6 ms·

Havent seen any mention of this yet but the reason for this is well known in the recreational drug community : amphetamine is a chiral molecule. The D isomer is

Havent seen any mention of this yet but the reason for this is well known in the recreational drug community : amphetamine is a chiral molecule. The D isomer is more psychologically active. The L isomer creates more physical side effects. There is no regulation for the % of each isomer in the product. This means that one brand may be 70% L, 30% D, and a different brand could be the opposite. I take this drug daily. The current supply crunch has meant I've had to take inferior versions of the product for nearly a year now. It fucking sucks. I need it to work but the side effects often mean little sleep, strange repetitive behaviour, absurd hypersexuality, etc. Its a travesty, not in the best interest of the consumer. If you are on this medication you are treated like dog shit from the doctor to the insurance company to the pharmacy to the pill itself. All in the name of either preventi g addicts from getting it (who cares?) Or making more money for some massive company.

robotastronaut 4y ago
Man, this helps me understand so much of what I’m experiencing. I had to switch to cheap stuff about two months ago and I’ve been all over the place. Absolutely terrible sleep, too.
refurb 4y ago
There is no regulation for the % of each isomer in the product. Do you have a source? The FDA label says it's 50% d,l-amphetamine (50/50) plus 50% d-amphetmaine, so you end up with a 3:1 ratio of dextroamphetamine to levoamphetamine. Why would a manufacturer do more work to change the 50/50 mix? And why would it vary from batch to batch? The FDA has requirements on manufacturing that each lot is made to the same specifications. The more reasonable explanation is that the binding agents changed, which may change the rate at which the drug dissolves and is absorbed. This actually happened a while back with generic bupropion. Generic manufacturers made a 300 mg version, which had 300 mg of drug in it. However, the medicine was absorbed much more quickly leading to a rash of side effect complaints from patients. The FDA eventually recalled the drug. If you want to read how generics are tested and approved, Derek Lowe did a nice blog post on it: https://www.science.org/content/blog-post/generic-wellbutrin-problem-whose-fault-it https://www.science.org/content/blog-post/generic-wellbutrin... "In that study, the results of which became available in August 2012, Budeprion XL 300 mg failed to demonstrate bioequivalence to Wellbutrin XL 300 mg."
- DontchaKnowit 4y ago
  Frankly, ive done all kinds of amphetamines, ingested them by every means except iv. It is not a matter of the rate of absorption. The experience is qualitatively different. Perhaps I am wrong about the stereoisomer mixture - but amphetamine salts are NOT racemic in the first place - so some amount of seperation is happening- I am quite certain that the different brands do not contain the same proportions.
  - PragmaticPulp 4y ago
    > Frankly, ive done all kinds of amphetamines, ingested them by every means except iv. I hate to say it, but recreational amphetamine use and abuse via different ROAs is very likely the explanation for why amphetamine feels different for you now. Abusing stimulants, especially through different routes of ingestion, will cause various forms of tolerance (as I'm sure you're well aware).
    - DontchaKnowit 4y ago
      Amphetamines dont "feel different to me now" - different preperations of the same drug feel markedly different. Name brand adderall and sandoz generic feel the same as they always have. Actavis feels like I am geeked the fuck out. Honestly feels quite similar to the effect of eating the cotton out of benzedrex inhalers (please, no judgement, I was very interested in drug experimentation as a youth) I did look into the stereoisomers of generics per your comment - you are correct, the fda does regulate the specific enantiomers present in a mediciation. So I am at a loss. I am certain Actavis specifically is chemically different. Perhaps there is an inactive ingredient that is modulating the effects? Or perhaps Actavis is just lying to the FDA. I would love to find some 3rd party which does evaluations of chemical makeup for generics. Was unable to find such a thing, if you know of something like that, id be very interested.
      - LorenPechtel 4y ago
        I do believe not enough attention is paid to the "inactive" ingredients. We have had too many reports of things like finding vitamin tablets in the septic tank--they contained the right stuff but didn't dissolve like they were supposed to.
daniel-cussen 4y ago
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Zetice 4y ago
> preventi g addicts from getting it (who cares?) I presume the families and loved ones of the addicts probably care...
- capableweb 4y ago
  If a drug is available and there is addicts of said drug, the addicts don't suddenly stop being addicts just because the drug is not available, they'll just move on to a different drug. The problem is that addicts are not being treated, not that a specific drug is available or not.
  - emodendroket 4y ago
    They can't become addicts if they don't start abusing the drug in the first place.
    - aarpmcgee 4y ago
      We all have addictions. For some it is substances, other relationships, power, sex, gambling, food, etc. What if yours suddenly became really difficult to manage within the societal-framework-du-jour? Just don't start doing it?
      - emodendroket 4y ago
        I think it's trivializing the concept to say "we all have addictions," since by definition an addiction is meant to be a significant impediment to living a normal life. And I'm not sure how you're answering the concern here. Like yeah, a lot of people get addicted to gambling -- that's a compelling argument against legalizing gambling.
        aarpmcgee 4y ago
