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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by laima on February 23, 2007, at 13:49:33
Today I filled my second script ever for brand name, ie, Shire Adderall. This particular version of Adderall, along with Emsam, has proven to be my miracle med combo. For the first time in over a decade, I've felt that I am finally finding relief from depression. Real relief, not ho-hum, not resolving myself to accept a dysthymic state. I didn't do quite as well with Barr's generic "amphetamine salts". In fact, after about two weeks, I am suspicious they were making me more depressed. Definately more emotionally volotile. Well, let me say, that for me, the difference between Barr's generic and Shire's brand version is so enourmous, they don't even feel to be the same drug. Imagine how stunned I was today to find that the manufacturer now listed for my "brand" Adderall is Barr! Walgreen's claims that there is no more Shire Adderall, and some googeling revealed that Barr bought it!!! And to top it off, sounds like there is some nasty business with them trying to also aquire the XR version from Shire several years before the patent even runs out. I'm worried- who is now manufacturing Adderall? The same lab, but owned by Barr- or did they take over the whole process?I know pharmacists claim that brand and generic are the same thing, but my doctor, a professor of psychopharmacology begs to differ- and I agree. He says that generics are not held to the same level of scrutiny by fda, and are given leeway specifically to cut costs.
I'm freaking out wondering if my effective, miraculous med combo was short lived. I mean, I was optimistic about myself and my future for the first time in eons! Not easy to find the right meds!!
Does anyone know more about this, ie, who is in control of manufacturing "brand " Adderall now? I'm so scared Barr will do their thing, whatever it is, to make it not the same anymore.
Apparently Barr is now in control of both "brand" AND "generic" adderall-and they are chompin to get ahold of the XR asap, too. How can this be allowed??? It looks like there was some legal stuff going on, but Barr won.Thanks.
Posted by Phillipa on February 23, 2007, at 15:12:00
In reply to feeling freaked out that Barr bought Shire's Adder, posted by laima on February 23, 2007, at 13:49:33
Call all your pharmacies around you and see who may have it in stock and right now I'm looking for a link for online pharmacy with a legitimate script. Try that too and if you have a name babblemail me please. Thanks phillipa
Posted by laima on February 23, 2007, at 15:26:13
In reply to Re: feeling freaked out that Barr bought Shire's Adder » laima, posted by Phillipa on February 23, 2007, at 15:12:00
Oh Phillipa, thank you- I already went to about 10 Walgreens today, and found news online which confirmed it's true. Even if someone had enough stockpiled for me to use this month- what about moving forward? Not to mention, I don't think it's allowed to buy online. In any case, I have the p[rescription filled, and took my dose, trying to tell if its the same or not. I HOPE like you'd never believe, that the product stays the same. But thank you for your kind words and offer of help.
> Call all your pharmacies around you and see who may have it in stock and right now I'm looking for a link for online pharmacy with a legitimate script. Try that too and if you have a name babblemail me please. Thanks phillipa
Posted by med_empowered on February 24, 2007, at 4:50:08
In reply to Re: feeling freaked out that Barr bought Shire's Adder » Phillipa, posted by laima on February 23, 2007, at 15:26:13
hmmm...I dunno. I think the fda allows up to a 20% variance...the problem, I imagine, would be potency--I mean, you're getting amphetamine salts, but the generic may have less active stuff per mg than the brand. So maybe upping the dosage? Or you could switch...Desoxyn, for instance, is only available in brand, and if you cut your adderall dose in 1/3 (I think) thats about the equivalent..at least that way you could be sure of quality...you could also switch to brand name dexedrine ir tabs.
