The Differences Between Brand Name and Generic Medications | Common Crazy Med Crap Index | Talking to Your Doctor

1.  Why Can’t You Take a Compliment?

Dietary/nutritional supplements, complementary and alternative treatments, and meds: another morass of misinformation, controversy, and outright holy wars1. Many people will take various cocktails of herbs, vitamins, minerals, and anything else that falls under the category of dietary/nutritional supplements along with their meds, or even instead of medication because they are afraid of the dangerous, yet extremely rare, side effects of medications. So, in fairness to the meds…

2.  It’s Natural, Man.

Note the name of this site. Crazymeds. The only thing classified as a nutritional/dietary supplement you can buy in the US without a prescription2 that has been more-or-less proven3 to do anything in the way of brain cooties - specifically unipolar and bipolar depression - is the EPA component of Omega-3 fish oils. The prescription version of concentrated EPA, Lovaza, is approved to treat the high triglycerides associated with heart problems and diabetes. The amount of EPA it contains - 465mg, along with 375mg of DHA - is a bit awkward for many people to use it to treat depression, as one capsule may not be enough but two would be too much, and too high a dosage can render EPA ineffective. Even one capsule might be too much, as the effective dosage to treat depression is usually 300–800mg a day. So you’re probably better off getting the non-prescription supplement, and that’s pretty much the only supplement we currently consider an actual treatment for any mental illness and/or neurological condition.
If you want to get information on using St. John’s wort, 5-HTp/tryptophan, or anything else you can buy from Ye Olde Vittamin Shoppe, to treat a condition, you’ll have to go elsewhere. I do have some advice for you:

  • Anything that may work (and even stuff that doesn’t) will have side effects. E.g. St. John’s wort causing photosensitivity and the failure of hormonal birth control, and that people have died from taking fish oil. (Go ahead, look it up on the PI sheet.) Anything that claims to have no side effects, interactions, etc. is either lying to you or is an expensive placebo.
  • Anything that may work (and even stuff that doesn’t) may have interactions with any medication, prescription or OTC, and other supplements you take. More on that below.
  • In the US regulation of supplements barely exists, as illustrated by their page of industry guidelines:

The key phrase on this page is: Guidance documents contain nonbinding recommendations

So what is promised on the label is often not the same as what is actually in the bottle. Although it’s usually peppermint or other innocuous substance instead of a prescription medication, you know, works. Or even a dietary supplement that would actually do something if that were what you were taking instead of dried grass clippings from the lawn around the supplement company’s headquarters.



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3.  Yeah, But Don’t We Need to Replace all the Stuff the Meds Suck Out of Us?

I’m aware of only two essential nutrients that are proven to be directly affected by crazy meds:

3.1  Folic acid/Folate/Vitamin B9.

If you take an anticonvulsant/antiepilepctic drug (AED) (which are also a class of mood stabilizers), you need to take a folic acid supplement. It’s just a given.

3.2  Vitamin D3

Like folic acid, it’s only if you’re taking an AED, and it’s a little more complicated, because too much vitamin D can cause problems. You mainly have to worry about it if you take an enzyme-inducing AED such as:

  • Tegretol (carbamazapine)
  • Dilantin (phenytoin)
  • Trileptal (oxacarbazepine)
  • Topamax (topiramate)
  • Sabril (vigabatrin)
  • phenobarbital
  • Or if you take a valproate:
  • Dilantin (phenytoin) and phenobarbital4 are the worst offenders, so if you take those your doctor may not even bother with a blood test and just tell you to take some vit. D.
  • You may have to take a vitamin D supplement if you take Lamictal (lamotrigine), as the data aren’t clear regarding Lamictal.
  • As to how much to take, that’s something you need to work out with a doctor, as it will take a couple of blood tests to determine if you need to take the USRDA of 600iu, or a lot more to compensate for one or more of the medications encouraging your liver to metabolize it a lot faster than normal.
  • Plus the enzyme-inducing AEDs are the worst when it comes to making you photosensitive, which makes it even harder to get your daily vitamin D!
  • However, since vitamin D isn’t water soluble, that, unlike folic acid, it’s almost easy to build up a toxic amount. That’s in the range of 10,000 to 40,000 IU a day if you’re not taking any of the AEDs listed above, which is something you can easily accomplish with a regular purchase from a supplement store.


