Do generics work the same as name brand drugs? That's the question patients, consumer advocates and health care officials are asking more and more as insurance companies peddle cheaper drugs as an alternatives to relatively more expensive brand names.

Lesley Alderman, in a recent health column for the 'New York Times' addressed the issue.

"I've recommended generics in this column many times and use them myself when possible,'' she writes. "But there is a gnawing concern among some doctors and researchers that certain prescription drugs may not work as well as their brand name counterparts. The problem is not pervasive, but it's something consumers should be aware of-especially now that more insurers insist that patients take generic medications when they are available.''

Patients have begun reaching out to consumer advocacy groups such as the Peoples Pharmacy to complain about side effects or the return of symptoms after being switched from a brand name drug to a generic, the article says quoting Joe Graedon, who has been writing about pharmaceuticals for three decades.

Graedon says in the article that he has been hearing complaints about generic forms of the antidepressant Wellbutrin XL 300 (known as Budeprion XL 300 in one generic form), the heart medicine Toprol XL (metoprolol succinate) and the antiseizure medicine Keppra (levetiracetam). He argues that generics and brand names are not identical.

But the Food and Drug Administration says generics are safe and effective and can be used with total confidence.
Here are some tips from a separate article by Alderman to help determine if your generic brand is working for you:

KEEP THE PACKAGING so you can research the drug at Drugs.com or RxList.com.

KEEP A DIARY of any side effects you may experience when taking a new drug. Generic drugs are allowed to contain different inactive ingredients from the brand drug - like flavors, fillers and dyes - which could potentially cause side effects.

BE CHOOSY. If one generic brand works better than another, shop around for it!

ENLIST YOUR DOCTOR if you are convinced that only the brand name works for you. He or she may be able to write a letter to the insurance company, which actually works sometimes.

REPORT PROBLEMS if you do have side effects or reactions to a specific drug, tell your doctor and then report it to the Food and Drug Administration's MedWatch Web site and post a message on the People's Pharmacy Web site.

Alderman says that if enough people complain about a specific medication, the F.D.A. or an independent group will investigate it.