Posted by laima on February 24, 2007, at 8:08:32
In reply to Re: feeling freaked out that Barr bought Shire's A, posted by med_empowered on February 24, 2007, at 4:50:08
The difference between Barr generic and Shire brand wasn't potency- it was the actions. If I took extra Barr, I'd fear for feeling jittery, fear pounding heart, getting flushed. And I am on Emsam- don't want to mess around! More than once I ran for my blood pressure reader to reassure myself I was ok. Barr's version made me feel jittery if I took it on an empty stomache, and even with food, I definately felt it kick in, or should I say, almost throttle on, and later, sink off. When it sunk off, I was emotionally volotile, even fragile. I was in a hurry to take my afternoon dose for this reason--but with the brand version, it is so smooth, I sometimes forgot to take the afternoon dose on time. Had to pep-talk myself out of a mood sink each evening with Barr-sometimes successfuly, sometimes not. After about two weeks I was feeling quite certain it was the wrong med for me. I sunk into a deeper depression when I took it, just about immediately after it started to work-all day and evening. I asked my doctor to switch me to dexedrine- but he's not big on sudden switches of meds, and I ended up trying the brand version instead. HUGE difference in my case: no jitteryness as it kicked in- or ever. No mood sinks, ever. No evening troubles at all. No temptation to ever take more to postpone a crash- no crash to postpone. At most- I get tired in the evening- but I think one is supposed to get tired in the evening after a full day. Just very smooth, very mood brightening. I don't feel like I am even "on" anything with it.
As for generics- well, I do consider my doctor's views to be credible, because he's a professor of psychopharmacology, and in the prime of his career. He also acts as consultant to some drug trials and studies. He wasn't at all surprised when I reported the difference between the two versions, and said indeed, generics are not under the same kind of fda scrutiny as brand name version drugs are. Sometimes it's a matter of varying quality of raw ingredients, or the amounts used, or manufacturing differences. Sometimes people don't absorb one version or another well. He even said that the fda gives generics extra lee-way for the specific purpose of enabeling them to cut costs. Forgive me, I can't remember if I already said this or not- but it also kind of reminds me of giving a number of people the same recipee, and yet each of their souflees turns out differently, despite same list of ingredients in the recipee, same instructions.
Meanwhile, most pharmacists insist there is no difference between brand and generic- except for one assistant who quietly told me that yes, loads of customers at her store insist on brand version adderall and don't care for the Barr. I said, "I thought they are the same?" She answered, sarcastically, "Supposedly!" The pharmacist overheard her, and she got in trouble.Barr's famous, or notorious per some, for specializing in generics. They are still making generic "adderal" despite acquiring the brand version. So, they themselves concede a difference? Or will this devolve into two generic products, one being considerably more expensive? I know a lot of pharmaceutical companies are accused of all kinds of tricks and schemes, but I found the news articles about them practically bullying Shire to give up their patent on Adderal XR several years early to be distasteful. Will such practices end up meaning it becomes less attractive to develop high quality new drugs? I mean, why spend millions to do so, if some generic company bullies you out of your patent before you ever turn a profit, or much of a profit?
But my biggest fear is simple: I found my miracle med combo, and do I end up losing it now, just a month after getting it right?
Who exactly is actually over-seeing the "brand" adderall manufacturing now? Will they be pressured to cut costs, etc- possibly altering the product as result? Will they get the same raw ingredients as Barr generic?
If things do go downhill for me, I'll ask about dexedrine again- I'd rather not have to make changes now though, because this past month has been the best in a longtime. Oh sure- I still have lots of problems to sort out in my life, but I actuallly finally feel capable and optimistic to do so- that's a BIG deal! Before this month, I was resigned to being always depressed, dysthymic at best.
I used ritalin in the past, and both brand and generic basically agreed with me, but both lacked the mood brightening effect at low doses, and I could definately feel both versions kick in and fall off. I felt like I was "on" something with both. I'm on Emsam, so how high I can go is limited. Higher doses of ritalin always made me feel speedy, unnatural, anyway. I always had some temptation to up the dose, too- to avoid any crash, and because it wore off so quickly. A colleague of my doctor consulted on my case, and reported that he's been noticing a number of people are "doing very, very well" by combining their Emsam with adderall, that the two seem to work synergistically, prompting the switch. I ended up not so sure he was right until I got my hands on the brand version.