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3.3  If Only it were that Simple

It’s difficult to tell if there’s a direct link between calcium and AEDs, as vitamin D is essential in how well your body utilizes calcium. The connection between long-term use of AEDs and bone density problems has been known since forever. But are the meds affecting the bones directly, or messing with calcium metabolism similar to vitamin D, or is it vitamin D to calcium to bone density? Damned if I know. Should you be taking calcium supplements? Again: ask your doctor and get a blood test for this one, and only if you’re taking one of the meds listed above5. You may also require a calcium supplement, and then it gets into all sorts of multiple vitamin and trace mineral combinations that are way beyond what I’ve looked into. Calcium can interfere with how well you absorb Neurontin (gabapentin), and if it can render the calcium channel blocker verapamil usage, who knows what it can do with AEDs that affect calcium channels? So you may have that to consider as well.

4.  Mother Earth, We May Have a Problem

People also look into using supplements to deal with side effects. This is where things really go sideways.

5.  No Matter What, Avoid These like the Plague

  • Kava (Piper methysticum). Banned or restricted all over the world because it can make your liver implode. There may be a way to process it in a way that is far less toxic, such as how Pacific Islanders have been doing since forever. And they still don’t use it every day.
  • Gingko biloba. While it might have a future as a source of something, the powdered leafs and tinctures you usually find are useless and have so many herb-drug and herb-herb interactions that it will mess with almost anything you’re taking.
  • Cascara sagrada. It’s “slimming” and used to “detoxify” you system as well as treat constipation. A lot of the preparations contain California buckthorn (Rhamnus purshianus), which is pretty freaking toxic. I guess after taking this you’ll be really thin after puking and shitting your guts out, so they aren’t lying about the constipation part. As for its detoxification properties, that must apply to after going to the hospital to deal with this poison.
  • Pennyroyal oil (Mentha pulegium). People take this internally? Seriously? Anyone who does should be filtered out of the gene pool.
  • Traditional patent medicines. I used to take this crap, and I wouldn’t be surprised if it contributed to making my various health problems worse.

6.  One More Thing

Finally, if you wound up preventing a med from working as it should, or otherwise screwed yourself with supplements, don’t beat yourself up over it, that’s our job. Anyone can mess themselves up with supplements, including me and members of the Special Forces.6

We have a topic on the Crazy Talk forum about meds and supplements.
There’s also one on drug-food-herb-etc. interactions.



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< The Differences Between Brand Name and Generic Medications | Common Crazy Med Crap Index | Talking to Your Doctor



1 Holy war: An intense, never-ending argument that spans newsgroups, fora, bulletin boards, mailing lists, etc., where no one's opinion will ever change. E.g. abortion, gun control, Mac vs. P.C., old Star Trek vs. subsequent Star Trek series.

2 Yes, there are such things as prescription-strength nutritional supplements like vitamins and minerals, and even prescription foods.

3 The data are still too mixed on St. John's wort, so go ahead and treat mild-to-moderate conditions with it instead of meds if you want to.

4 Phenobarbital is still a second-line, and even first-line AED in many parts of the world. Places where money, crappy infrastructure, and stigma make it difficult enough for people to take the phenobarbital, let alone another pill on top of it.

5 Or anything else that is a CYP3A4 inducer. If "CYP3A4 inducer" doesn't mean anything to you, don't worry, just type it into teh googles and you'll get a bunch of relatively complete lists. Read enough of this site and you'll learn what it means along with all the crazy meds that induce, inhibit, or suppress various enzymes. Don't forget: supplements and even foods can mess with you. Too much beta carotene, garlic or vitamin E can cause you to lose vitamin D. Drinking grapefruit juice and taking megadosages of vitamin D every day (it doesn't have to be at the same time) and you need only 5,000 to 20,000 IU a day to reach a toxic level of vit. D.

6 I'm pretty sure they won't have to kill us now that I've told you about it.



Taking Supplements with your Crazy Meds by Jerod Poore is copyright © 2011
Page created by: Jerod Poore. Date created: 30 May 2011 Last edited by: JerodPoore on 2016–04–18





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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, and 2016 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.



All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
Crazymeds now uses a secure server, but it is not so secure that you can discuss anything having to do with nuclear power facilities, air traffic control systems, aircraft navigation systems, weapons control systems, or any other system requiring failsafe operation whose failure could lead to injury, death or environmental damage. Just so you know. So if you’re mentally interesting and have a job that deals with that sort of thing, talk about said job elsewhere. Otherwise feel free to discuss your meds and brain cooties.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!

‘Everything is true, nothing is permitted.’ - Jerod Poore


1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.

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