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This generic Adderall is different from the other generics [Long but controversial]
King Boo Hoo
Registered User regular
Registered User regular
Act I: How I got involved
I've been taking 20mg Adderall for over a year now. Recently, my pharmacy started changing which generic version of Adderall they stock. Last month I went from my usual oval orange ones (Barr) to circular orange ones (Eon). When I openned my bottle and discovered I had something new looking, I went online to see if there were any differences in the generics. This is where my adventure began.
I was looking through online forums and blogs and there was a lot of talk about how some generics are better than others, and how name-brand is better than the generics. And I thought to myself, that's really odd. Normally, I'd just assume placebo effect was the reason people thought name-brand was better, and different experiences day to day made people feel that the generics were somehow different. But there was a lot of these comments, more than I felt comfortable just ignoring. So I went to work on the comments.
Act II: Data collection and drug preferences
I tried to turn the qualitative data, all these blog and forum comments into quantitative data. What drug did you use, what did you switch to, what was the different in symptoms/experience between the two. I ended up with about 200 "participants". Most of them just said what drug they prefered and didn't specify a reason, but there was a good deal of reasons as well.
First interesting finding: lots of uniformity as to which Adderalls are better than others. I'm only listing 3 drug names because there was a LOT more talk about these than the others:
41 prefer Brand over Barr, 1 prefers Barr over Brand
72 prefer Barr over Cor, 5 prefer Cor over Barr
4 prefer Brand over Cor, 0 prefer Cor over Brand
Few people commented on Cor/Brand but it maintains the consistency of the transitive property: People prefer Brand over Barr, and Barr over Cor, so what little evidence there is shows people prefer Brand over Cor.
Fine I said, there's some consistency. That's odd, let's find out why. Before I push further, why am I using these 3 drugs? Brand name Adderall, Barr, and Cor? Brand name Adderall is an obvious one on the list, as generics should be matching up to their brand-name equivalents. Barr is by far the most widely produced generic. And Cor? Cor because Walgreens switched from stocking Barr to stocking Cor and hundreds of people went crazy about it because they all noticed a difference. Which really shouldn't be occuring with generics.
Act III: Brand vs Barr -- cheaper filler means more drug faster
So before I went into true quantitative stuff, I tried to see if I could make any hypothesis by eyeballing the data and reading the forums. Why is Brand better than Barr? Why is Barr better than Cor? In the former case, I found out that generic drugs use different fillers than the brand-name drug (the 99% of the pill that's NOT medicine). Well, if you use a cheap easily disolvable filler, then it will disolve very quickly in your stomach and enter your bloodstream sooner, stronger, and for not as long. If that's the case, I'd expect people to complain about a shorter duration, and otherwise complain about symptoms as if you took too high of a dose of Adderall. In the latter case, Cor vs Barr, I had no idea but something fishy was up because the complaints just looked odd.
So I put my quantitative hat on and went to work to see if there was any consistency to the specific complaints people were making about various drugs.
Here's the differences in symptoms/experience that people who prefered Brand over Barr came up with (only listing symptoms that showed up a LOT more prevalent than the other symptoms).
Strong consensus:
It's not as effective for controlling ADHD
It has a higher peak potency
More side-effects
Causes head-aches
Causes a foggy mind feeling
Weaker (but still significantly higher than most symptoms) consensus:
More jitteriness
Less duration
Issues with focusing
Experiencing hyperfocus
Sleep less
Eat less
Feel less motivated
Higher peak potency, less duration, sound like the drug is going through your system faster and more of it at once. More side-effects, less sleep and less hunger appears to back that up as well, because you've got too much Adderall in you for a while. Hyperfocus also happens when you take too much Adderall. Less motivated, issues with focusing, and not as effective are because the drug leaves your system sooner so you go through longer periods of having no Adderall in your system to help you than you're used to.
Overall, the complaints that people had lined up very well with my hypothesis that Barr generic Adderall simply uses a cheaper filler than the brand-name.