If anyone is doing great on Barr generic- I don't mean to insult.
Please don't misinterpret. It just wasn't a good med for ME- it seemed to be at first, but this depression came on early during the first month I used it, then I took a two week break, felt better (though deflated), and then the pattern repeated itself the following month. No issues, no problems from a full month of Shire. Just excited optimism- which is now feeling in jeopardy.But thank you for your thoughts- I'm taking note of your suggestions, in case I have any issue and end up needing to monkey around with changes again. But I still hope like you'd never believe that they just "bought" it, and are not digging in to the manufacturing process. Fingers crossed big time!
> hmmm...I dunno. I think the fda allows up to a 20% variance...the problem, I imagine, would be potency--I mean, you're getting amphetamine salts, but the generic may have less active stuff per mg than the brand. So maybe upping the dosage? Or you could switch...Desoxyn, for instance, is only available in brand, and if you cut your adderall dose in 1/3 (I think) thats about the equivalent..at least that way you could be sure of quality...you could also switch to brand name dexedrine ir tabs.
Posted by ttee on February 24, 2007, at 11:08:52
In reply to Re: feeling freaked out that Barr bought Shire's A » med_empowered, posted by laima on February 24, 2007, at 8:08:32
How much money does your leading pyschopharmocologist get paid from the generic drug companies, versus the money he gets from the branded drug companies for all the trials he is involved with and the money they give him as a consultant? Just like everything else, it is always wise to follow the money to get to the bottom of things.
Posted by dbc on February 24, 2007, at 14:32:59
In reply to Re: feeling freaked out that Barr bought Shire's A, posted by ttee on February 24, 2007, at 11:08:52
Yep. their dexedrine completely sucks and is universally loathed on ad/hd boards. People go to great lengths for the malinkrodt brand and to avoid the barrs.
Posted by laima on February 24, 2007, at 18:19:15
In reply to Re: feeling freaked out that Barr bought Shire's A, posted by ttee on February 24, 2007, at 11:08:52
Well, that concern has obviously crossed my mind, but he said he hasn't used adderall much- it was his colleague who suggested it-and he doesn't work with Shire either. I live in USA- I think Shire is in UK? (If I remember that accurately-not positive.) Still, I try not to be too cynical, and do consider that this is a person who has a little inside knowledge of the pharmaceutical industry and fda guidelines for it. I can read between the lines. If his interests were totally biased, I can't imagine a major med school would employ him well. And furthermore, he took me OFF of one of said company's meds when I first saw him- that was one of the first changes he made. I know what company he's done some "independent overseeing of drug trials" for, and Shire isn't it. Other people have discussed shortcomings of some generics on babble before, what I got from my doctor was some fleshing out of that info. He doesn't ever say that "brand is better than generic", or anything like that-but does acknowledge that for certain meds, a number of patients can tell a difference, while others do not. That seems to be a balanced view. I can see well for myself that the Barr generic and the Shire brand are quite different. And uh, part of what I'm "getting" is that the generic companies aren't doing trials- they let the brand companies pay for all that. They just get the pharmacies and insurance companies to push their products. This would seem to help them keep costs down, too. But if the cheap generic doesn't work for me, it's no bargain.
> How much money does your leading pyschopharmocologist get paid from the generic drug companies, versus the money he gets from the branded drug companies for all the trials he is involved with and the money they give him as a consultant? Just like everything else, it is always wise to follow the money to get to the bottom of things.
Posted by laima on February 24, 2007, at 18:25:56
In reply to Re: feeling freaked out that Barr bought Shire's A, posted by dbc on February 24, 2007, at 14:32:59
I was looking at some of the add/adhd boards- Barr doesn't seem to be very popular with the posters, though there are exceptions. I formed my opinion of Barr generic adderall before I found those boards- and lo and behold- there were loads of people who liked it about as well as I did, reporting very similar effects that I experienced with it. I also find Barr's heavy-handed demmanding that Shire give up trheir adderall xr patent several years ahead of schedule- even taking them to court over it- to be a bit ballsy, squirly. If Barr's generic works for some people- lucky them! I wish I could say the same, and spare myself the worry and additional cost. At least the supply of THEIR med seems secure.Is there still a brand version of desedrine? Who makes it?
