I doubt every fish-oil-taker in the sample was taking 9 capsules per day.
But the story only gives the one example of the 1 individual who took 9 capsules a day--over 4 times the recommended dosage.
While I've been taking fish oil capsules for years, I only ever take 1 per day. Heck even during peak marathon training I never take more vitamins.
It would be interesting to know more about this sample group and how many capsules they actually took.
As I indicated above, I should be at risk to develop this; I fit the bill nearly every step of the way, including past history of hypertension, and a family history of cardiac problems. Yet I've never had anything remotely close.
I read a similar story somewhere else recently that pointed to wetsuits as the culprit.
The article raises the possibility of a link between fish oil overdose and pulmonary edema.
The individual whose story is in the article was indeed taking enormous doses of fish oil. But the statistical research the article describes has more predictive or explanatory value than the single-person anecdote. That research found a significant association between fish-oil supplementation and SIPE, but the article does not say whether or not the study showed that association to be dose-dependent in any way. The study design may well have asked only "yes" or "no" on fish oil, not how much. I doubt every fish-oil-taker in the sample was taking 9 capsules per day.
I am not saying "Big Pharma" is great(they don't even give me free pens anymore.) I am saying the government could make generics better by tightening up the definition of equivalent.Once a med has gone generic for several years the quality of the generics is generally pretty good,but I had many patients with depression who were doing great on Wellbutrin XL who had a recurrence of symptoms when it went generic.
If I'm not mistaken, a generic of Wellbutrin just got pulled from the market.
As someone who (unfortunately) has to take a lot of medication, I am always delighted when they go generic but it is frustrating when the particular generic changes at the pharmacy. This has been happening a lot lately. I don't notice any change in the medication's effects, but there are two in particular that are prone to turning to powder. :bitching:
global what? I thought that was over when Al Gore lost the election and quit flying around in a private jet. :D
Judge Matysek, permission to respond? The defendant has opened the door to this line of questioning!
static.happyplace.com/.../509bedacdc6e5.jpeg
I will note that Texas did not make the Top 10 list here, though I suspect that's because they have thus far managed to import college graduates from the Northeast. The choking wildfires and West Nile virus pandemic will no doubt soon put an end to this, however, allowing the Lone Star State to once again ascend in the pantheon of know-nothing-ism!
Your Pharmacy will say that they can substitute a generic equivalent to your medication.What they don't say is that goverment declared that equivalent is"not less than 80% nor more than 125% as bioavailable as the brand name.That is a very low bar to clear.
There are a lot of myths put out by Big Pharma hoping to convince the credulous that generic substitution is a horrible idea that imperils the public health.
Since even active medications benefit from a kind of placebo halo that turbocharges its efficacy above and beyond the primary physiological effect, this kind of poor-mouthing by Big Pharma most likely does have some effect at making generics work less effectively than their brand name equivalents.
However, brand name equivalents, as well, show a steady decline in efficacy from their initial release, when doctors and patients alike are excited about the latest and greatest new thing.
As a psychiatrist, did you once have more excitement, for instance, about Prozac than you do today, and did you manage to communicate this excitement to your patients? The bloom is off the Prozac rose not because generic fluoxetine is really any different from its brand name predecessor, but because it's no longer benefiting from patent protection, and drug makers have moved on to the latest "new and improved" variations to hype and extort profit from.
As far as the 80 to 125 percent bioavailability, three responses:
1) this is most likely important only in a very slim number of drugs, like anti-seizure medications, were the therapeutic window can be quite thin--a slightly low dose might not work, and a slightly high dose might cause side effects. Most drugs don't have this problem. If you have a headache, you can take either 1, 2, or 3 aspirins, and it's not going to have a huge deleterious effect.
2) many generics end up being too strong in dosing because the FDA doesn't require that manufacturers use the same inert filler materials. There have been cases where the generic maker is told to, in effect, make their drug weaker so that it is closer to the original brand name drug.
3) most big pharmaceutical companies make generics themselves--it's not only the Mylans of the world (and other dedicated generic manufacturers) that specialize in this. The Brand Name companies very often make their own generic forms of brand name drugs, hoping to capture at least some of the generic market while at the same time continuing to mean-mouth generics in the hopes patients will demand the Brand Name originals at many multiples of the cost.
Bottom line: Big Pharma is part of the Solution. It is, alas, a bigger part of the Problem.
There are a lot of myths put out by Big Pharma hoping to convince the credulous that generic substitution is a horrible idea that imperils the public health.
Since even active medications benefit from a kind of placebo halo that turbocharges its efficacy above and beyond the primary physiological effect, this kind of poor-mouthing by Big Pharma most likely does have some effect at making generics work less effectively than their brand name equivalents.
However, brand name equivalents, as well, show a steady decline in efficacy from their initial release, when doctors and patients alike are excited about the latest and greatest new thing.
As a psychiatrist, did you once have more excitement, for instance, about Prozac than you do today, and did you manage to communicate this excitement to your patients? The bloom is off the Prozac rose not because generic fluoxetine is really any different from its brand name predecessor, but because it's no longer benefiting from patent protection, and drug makers have moved on to the latest "new and improved" variations to hype and extort profit from.
As far as the 80 to 125 percent bioavailability, three responses:
1) this is most likely important only in a very slim number of drugs, like anti-seizure medications, were the therapeutic window can be quite thin--a slightly low dose might not work, and a slightly high dose might cause side effects. Most drugs don't have this problem. If you have a headache, you can take either 1, 2, or 3 aspirins, and it's not going to have a huge deleterious effect.
2) many generics end up being too strong in dosing because the FDA doesn't require that manufacturers use the same inert filler materials. There have been cases where the generic maker is told to, in effect, make their drug weaker so that it is closer to the original brand name drug.
3) most big pharmaceutical companies make generics themselves--it's not only the Mylans of the world (and other dedicated generic manufacturers) that specialize in this. The Brand Name companies very often make their own generic forms of brand name drugs, hoping to capture at least some of the generic market while at the same time continuing to mean-mouth generics in the hopes patients will demand the Brand Name originals at many multiples of the cost.
Bottom line: Big Pharma is part of the Solution. It is, alas, a bigger part of the Problem.
I am not saying "Big Pharma" is great(they don't even give me free pens anymore.) I am saying the government could make generics better by tightening up the definition of equivalent.Once a med has gone generic for several years the quality of the generics is generally pretty good,but I had many patients with depression who were doing great on Wellbutrin XL who had a recurrence of symptoms when it went generic.
I will note that Texas did not make the Top 10 list here, though I suspect that's because they have thus far managed to import college graduates from the Northeast. ...allowing the Lone Star State to once again ascend in the pantheon of know-nothing-ism!
Wait, what? Next you Yankees will tell us know-nothing Texans that the Earth is not 6,000 years old.
