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Re: Brand Name vs. Generic Drugs

Posted by valene on November 15, 2006, at 9:20:56

In reply to Re: Brand Name vs. Generic Drugs » valene, posted by yxibow on November 15, 2006, at 1:43:14

Thank you, Jay. Are you a psychopharmacology student? You are so well informed about meds.

All I know is I have been on xanax for over 20 years and I used to be able to take 2mg. of the brand Upjohn at bedtime only. Now it does not even last all night. I am feeling hopeless about the awful anxiety and head pressure/heart pounding which seems just like withdrawal. I am planning on asking my pdoc next week for either something to add on to *generic* xanax. She knows I have wanted off this drug. Instead I find myself going up to 2mg. due to the short half-life of the drug. I sure hope this is not tolerance w/d. I have heard people have success using a combo of neurontin/trileptal in discontinuing or reducing xanax. I dread going to bed and keep .125mg. xanax beside me so that when I wake up at 5am or so I can take it.

My pdoc is a Harvard grad and in 2 years got promoted to the director of outpatient psychiatry but when I called her yesterday she said "What do you want me to tell you to do?" What a bizarre question. If I knew I wouldn't be calling her!

Val

> > While searching the web today, I found this weblog from WebMD where a doctor states that generic benzodiazepines and other drugs can be as much as 20% different:
> >
> > http://blogs.webmd.com/anxiety-and-stress-management/2006/02/differences-in-medications.html
> >
> > All I know is that after being on generic xanax for so long and then switching, I did notice a marked difference in how I felt. It was almost like having to adjust to a whole new medication. My heart pounded faster at first (never expected that), and the brand name seems to not last as
> > long. Oh well. I just wish I could be off it entirely but that's another story!
>
>
> This is also a possible scenario -- there's no guarantee that from individual batch to batch of a "brand name" that they also have to be 100% the same -- they ought to be for the money but I believe bioavailability also comes in for original medications, quality control, etc. I don't know the exact FDA regulations for patented medications.
>
> And you could have also had what is known as a paradoxical (opposite to expected) reaction to a benzodiazepine in the first place. Heart pounding and non anxiolytic response is not unheard of.
>
>
> Its about bioavailability -- it won't always be 20% different as an absolute, these things are logarithmic from 80 to 125% under the AUC curve. They could be even more potent than less potent too.
>
> The key still is in the binding -- some generics may truly release it at a different rate, I'm not arguing that.
>
> What I'm saying is that if your insurance company is making you pay lots of money for a non generic benzodiazepine or you have to pay out of pocket for it, one might as well start off (when one starts taking it for the first time) with a generic benzodiazepine. Then regardless whether there is a 20% difference between it and a drug, that by the way was mostly invented at least 20-30 years ago, in this class, one will already be used to the generic. And if the pharmacy switches generics, then insist on the other generic or use a different pharmacy if one is really worried about it. I can understand the concern, but the price differences are highway robbery for benzodiazepines (and similarly high produced drugs).
>
> -- Jay
>
>
>


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poster:valene thread:702989
URL: http://www.dr-bob.org/babble/20061110/msgs/703850.html