![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by AdamCanada on June 12, 2008, at 23:15:23
Next month i am going to try brand name paxil instead of this generic crap despite the cost.
I know years ago when i switched from brand name to generic i felt worse.
why on earth? i have no idea but my guess is that the generic is formulated differently.
well i am sick of feeling like garbage.
i was feeling better, less depressed, more social, etc etc.
anyone else experience the same? what specific ways was brand name better for you?
Posted by Phillipa on June 13, 2008, at 1:07:44
In reply to Paxil brand name superior to generic???, posted by AdamCanada on June 12, 2008, at 23:15:23
Years ago first ad ever took was paxil l0mg and had to take lopressor so anxiety wouldn't be real high even on xanax. Took three months to adjust. I now have generic and notice nothing. Maybe the fillers? Phillipa
Posted by SLS on June 13, 2008, at 6:37:20
In reply to Paxil brand name superior to generic???, posted by AdamCanada on June 12, 2008, at 23:15:23
> Next month i am going to try brand name paxil instead of this generic crap despite the cost.
>
> I know years ago when i switched from brand name to generic i felt worse.
>
> why on earth? i have no idea but my guess is that the generic is formulated differently.
>
> well i am sick of feeling like garbage.
>
> i was feeling better, less depressed, more social, etc etc.Yup. The generic paroxetine is demonstrably inferior to the name brand Paxil. My doctor has witnessed his patients relapse when they made the change from the name brand to the generic. I have heard of this phenomenon with paroxetine happening quite a few times.
It would be interesting to know why this difference exists. However, it is not terribly important to know how. That this difference exists has been documented.
- Scott
Posted by SLS on June 13, 2008, at 6:44:11
In reply to Re: Paxil brand name superior to generic??? » AdamCanada, posted by SLS on June 13, 2008, at 6:37:20
1: Clin Ther. 2003 Jun;25(6):1578-92.Click here to read Links
Comment in:
Clin Ther. 2004 May;26(5):801-2.The bioequivalence and therapeutic efficacy of generic versus brand-name psychoactive drugs.
Borgheini G.Neurological and Psychiatric Department, University of Padua, and Casa di Cura Parco dei Tigli, Padua, Italy. g.borgherini@gpnet.it
BACKGROUND: For the purposes of drug approval, the interchangeability of a generic drug and the corresponding brand-name drug is based on the criterion of "essential similarity," which requires that the generic drug have the same amount and type of active principle, the same route of administration, and the same therapeutic effectiveness as the original drug, as demonstrated by a bioequivalence study. However, bioequivalence and therapeutic effectiveness are not necessarily the same. OBJECTIVE: This review summarizes available data comparing the bioequivalence and therapeutic efficacy of brand-name psychoactive drugs with those of the corresponding generic products. METHODS: Relevant information was identified through searches of MEDLINE, Current Contents/Clinical Medicine, and EMBASE for English-language articles and English abstracts of articles in other languages published between 1975 and the present. The search terms used were generic drug, branded drug, safety, toxicity, adverse events, clinical efficacy, bioequivalence, bioavailability, psychoactive drugs, and excipients. RESULTS: Few publications compared the bioequivalence and efficacy of brand-name and generic psychoactive drugs. Those that were identified revealed differences in the efficacy and tolerability of brand-name and generic psychoactive drugs that had not been noted in the original bioequivalence studies. Specifically, l study found that plasma levels of phenytoin were 31% lower after a switch from a brand-name to a generic product. Several controlled studies of carbamazepine showed a recurrence of convulsions after the shift to a generic formulation. After a sudden recurrence of seizures when generic valproic acid was substituted for the brand-name product, an investigation by the US Food and Drug Administration found a difference in bioavailability between the 2 formulations. Statistically significant differences in pharmacokinetic variables have been reported in favor of brand-name versus generic diazepam (P < 0.001). Finally, a case report involving paroxetine mesylate cast doubt on the tolerability and efficacy of the generic formulation. CONCLUSION: The essential-similarity requirement should be extended to include more rigorous analyses of tolerability and efficacy in actual patients as well as in healthy subjects.
PMID: 12860486 [PubMed - indexed for MEDLINE]
Posted by Bob on June 13, 2008, at 12:02:38
In reply to Paxil brand name superior to generic???, posted by AdamCanada on June 12, 2008, at 23:15:23
> Next month i am going to try brand name paxil instead of this generic crap despite the cost.
>
> I know years ago when i switched from brand name to generic i felt worse.
>
> why on earth? i have no idea but my guess is that the generic is formulated differently.
>
> well i am sick of feeling like garbage.
>
> i was feeling better, less depressed, more social, etc etc.
>
> anyone else experience the same? what specific ways was brand name better for you?_________________________________________________
I have experienced this unfortunate phenomenon with Klonopin and generic clonazepam. The generic was palpably inferior for me. I could not switch casually between the two as I would suddenly start to deteriorate and the generic just didn't seem as potent or "clean".Although the active ingredients need to be the same, the binders, fillers, etc don't. I think this effects bioavailability and absorption in some people. I truly don't understand why the maker of a generic drug shouldn't be required to make the EXACT SAME formulation as the original. WTF?