> Yep. their dexedrine completely sucks and is universally loathed on ad/hd boards. People go to great lengths for the malinkrodt brand and to avoid the barrs.
Posted by laima on February 24, 2007, at 18:42:45
In reply to Re: feeling freaked out that Barr bought Shire's A, posted by ttee on February 24, 2007, at 11:08:52
Bottom line message that I "got"- generics are given leeway by fda, allowing them to cut their costs.
That might mean not buying the premium raw materials, buying "impure" (but perfectly safe-as safe as for any drug) raw materials (per conversation with doctor), or maybe they simply use less (I guess per babble posters- up to 20% less?), they might save on production costs, (I rather doubt they all copy the premium production methods), they can use different "inactive" ingredients which lo and behold make a difference (ask nardil people-isn't that the med where the old version was more effective than the new for many- and all that was done was a switch of inactive ingredients? And I think that was brand, too- not sure if I remember that accurately-maybe someone else knows.) There are many areas where something can get different. And the fda seems more interested in monitoring "new" drugs than in overseeing existing generics. FDA is apparently, notoriously, er, not caught up on monitoring everything- whether that's meds, meat, or even spinach processing plants.
Posted by jonathanupr on February 28, 2007, at 21:33:25
In reply to Re: generics » ttee, posted by laima on February 24, 2007, at 18:42:45
Funny that everyone reacts differently to meds.
I'm on the thank god there's a Barr form of Adderall. In taking the Barr tabs my OCD and irritability aren't even close to the intensity of 'em that I experienced in taking the Shire form of Adderall.
from my experience in taking pretty much all the stims out there (from Desoxyn on down to Focalin), I'd say the biggest difference between the Barr and Shire versions lay within the Dexedrine content within each versions. I can definitely feel the Dexedrine in the Shire form (which I don't prefer at all), and there seems to be less Dex in the Barr form and possibly more L-amphetamine (which I have much better success with).... its this or the absorption rate of the Barr form is just a bit different (possibly absorbed quicker, more lipid soluable, though it doesn't seem as addictive/habit forming as Desoxyn seemed). The Shire form definitely lasts longer, around 3 to 4 hours per tab, where as the Barr form lasts 2 to 2 1/2 hrs. I don't mind popping 5 mgs every 2 to 3 hours, not a big deal as I've grown accustomed to it. Big thing I experienced on the Shire version was a big kick of euphoria once I took it (around 1st 2 hours of XR dose, and then after that I was pretty much going down-hill from there in my ability to concentrate....what I like about the Barr version is that it's pretty even keeled all the way through, as I feel the same way on the first dose as I do pretty much on the last dose). I look forward to the Barr version of the extended release capsule.
Posted by laima on February 28, 2007, at 22:33:06
In reply to Re: generics, posted by jonathanupr on February 28, 2007, at 21:33:25
Wow, thank you for some interesting insight from " the other side"!You know, I was suspicious that part of the difference could be with the dex- I responded quite well to a dexedrine trial once in the past- very mood brightening, calm, smooth and steadyfor me. In a way, the Shire reminded me a bit of dexedrine.
How interesting that you've thus found Barr smoother, and I the opposite- Barr choppy and Shire super-smooth. And for me, I deteriorated after a couple weeks on Barr, but Shire stayed consistently great all month long.
Well- maybe indeed there is a difference around the dexedrine content of the two versions, or at least in the way it's set to release, and perhaps some people respond to the different types of amphetamine differently. Personally, since I found Barr quite agitating for about 45 minutes-1hour as it kicked in and at other moments, I would speculate that that l-amphetamine isn't good for me- and perhaps Barr does have more of it, or releases it differently than the Shire did. That would explain a lot to me, if true.
