Generic vs Name brand drugs

I'll start by stating that I used to work for big pharma companies, as well as a fairly big generic pharma company. that being said, I have seen both sides and I have no allegiance to one side or the other. I know that there is a very good reason for why the name brand drugs are so expensive, but I also know that, generally, generic drugs are just as good.

generally.

I used to take wellbutrin xl. it's an extended release of an antidepressant, designed to release the main ingredient slowly over 24 hours. it worked wonders. i was terribly stressed (my job was very stressful), always highly anxious, stayed awake for days at a time sometimes. then i started on wellbutrin xl, and not only was i more human, i actually had a sexual appetite. i felt normal for the first time in a long time. because i was working for the company that made the drug, and had a great pharmacy benefit for using their drugs, i always got the name brand. when i left the company to go to school full time, however, i didnt make a fuss when the pharmacist switched me to the generic version. when i got home to take it for the first time, though, i should have known something was wrong right away. the name brand wellbutrin xl is a tiny pill, its a high dose, but the formulation used to make it an extended release is from a special process, which i am not sure if i am allowed to get into, so i won't, just to be safe. anyhow - the generic version, budeprion, made by the same generic company i used to work for, was this HUGE horse-pill. i shruged and said well, its the same active ingredient, its the same amount of active ingredient, i guess they just needed to put a whole lot more filler in there? and i just "went with it."

tip #1: if you are ever switched from a name brand to a generic brand, and you see that the pill is more than twice the size of the original, think more carefully before making the switch.

so i went with it, and things started changing back. i was anxious, stressed, full-on depressed, barely holding on and barely worrying about eating. i lost a crazy amount of weight in the fall, then put it back plus some more in the spring! i had days when i did not react at all to the things i hsould be reacting to in the classroom, and days wheni broke down completely. i chocked it up to being in an intense graduate program and figured it would be worse if i were not on my meds.

a year later, i had my first teaching job, so things were different, more calm. but i was still not quite normal. i had just gotten so used to it by this time that i had not thought anything of it. then, due to some extenuating circumstances that i have not quite gotten over yet, i was yanked off the meds, with no step down process. just taken off of 300mg budeprion/wellbutrin without refills. i went through a short period of insanity, as could be expected for being yanked off a mind-altering drug. however, after that initial period of insanity, i was suddenly extremely normal. it was the first time i have felt this normal ina very very long time. 2 things are different here. 1 - i am no longer in the stressful environment that i used ot work in. 2 - i am no longer taking the generic budeprion. i am also not taking wellbutrin, however now that i am no longer working in such stressfuol conditions i do not need it. i am in the same place i was while taking budeprion, however. so really, the only thing I can point to as being responsible for my sudden recovery is the lack of budeprion.

i just read an article (Self, June 2009) that suddenly gave me the "aha!" moment. i hadn't really thought much about all this until i read the article. it turns out that the main difference between the two formulations (welbbutrin xl vs budeprion xl) is the extended release formulation. the big name company has two different patents for the drug, the active ingredient was approved before the extended release (probably because the active ingredient was discovered first, then made into a regular pill, then firther developed into this extended release muc later), so the active ingredient patent was expired before the extended release formulation patent. this means that the generic company could use the active ingredient, but were not allowed to use the same extended release formula, so they had to engineer their own. this explains the huge difference in the size of the pill. the stuff the generic company uses actually releases four times the dose right away, andf then the rest of it very slowly throughout the day. this huge of a dose all at once is what is responsible for making you crazy at times and then the complete opposite at other times.

so where is the fda in all this? well, they approved the 300mg dose based off the info they were given by the generic company. the generic company gave them info that was actually for the 150mg dose, though. so, they approved something not knowing they were not given the correct information for it. yes - the fda should be more vigilant. the fda also used to do on site inspections any time a new approval was sought, no matter how small the change was. now, they dont go nearly as often as they used to. in my ten years in pharma, between generic and name brand companies, i saw fda inspectors on site twice. i can tell you i have seen a greater number of applications than that in ten years.

tip #2: if you are going to try a new drug, lean toward trying the name brand first, this way you know what you are "supposed" to be experiencing. after a couple of months, then switch to the generic brand, if there is one, to save money. this way if there is a sudden change, you ave a better chance of figuring out that its the formulation of your generic pill.

tip #3: ask the doctor if there are reported differences between the generic and the name brand of that medicine. if she says there is, ask her to denote "name brand only" on your prescription. then double check at the pharmacy that the pharmacist didnt miss it.

the differences between the drugs are not so huge for most types of drugs, but for things like heart meds, seizure meds, anti-depressants, and anti-acne meds, keep an eye out and be on top of what you are taking.

