Generics are similar to brand-name drugs

DEAR DR. DONOHUE: I know your answer to my question will end an ongoing debate I have with several friends. They have the mistaken idea that generic medicines are inferior to brand-name medicines. I say acetylsalicylic acid (aspirin) is acetylsalicylic acid, regardless of its brand. They say the generic is less potent, not subject to quality control and does not work as well. I also think a percentage of the American public believes that the more you pay for something, the more superior the product. Please set them straight. — M.W.

A generic drug has the exact chemical structure that the brand-name drug has. It has the same amount of drug in it. It has the same effect as the brand-name drug. These criteria have to be met before the generic is released to the public. Generic drugs, like brand-name drugs, are monitored by the Food and Drug Administration.

The generic drug doesn’t look the same as the brand-name drug. It has a different color and a different shape. It contains different binders — inert substances that give the pill a different consistency. Troubles from inert components are theoretically possible, but seldom occur.

If a doctor wants a patient to take only the brand-name drug, the doctor indicates that on the prescription. Few drugs have no effective generic equivalent. Generics are permitted on the market when the patent of the original drug expires.

The biggest attraction of generic drugs is their reduced cost.

DEAR DR. DONOHUE: Will you write about anxiety disorder and panic attacks? I was recently diagnosed as having panic attacks. My symptoms were extreme heart palpitations, shortness of breath and trembling. I saw a cardiologist twice, my internist three times and my lung doctor twice. None of them found anything wrong with me. I have started on Xanax and saw a psychiatrist, who added Celexa. I am doing much better. Will I ever get entirely well? I will probably change psychiatrists, since I can’t understand the one I’m seeing. — C.M.

“Anxiety” in medicine has the same meaning as it does in everyday language. It’s worry and fear. When people live in a state of constant fear and worry without any ground for those emotions, anxiety is unhealthy and needs treatment.

Panic attacks are sudden occurrences of such intense dread and terror that the heart beats fast, sweat rolls down the face, trembling takes hold and chest pain and dizziness materialize. The attack takes place in places where there is no threat of harm. A person can be shopping or driving or visiting a friend.

Both anxiety and panic attacks take place due to an imbalance of brain messenger chemicals. Brain chemistry has gotten off track.

If you are like most people who suffer from anxiety and panic attacks, you will get well with the kinds of medicine you are currently taking and with talk therapy. You need to be comfortable with your therapist, and you do need to understand the doctor. The talk therapy helps you understand how your feelings are inappropriate to your situation. Talk treatment is as important as medicine treatment.

DEAR DR. DONOHUE: Years ago, after the birth of my son, the doctor said I had milk leg. It was very painful. What would this be called today? — A.R.

I’ve never heard the term “milk leg” used by a doctor, but I have seen it in print. Today the condition is called thrombophlebitis (THROM-boh-flea-BITE-iss) a clot (thrombo) in an inflamed vein (phlebitis). In milk leg, the vein is the femoral vein, the large leg vein. It can be a complication of pregnancy even today.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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