Wow, well thank you for a most informative and enlightening post. If Barr's new brand version proves unsuccessful for me, I think perhaps dexedrine might be the thing to try.
Choices are good though, wouldn't you agree? We each get to use then what's tweaked a way to be best for us.
ps- doesn't sound like you'll have to wait long for Barr to get an extended version, from the sounds of the news reports.
> Funny that everyone reacts differently to meds.
>
> I'm on the thank god there's a Barr form of Adderall. In taking the Barr tabs my OCD and irritability aren't even close to the intensity of 'em that I experienced in taking the Shire form of Adderall.
>
> from my experience in taking pretty much all the stims out there (from Desoxyn on down to Focalin), I'd say the biggest difference between the Barr and Shire versions lay within the Dexedrine content within each versions. I can definitely feel the Dexedrine in the Shire form (which I don't prefer at all), and there seems to be less Dex in the Barr form and possibly more L-amphetamine (which I have much better success with).... its this or the absorption rate of the Barr form is just a bit different (possibly absorbed quicker, more lipid soluable, though it doesn't seem as addictive/habit forming as Desoxyn seemed). The Shire form definitely lasts longer, around 3 to 4 hours per tab, where as the Barr form lasts 2 to 2 1/2 hrs. I don't mind popping 5 mgs every 2 to 3 hours, not a big deal as I've grown accustomed to it. Big thing I experienced on the Shire version was a big kick of euphoria once I took it (around 1st 2 hours of XR dose, and then after that I was pretty much going down-hill from there in my ability to concentrate....what I like about the Barr version is that it's pretty even keeled all the way through, as I feel the same way on the first dose as I do pretty much on the last dose). I look forward to the Barr version of the extended release capsule.
Posted by jonathanupr on March 1, 2007, at 20:50:45
In reply to Re: generics » jonathanupr, posted by laima on February 28, 2007, at 22:33:06
choices are definitely good
you may have luck taking 1/4 to 1/2 of a Barr tablet and 1/2 to 3/4 of a Dexedrine tab to try and find the right ratio that worked for you in the Shire form (this could turn out to be much more cost effective for you in the long run as well). If Dex seemed to do the trick for you, and L-amphetamine doesn't do much good for you, then you may want to just give dex a try. What I know for me was that when I took Dex, I had some hellacious rebound, piss and vinegar (though it gave me a bit more drive).
People definitely react differently to meds, given their make-ups. One individual could be more in need of dopamine and the other individual could be in more need of nor-epinephrine.
From the research I've dug up, Dexedrine (also dextro-amphetamine) primarily triggers the release and re-uptake of dopamine, where as L-amphetamine primarily triggers the release and re-uptake of nor-epinephrine (which would give reason for the Barr winding one's body up more than one's mind....Barr definitely hits my body much more than Shire's form did). Other stims such as Concerta and Focalin seem to do much more towards the dopamine networks as well, the latter 2 seemingly more reuptake than catecholamine release (my main sign of this is when my OCD gets exacerbated greatly when on Dex & Concerta, and other dopamine agonists and reuptake inhibitors, versus NRIs and NE agonists).
hope all turns out decent
Posted by laima on March 2, 2007, at 7:41:11
In reply to Re: generics, posted by jonathanupr on March 1, 2007, at 20:50:45
Hi, and thanks again!
I'm saving all of the very interesting and very useful information you've shared for my future reference.
