Posted by bleauberry on July 14, 2009, at 15:21:53
In reply to switched to brand name Lamictal., posted by sam K on July 12, 2009, at 20:02:52
I know I've said it before, but my doctor has seen the generic vs brand thing so often in his 25 years of practice that it is actually a more important issue to him than the choice of the drug. It works both ways sometimes. For the most part he sees relapses turn into remissions when generic is switched to brand, but with a couple un-named pain meds he sees better pain control with one particular generic company. Nortriptyline is especially wild, requiring sequential trials of several manufacturer's to find the best version.
What an amazing topic. I mean, it seems so logical that lamictal is lamictal no matter who makes it, right? But we know it isn't. We've seen it here at pbabble dozens of times with meds like prozac, wellbutrin, xanax, zoloft, and most others. We've seen enough evidence to account of a placebo effect in maybe a small percentage of those experiences, but a true unbiased experience in the majority.
My doc had a patient stable and well on zoloft. Some months later the patient deteriorated severely. Doc very puzzled. Toward the end of his investigation into what went wrong, still puzzleld, he asked the patient what color the pills were. They were the color of generic. The patient had previously been on brand. Insurance had made the switch unknown to the patient or the doctor. The doctor did not inform the patient of his discovery or that he was about to be switched back to brand, but wrote a new prescription and asked the patient to tough it out two more weeks and see what happens. He called the pharmacy and the insurance company himself to specify brand on this prescription. Two weeks later the patient was in remission on the new prescription.
Several other similar stories were really eye opening. Especially when they involve serious pain control, and even more so when they involve epilepsy and seizure control. I mean, the whole generic vs brand thing has the potential to be deadly in terms of suicide or seizure complications.
I wonder with fascination what it is that makes a seemingly identical medication have the potential to be so different in some people, but not all people? What a puzzle. Do the supposedly neutral fillers take a ride to the brain and somehow compete with or modify the action of the actual drug? Do those fillers somehow change into something else when digested that impacts the parent drug? Is the actual manufacturing process of the drug (temperatures in the recipes, cooking times in the recipes, etc.) somehow an influencing factor on the outcome of the apparently identical drug?
I know generic corn flakes suck compared to the real stuff. I mean, they are both just sugar, corn, and barley malt, both made the same way. I know that example doesn't really apply, but just had to throw that out there. :-)
So a generic lamictal has no effect on body pains or induces them, while the brand version results in a painless condition. How interesting. I mean, it doesn't surprise me at all. I have documented so many similar stories it is almost scary how often it is happening right under the noses of FDA, doctors, and pharmacists, and they are blind to it all! With the exception of a few observant physicians, and a few pharmacists who admit "yeah, we've heard of that before".
I wonder why it is. A brand is better than generic. But in some cases, a generic is better than brand. A specific generic version will outperform all the others.
What the heck? Our first inclination is to point the finger and say, "placebo effect!", or "imagined". But no, this is real stuff folks.
poster:bleauberry
thread:906442
URL: http://www.dr-bob.org/babble/20090709/msgs/906753.html