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      OT APPROVED, 365MC637, FAROOQ, EVRi, 12.07.23 (BRENT) - J v4.pdf
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Question for GP's and Pharmacists!


aDvicePls
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I have been taking medication to help me sleep ( for approximately 2 years). (It is an anti-depressant that causes drowsiness - so works quite well as a sleep aid).

Well - It has always worked very well in the past.

 

This last month however, after picking up my meds from the Chemist, I have lain awake night after night after night.

After about 2 weeks of sleepless nights, it did cross my mind that maybe I had picked up a 'bad batch'..... my reasoning being that you can get faults in other goods - so why not medicine as well?

 

Then I thought -maybe that's ridiculous - maybe I have just become immune to them and need to now change my meds to something else or change the dose or something.......

 

But, then I found an old strip that still had 2 tablets left in it (from a couple of months previously) - and I took them for the next two nights (as an experiment) - and I Slept like a Baby!

 

So, now I know that there IS a fault with the new batch (even though I have examined the boxes and inside info and they both appear to be the same - same make and everything).

 

My question to any Pharmacists/GP's (or anybody with any views) reading this is:

 

In your experience - does this sort of thing happen often?

What do you think causes it?

Is it the drug companies trying to cut corners?

Or pharmacies trying to keep costs down,

Or is it:

a simple manufacturing problem (once in a while the odd batch might 'slip through the net' and be missing the active ingredients)

or

Use of sub-standard ingredients.

 

Is it possible to ask the Pharmacist if he/she could give me another 'brand'? (or would the GP have to prescribe me another brand - How does that work?)

 

I don't really want to go back to my GP (because he and I had words the last time I went to see him) (Co-incidence that I start having problems with my medication after that?:| - that's crossed my mind). Lack of sleep is making me think allsorts!!

 

Can Doctors prescribe placebos/sub-standard meds without you knowing?

 

Any advice appreciated.

Thanks!

Edited by aDvicePls
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Something I meant to add:-

 

Who decides which brand of medicine you receive.

 

Is it the GP or Pharmacist?

 

For example - When I hand in my prescription at the Chemist, can I say to the Pharmacist ''Please can you give me a different brand to X... because X brand didn't work last time and I would like to try Y''

 

Also - Who decides whether it should be generic or otherwise?

 

(I'm sure there are other consumers that would be interested to know the answers to these questions!)

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Something I meant to add:-

 

 

 

Who decides which brand of medicine you receive.

 

 

 

Is it the GP or Pharmacist?

 

 

 

For example - When I hand in my prescription at the Chemist, can I say to the Pharmacist ''Please can you give me a different brand to X... because X brand didn't work last time and I would like to try Y''

 

 

 

Also - Who decides whether it should be generic or otherwise?

 

 

 

(I'm sure there are other consumers that would be interested to know the answers to these questions!)

 

 

 

 

 

I think there is a big difference in generic medication one example 28 lanzaprezole as generic cost £1.28 for a chemist to buy, zoton fastab which is also lanzaprezole cost the chemist £5.35 to buy and I know that zoton work a lot better than the generic.

 

the nhs can not cope with the amount of money spent on the branded drugs. I have to say I only started to receive all these generic drugs when my own doctors was flooded with new foreign patients.

 

I take 22 tablets every day so I know the difference between branded and generic. the next time anyone is in a chemist getting there prescription have a look and see which country the generics are coming from you will get a nice surprise.

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Have you spoke to your pharmacist concerning this batch of medications there is a reporting system for this type of incident. There have been incidents within the health service of counterfeit medications so please report it.

 

Normally if you are prescribed a medication then you will be given the cheapest brand that the NHS can buy.

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Good idea! I think I will have a chat with the Pharmacist. They are a small place and very friendly and chatty - so think they would be receptive to 'constructive' criticism. (well its not really criticism)

 

(I will get my next batch from Boots first though - don't want 2 lots of dud tablets lol)

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Don't use Boots - they have twice given me generic medication which did not work and once gave me the wrong medication - luckily I checked it before I left the shop.

 

Smaller pharmacies are much better and more approachable when you have health problems. I am using a small local one now as they have a specialist person who comes in once a month and you can arrange an appointment with them for free advice and help. This person can put you in direct touch with organisations without having to be referred via a GP.

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I could chance getting them from the same place, (it would give me an opportunity to discuss things with the pharmacist) but don't think I can stand another whole month of sleepless nights if I getting another iffy lot of tablets!

 

I think problems are arising because everywhere is trying to do things for as cheaply as possible, so quality has gone down. Similar to what's happened with the clothing industry.. they find the cheapest place possible (usually overseas) to do the manufacturing - and the customer ends up paying the price.

