Switch to cheaper meds could jeopardize mental health of inmates, critics say

[Bozita]

Source: Detroit Free Press

Switch to cheaper meds could jeopardize mental health of inmates, critics say
12:33 PM, Apr. 21, 2011
BY CHRIS CHRISTOFF
DETROIT FREE PRESS STAFF WRITER


LANSING – Michigan’s prison system is jeopardizing the mental health of some 1,500 inmates by switching their psychotropic medication from name brands to generic forms to save money, a coalition of mental health advocates charged today.

The Michigan Partners in Crisis said switching inmates from medications that work to equivalent generic drugs can often cause relapses for people diagnosed with schizophrenia, bi-polar disorder and other mental health illnesses. The coalition includes physicians, judges and law enforcement officials.

The group said substituting generics for brands, such as generic Risperdal for brand Seroquel, is risky because the two drugs are not identical, and patients respond differently.

“This is going to cause problems,“ said Mark Reinstein, president and CEO of the Mental Health Association of Michigan. “You don’t mess with someone’s medication if they are stable, that’s a number one rule.”

Read more: http://www.freep.com/article/20110421/NEWS06/110421041/Switch-cheaper-meds-could-jeopardize-mental-health-inmates-critics-say?odyssey=tab|topnews|text|FRONTPAGE

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So fucking sad at so many different levels.

[FSogol]

1. Switch to cheaper meds could jeopardize financial health of corporations, executives say

:shrug:

[DCKit]

3. Definitely two sides to this argument, and I don't trust either one. nt

[formercia]

2. Nasty side-effects are just part of the punishment

like in the old Soviet Union. Declare someone Mentally Ill, institutionalize them where you can really and literally fuck with their heads.

[snagglepuss]

4. Who is to know this group isn't shilling for BigPharma who has a vested

interest in not prisons not switching to generics. I'd be interested to see proof generics aren't identical.

[nolabear]

6. They're often really not, snagglepuss. Generics may have differences in manufacturing

which can cause side effects if the patient reacts negatively to, say, a dye or the rate of release of the drug into the system or interaction with another medication. There can be numerous and significant differences. You can look it up in the American Psychiatric Association's literature. There's ample evidence, not just conjecture.

[snagglepuss]

11. If that is the case, I'm wondering whether my brother who has been

severly clinically depressed for many years and right now is on generic Zoloft and Lithium isn't responding well because he takes generics. Interesting to know there is a difference. Thanks.

[bethfully]

7. It's complicated

I don't have proof of this situation, but as someone involved in the mental health field and who knows several people on psychotropic meds, it is well known that generic brands are often not an appropriate substitute for brand name medication. What's really at issue are the outrageous prices of our medications.

[snagglepuss]

12. Do you know if people react differently to sertraline as opposed to Zoloft?

I ask because my brother has been unresponsive to many antidepressants all of which have been generic.


Welcome to DU :hi:

[bethfully]

13. Does unresponsive mean they had no effect

or that there were adverse side effects that outweighed the benefits?

[snagglepuss]

15. No effect. I had to admit him to hospital 3 weeks ago because he was

sleeping 23 hours a day for quite sometime. Doctors have since doubled the Sertaline, stopped the Abilfy and added Lithium. There is yet not much difference so I was wondering if the generic drugs may be an issue.

[bethfully]

16. And is this just for depression or for co-morbid issues?

I ask b/c lithium and Abilify are more bi-polar/schitzoaffective meds

[snagglepuss]

17. A year ago a doctor changed his diagnosis to hypo bipolar and put him on

Abilfy. Since he hasn't at all responded well to Abilfy/Serataline, they going to try Lithium and Serataline because other antidepressant haven't worked.

[bethfully]

18. With what you've told me, I think trying the name

brands of these drugs would be very worth it. Esp. given that there were no serious ill effects. I recommend you search for research that shows a link between different outcomes with generic vs. name brand with those specific meds. I'm sure there's stuff on Abilify/Seratlaline. Do you have access to scholarly databases? The reason for the research is that I would want to look at the I do. I could see if I can find anything and send you the articles as PDFs.

Also, I have no idea what your brother is interested in or willing/able to do beyond medication, but Dialectical Behavioral Therapy (you can google, I'm terrible w/ HTML) is a very well studied, clinically proven therapeutic method to address mood and thought disorders. It's powerful. I strongly recommend people find some way of including it in their therapeutic framework if at all possible.

Let me know if I can search for you. My brother has Tourette/OCD and anxiety/depression. He's currently facilitating support groups for schizo-affective young adults and both of us are strongly committed to helping in whatever way possible people who are trying to navigate this crazy arena of mental illness.

[snagglepuss]

19. Thanks for that information.

:hi:

[canucksawbones]

8. there can be differences

Depending on what the state or federal rules are.

In Canada generics can be anything between 80% and 120% bioavailability of the original drug, so when switching, one does need to monitor and may need to adjust dose. This is something physicians deal with all the time. The biggest problem comes when switching from the brand name to generics, then the pharmacy makes changes from one generic to another frequently, meaning you get the anywhere from 80% to 120% of the intended dose, and that keeps changing.

Personally I don't have a problem switching brand--> generic, as long as the provider keeps the same generic available and doesn't change company to company

[musette_sf]

21. Generics of ANY drug are not identical

in many ways. For starters, generics only have to have a certain percentage of the active ingredient(s). I've gotten to the point with generic OTC allergy meds that I now always purchase name brand. The quality of the generics has declined over the past several years.

[canoeist52]

5. Generics are not always the exact same potency

I've heard that generics are allowed to differ in potency by as much as 25% (either more OR less potent than the name brand).

My mother was just switched to the generic form of Aricept. We noticed a tremendous change in affect and disposition. Not good. We may have to raise the dose or switch back.

[w4rma]

9. Different. I'm not sure that one is better or worse than the other, though.

It's a case by case basis on which is better and which is less effective.

[Dappleganger]

10. Beating them is free.

:sarcasm: :sarcasm: :sarcasm:

[Bozita]

14. Could this change be due to pressure from the growing for-profit prison industry?

This was posted last night here in LBN:
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=102x4821931

[musette_sf]

20. + 1, generics of psychotropic drugs are NOT the same

and some have ZERO efficacy. There's a study of Canadian patients whose name brand was switched to generic Celexa, and they had ZERO efficacy.