Act IV: The part where I subtly hint at scandal
Now for the fun part. Cor vs Barr. Like I said, I couldn't predict why the effect was different because the symptoms were odd. I'll show results first, then explain my hypothesis based on the data:
Strong consensus:
More jitteriness experienced
A LOT less effective for ADHD (almost everyone was talking about this)
Less duration
A LOT of problems focusing
More side-effects
More head-aches
A LOT of emotionality (rage, depression, anxiety)
Physical weakness
Weaker (but still significantly higher than most symptoms) consensus:
Sleep more
Sleep less
Eat less
Fogginess
Less motivated
First, let me clarify ways in which this is a different comparison from Brand vs Barr:
A LOT more people complained about the lack of effectiveness
Almost NO discussion about whether there's more or less potency at the peak
A LOT more focusing problems
No hyperfocus mention
Huge amount of emotionality where there was NO mention of it at all for Brand vs Barr
Sleep more and weakness also had to be added as variables because NO ONE mentioned that for Brand vs Barr
So here's my hypothesis for Cor. Something is actually not right chemically. This isn't placebo effect, there's far too much consistency in complaints. This isn't a different filler, because potency wasn't mentioned at all, nor was hyperfocus, and a variety of new and very strange complaints were mentioned.
It looks to me like there are 2 groups of people affected by this version of Adderall (Cor). Neither group is helped by the medication for ADHD, both groups very strongly complain that they can't feel ANY difference in ADHD on the drug so there's really no reason to just take a side-effect making pill.
One group's side effects appear like taking too much Adderall side-effects: sleep less, eat less, more side-effects, less duration, jitteriness. The other group's side effects almost resemble the opposite of what Adderall should be doing: physical weakness, decreased motivation, no help in focusing, sleeping more, strong emotional problems.
I don't know if there are 2 groups of effects, but it is clear there's a lot of consensus on symptoms that really no one mentioned in conjunction with any other type of Adderall other than Cor. And that's just bizarre given that I can't think of any reason there should be such a difference in effect. Interesting thing to note: there were a good number of people who mentioned somewhere in there comment how 'they thought they were going crazy' for thinking there was a difference in the drugs until they stumbled across this blog/forum, so people were feeling VERY serious differences in effect.
Act V: THERE'S A SURPRISE TWIST ENDING
Now here's the real kicker. I really had no reason to do all that research other than intellectual curiosity. The generic I was given was Eon brand, not Barr or Cor, and people said Eon and Barr had relatively similar effects, and I had the same experience. However, today I went to my pharmacy and picked up their new generic type, some weird pink circular pill. I took it, and a couple hours later, watching myself drink an energy drink because I was feeling absolutely no burst in motivation, it dawned on me. This pink pill I'm taking must be Cor. And sure enough, I checked the engravings on the back, and it is.
So I experienced very similar problems to what the people were talking about on the forums, but it's my problems which led me to realize I'm taking Cor, not finding out I'm taking Cor made me experience symptoms I just studied. It really is how the people on the forums described it, I have symptoms as if I'm taking a good dose of Adderall -- no sleepiness, no hunger, slight jitteriness, yet I feel NO mental help. I absolutely feel no motivation, I feel no increase in ability to focus. I've never felt like this after over a year of taking Adderall. There's something seriously not right here. So what do you guys think? What the hell is up with this Cor generic? It can't really be different, can it? And if not, why the hell is everyone commenting on the same symptoms and why did I experience it too prior to learning I had Cor?
PS: I know this is a very unscientific approach I took and it has thousands of holes and problems which would obviously never pass if I were trying to publish this in an academic journal, but I just did it out of curiosity at the time given the resources I had available to me. Anyway, it's better than just coming in here claiming my own personal experience must dictate how the world experiences things.
I've been taking 20mg Adderall for over a year now. Recently, my pharmacy started changing which generic version of Adderall they stock. Last month I went from my usual oval orange ones (Barr) to circular orange ones (Eon). When I openned my bottle and discovered I had something new looking, I went online to see if there were any differences in the generics. This is where my adventure began.
