Editor, – I am concerned about the ongoing push for semi-compulsory generic prescribing. Over many years I have had substantial clinical experience of observing the changed level of health of some patients on changing brands. I have reported some dramatic examples to the Adverse Drug Reactions Advisory Committee (ADRAC).
We should remember that we are NOT just prescribing the active ingredient when we prescribe. There is the issue of varying particle size and varying excipients that may make a difference. For example, I once had a psychotic patient with lactose intolerance and I had to work to identify which brands (or even which strengths of the same brand) of antipsychotics were lactose free. The Pan Pharmaceuticals experience tells us that this is still applicable today and not just a risk from the distant past.
R.J. Taylor
Psychiatrist
Boronia, Vic.