        My point was more an attempt to point at an empathetic response as a possibility. "don't start abusing the drug in the first place", to me, felt like a way to dismiss the reality that it can be really easy to fall into addiction, because most of us are broken in our own peculiar ways and have our own vulnerabilities. What if someone else's response to one's own brokenness was "just don't do that"? It doesn't really help much, because the reasons for it are valid, and the need itself needs to be seen. My own comment was a knee-jerk reactive comment in reply to what I felt in your post, which may or may not have been a real thing. Idk. My hunch is that we are all addicted to something, and if you don't see what it is yet, then either you or society (or both) must not have much of a problem with that particular addiction, and that can always change.
astockwell 4y ago
By inferior, do you mean you’ve switched to a different “brand”? Or to a generic from a “label”, or..?
- DontchaKnowit 4y ago
  I was previously consistantly using a generic that I tolerated well. In the last year I have had several months (maybe 6) where I was only able to obtain generics produced by actavis or amneal. These 2 absolutely suck compared to sandoz, teva (which I think may be exactly the same) or shire. The side effects are overwhelming
PragmaticPulp 4y ago
> There is no regulation for the % of each isomer in the product. This means that one brand may be 70% L, 30% D, and a different brand could be the opposite. This is true for the unregulated illicit drug market, but it's most certainly not true for regulated drugs like Adderall. The ratios of the different isomers in Adderall are well-defined and are part of the drug definition. There are also stimulant variants that are 100% d-amphetamine, which would obviously be in violation of their drug definition if manufacturers starting shipping racemic versions. > Havent seen any mention of this yet but the reason for this is well known in the recreational drug community : amphetamine is a chiral molecule. The D isomer is more psychologically active. The L isomer creates more physical side effects. This is over-simplifying the matter. The L-isomer has different effects and duration, but it's incorrect to suggest that it's all "side effects". Some patients do better on racemic mixtures with L-amphetamine. Some patients do better on pure D-amphetamine. It's not correct to suggest that one is pure side effects.
- scythe 4y ago
  >This is true for the unregulated illicit drug market, but it's most certainly not true for regulated drugs like Adderall. It's not even consistently true for the illicit drug market. You can just Google "amphetamine isomer separation tartrate" to get a bunch of information about it. The l-isomer of amphetamine is very weak, and sellers want return business.
- DontchaKnowit 4y ago
  You are correct. After looking it up it seems I was misinformed about the enantiomers in generics thing. As far as the effevts of l amph- eh. Yes. There is some amount of evidence the the L isomer produces symptom relief similar to d amph. Frankly ive never had the two seperated so I wouldnt know from experience, but I have read repeatedly over the years that L amph is associated with more norepinephrine effects than D, and norepinephrine agonists produce ohysical side effects such as vasoconstriction.
- fdathrow2321 4y ago
  Yeah, naw. You can state the hypothetical way things are supposed to work in the best case -- and you can state so confidentially -- but that doesn't mean that reflects the real world at all. Look through the FDA warning letters database for manufacturers of adderall (f.e. the "Auro" family of producers). You'll notice a lot of warnings have already been issued for quality control and adulteration issues (and continue to be issued yearly, ad infinitum). Yeah, the 3rd world factory where these drugs are manufactured, for sure tested their product themselves and found it to be bio-equivalent and within the acceptable FDA variance of "how much of the active drug is actually in each pill, vs. what's stated on the specs." And yeah, the FDA for sure trusts these factories which are thousands of miles away are always up-to-snuff -- even when they don't have an inspector around. Your statements about the illicit market aren't true either (pro-tip: the legal and illegal market for the usual, non-exotic synthetic drugs comes from the same source; with minor exceptions in local markets). And a final pro-tip: if you think the only reason brand drugs are expensive is branding/marketing/some other bullshit -- some of the cost is in proper quality control (they're incentivized to maintain high standards, so people keep coming back to ask for the brand-name -- instead of some nameless generic any fly-by-night shop can manufacture).
sva_ 4y ago
I get where you're coming from, but the stereoisomers in the formulation for Adderall are clearly defined, see https://en.m.wikipedia.org/wiki/Adderall https://en.m.wikipedia.org/wiki/Adderall > Combination of > amphetamine aspartate monohydrate 25% – stimulant (12.5% levo; 12.5% dextro) > amphetamine sulfate 25% – stimulant (12.5% levo; 12.5% dextro) > dextroamphetamine saccharate 25% – stimulant (0% levo; 25% dextro) > dextroamphetamine sulfate 25% – stimulant (0% levo; 25% dextro) I don't see why there should be no regulation? They are distinct chemicals, in that sense...
- DontchaKnowit 4y ago
  Yeah you are right. I wonder how closely this is adhered to in practice. Stranger things have happened in the pharma world. But yes I was definitely mistaken. Thank you for the correction
HybridCurve 4y ago
My understanding is much of the difference between name brand and generics is the excipients used, as they effect drug delivery. Not all generics will use the same and the name brands generally have patents on the ones they use. For psychoactive compounds this can make a considerable difference in how the drug functions for an individual. YSK that lisdexaphetamine has come off patent this year, and is purely a dextroamphetamine prodrug. It might provide more consistent results compared to adderall even in a generic formulation.
- DontchaKnowit 4y ago
  Thank you so much. I had no Idea. I used to take vyvanse but my insurance no longer covers it. It was far superior to adderall so Ill see if my doc can get me back on it. Thanks!
Forestessential 4y ago
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robotastronaut 4y ago