I was looking through online forums and blogs and there was a lot of talk about how some generics are better than others, and how name-brand is better than the generics. And I thought to myself, that's really odd. Normally, I'd just assume placebo effect was the reason people thought name-brand was better, and different experiences day to day made people feel that the generics were somehow different. But there was a lot of these comments, more than I felt comfortable just ignoring. So I went to work on the comments.
Act II: Data collection and drug preferences
I tried to turn the qualitative data, all these blog and forum comments into quantitative data. What drug did you use, what did you switch to, what was the different in symptoms/experience between the two. I ended up with about 200 "participants". Most of them just said what drug they prefered and didn't specify a reason, but there was a good deal of reasons as well.
First interesting finding: lots of uniformity as to which Adderalls are better than others. I'm only listing 3 drug names because there was a LOT more talk about these than the others:
41 prefer Brand over Barr, 1 prefers Barr over Brand
72 prefer Barr over Cor, 5 prefer Cor over Barr
4 prefer Brand over Cor, 0 prefer Cor over Brand
Few people commented on Cor/Brand but it maintains the consistency of the transitive property: People prefer Brand over Barr, and Barr over Cor, so what little evidence there is shows people prefer Brand over Cor.
Fine I said, there's some consistency. That's odd, let's find out why. Before I push further, why am I using these 3 drugs? Brand name Adderall, Barr, and Cor? Brand name Adderall is an obvious one on the list, as generics should be matching up to their brand-name equivalents. Barr is by far the most widely produced generic. And Cor? Cor because Walgreens switched from stocking Barr to stocking Cor and hundreds of people went crazy about it because they all noticed a difference. Which really shouldn't be occuring with generics.
Act III: Brand vs Barr -- cheaper filler means more drug faster
So before I went into true quantitative stuff, I tried to see if I could make any hypothesis by eyeballing the data and reading the forums. Why is Brand better than Barr? Why is Barr better than Cor? In the former case, I found out that generic drugs use different fillers than the brand-name drug (the 99% of the pill that's NOT medicine). Well, if you use a cheap easily disolvable filler, then it will disolve very quickly in your stomach and enter your bloodstream sooner, stronger, and for not as long. If that's the case, I'd expect people to complain about a shorter duration, and otherwise complain about symptoms as if you took too high of a dose of Adderall. In the latter case, Cor vs Barr, I had no idea but something fishy was up because the complaints just looked odd.
So I put my quantitative hat on and went to work to see if there was any consistency to the specific complaints people were making about various drugs.
Here's the differences in symptoms/experience that people who prefered Brand over Barr came up with (only listing symptoms that showed up a LOT more prevalent than the other symptoms).
Strong consensus:
It's not as effective for controlling ADHD
It has a higher peak potency
More side-effects
Causes head-aches
Causes a foggy mind feeling
Weaker (but still significantly higher than most symptoms) consensus:
More jitteriness
Less duration
Issues with focusing
Experiencing hyperfocus
Sleep less
Eat less
Feel less motivated
Higher peak potency, less duration, sound like the drug is going through your system faster and more of it at once. More side-effects, less sleep and less hunger appears to back that up as well, because you've got too much Adderall in you for a while. Hyperfocus also happens when you take too much Adderall. Less motivated, issues with focusing, and not as effective are because the drug leaves your system sooner so you go through longer periods of having no Adderall in your system to help you than you're used to.
Overall, the complaints that people had lined up very well with my hypothesis that Barr generic Adderall simply uses a cheaper filler than the brand-name.