Parent Autobiography

as part of the adoption process, we both need to write up an autobiography detailing our childhood: how we were raised, who raised us, what they were like, how they disciplined, how they fought and settled disagreements, etc. if you know me, you might have an idea as to how difficult writing this has been for me. i never thought i was the type of person to hold a grudge, i always said i wasn't. then i read over my writing to do some edits. it wasn't the writing itself that got me thinking, but my thoughts to myself as i did the reading. i thought, with a wry grin, "should i die soon, this should be read as my eulogy, as a reminder to the people who would be there to cry for themselves and their guilt. a reminder of the harm they did me and that they have only themselves to blame for that deep guilt they would be feeling." thats when i caught myself. maybe i am the type to hold a grudge, after all.

"See you in September..." and adoption stuff

Today i have everything finished, the room is cleaned, the books are put away and covered, all my resources are taken home so i can work on the lessons for next year, my paperwork is in and things are signed off. the only thing i have left to do is turn in my keys on Monday. the only thing i am debating now is whether or not i should take home my plant. frankly, i think the plant stands a better chance here all summer than it does at home with the cats. then again, i could just put it out on the porch... hrm. yes, i think i will do that.

Hubby Bear's playing wing man tonight for his friend, and i am planning ... *PLANNING*... on mopping the floors at home. this warm, muggy, rainy weather is nasty and brings out all the yucky smells in things. everything just smells really stale and gross. not pleasant at all.

we had another adoption training on Wednesday night with current resource parents. if you are the caretaker of a child who is in the system (not adopted yet), you are a resource parent. it was good to hear about their experiences. it really made me feel a lot better about the possibility of doing foster-adoption. there's still the "legal risk" that they will be reunited with their bio parents, but it rarely happens. the main benefit is that there are less moves for the child. if you do straight adoption, where you wait until a child is free for adoption before being placed in your home, not only do you wait longer and have a harder time finding younger children, but that's at least one more time they are being uprooted. the only benefit to it is that there is no legal risk. i personally think the benefits of fost-adopt outweigh the risk, i think Hubby Bear is there with me. i also feel better about keeping our age range lower at 5 and under. i would consider older children if we go through this again, but for right now, as first time parents taking on two at a time (and possibly more, depending on the sibling group), i feel better looking for younger children.

i got an invitation the other day to a baby shower for Hubby Bear's cousin who's expecting this fall. i got a little sad because i thought "gee, there's one bit of normalcy we wont have." i mean, so you're a new parent for the first time, so it makes sense to have a baby shower. but somehow you get the feeling that adoption just isn't the same, and they wont be new born babies (not likely), so does that make it even less of a thing to get excited over and have a baby shower for? i talked to a coworker and he said we could call it a "toddler shower." i kind of like that idea, actually. initially i thought maybe calling it an "adoption shower" would be nice, but then i thought that would be another label that would put them in a different category other than "your children." another thing i wondered about was timing. you get placed, you're still dealing with visitations with the original parents, and it could be some time before the rights get terminated. so WHEN do you do a shower? i see it as something that is supposed to help you get started with the stuff you'll need as parents, so it wouldn't make much sense to have it two years later, when you are finally a family legally, but is it too presumptuous to do it early?

at the meeting, i asked one of the parents if they had a baby shower, and she said "oh yes!" she said that the other resource parents did too. they had theirs a week after placement.

so, now i feel better about doing things just like you normally would do it. having a baby shower is OK, and having it soon after placement is pretty much expected.

today, since i have nothing to do but still need to be here until 2:40, i am going to work on that novella called a resource parent autobiography. i am sure i will be utterly depressed by the time the day is over.

adoption/parenting classes

hubby bear sent in the adoptive parent application to the agency last week, so we are all set to start the classes this weekend. this saturday will be an 8 hour class (i think), next wednesday a couple of hours, another 8 hours the following saturday, and a few more hours the following wednesday eveening. so the next two saturdays and wednesdays, we are going to be in parenting classes. its a lot all at once, but i think i prefer to get things done more quickly, rather than dragging things out. i am not sure what to expect, with the exception of being overwhelmed with alot of info that will not make any sense until we are actually parents and the situations arise. i am sure that if they ask any "what if" questions, my answers are all going to be "i call the doctor!" isnt that what all new, nervous, first time mothers do, after all?

as for getting the house ready, we still need to finish finding new homes for stuff from the study, then we can start setting up a bedroom. i am taking things in stride now, i feel better, not so baby-crazed as i was before, since we are actually taking the steps necessary to get started.