Man, this helps me understand so much of what I’m experiencing. I had to switch to cheap stuff about two months ago and I’ve been all over the place. Absolutely terrible sleep, too.

refurb 4y ago

There is no regulation for the % of each isomer in the product. Do you have a source? The FDA label says it's 50% d,l-amphetamine (50/50) plus 50% d-amphetmaine, so you end up with a 3:1 ratio of dextroamphetamine to levoamphetamine. Why would a manufacturer do more work to change the 50/50 mix? And why would it vary from batch to batch? The FDA has requirements on manufacturing that each lot is made to the same specifications. The more reasonable explanation is that the binding agents changed, which may change the rate at which the drug dissolves and is absorbed. This actually happened a while back with generic bupropion. Generic manufacturers made a 300 mg version, which had 300 mg of drug in it. However, the medicine was absorbed much more quickly leading to a rash of side effect complaints from patients. The FDA eventually recalled the drug. If you want to read how generics are tested and approved, Derek Lowe did a nice blog post on it: https://www.science.org/content/blog-post/generic-wellbutrin-problem-whose-fault-it https://www.science.org/content/blog-post/generic-wellbutrin... "In that study, the results of which became available in August 2012, Budeprion XL 300 mg failed to demonstrate bioequivalence to Wellbutrin XL 300 mg."

