I'm looking for neurologists, NPs, PAs, or pharmacists who work with patients with epilepsy to talk about variability between different drug manufacturers. MedShadow.org recently posted a few articles about the differences that patients and doctors are seeing between ADHD medications made by different manufacturers, and articles about the difficulties of overseeing quality drug manufacturing. After posting those articles, we received hundreds of comments on social media, several asked whether we see differences in efficacy, dose dissolution, etc in epilepsy medications. I'm looking for experts to talk about how these meds work, what potential differences could feel like, whether you've seen patients who have trouble after switching between manufacturers, whether you see problems with any particular meds more than others (ie extended release vs immeidate), and how patients should respond if they suspect it's a problem for them. Please let me know. Thanks in advance for any help you can provide!

Good Day, Have you noticed changes in the efficacy or side effects after patients switch pharmaceutical companies? Yes. More often there have been incidences in which some patients notice increased seizures or new side effects following the substitution of generics, with no changes at all. Are there formulations that are linked more often to problems after being changed? Extended-release formulations usually cause problems because different manufacturers may include various release mechanisms that could result in fluctuating blood levels, while immediate-release formulations are usually more stable across brands. In your practice, have you observed specific epilepsy medications cause more trouble than others during a manufacturer switch? Most common in my experience are lamotrigine ER and carbamazepine ER. Patients often have said they feel different or have experienced an increase in seizure activity. More tolerable would have been the response to generic levetiracetam mostly, but again it varies so much between individuals. What should patients do when they suspect any problem following switching of medications? Contact your provider immediately. Look at the name of the manufacturer on the drug label and report that. Also report to your physician if of the prescribed formulations Worked well for you before requesting that it be included in your future prescriptions. The pharmacies would usually comply. Any final recommendations for patients and caregivers? Stay watchful for any alterations—physical, seizure, psychological disaster—that arise after refills. Be sure to write down such symptoms or seizures so that you can recount it if something odd is felt. It would be better to try to re-establish communication in the case of Epilepsy. A slight change can trigger serious direct set-backs(Resources) to the patient. Secret been turned to death. If you decide to use this quote, I'd love to stay connected! Feel free to reach me at gregorygasic@vmedx.com and outreach@vmedx.com.