March 24, 2023

I want to provide two video responses to question I received. The first one was regarding generic Wellbutrin not working as effectively as brand name. To that person who commented on this topic this video is for you and thank you for braining it to my attention.

What’s up everybody dr rossi shrinks and so i want to do a video response for a couple of questions that i received and the first question i want to answer here is what is the problem with the generic bupropion or generic wellbutrin so this one is related to a question i received or comment i received from one of our one of our viewers who basically

Said you know to be mindful of the generic wellbutrin because it’s been known to cause more side effects it’s been known to have contaminants so i did some investigating and i came up with some answers to this and i responded in the comments also but i wanted to kind of put this out there for everybody to kind of know a little bit more about what i found because

It’s been a major issue recently so if you’ve been following the news at all and and even if you’re not following say medical news you might have seen this come up at some point and that is there’s been an issue with fda recalls over the last several years there’s been more fda recalls than ever before on medications and specifically most of those medications

Are the generic medications or generic forms of these medications so what is going on there the first thing is there was a contamination so there’s a significant contamination of several drugs three of which i can name off the top of my head retinidine losartan and then of course metformin which is actually commonly used in psychiatry for antipsychotic induced

Weight gain so this is a medication we actually do work with and we do use and they were all contaminated with the same contaminant it’s called ndma so ndma it’s a carcinogen a cancer causing drug and it’s a byproduct of the manufacturing process that was found in several medications and and where so where does this come from and why it doesn’t matter well most

Of the generic medications in order to cut costs and make more of a profit the companies that manufacture these drugs have basically outsourced the manufacturing to places like china and india and not that there’s anything wrong with necessarily having the products made in china or india it just happens to be that a lot of these facilities are not keeping up

The necessary standards and the fda does do individual inspections at these sites but they often give these plants you know months to prepare for the site visit so of course they prepare really well during the site visit but if you were to improperly drop in there and see you know what was really going on people have found things like snakes and monkeys and

All kinds of stuff running around the lab you know rusty equipment contaminated equipment just really poor standards of control which is leading to some of the problems so that’s where we think the contamination aspect came into play now the wellbutrin story is actually quite different and the reason i want to say this is because it wasn’t a contaminant it

Wasn’t a cancer-causing agent or anything like that what happened with wellbutrin was we have what we have three versions of it there’s an immediate release there’s a sustained release and then there’s an xl version or extended release version now this was specific to the xl version and specifically the 300 milligram tablets from one manufacturer and the way

The story goes is actually really interesting there’s a pharmacist who has a radio talk show called the people’s pharmacy and on this talk show he was getting a lot of phone calls uh with people complaining of issues with you know nausea just side effects not feeling like the medication was working effectively and that medication that most of those people were

Calling in about was wellbutrin and specifically the extended release version that we’re talking about here so after some talk he reported this information to the fda the fda said oh no it’s psychosomatic the patients are just making it up you know essentially they don’t know what they’re talking about so he was kind of dismissed by the fda and he went and had

The medication tested independently at an independent lab so at the independent lab what they found was the extended release mechanism that was supposed to be working on these medications did not work at all so what we what we get in that sen in that case is what we call medication dumping so medication dumping is this concept where if i’m taking an extended

Release formulation of a medication it should theoretically slowly be released in my bloodstream over time so that i don’t get an immediate spike in my peak peak at blood levels which can cause more side effects which can also be a problem for people who are abusing drugs we’re going to talk about that in a second so this idea of medication dumping was going on

And essentially that’s what was found the fda reinvestigated this and did indeed find that the 300 milligram version of these excel tablets by this manufacturer did not meet the standards necessary for necessary to be on the market so these were removed from the market after this incident it’s a very very interesting story and i i’m glad this was brought to my

Attention it was good for me to learn more about it as well now i just want to comment a little bit more on this deuce dumping idea so there’s a couple of medications that you can get dose dumping with one that comes to mind for me is quetiapine xr or seroquel xr which is an extended release version of the dopamine of the dopamine blocking medication quetiapine

Now if you take that medication with a large meal specifically one that’s high in fat it tends to dump all of the medication so we recommend our patients don’t take that medication with large meals or fatty meals because you can get medication dumping now i promised i would comment to you real quick on how this works with with addiction or potentially addictive

Medications so if you’re talking about opioid pain medications let’s say the oral formulations of them a lot of people will take those medications with alcohol and alcohol is also a known cause of medication dumping in extended release formulations so you can see this also with patients that take the quetiapine or they take the opioid medication with alcohol

Now when you take the quetiapine with it with alcohol you just get this the peak blood level maybe you have some side effects like the people were experiencing with the wellbutrin but you’re not having you’re not having the euphoria and the addictive potential that comes along with the opioids so when you drink alcohol and take opioids you can get again this

Medication dumping and that can lead to increased euphoria and of course when we get peak blood levels this is one of the ways addiction happens is that if we if we rapidly raise our level or concentrations of the drug in the blood that in and of itself is what leads to a lot of the addictive potential and that leads to the reinforcing behaviors so you want to

Watch out and be mindful of those things so hopefully that clarifies the story of the wellbutrin recall and exactly what the difference is here when we’re talking about these generic xl formulations versus the brand name formulations so please like and comment below i’m happy to answer any additional questions and like and subscribe to the channel we’ll keep

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Transcribed from video
What’s the problem with Generic Bupropion/Wellbutrin? By Shrinks In Sneakers