as far as our finances go, well.... they arent that great, but it isnt that terrible either. its like a roller coaster. we go from "oh my god! we are doomed!" to "hey, look at that, a little extra money, we can pay someone something this week!" i put together a list of debts that need to be paid off, its about 9 people long before we get to things like the car loan and the mortgage. most of them are things that could be paid off with one check, if we have enough left over after a pay check. there are a few things that will require a payment schedule of some sort, but most of it is little stuff, its just a lot as a whole. but you know what? you can only do one thing at a time. it turns out that doing one thign at a time works really well when it comes to getting your money situation squared away. sometimes i freak out and think "my god! we cant have a family with this situation!" then i remind myself that when you are expecting a biological child through birth, you dont get to put off gestation until your savings account is favorable for it. you just kind of figure it out as you go. and we're pretty good at that.

plus, thats probably something that will come up in these classes.

Teeeeeea!

today, after a student asked me how he can make sure he gets me for class again, a student from a different class period brought me a cup of hot tea.

The Future

i was about 3/4 of the way through my first period lesson today when one of my students arrived to class. i handed her the lesson handout and she sat down, opened to where we were, looked at how much she missed, interrupted me mid sentence and asked me to go back to what she missed. i said no, she will have to get it later. she sucked her teeth and whined at me "whyyy?" in this really annoying high pitch-yet-at-the-same-time-groaning voice. i said "you dont come to my class late and then demand that i go back and reteach my whole lesson because you missed it. you can get it later." she rolled her eyes and got an attitude, but i shut her down.

this girl is about to graduate in two weeks!

i think we have an agency

on tuesday night we went to an info meeting at an agency in the city. it was good, lots of info was given. lots of focus on who the children were and the experiences they have been through. it was a little emotional for me because i am well aware of what the kids have been through, though i did manage to keep it together just fine. we walked away feeling excited about this new road we are about to go down in our journey. i didnt feel like there was anything "wrong" with the agency, it wasnt screaming"no!" at me, but i figured we would figure out along the way which agency was right for us. we wondered how many agencies do you look at before you pick one? was it a matter of looking at three and pickingt he best one? did you wait until you just "knew" it was the right one? i decided we would figure out along the way.

so last night, wednesday, we went to another info meeting for a different agency. this one is quaker-affiliated, which is why it stood out to me. he talked about how our life's challenges are not looked at things that will count against us, but rather, things that add to our strengths. they have these guides for writing your autobiography, and its very detailed. i liked that. i felt like we would be taken by the hand every step of the way. also, while both agencies have a state requirement of 20 hours of training, the one we saw on tuesday spreads it out in little sessions over two months, meaning we would be running into the city all the time. last night's agency does it with two week nights and two extended saturday sessions. i prefer that! and its not in the city, so we dont have to worry about traffic or paying 16$ for train tickets every week, or walkign through some shady streets in philly in the dark! by the end of the info session, i was feeling pretty excited about them, and i was wondering how Hubby was feeling about it. he felt the same way as i did, he said just what i was thinking, that the vibe was right. another thing i thought was a bit of a benefit over the first one was the number of references. we just need a total of four for the both of us as a couple. thats a little bit easier than getting three separate ones for each of us. one thing that added to the good vibe was how much they stressed that having a non-perfect life adds to your strength because you have had to overcome challenges, you have had loss, you've had to grieve as a child. that made me feel really good.

the training session starts in two or three weeks. thats coming up fast! so we need to fill out the parent application form and get that to them soon. we also have a list of the thigns they will check when doing the home study, so we know what we need to work on, specifically, other than just "straighten up and put together a baby-room." we were going to spend some money on a patio out back, and also new fencing, this was going to cost us a lot of money and have to be spread out over the next couple of summers. but the ultimate goal is to get out of norristown altogether, so we decided to cancel the backyard plans, its good enough, if not better than it was when we got there, what with the flower beds that are practically self-sufficient now. instead, we are going to put our money towards the kitchen. we need new cabinets and counters. if you have been in our kitchen, you would know that it looks like some guy got a table saw for xmas and a gift card to lowes, but not enough to pay for good wood, but cheap flimsy particle board, and decided to make his own kitchen cabinets! i mean, those draws are child hazards with their metal edges and inability to close all the way in. the doors are so flimsy we couldnt put a child safety thing on their if we wanted to! so, we are going to focus on doing that this summer. i wanna see what it would cost to have lowes come on in and just do it for us, easy and done.

writing this autobiography is going to be a massive undertaking for me, looking at the outline of the stuff we should cover. its going to require time that i am not goingto have until the school year is over. but hey, thats what the summers are for: stuff you dont have time to do any other time of the year!