 

Its happening in all areas.

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Possible causes include:

 

1) Duff batch of meds : trying a different box from same batch from different retail source might be useful.

2) Fake meds : the pharmacist should advise MHRA and return the product to the manufacturer

3) Expired meds : do they state a date of manufacture?. They should have a "use by" date

4) Poorly stored meds : somewhere from manufacturer to distributer to wholesaler to retail chemist to end-user.

 

Were these identical 'brands' or use of generics?

 

Generics SHOULD be identical except for cases where it is known different supplies have different "Bio-availability",

(Well recognised for e.g. Lithium preparations)

Edited by BazzaS
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I am not a Pharmacist, but I have been interested in orthomolecular medicine (a legitimate science, despite claims of the opposite). If you don't suffer from depression, there's no need to take an antidepressant.

 

Please ask you GP to prescribe you melatonin. There are tons of medical evidence that it improves sleep dramatically and it is also a proven method of life extension. You go to pubmed,org and search "melatonin sleep" and you will find tons of evidence.

 

If your GP refuses a prescription you can legally buy from the USA (I have correspondence from the HMRC confirming it's legal to order it from abroad despite it being sold only on prescription in the UK). Feel free to PM me.

"Ask not what your country can do for you, ask what you can do for Poundland"

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I agree about Melatonin and sleep, don't know about the rest. It's widely available in the States over the counter, I don't really understand why the UK has a problem with it. I think I bought the last lot from an interweb site based in Guernsey.

 

My best, HB

Illegitimi non carborundum

 

 

 

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I agree about Melatonin and sleep, don't know about the rest. It's widely available in the States over the counter, I don't really understand why the UK has a problem with it. I think I bought the last lot from an interweb site based in Guernsey.

 

My best, HB

 

Hi Hb, I was thinking about taking it myself. However there are a number of other medications which react in combination with this drug and a great many drugs that lack research. It can cause hormonal inbalances and can effect the uptake of a number of mental health medications. Some of this is not proven but there remains question marks about the safety of this drug when used with others.

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Hi Hb, I was thinking about taking it myself. However there are a number of other medications which react in combination with this drug and a great many drugs that lack research. It can cause hormonal inbalances and can effect the uptake of a number of mental health medications. Some of this is not proven but there remains question marks about the safety of this drug when used with others.

 

I think you are confusing melatonin with 5-htp, which is a precursor. Melatonin is not a drug but a natural hormone produced by our pineal gland. Ideally the pineal gland produce 0.2 mg of melatonin after dark, but with age or stress this amount can be greatly reduced. It has been experimented on humans for long time, there are thousand of studies that have never proven any negative reaction with any drugs. Only one study concluded that taking melatonin along with sedative medications might cause too much sleepiness. Just avoid taking it at the same time with any SSRI, to be 100% safe.

 

The UK is one of the few countries in Europe that have banned the sale of melatonin over the counter.

"Ask not what your country can do for you, ask what you can do for Poundland"

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I think you are confusing melatonin with 5-htp, which is a precursor. Melatonin is not a drug but a natural hormone produced by our pineal gland. Ideally the pineal gland produce 0.2 mg of melatonin after dark, but with age or stress this amount can be greatly reduced. It has been experimented on humans for long time, there are thousand of studies that have never proven any negative reaction with any drugs. Only one study concluded that taking melatonin along with sedative medications might cause too much sleepiness. Just avoid taking it at the same time with any SSRI, to be 100% safe.

 

The UK is one of the few countries in Europe that have banned the sale of melatonin over the counter.

 

San_D I did say that some of this was not proven. Doubts have been raised as to the safety of this drug/hormone and long term effects. I am just saying that with this product and with any other medication that there could be problems.

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Doubts have been raised as to the safety of this drug/hormone and long term effects.

 

Can you please cite evidence?

"Ask not what your country can do for you, ask what you can do for Poundland"

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Is there a reason for your inability to sleep with out chemical assistance ? Has your GP referred you to a sleep clinic ? If you have been taking these for 2 years your body could have become immune (although I accept you did a test with a different batch).

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Can you please cite evidence?

 

That is my evidence No long term study as been made. As you must be aware it is a natural hormone. The body as natural mechanisms which regulate hormone production. The body if given too much will in some cases stop producing that hormone or carry on producing the same amount which can lead to hormonal imbalance. This is basic physiology. Due to the physiology of the intake of SSRI they take a period of time before the levels build up within the body. It would not matter what time you took this hormone because the level of the SSRI would still be at a high therapeutic level.

