried. Most of the SSRI group of medicine are quite cheaper than Cymbalta and in case there is problem with affordability they are the much better choice.Discuss about this your treating doctor. 'Hope I have answered your query. If you have any further questions I will be happy to help". Thanks