DontchaKnowit 4y ago
Frankly, ive done all kinds of amphetamines, ingested them by every means except iv. It is not a matter of the rate of absorption. The experience is qualitatively different. Perhaps I am wrong about the stereoisomer mixture - but amphetamine salts are NOT racemic in the first place - so some amount of seperation is happening- I am quite certain that the different brands do not contain the same proportions.
- PragmaticPulp 4y ago
  > Frankly, ive done all kinds of amphetamines, ingested them by every means except iv. I hate to say it, but recreational amphetamine use and abuse via different ROAs is very likely the explanation for why amphetamine feels different for you now. Abusing stimulants, especially through different routes of ingestion, will cause various forms of tolerance (as I'm sure you're well aware).
  - DontchaKnowit 4y ago
    Amphetamines dont "feel different to me now" - different preperations of the same drug feel markedly different. Name brand adderall and sandoz generic feel the same as they always have. Actavis feels like I am geeked the fuck out. Honestly feels quite similar to the effect of eating the cotton out of benzedrex inhalers (please, no judgement, I was very interested in drug experimentation as a youth) I did look into the stereoisomers of generics per your comment - you are correct, the fda does regulate the specific enantiomers present in a mediciation. So I am at a loss. I am certain Actavis specifically is chemically different. Perhaps there is an inactive ingredient that is modulating the effects? Or perhaps Actavis is just lying to the FDA. I would love to find some 3rd party which does evaluations of chemical makeup for generics. Was unable to find such a thing, if you know of something like that, id be very interested.
    - LorenPechtel 4y ago
      I do believe not enough attention is paid to the "inactive" ingredients. We have had too many reports of things like finding vitamin tablets in the septic tank--they contained the right stuff but didn't dissolve like they were supposed to.

daniel-cussen 4y ago

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Zetice 4y ago

> preventi g addicts from getting it (who cares?) I presume the families and loved ones of the addicts probably care...

capableweb 4y ago
If a drug is available and there is addicts of said drug, the addicts don't suddenly stop being addicts just because the drug is not available, they'll just move on to a different drug. The problem is that addicts are not being treated, not that a specific drug is available or not.
- emodendroket 4y ago
  They can't become addicts if they don't start abusing the drug in the first place.
  - aarpmcgee 4y ago
    We all have addictions. For some it is substances, other relationships, power, sex, gambling, food, etc. What if yours suddenly became really difficult to manage within the societal-framework-du-jour? Just don't start doing it?
    - emodendroket 4y ago
      I think it's trivializing the concept to say "we all have addictions," since by definition an addiction is meant to be a significant impediment to living a normal life. And I'm not sure how you're answering the concern here. Like yeah, a lot of people get addicted to gambling -- that's a compelling argument against legalizing gambling.
      - aarpmcgee 4y ago
        My point was more an attempt to point at an empathetic response as a possibility. "don't start abusing the drug in the first place", to me, felt like a way to dismiss the reality that it can be really easy to fall into addiction, because most of us are broken in our own peculiar ways and have our own vulnerabilities. What if someone else's response to one's own brokenness was "just don't do that"? It doesn't really help much, because the reasons for it are valid, and the need itself needs to be seen. My own comment was a knee-jerk reactive comment in reply to what I felt in your post, which may or may not have been a real thing. Idk. My hunch is that we are all addicted to something, and if you don't see what it is yet, then either you or society (or both) must not have much of a problem with that particular addiction, and that can always change.

astockwell 4y ago

By inferior, do you mean you’ve switched to a different “brand”? Or to a generic from a “label”, or..?

DontchaKnowit 4y ago
I was previously consistantly using a generic that I tolerated well. In the last year I have had several months (maybe 6) where I was only able to obtain generics produced by actavis or amneal. These 2 absolutely suck compared to sandoz, teva (which I think may be exactly the same) or shire. The side effects are overwhelming