Act IV: The part where I subtly hint at scandal
Now for the fun part. Cor vs Barr. Like I said, I couldn't predict why the effect was different because the symptoms were odd. I'll show results first, then explain my hypothesis based on the data:
Strong consensus:
More jitteriness experienced
A LOT less effective for ADHD (almost everyone was talking about this)
Less duration
A LOT of problems focusing
More side-effects
More head-aches
A LOT of emotionality (rage, depression, anxiety)
Physical weakness
Weaker (but still significantly higher than most symptoms) consensus:
Sleep more
Sleep less
Eat less
Fogginess
Less motivated
First, let me clarify ways in which this is a different comparison from Brand vs Barr:
A LOT more people complained about the lack of effectiveness
Almost NO discussion about whether there's more or less potency at the peak
A LOT more focusing problems
No hyperfocus mention
Huge amount of emotionality where there was NO mention of it at all for Brand vs Barr
Sleep more and weakness also had to be added as variables because NO ONE mentioned that for Brand vs Barr
So here's my hypothesis for Cor. Something is actually not right chemically. This isn't placebo effect, there's far too much consistency in complaints. This isn't a different filler, because potency wasn't mentioned at all, nor was hyperfocus, and a variety of new and very strange complaints were mentioned.
It looks to me like there are 2 groups of people affected by this version of Adderall (Cor). Neither group is helped by the medication for ADHD, both groups very strongly complain that they can't feel ANY difference in ADHD on the drug so there's really no reason to just take a side-effect making pill.
One group's side effects appear like taking too much Adderall side-effects: sleep less, eat less, more side-effects, less duration, jitteriness. The other group's side effects almost resemble the opposite of what Adderall should be doing: physical weakness, decreased motivation, no help in focusing, sleeping more, strong emotional problems.
I don't know if there are 2 groups of effects, but it is clear there's a lot of consensus on symptoms that really no one mentioned in conjunction with any other type of Adderall other than Cor. And that's just bizarre given that I can't think of any reason there should be such a difference in effect. Interesting thing to note: there were a good number of people who mentioned somewhere in there comment how 'they thought they were going crazy' for thinking there was a difference in the drugs until they stumbled across this blog/forum, so people were feeling VERY serious differences in effect.
Act V: THERE'S A SURPRISE TWIST ENDING
Now here's the real kicker. I really had no reason to do all that research other than intellectual curiosity. The generic I was given was Eon brand, not Barr or Cor, and people said Eon and Barr had relatively similar effects, and I had the same experience. However, today I went to my pharmacy and picked up their new generic type, some weird pink circular pill. I took it, and a couple hours later, watching myself drink an energy drink because I was feeling absolutely no burst in motivation, it dawned on me. This pink pill I'm taking must be Cor. And sure enough, I checked the engravings on the back, and it is.
So I experienced very similar problems to what the people were talking about on the forums, but it's my problems which led me to realize I'm taking Cor, not finding out I'm taking Cor made me experience symptoms I just studied. It really is how the people on the forums described it, I have symptoms as if I'm taking a good dose of Adderall -- no sleepiness, no hunger, slight jitteriness, yet I feel NO mental help. I absolutely feel no motivation, I feel no increase in ability to focus. I've never felt like this after over a year of taking Adderall. There's something seriously not right here. So what do you guys think? What the hell is up with this Cor generic? It can't really be different, can it? And if not, why the hell is everyone commenting on the same symptoms and why did I experience it too prior to learning I had Cor?
PS: I know this is a very unscientific approach I took and it has thousands of holes and problems which would obviously never pass if I were trying to publish this in an academic journal, but I just did it out of curiosity at the time given the resources I had available to me. Anyway, it's better than just coming in here claiming my own personal experience must dictate how the world experiences things.
King Boo Hoo on
+1
This discussion has been closed.
Posts
I can see however, that the drugs are helping.
In all seriousness, no not all generics are identical. The criterion for a generic drug to be sold is "bioequivalence." What bioequivalence means is that the active ingredient of the drug needs to be detectable in blood plasma in studies at the same concentrations at the same time intervals after dosing as the name-brand drug within a 10% margin of error. However, it does not mean that the generic has to have exactly the same effects. (And we're already starting with a 10% margin of error anyway.)
A few things can change the way a drug works in your body. Different drugs have different additives: for instance, if you're allergic to a particular red dye, and a drug is colored pink with that red dye, then you shouldn't take it. That's an extreme example but there are other more subtle ways that a pill can work differently, like the composition of the fillers that they use or even the surface area of the pill itself. While these differences are not significant enough to change the way the drug works for the vast majority of people - therefore not showing up on a FDA-required study on bioequivalence - it is possible that individual people will react slightly differently to them.
