Posted by morgan miller on October 19, 2010, at 20:31:34
In reply to Re: The potency of sertraline » morgan miller, posted by ed_uk2010 on October 19, 2010, at 13:18:22
> >And if it is just the fillers, they are enough to change the way the drug reacts in the body
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> I appreciate that there are occasionally differences between brands but this is undoubtedly a topic which receives a excessive amount of attention. It is to be expected that people will believe that more expensive brands are superior. The immense impact that this perception has on patient response should not be underestimated. What people may not realise is that Zoloft, Prozac and other brands still only cost a few cents per box to manufacture, like any mass produced off-patent medication. The inflated price is mostly profit for the manufacturer. Eli Lilly currently sell branded Prozac in the UK for only £1.50 per pack of 30 capsules. How they can justify the US price I do not know.
>
> The excipients used in generics are sometimes the same as the brand, sometimes different. In all cases, bioavailability will be tested. Excipients have a substantial affect on the absorption of some drugs (eg. ciclosporin) but the excipients used in SSRI formulations are mostly inert. Most brands of generic sertraline in the UK have the same or very similar excipients to Lustral/Zoloft.
>
> >He sometimes prescribes double the dose of generic fluoxetine if his patient is switching to it from brand Prozac.
>
> That is not very sensible! Doubling the dose is a very substantial increase and I cannot imagine that it would be appropriate.
>
>It's because he has seen what happens first hand in all his years of experience. Even my therapist has heard of the same approach with brand vs. generic fluoxetine.
I'm not buying the placebo effect. Not in my case at least. I never once thought generic would effect me the way it did. I was actually excited about not having to pay as much. Unfortunately, after a few days I began to notice a difference. I know it doesn't make sense, but with some people there is a significant difference, and it is NOT placebo. I admit, this is just my belief and my opinion. My old psychiatrist is a very very bright and rational guy. I think he and others in the field are starting to believe that there really is a difference and not one resulting from some placebo effect.
I agree that this issue needs a lot of attention before we can know for sure what is going on here.
poster:morgan miller
thread:963711
URL: http://www.dr-bob.org/babble/20101009/msgs/966300.html