So far I'm unclear how the new Barr version of brand adderall is working for me- there are some new effects- but most of it can reasonably be psychologically induced. Some not. Ie- appetite still vanished. 4pm yesterday, I realized I plain FORGOT to eat! And I had an impression that it was still late morning until I looked at the clock. That's pretty weird for me, didn't experience that sort of thing ever before I started the new version of the med Friday. I'm normally quite a food enthusiast. At most, I'd get VERY mild appetite suppression from stims, almost insignificant-but still feel like eating, and never simply forget. I wonder if this sort of severe loss of appetite, so severe I am forgetting to eat is possibly an l-amphetamine associated effect? I was starving for a few days, but now I don't even notice it so much. I also am increasingly suspicious that my perception of time is altered. Meaning, it seems to be vanishing. I don't feel speedy or anything, but large lapses of time are vanishing at lightning speed, and I can't explain how/why, or what I was even doing. I'm an expert procrastinator, but have always had a sense before of,"oh, I'm wasting time", or "oh, I'm taking too much time with this". Part of it could be I'm not getting hungry anymore, so there haven't been regular meals to mark passing of time. This is weird, and I will definately mention at my appointment next week. What do you think, do you know if this could be an l-amphetamine thing? But this didn't happen on Barr generic.
As for your Barr adderall/dex mix recipee- thanks- sounds like a good idea, but in reality, I have a hard time picturing getting those prescriptions together to do that! My prediction, if there is a switch, is that adderall xr will be suggested. But perhaps since I'm on Emsam, the regular versions actually last plenty long already, and I don't like the idea of a stimulant med that lasts even longer. What if I take it late one day? My 1pm dose of the IR, whether brand or Barr, lasts into the early evening. For me, the 1pm Shire lasted until about 5 or 6 minimum, and this new version seems to be lasting even longer- definately, 1pm dose lasting at least 6 or 7pm or so. (Actually, this part is an improvement!)
You mentioned another interesting thing, about l-amphetamine (speaking roughly) hitting norepinephrine more, and being felt more bodily; and dex hitting dopamine more, maybe being more mental. My doctor has mused that a number of my primary complaints are associated with dopamine abnormalities/issues: tiredness, cognitive sluggishness, spaciness/inattentive, sleep disorders, specifically sleep movement disorders. And I used to take ssris for a real long time- some people claim that their long term use can mess up dopamine, but I don't know if that's true or not. Still, lots to think about from what you write.
You know, the stim which gave me most drive was actually ritalin-but though I loved being so productive, it felt unnatural and at times, quite speedy. Literally rushing about at times, in addition to feeling a bit "wired". And I was very prone to fixation, and on higher doses, I could easily crash if if I didn't specificallly pep-talk myself out of it. The dexedrine, but especially the Shire adderall, by comparison, have felt very calm, smooth. "Unplugged" compared to ritalin. Zero crash on Shire adderall, no good recollection about dex- that was long ago for a short spell only. The Barr was somewhere in between, going through distinct periods of speedy-pounding as well as calmness--my worst complaint being that it ultimately induced depression and crashes after a couple weeks of use.
So- are you taking adderall for OCD, or other reason?
Thanks again for so much useful and interesting information.
I am extremely, extremely appreciative!Laima
> choices are definitely good
>
> you may have luck taking 1/4 to 1/2 of a Barr tablet and 1/2 to 3/4 of a Dexedrine tab to try and find the right ratio that worked for you in the Shire form (this could turn out to be much more cost effective for you in the long run as well). If Dex seemed to do the trick for you, and L-amphetamine doesn't do much good for you, then you may want to just give dex a try. What I know for me was that when I took Dex, I had some hellacious rebound, piss and vinegar (though it gave me a bit more drive).
>
> People definitely react differently to meds, given their make-ups. One individual could be more in need of dopamine and the other individual could be in more need of nor-epinephrine.
>
> From the research I've dug up, Dexedrine (also dextro-amphetamine) primarily triggers the release and re-uptake of dopamine, where as L-amphetamine primarily triggers the release and re-uptake of nor-epinephrine (which would give reason for the Barr winding one's body up more than one's mind....Barr definitely hits my body much more than Shire's form did). Other stims such as Concerta and Focalin seem to do much more towards the dopamine networks as well, the latter 2 seemingly more reuptake than catecholamine release (my main sign of this is when my OCD gets exacerbated greatly when on Dex & Concerta, and other dopamine agonists and reuptake inhibitors, versus NRIs and NE agonists).
>
> hope all turns out decent
This is the end of the thread.
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