Another difference can be isomerism. Basically, (and this is an oversimplification, I'm deliberately dumbing it down so chemistry majors don't attack me, k?) just because you put a bunch of atoms together in a certain sequence doesn't mean the molecule is going to have exactly the same shape. Sometimes a drug development process will end up with two isomers; two molecules with technically the same formula but a different shape. Amphetamine - the active ingredient in Adderall - is a good example of this, as it is "chiral" which means that you can get one of two mirror images of the molecule:
Each mirror image is called an "enantiomer."
Now, remember that drug stimulating or blocking a receptor site is like a key fitting in a lock - change the shape, and the key may or may not fit. And you have multiple, but related, receptors throughout your body. One enantiomer might fit with one type of receptor while another might not. So if one manufactuer's generic contains 60% of the L isomer while another generic contains only 50% of that isomer, and it happens to be the L isomer that causes more jitteriness but less concentration-boosting effects, then you would experience a slightly different set of effects from one generic than the other.
Yet the two generics would pass tests of bioequivalence because they're looking for blood serum levels of "amphetamine," (ie, the mixture of enantiomers), not for one specific enantiomer over the other. If the original drug patent specifies that the patented drug contains only one isomer, then the generic must contain only one isomer. However, if the patent does not specify anything about chirality or isomerism, then the generic may vary.
Make sense?
the "no true scotch man" fallacy.
'Generic' is a term, not a brand, all brands are different.
In organic chemistry, the process can alter associated chemical content, different brands have different processes. Similar, but different.
Alcohol will get you drunk. Different methods of making alcohol result in slightly different buzzes and effects. Many people find a preference for both intake and effect.
Find a drug that suits you, they're not all created equal. If your generic isn't doing it for you, switch back to your original brand.
Well... it's more scientific than many H&A posts, so I'll give you credit there. But really, you have around 200 people out of how many who are taking adderall? And it's gathered from internet forums, where you're going to have a heavy skew towards complaint.
It's certainly possible there's something there. I think it's unlikely considering the extensive FDA testing all drugs (including generics) have to go through. But it's possible. It's even possible that your symptoms with the new drug were psychologically driven. Sure, maybe you didn't know it was Cor, but you knew it wasn't the same generic you'd been taking before. And after doing all that research I assume you had some knowledge about how many/what brand of generics were available. Or of course it's possible they were real symptoms.
This may go better in D&D though, as you don't really seem to be asking for help with this, rather simply stating the results of your investigation.
If you really think there's a problem, first you should get your prescription filled at a place that uses a different generic, or take the name brand if your insurance covers it. Then you should be contacting your political representatives and/or the drug manufacturer and/or the FDA and/or local news outlets. If there truly is something wrong with it, it basically needs to either reach public awareness, or enough people need to complain to the right combination of government/corporate entities for them to look into it.
Thank you to everyone's long and thought out replies, I really appreciate it. I brought it here because I'm just thoroughly confused on the topic so I need information rather than an opportunity to debate on it.
The alcohol analogy was very good, can anyone back it up that it is a good analogy scientifically? Because it is true, wine drunk is very different from beer drunk. If that can happen with things like pharmaceutical drugs, that's interesting.
I also thought the isomer reply was very good. Is there any way to test for various isomers or whatnot in a fairly inexpensive way? Get it sent somewhere or something? I'm at a huge research university, anything exist here which could help me out?
I know there's bias because people chose to post there, because it's only 200 people, because it's the Internet, but there was just such a radically and consistently different set of complaints about Cor compared to Barr that I just couldn't chalk it up to coincidence or psychological effects. I'll do some more research and hopefully will find a way to test the drugs, but I may eventually take this to some politician if I'm convinced enough that something odd is at play.
CUZ THERE'S SOMETHING IN THE MIDDLE AND IT'S GIVING ME A RASH
Not really, unless there's been a major technological breakthrough in the last few years that I don't know about.
