Sometimes I Like to Pretend That I Don't Have a Chronic Illness

[saavedra77]

OK, sorry, this is kinda gross:

I'd planned to write something meaningful about how pleased I am that the Obama Administration is hitting the ground running. Unfortunately, I've been preoccupied by matters more personal and less pleasant:

My neurologist switched me over to a generic anti-epileptic a few weeks ago, one which supposedly contains the same active molecule as the drug that had been keeping me seizure-free.

Well, I'm coming to the conclusion that some of those allegedly inactive molecules were an important part of the compound, after all, because this generic stuff isn't working. I suffered a seizure one night last week, and another during the early morning hours today. Last week's episode left me exhausted and sore all over; this morning ... this would be the gross part ... I appear to have hit my head and bit my tongue, somewhat.

Once I was coherent, I phoned the on-call physician, who remarked ruefully about the unreliability of generic anti-epileptics, recommended a temporary dose increase and lots of sleep, and strongly advised that I speak to my regular doctor about going back to the name-brand on Monday.

So that would be the plan, at this point.

Edit, 01/25/09: I'm feeling a whole lot better after eight hours' sleep.

Comments

[feyandstrange.livejournal.com]

That's an "oh hell yeah" to your post title, and an "Oh jeez, sorry" to the meds issue.

I understand that generic meds may vary in the active ingredient amounts and things like that by up to 30% - which is way too much for delicate brain chemicals. But try telling that to insurance... (Although a doctor's note sometimes works on that one, actually, and is worth a try.)

Best wishes for your seizure-related injuries, and for the doctor getting you sorted out soon.

[saavedra77.livejournal.com]

Thanks, fey. I may use that "up to 30%" element in my argument to the neurologist, tomorrow.

[feyandstrange.livejournal.com]

I can't find the 30% statistic any more, but here are a few papers specifically mentioning bioavailability and problems with generics in epilepsy:

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WDT-4CRY54X-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=b0fb7b97d8c47903972b9b9fe0465c33

http://www3.interscience.wiley.com/journal/117957759/abstract?CRETRY=1&SRETRY=0

http://www3.interscience.wiley.com/journal/117957557/abstract

If looks like this is a fairly common issue with epilepsy drugs, and hopefully your doctor won't see a problem with switching you back to the non-generic, even without hefty scientific arguments. According to that Science Direct link (the first one), over 80% of neurologists in their survey agreed that the FDA requirements for generics and bioavailabity were too narrow, and about 50% have seen this exact problem.

The FDA does mandate the same amount of active ingredient in generics, but the inactive ingredients and "bioavailability" don't have to be the same, and this often results in issues where the drug wears off too fast or an insufficient amount of the active ingredient actually makes it to the brain, for instance. The drug for your brain does no good if it sits in your stomach or gets rinsed away rather than going to where you want it.

Best of luck getting it sorted out.