Ever get "The Look" when you casually mention ADD or ADHD to a friend or colleague? It’s that poor-you-for-buying-into-the-hype cover-up smile that implies you are sadly mistaken about the validity of ADHD.

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I’ve always worried that generic drugs aren’t quite as good as the brand name version and now there’s mounting evidence to prove it.

Wellbutrin XL 300 (Budeprion XL) works just fine for depression and many ADHD symptoms. But when some patients are switched to the generic formulation, they reported frightening symptoms: fast onset of severe depression and serious suicidal thoughts.

In a recent article published by the People’s Pharmacy a woman reported no problems with the original Wellbutrin XL 300 but said that she had "the worst case of depression" she could remember when her pharmacy substituted the generic equivalent. It should be noted that the difference has not been reported in the 150 XL formulation at this point.

Apparently the generic version releases the medication at a different rate than the original, thus creating quite different response rates and effectiveness.

This news scares me - because a lot of ADDivas take Wellbutrin, including me - and there is the potential for serious repercussions. Suicide is not to be taken lightly, especially when antidepressants are supposed to ward off those thoughts and actions.

Equally important, however, is that many ADD women and men have already experienced differences in generic medications vs. brand name drugs that treat ADHD. I cannot take generic Adderall, for instance. Other people cannot take the brand name version. Ditto for any of the other drugs on the market today.

There are two ways to look at this issue, in my opinion.

1) We need to make SURE that we are receiving the exact drugs prescribed for us with NO substitutions by the pharmacy or insurance company (this may take some lobbying by you or your doctor).

2) If generics really do release their active ingredients at different rates than the original drug, it gives us even MORE options to play with to treat our ADHD symptoms.

After all, drug companies are making a fortune by adjusting the release time of ordinary drugs like old fashioned Ritalin, slapping their brand on the bottle and charging 10 times the price of generics. I know folks who can’t take the brand name drug but have good results with the generic. It works both ways. But the bottom line is the same: we all react differently to medication release schedules, to the type of drug prescribed, to the interval we take the drug, etc.

OK, now the disclaimer: this is NOT something to play with on your own. Obviously there can be serious consequences. Drugs are not a smorgasbord from which we can pick and choose. Work with your doctor to find the best combination for you.

But if you are switched to a generic and suddenly notice your symptoms change, call the pharmacy AND the doctor immediately. You deserve to take the meds that work best for you,
brand name OR generic.

Read the full report at Consumer Lab.

Back in 2002, when my peri-menopausal hormones were poised to take a dive, I followed the advice of my OB-GYN and stopped taking my low dose birth control pills.

Now, mind you, I didn’t need them for birth control — I’d had that tubal ligation thing-y a long, long time ago. But as I moved into my late 40s, my migraines had gotten worse, I was a mess the day or two before my period and things just didn’t feel right to me. When the doc suggested birth control pills, I was skeptical — I didn’t want to take pills every day (an ADDiva remembering to take pills EVERY DAY? OK, I missed them regularly, with breakthrough results, if you know what I mean).

I knew somehow that taking hormones wasn’t so good for my body, but I put my brain on hold and followed the prescription. Happily, they worked like a charm. I was calm, only a couple of migraines a YEAR instead of a month and I didn’t seem to be stressed at the EXTREMELY HIGH level I had been pre-meds.

The doctor told me that when I turned 50, we’d switch to HRT (hormone replacement therapy). I balked - Oh no! Hormone replacement is bad for women, I’d say. I don’t want breast cancer or uterine problems or whatever the latest research bad news relayed. Then my doctor told me something I hadn’t read in the science section of the newspaper: HRT actually had a lower dose of hormones than even my low dose birth control pills. I was shocked. Who knew?

In order to see whether I was really getting to the Big M (Menopause), we had to measure my current hormone level. So in January, I stopped taking the birth control pills for a test in February - we needed at least four weeks off artificial hormones to test my real hormone level.

I had the test - simple as I recall. And then waited to hear from her about going back on the low dose pills. She never called me, although the test results (sent by mail) showed that I wasn’t in menopause yet. By March, I was beginning to flush and by
April I could hardly get out of bed in the morning, suffering through 40-50 hot flashes a day.

I finally called the doctor’s office and told her what was going on. “Why didn’t you go back on the birth control pills?” she asked in amazement. Because no one told me to, that’s why!

