To save money, many people with ADHD take generic medications. Most have received assurances from their physicians that “bioequivalence” with the brand-name version is required and assured. Unfortunately, that is not always the case. Increasingly, patients who do notice a significant difference between brand-name and generic are making their voices heard.
The ADHD Roller Coaster covered this topic a few months ago, after I read an outrageous Consumer Reports press release that even warned consumers away from brand-name medications for ADHD as being too costly and unnecessary. I countered with this blog post on the potential dangers of generic medications for treating ADHD and co-existing conditions.
With other readers, I left comments at the Consumer Reports blog post (”Parents: Don’t rush Children to Adderall, Concerta, Strattera”).
Today’s New York Times article (”Not All Drugs Are the Same After All”) today backs up my points on generics. Some snippets:“There is a gnawing concern among some doctors and researchers that certain prescription generic drugs may not work as well as their brand-name counterpart.”
“Some specialists, particularly cardiologists and neurologists, are concerned about generic formulations of drugs in which a slight variation could have a serious effect on a patient’s health.”
“After hundreds of consumers posted messages about problems with the generic drug Budeprion XL 300 on the People’s Pharmacy Web site, Mr. [Joe] Graedon worked with an independent laboratory, ConsumerLab.com, to test the drug, which in other generic versions is typically known as bupropion. The lab found that Budeprion XL 300 released the active drug at a different rate than the brand name Wellbutrin XL 300. Mr. Graedon and the lab conjecture that the different dissolution rates might be to blame for the reported side effects and lower effectiveness of Budeprion.”
Kudos to Joe Graedon of The People’s Pharmacy for listening to his readers (despite his own longstanding support of generics) and probing the issue!
TagsADHD medication, generic, stimulants
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December 28, 2009 at 10:17 pm
Vancouver Therapist
Wow interesting post. I need to do some more research on this stuff since I always believed generics to be identical as well. Fascinating.
December 29, 2009 at 4:29 pm
Gina Pera
Hi Will,
Thanks for visiting. I’m preparing for facing the New Year (and maybe new resolutions) by reading your blog post:
http://willmeekphd.com/item/the-secrets-of-changing
December 29, 2009 at 5:11 pm
Vancouver Therapist
Hope it is helpful! I think esp for people with ADD/ADHD that cycle of starting something and not being able to sustain it is huge. Working with adult ADD clients is what helped me really realize that the routine is a real secret. Best of luck!
December 31, 2009 at 9:27 am
mark heath
I mentioned this to my doctor, regarding my generic Ritalin, but she disagreed. It’s an awkward position. This is the doctor who diagnosed my ADD, and I’m grateful to her. I’m also grateful to you for suggesting other options. When I’m more sure of my footing, I’ll be sure to press the issue.
December 31, 2009 at 10:36 am
Gina Pera
HI Mark,
I wonder what she could disagree with. In general, generics aren’t as reliable.
Maybe your doctor feels your generic Ritalin is working just fine for you. How would she know, though, if you’ve tried nothing else? Do you feel that your medical treatment is as good as it gets?
Of course, inexpensive generic Ritalin can be a huge help to people who don’t have insurance and can’t afford otherwise. But if one has insurance coverage and can afford the co-pays, I can’t imagine why any physician would prefer generic medication for ADHD. It’s just reckless, IMHO.
Gina
December 31, 2009 at 8:59 pm
Terry Graedon
Gina,
Thanks for such a thoughtful post. It is frustrating that there is no good way of sorting out drugs that work from drugs that don’t other than trial and error. Some generics seem to be just fine; we do get a lot of reports that others are not providing the expected benefit. If only the FDA were able to monitor such medications, consumers could have a lot more confidence.
Terry Graedon
January 1, 2010 at 12:30 pm
Dr. Charles Parker
Hey Gina,
Happy New Year! Great post, – right on with the caution.
Just thot your readers might be interested in some additional ideas on how to adjust IR [immediate release] products – so will send along this link to an article I did awhile ago on thinking scientifically if generics are your only alternative -http://ezinearticles.com/?ADD-ADHD-Medication-Treatment—7-Tips-to-Solve-Immediate-Release-Confusion&id=1739408
Hope these suggestions help! Best to you and all of your team over here.
Chuck
January 4, 2010 at 3:57 am
Bryan
This is a very, very interesting and very important post Gina – thank you for talking about this.
I suffer from SSRI withdrawal syndrome after taking a prescribed generic SSRI. It has lasted nearly 3 years and has only let up for short periods of time. I wonder if it will ever go away. However, I have no way of knowing if this is due to ‘generic’ or not, but it would be interesting if there was a study conducted by those with SSRI withdrawal syndrome or discontinuation syndrome to find out how many were taking the ‘real’ stuff and how many were taking the ‘generic’ stuff. Lately, I may have found some hope, but then again maybe not. It seems the SSRI may have triggered migraines. I had a history of migraines from my youth, but only 1 or 2 attacks a year. Since the SSRI I get the attacks almost daily or rather an attack can last for prolonged periods of time. Checking my vitamins it seems that I also have low magnesium levels in my blood which could be a culprit, so with that I have taken magnesium the last few days, but it seems to be getting worse. Hopefully this is a worse before better scenario but regardless of what I have tried nothing has really ‘worked’ – so I think it is very, very important that generics get thorough testing with comparisons to the originals. Again, I don’t know if it is because of a generic, but I would be interested in finding out – not that it would help me now, but it might help others.
Thanks,
Bryan