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Not all drugs are the same after all

posted Monday, 21 December 2009

By LESLEY ALDERMAN

LET me start by saying I'm a fan of generic drugs. They save Americans billions of dollars each year and give us access to wonderful drugs at affordable prices. I've recommended generics in this column many times and use them myself when possible.

But there is a gnawing concern among some doctors and researchers that certain prescription generic drugs may not work as well as their brand-name counterparts.

More...


Copyright 2009 The New York Times Company
Comment:  
It works the opther way too. Some people find a generic is better than the brand. I do much better on the generic version of my antidepressant, possibly because the brand tablets have a thick red coating which I may react to.

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1. jay left...
Wednesday, 20 January 2010 6:00 pm

I have read your comments on Benzos in a prior posting. It appears you believe dependence is more fiction than fact. I recall your statement regarding epileptics and their lack of withdrawel. Assuming I have assumed correctly, do you see or know of a doctor that agrees? I ask out of personal need as I am torn between the use of this medication Thank You


2. Anxiety Insights left...
Thursday, 21 January 2010 7:00 am :: http://www.anxietyinsights.info/

No, I don't believe dependence is 'more fiction than fact,' Jay. It is a very real, well documented phenomenon.

What I do reject is that it is responsible for the severe reactions anxiety patients often report. I believe much of their symptoms are due to anxiety and psychology rather than a purely physical brain response to the cessation of additional benzodiazepines (additional because naturally occurring benzodiazepine compounds are delivered to the brain on a daily basis from food). The evidence against the severe response being wholly physical/chemical is the general lack of such severity in epilepsy patients.

You may find a search for the keywords: +"benzo OR benzodiazepine OR klonopin OR clonazepam" +"withdrawal OR dependence OR addiction OR hooked" at http://groups.google.com/group/alt.support.anxiety-panic/topics and http://groups.google.com/group/alt.support.epilepsy/topics instructive. Today I get 650 hits out of nearly 70,000 posts at the anxiety Usenet group, but only 4 of 13,260 at the epilepsy group. Do a general Google web search on the same keywords plus either anxiety or epilepsy and you'll find a less pronounced but still large variation in the number of hits.

I also reject the claims for a so called 'prolonged benzodiazepine withdrawal syndrome.' None of those proposing this, and there are only a handful of physicians and psychiatrists that do, has yet been able to demonstrate a physical mechanism that would account for it. Many of the anti benzodiazepines websites make claims about receptors needing to heal and benzos being stored in fat tissue etc, but they don't stack up. Receptors are not permanent structures but simple protein molecules that have a half-life of about 9 hours, and while benzodiazepines may be stored in fat, this is the case whether you ingest them as pharmaceuticals or food.

The facts are that yes, as with many pharmaceutical (and OTC supplements), there is a withdrawal effect when benzodiazepines are discontinued, especially if they are stopped abruptly. The same is true of antidepressants. Indeed, the evidence suggests that symptoms can be more severe when discontinuing the latter. There have been many more adverse antidepressant withdrawal reports under the UK mandatory Yellow Card reporting scheme than for benzodiazepines, for example.

OTOH, aspirin can be highly addictive and very difficult to quit, even in the face of severe physical harm. See: http://www.ncbi.nlm.nih.gov/pubmed/9558275

I can't recommend a doctor. The degree of benzophobia seems to vary from country to country. It is very difficult to get a NHS prescription for them in the UK, becoming more difficult in some US states and New Zealand, and not usually a problem through much of Western Europe and Australia.


3. Kelly Chow left...
Thursday, 18 February 2010 1:17 am :: http://www.reversingibs.com

I have also found this topic of generic vs brand name to be very controversial. I was diagnosed with IBS and I have been an avid health researcher since. There is a drug that has always existed that helps with traveller's diarrhea caused by the e.coli bacteria. This drug is now shown to provide results to those suffering from predominant diarrhea as a result of IBS. There is a brand name brand called rifaximin in the United States, however it is also made in Africa under a different name but it is the generic brand. This generic brand was about 30x less expensive than the brand name, so the urge to buy the generic was all too tempting. However, after some investigation, it has been noted that many African pharmaceutical companies lack the rigid quality controls and government inspections such as those conducted in the United States. There have been sightings of rats in the African labs and sometimes clunks of accumulated dirt/debris sitting on the beltlines in which the drugs are manufactured on. After hearing this, it truly lead me to believe that if you were to purchase a generic brand, it should be determined where the drug came from, what the quality standards are in that country and read the reviews on how effective the generic brands are.


4. Anxiety Insights left...
Thursday, 18 February 2010 5:13 am :: http://www.anxietyinsights.info/

It is my understanding that the FDA has a tight inspections regime for foreign facilities supplying pharmaceuticals to the U.S. market.


5. aldactone left...
Monday, 1 November 2010 4:10 pm :: http://www.sundrugstore.com/aldactone-c-

and includes hyperaldosteronism due to adrenal tumors . Aldactone can be used to diagnose and treat primary hyperaldosteronism. It can be used short-term, while waiting for other treatment (such as surgery), or long-term (for those who cannot or will not have surgery). o evaluate the use of spironolactone in class III and IV heart