So, no matter what the test showed, I was definitely menopausal with a capital M — and there was nothing Divine about it.

I was miserable. I needed to do something. So I forced myself to read all those books on menopause I had bought but avoided for years. My reasoning was completely illogical: if I didn’t educate myself on menopause, perhaps I could sneak by without going through it. Just stop having periods and become 50 with grace and ease.

Ha.

About the same time, I lost my mind.

No really. I couldn’t carry on a conversation. I could barely keep my mind on doing a load of laundry. And as to coming to the table with business associates? I just kept my mouth shut most of the time - an unusual state for me.

It was awful. I realized that I had gotten by on my intelligence and wit most of my life. I had worked hard to think ahead of where conversations were going so I could be seen as brilliant and interested in the subject. I had brought a unique point of view to projects and conferences. I was seen as bright and witty.

Yet now I couldn’t even rub two words together and make a sensible sentence. I was in despair. I realized, to my great sorrow, that my psychiatrist was right. I did, indeed have ADHD. And it had taken control of my brain. Or what brain I had left, anyway.

Reluctantly, I made an appointment with the psychiatrist and spilled out my torturous story. I had turned into the town idiot in a matter of months. I was stupid where I had once been intelligent. I was distracted beyond belief. I was … doomed.

He listened for a few minutes and then said calmly, “Your brain needs estrogen. Go get some.”

Well! This was about the time the Women’s Health Initiative Study had been stopped because women who were receiving HRT were dying of heart disease because of the estrogen (at least that’s what I HEARD from the hundreds of news reports that penetrated my conscious mind).

I wasn’t about to put myself at risk of heart disease; my dad had almost died of a massive heart attack at age 49. I had always soothed myself that I wasn’t a candidate for a heart attack because I was a woman with estrogen and I was too young to die. Now, one of those weapons was gone. And was I too young to die? Maybe not.

I found myself a supply of human identical hormones and used progesterone cream to calm the hot flashes. Note I said progesterone, not estrogen. I was too afraid of estrogen to try it. But I did find an OB-GYN who was also a psychiatrist. She headed up the PMS clinic at Duke Medical Center and I was allowed to see her for hormone consultation;

Predictably. she said “You need estrogen. Here’s a prescription.” I fought the idea like a crazed tiger — the Women’s Health Initiative said… I’ve heard of someone who… What are the data for cancer in women who have taken… I pretty much drove her crazy for months with my worries and questions. She printed out the data, sighed, and printed out more data.

I was finally convinced: the WHI study had been done with women over 60 who had never taken hormone replacement; many of them already had heart disease which was exacerbated by the addition of hormones. I was still fuzzy headed and feeling so unlike myself that I filled the prescription for the Vivelle estrogen patch - the name sounded so soothing and calm. But I was so edgy about the whole idea.

Within a couple of weeks I was doing better. And when we added my Wellbutrin back into the mix, it was like I had been asleep and Prince Charming had come along to give me a little kiss. I was ALIVE again! I could THINK. I could REASON. I could sleep through the night without alternately sweating and freezing!

I have to tell you - it’s been four years now and I have tried twice to stop using the patch or reduce the dosage. And it doesn’t work. I fall back into the same trap. As my doctor says “This is a quality of life issue. Do you want to live in misery or do you want to risk the estrogen possibilities?” Of course, she thinks the risks are minimal.

I can’t help feeling that I am a walking, talking science experiment and one day if we find out that the estrogen patch was a bad idea, it will be too late. I am playing hormone roulette with MY LIFE here. It’s an uncomfortable place to be.\

But I can tell you that this supplement to my brain has made my life bearable again. I can function, reason, think, talk intelligently. I like me again. And I supposed that IS a quality of life issue, isn’t it?

NOTE: Please know that this post represents MY experience only and is not an endorsement or recommendation for you or your body. Only you and your doctor can make the choices that are right for you!

It’s 6:15 am in California and I’m sitting at the pumpkin-colored Formica breakfast bar that separates the living room from the kitchen in my tiny retreat cottage. The cottage is actually a one-bedroom trailer anchored into the rocky north San Diego County hills. I booked it to accommodate my return appointment at the Hallowell West Clinic. I am determined, at last, to stand toe-to-toe with my Attention Deficit Disorder.

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