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by rincebrain 1068 days ago
The problem with "there are similar efficacy rate alternatives" is that, for most psychiatric drugs, it's not necessarily the _same_ population that is helped by two different drugs at similar efficacy for the same issue, even if the total success rates are comparable.

A number of people have tried many different individual or combinations of treatments before finding something workable, or close enough to workable that you can paper over the cracks. I would strongly suggest against concluding the lack of access to something isn't an issue for some patients because they have alternatives, without very compelling evidence.

A story from my recent past - I've had, historically, no issues swapping between different generic manufacturers, or name brand and generic, if someone stopped making something I was taking, or I moved and the pharmacies stocked different versions, or whatever. So a little over a month ago, when I noticed my meds looked visibly different after getting them filled, I checked to be sure they hadn't given me the wrong thing, but no, same dose, different generic manufacturer, and I stopped worrying.

...until I started getting extremely nauseous to the point of being debilitating, for 6-8 hours every time, when I take this medication twice a day. So I went back and tried the third generic manufacturer the pharmacy had, after a few days of making sure it wasn't a fluke, and the third one had the same issue. We finally ended up switching to the extended release version of the med, which had still more different manufacturers, and did not have this issue, since the first manufacturer had a shortage for over a month and counting.

Medications are a lot less interchangeable than we might hope.