Enantiomers have very similar chemical properties so the usual methods for testing for impurities - gas chromatograph, melting point, solubility, mass spectrometry, etc - fail. All they see is a big test tube of the same molecule, not a mixture of two virtually-identical mirror images. They certainly can't detect different enantiomers well enough to tell the difference between, say, a 70/30% mixture and a 60/40% mixture. The available methods for testing enantiomer concentrations are generally speaking somewhat expensive.
If you're thinking about getting your Adderall tested... well, I have to say that's kind of silly. That's a little bit like sending your Starbucks coffee to a lab to figure out if it has higher caffeine content than Pete's. If you like Pete's better, then just drink Pete's! In other words, try a different brand if you're unhappy with the first one or go back to name brand drugs only.
If your faith in the FDA is shaken now that you've learned that generics don't have to be exactly the same, then write your Congressman.
the "no true scotch man" fallacy.
Well, if this is how it works with every drug, then I'll just stick with the one I prefer like you recommended. But if this is a problem that doesn't really happen with other drugs and only appears to be happening in this case or in very few cases, maybe it's worth getting some attention onto it.
What I mean is that if you're taking an asthma inhaler, and you get the generic version, your key concern isn't that the chemical composition is identical, it's that the drug works. I was under the impression that given how life & death important certain medications can be, that for the vast majority of drugs the generic versions functioned nearly identically. However, in this drug's case, the primary purpose that it seeks out to accomplish -- improve ADHD symptoms, it fails to do so, according to a lot of posters. So the chemical composition may be identical but the effect isn't, and that seems like it should be as big of a deal, if not bigger.
So is this a pharmacy-wide occurrence that I just never learned about or do generics for other drugs continue to function the same way but just have slight variations in symptoms if any variation at all?
Well, nobody's going to die because they were given a generic rather than a name-brand. The differences between a generic and a name-brand are pretty minor, even taking all this stuff into account, and most people will never notice the difference. However, it is an important issue IMO.
Well, I need to reiterate that I just mentioned a couple of reasons why bioequivalent generics might not be exactly the same. There are other reasons too, and they're a little technical... but what it boils down to is that, no, this is not a problem with all drugs but it is with a lot of drugs.
There's been a lot of scholarly attention given to the problems with current bioequivalence testing. Just Google "issues in bioequivalence" and you can see what I mean. The FDA and other regulatory agencies worldwide have been slow to take these issues into account. Governments are slow to adapt to science; that shouldn't be a surprise. Like I said, if you're really worried about it as a political or commercial issue, then write your Congressman.
the "no true scotch man" fallacy.
Educate me!
also, let's say hypothetically that I think I've got focus/concentration and motivation issues, is this something I should bring up at my next visit with the family doctor or should I be looking up a therapist or something else?
A lot of DSM disorders can be viewed as on a spectrum. Imagine a spectrum, where 0 is 'hate your life so much you kill yourself' and 10 is 'manic to the point of that being an illness', and 5 is normal human happiness. Then, perhaps a '2' is enough grounds to be considered depression.
See the point I'm struggling towards? It's all a matter of degree, severity. It's stated several times all over the DSM -- it becomes a disorder when it starts to cause you to not function well in several contexts -- ie: relationship, academics, home, work, etc. If your focus problems are bad enough that they affect academics and how you percieve social situations and solutions to them you can come up with and such, maybe you should mention it to your family doctor.
Its not as an exact science as many people beleive; theres a lot of guesstimation involved, which is why lots of people try out differerent brands before they find one that works. There is no small amount of discussion regarding the qualification process: for example, what if buddy only shows 8 of the sixteen required characteristics for diagnoses, but those 8 things are fucking up his life but good?
In the end, if you need meds, its a good bet to have an ongoing relationship with your psych dude, because it may to some time to sort out what your needs are and what the best fit is.
CUZ THERE'S SOMETHING IN THE MIDDLE AND IT'S GIVING ME A RASH