 

I am not knocking this product it may work very well in most people, nor do I have any problem with orthomolecular medicine ( I am a great believer in what works for you). My main problem is that I have taken part in drug trials both as subject and as part of the team compiling the results and most of the evidence used in relation to melatonin fails to meet requirements in relation to Licencing it for use in the UK.

Edited by mr_mastiff
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Is there a reason for your inability to sleep with out chemical assistance ? Has your GP referred you to a sleep clinic ? If you have been taking these for 2 years your body could have become immune (although I accept you did a test with a different batch).

 

I think he is on the same medication as me Mirtazapine. I had a similar problem about six months ago. I am a member of a self help group on another site, there have been a number of issues reported with both this medication and other MH medications. BazzaS gave an excellent run down of causes.

 

The sleep clinic is an excellent idea the only problem in my area there is a very strict criteria for referral.

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That is my evidence No long term study as been made.

Not correct. Many long term studies have been conducted. Then it depends what long term means. The usual cut-off for a medical trial is 6 weeks, this is the benchmark against which most drugs have been assessed.

Give a look at these studies:

http://www.ncbi.nlm.nih.gov/pubmed/19486273

http://www.ncbi.nlm.nih.gov/pubmed/21340475

http://www.ncbi.nlm.nih.gov/pubmed/21091391

http://www.ncbi.nlm.nih.gov/pubmed/21845053

"Ask not what your country can do for you, ask what you can do for Poundland"

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San_d these studies are all American where each state can and does licence different types of medications. The point I am trying to make is that these studies fail to meet the requirements in the UK. I accept that these studies suggest that this medication is safe.

 

If I can remember correctly there are 117 known drug inter reactions known with this medication only 7 of which could be classed of a moderate risk. There are still a large number of other medications where the risks are not known.

 

Due to medications I am taking and my medical history I believe this medication could cause problems for me.

 

In your own case it may be totally different. I have already said I am not knocking this medication I am just warning people that there could be risks.

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citizenB, there are virtually NO NHS funded sleep clinics, I know because my GP has been trying to get me into one for about a year. The local NHS funding doesn't run to these either (and I am in London).

 

5-htp is a dodgy thing to take on a regular basis as it is a hormone and it could affect your thyroid gland and other glands. It is not recommended to take it with an SSRI (as mentioned) or the Pill it can cause a lot of problems.

 

My insomnia is caused by the pain in my neck from osteo-arthritis so the sleep aids aren't really the way to go.

 

There are other over-the-counter sleep aids which do work, one is called Peaceful Night and you take one at lunchtime, one about five or six and then one before you go to bed. That way you are calming your body down and getting a good nights sleep.

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citizenB, there are virtually NO NHS funded sleep clinics, I know because my GP has been trying to get me into one for about a year. The local NHS funding doesn't run to these either (and I am in London).

 

5-htp is a dodgy thing to take on a regular basis as it is a hormone and it could affect your thyroid gland and other glands. It is not recommended to take it with an SSRI (as mentioned) or the Pill it can cause a lot of problems.

 

It isn't clear what med the OP was referring to .

 

Melatonin has been mentioned, and now 5-htp.

Melatonin (n-acetyl-5MTP) has been conflated with 5-htp in the past, so I'm not sure if wires have been crossed here too.

 

Melatonin is licensed by the European Medicines Agency, whose product license is for short term insomnia treatment in the over-55's.

It is a prescription only medicine within the UK

 

For those who might be considering sourcing melatonin outside the UK (legally) : where it can't legally be sold openly in the UK : I 'm aware of at least one sleep physician who has highlighted use of melatonin, but advised anyone considering importing melatonin to look at its source.

 

Synthesized melatonin is considered less of a risk of infection than melatonin derived from animal pineal tissue.

Edited by BazzaS
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Synthesized melatonin is considered less of a risk of infection than melatonin derived from animal pineal tissue.

 

All melatonin on the market is synthetic, unless it's "homoeopathic" melatonin, in which case it's basically placebo.

"Ask not what your country can do for you, ask what you can do for Poundland"

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San_d these studies are all American where each state can and does licence different types of medications

There is only one Food and Drug Administration in USA.

The point I am trying to make is that these studies fail to meet the requirements in the UK. I accept that these studies suggest that this medication is safe.

I am not 100% sure that the UK requirements are stricter than in the USA. The reason why melatonin cannot be sold over the counter is that it is technically a hormone. However one can say that virtually all beef, chicken and turkey on the market has added levels of hormones.

 

It is safe, this is why it can only be bought on prescription. Just ask your GP to have it prescribed. I don't see any reason why GPs should object to that.

"Ask not what your country can do for you, ask what you can do for Poundland"

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