PragmaticPulp 4y ago

> There is no regulation for the % of each isomer in the product. This means that one brand may be 70% L, 30% D, and a different brand could be the opposite. This is true for the unregulated illicit drug market, but it's most certainly not true for regulated drugs like Adderall. The ratios of the different isomers in Adderall are well-defined and are part of the drug definition. There are also stimulant variants that are 100% d-amphetamine, which would obviously be in violation of their drug definition if manufacturers starting shipping racemic versions. > Havent seen any mention of this yet but the reason for this is well known in the recreational drug community : amphetamine is a chiral molecule. The D isomer is more psychologically active. The L isomer creates more physical side effects. This is over-simplifying the matter. The L-isomer has different effects and duration, but it's incorrect to suggest that it's all "side effects". Some patients do better on racemic mixtures with L-amphetamine. Some patients do better on pure D-amphetamine. It's not correct to suggest that one is pure side effects.

scythe 4y ago
>This is true for the unregulated illicit drug market, but it's most certainly not true for regulated drugs like Adderall. It's not even consistently true for the illicit drug market. You can just Google "amphetamine isomer separation tartrate" to get a bunch of information about it. The l-isomer of amphetamine is very weak, and sellers want return business.
DontchaKnowit 4y ago
You are correct. After looking it up it seems I was misinformed about the enantiomers in generics thing. As far as the effevts of l amph- eh. Yes. There is some amount of evidence the the L isomer produces symptom relief similar to d amph. Frankly ive never had the two seperated so I wouldnt know from experience, but I have read repeatedly over the years that L amph is associated with more norepinephrine effects than D, and norepinephrine agonists produce ohysical side effects such as vasoconstriction.
fdathrow2321 4y ago
Yeah, naw. You can state the hypothetical way things are supposed to work in the best case -- and you can state so confidentially -- but that doesn't mean that reflects the real world at all. Look through the FDA warning letters database for manufacturers of adderall (f.e. the "Auro" family of producers). You'll notice a lot of warnings have already been issued for quality control and adulteration issues (and continue to be issued yearly, ad infinitum). Yeah, the 3rd world factory where these drugs are manufactured, for sure tested their product themselves and found it to be bio-equivalent and within the acceptable FDA variance of "how much of the active drug is actually in each pill, vs. what's stated on the specs." And yeah, the FDA for sure trusts these factories which are thousands of miles away are always up-to-snuff -- even when they don't have an inspector around. Your statements about the illicit market aren't true either (pro-tip: the legal and illegal market for the usual, non-exotic synthetic drugs comes from the same source; with minor exceptions in local markets). And a final pro-tip: if you think the only reason brand drugs are expensive is branding/marketing/some other bullshit -- some of the cost is in proper quality control (they're incentivized to maintain high standards, so people keep coming back to ask for the brand-name -- instead of some nameless generic any fly-by-night shop can manufacture).

sva_ 4y ago

I get where you're coming from, but the stereoisomers in the formulation for Adderall are clearly defined, see https://en.m.wikipedia.org/wiki/Adderall https://en.m.wikipedia.org/wiki/Adderall > Combination of > amphetamine aspartate monohydrate 25% – stimulant (12.5% levo; 12.5% dextro) > amphetamine sulfate 25% – stimulant (12.5% levo; 12.5% dextro) > dextroamphetamine saccharate 25% – stimulant (0% levo; 25% dextro) > dextroamphetamine sulfate 25% – stimulant (0% levo; 25% dextro) I don't see why there should be no regulation? They are distinct chemicals, in that sense...

DontchaKnowit 4y ago
Yeah you are right. I wonder how closely this is adhered to in practice. Stranger things have happened in the pharma world. But yes I was definitely mistaken. Thank you for the correction

HybridCurve 4y ago

My understanding is much of the difference between name brand and generics is the excipients used, as they effect drug delivery. Not all generics will use the same and the name brands generally have patents on the ones they use. For psychoactive compounds this can make a considerable difference in how the drug functions for an individual. YSK that lisdexaphetamine has come off patent this year, and is purely a dextroamphetamine prodrug. It might provide more consistent results compared to adderall even in a generic formulation.

DontchaKnowit 4y ago
Thank you so much. I had no Idea. I used to take vyvanse but my insurance no longer covers it. It was far superior to adderall so Ill see if my doc can get me back on it. Thanks!

Forestessential 4y ago

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