Posted by bleauberry on April 2, 2010, at 18:06:36
In reply to Different generics Different outcomes?, posted by morganator on April 1, 2010, at 2:45:19
> Is it possible that someone could react differently to different manufacturers of something like fluoxetine?
Definitely.
Happens all the time.
I was just discussing with my spouse, why doesn't someone either sue the FDA or sue the drug company for allowing inconsistent treatments to be accepted as equivalent?
Brand is not the same as generic.
Generic A is not the same as generic B.
Different is different.
There is no way to predict which would be better or worse.
Skeptics would say if 50% of people on the brand and 50% of people on the generic improved, then they are equivalent. Not true.
Did every single person in the brand group stay well when switched to generic? See the flaw in the way they approach these tests?
No, the people responding were all over the map. The total stayed about the same at 50%, in this hypothetical example, but they were not the same exact people as the initial 50% group. There was not consistency from one group to the next. Only the totals appeared consistent. Within, there was a lot of discrepancy.
A more accurate test would be to take robust responders to brand and them switch them to generic.
Sometimes generic is better.
Sometimes one particular generic is better and all the others suck.
Sometimes all the generics seem to feel different from one another, each with its own unique quirks and differences.
Sometimes someone will respond equally well to either one and it makes no difference to them.
Bioequivalence does not equal clinical equivalence. And in fact, long complicated story, they are not bioequivalent.
I am surprised the FDA has not been taken down by massive lawsuits on this topic. People have probably died from being switched from a stable condition on a heart drug or seizure drug or whatever to a different version of that same drug. Of course, it was blamed on the disease, not the switch.
Ask SLS his experience with brand and generic Lamictal.
That is just one of hundreds of stories I could point my finger at.
poster:bleauberry
thread:941580
URL: http://www.dr-bob.org/babble/20100328/msgs/941848.html