Posted by bleauberry on June 13, 2008, at 18:41:22
In reply to Paxil brand name superior to generic???, posted by AdamCanada on June 12, 2008, at 23:15:23
I have personally experienced this phenomenon with prozac, xanax, and modafinil. I often wonder how many other drugs I tried that worked badly (and were generic) that might have had different outcomes if they had been brand.
The fillers and binders do apparently have more purpose than simply filling the capsule or giving shape to the pill.
I agree with the previous post that all generics should be required to be the exact duplication of the brand. Fillers, binders, capsule, everything.
And on the same topic, some people are sensitive, intolerant, or allergic to food colors, with red and yellow being the most offensive. No surprise, most people with sensitivities are already ill. They don't know they are experiencing a reaction. What the heck is the purpose in making a pill red, blue, or have a yellow stripe, or whatever? I mean, it is going to be viewed for about a second before going down the hatch. Ridiculous. If nothing else, companies could make more profit by selling the exact same pill without color, and save the expense of gallons and gallons of chemical colors.
Strange, but I have heard several people say the generic modafinil from overseas pharmacies is better than brand. So I guess the phenomenon could go both ways, though it seems mostly it goes in a negative way.
Posted by Phillipa on June 13, 2008, at 20:02:43
In reply to Re: Paxil brand name superior to generic???, posted by bleauberry on June 13, 2008, at 18:41:22
Yellow huh? as my new dose of synthroid is yellow old was beige and I don't tolerate it like the old one. Phillipa
Posted by bleauberry on June 13, 2008, at 21:15:41
In reply to Re: Paxil brand name superior to generic??? » bleauberry, posted by Phillipa on June 13, 2008, at 20:02:43
Just do what I do. Go to the health food store and buy the largest empty capsules they have. I get mine at Whole Foods Market. A whole bag is cheap. Dump out your med from a capsule onto a flat plate and with a knife or razor blade form it into a pile. Push it onto the end of a pointed knife that fits in the empty capsule you bought and dump the med in it. Do a couple or a few times until the pile is all in the capsule. Close it up and swallow it.
If nothing else, you would find out for sure if you are allergic or not. If you noticed no difference after a week or two, then you aren't allergic.
> Yellow huh? as my new dose of synthroid is yellow old was beige and I don't tolerate it like the old one. Phillipa
Posted by Phillipa on June 14, 2008, at 19:18:22
In reply to Re: Paxil brand name superior to generic??? » Phillipa, posted by bleauberry on June 13, 2008, at 21:15:41
Thanks same as the cymbalta withdrawal or small amount. Love Phillipa
Posted by yxibow on June 17, 2008, at 14:38:50
In reply to Re: Paxil brand name superior to generic??? » AdamCanada, posted by SLS on June 13, 2008, at 6:37:20
> > Next month i am going to try brand name paxil instead of this generic crap despite the cost.
> >
> > I know years ago when i switched from brand name to generic i felt worse.
> >
> > why on earth? i have no idea but my guess is that the generic is formulated differently.
> >
> > well i am sick of feeling like garbage.
> >
> > i was feeling better, less depressed, more social, etc etc.
>
> Yup. The generic paroxetine is demonstrably inferior to the name brand Paxil. My doctor has witnessed his patients relapse when they made the change from the name brand to the generic. I have heard of this phenomenon with paroxetine happening quite a few times.
>
> It would be interesting to know why this difference exists. However, it is not terribly important to know how. That this difference exists has been documented.
>
>
> - ScottThere is still the remore possibility of placebo effect. However, I'm not doubting these reports.
If there is any difference, its probably because patients are not getting enough Paxil.
It has a shorter half life than any of the SSRIs and must be taken daily as directed or withdrawals can occur within a dose or so.
That's my guess -- which would mean upping the dose or paying a penalty copay (our great system in the states)
-- jay
Posted by SLS on June 17, 2008, at 15:18:41
In reply to Re: Paxil brand name superior to generic??? » SLS, posted by yxibow on June 17, 2008, at 14:38:50
> > > Next month i am going to try brand name paxil instead of this generic crap despite the cost.
> > >
> > > I know years ago when i switched from brand name to generic i felt worse.
> > >
> > > why on earth? i have no idea but my guess is that the generic is formulated differently.
> > >
> > > well i am sick of feeling like garbage.
> > >
> > > i was feeling better, less depressed, more social, etc etc.
> >
> > Yup. The generic paroxetine is demonstrably inferior to the name brand Paxil. My doctor has witnessed his patients relapse when they made the change from the name brand to the generic. I have heard of this phenomenon with paroxetine happening quite a few times.
> >
> > It would be interesting to know why this difference exists. However, it is not terribly important to know how. That this difference exists has been documented.
> >
> >
> > - Scott
>
>
>
> There is still the remore possibility of placebo effect. However, I'm not doubting these reports.
>
> If there is any difference, its probably because patients are not getting enough Paxil.
>
> It has a shorter half life than any of the SSRIs and must be taken daily as directed or withdrawals can occur within a dose or so.
>
> That's my guess -- which would mean upping the dose or paying a penalty copay (our great system in the states)
>
> -- jayYes. Increasing the dosage would make sense if the two preparations are not bioequivalent. Who knows how the differences in binders and excipients between the two preparations affect the delivery of the drug.
- Scott
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.