Dr. John Kruse
Dr. John Kruse
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Generic Drugs Problem or Solution?
Prior to 1984, generic drugs in the US had to undergo the same application process as brand name drugs, demonstrating safety and efficacy. Consequently they made up less than 20% of the medication market. The Hatch-Waxman Act changed the rules, so that generic drugs now only need to show that they bioequivalent to brand name drugs. Now 90% of medications consumed in the US are generic.
Generics must contain the active ingredient of the drug, but are actually (by trademark law) required to look different. They may also have different colorants or other “inactive” ingredients. Bioequivalence is measured by the peak concentration and the total amount of drug delivered, and the generic levels can be as low as 80% and as high as 125% of the brand name product.
Generic drugs can provide huge cost savings, since the company generally needs to cover just manufacturing costs, not research, development and marketing. But generic versions of medications whose action is very sensitive to peak concentrations, or the rate of absorption, may result in different experiences for patients. In psychiatry the generic drugs for which patients most frequently report problems include the stimulants (versions of Adderall and Ritalin) and the anti-anxiety benzodiazepines (Valium, Xanax, Ativan, and others.)
For many drugs, multiple pharmaceutical companies produce generic versions. An individual who has problems with one manufacturer’s product (which is required to be identified on the pill bottle label) can request that the company’s product be avoided on subsequent fillings.
(The original of this video is a UA-cam Live, and contains several additional minutes of Q&A. It can be found in the Live section of this UA-cam Channel.)
References:
FDA Bioequivalence Guide
www.fda.gov/media/70115/download
Generic Drugs in the United States: Policies to Address Pricing and Competition (2019)
www.ncbi.nlm.nih.gov/pmc/articles/PMC6355356/#:~:text=Prior%20to%20the%201984%20Hatch,drugs%20made%20it%20to%20market.
‘Inactive’ ingredients in oral medications (2019)
www.ncbi.nlm.nih.gov/pmc/articles/PMC7122736/
Update: Bupropion Hydrochloride Extended-Release 300 mg Bioequivalence Studies (2014)
www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/update-bupropion-hydrochloride-extended-release-300-mg-bioequivalence-studies
IF YOU WANT TO HEAR THE Q & A THAT FOLLOWED THIS VIDEO, A LONGER VERSION IS IN THE "LIVE" SECTION OF THIS CHANNEL.
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Відео

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КОМЕНТАРІ

  • @suzanne9618
    @suzanne9618 17 годин тому

    So it's funny that you fail to mention that Biden is a covert narcissist, hence his pathological lying his entire life. You're clearly biased.

  • @carolcrumley4597
    @carolcrumley4597 21 годину тому

    It is possible to see your bias.

  • @djallalnamri1
    @djallalnamri1 День тому

    I would like to talk about the case of fathers who have worked away from home for a long period and who as a result have not been able to establish a meaningful parental relationship with their child(ren). once retired, they discover that their child(ren) have somehow grown up in their absence and have become like strangers whom they avoid outside the home and sometimes even inside of it. the children grew up in the shadow of a structuring authority which would have been the mother or an institution, generally the school and a whole theory of teachers and instructors onto whom the children will project the image of the absent father even when he is present because he is unable to reconnect the bond of paternity with his children.

  • @JScox
    @JScox День тому

    Before making your video, you should've done at least a modicum of research into publicly available evidence of the history of lying and other characteristics of someone who believes he has the absolute BEST IDEAS for the way to lead the American people... ua-cam.com/video/O7fJalyEeCw/v-deo.htmlsi=_D4nXo_yxHQxhB4N

  • @Rob-t2n
    @Rob-t2n День тому

    Your shilling belittles your profession.

  • @ekhlasa.abdulraheem9857
    @ekhlasa.abdulraheem9857 2 дні тому

    Very detailed and great video that gave me insight to the problem , I feel that the social media exacerbated my symptoms and now I feel more dysfunctional. I’m looking for a way to disconnect from my phone and focus without the medication

  • @Northdallasguy00
    @Northdallasguy00 2 дні тому

    FYI, studies have shown you should intake caffeine 90 to 120 minutes after you wake up. You shouldn’t take it right as you wake up because it can have a counter effect on you.

  • @Fairtaxpatriot
    @Fairtaxpatriot 2 дні тому

    This is pure deception! Trump was originally elected by the American voters and the deep state stole the election! Those are the real facts. God is going to wake you up soon.

  • @DrHill
    @DrHill 2 дні тому

    It is not that hard to blind EEG neurofeedback. The commercial EEGer software does this, and you can look at my PhD dissertation to see evoked potentials (ERSP) that are specific to neurofeedback and absent in sham.

  • @DrHill
    @DrHill 2 дні тому

    Neurofeedback is mostly involuntary - it's a form of operant conditioning, but on the EEG, which you cannot feel, so it becomes instrumental conditioning on involuntary behavior. Also, LORETA EEG is a real time source method, and at 70 electrodes has the same spatial resolution of MRI... But since we are training microcolumns/minicolumns in the EEG, you don't need super tight spatial precision (EEG is not just the firing of a column, but the mixing of information). You can also do pirHEG or fNIRS which are biofeedback on blood flow, which are insensitive to movement, but are more of a voluntary. EEG neurofeedback was discovered by Barry Sterman at UCLA in the mid 1960s - that was SMR, and it was discovered on cats by mistake, and then Sterman showed it in humans, and by Joy Kamiya at about the same time. And QEEG helps with standardization - you can see the conserved resources you are training. But it is closer to personal training than a discrete intervention like a medication. FWIW I routinely see 1-2 standard deviations of change on a CPT (IVA2) and the resting QEEG, in 40-50 sessions with ADHD... and yes, things often do continue to get better for a few months as well. Seems to actually work almost all the time. I have seen this in thousands of people, with ADHD. If i can talk you into mapping your brain (or anyone you want me to - perhaps with and without a stimulant, if you use those) - I bet I can convince you that QEEG brain mapping is worth using when thinking about ADHD. Just let me know - I'll send equipment to you. :) Getting reliable changes in CPT outcomes again and again does underscore that is is "real".. regardless of what you think of interpreting the EEG.

  • @shiningoutlight
    @shiningoutlight 2 дні тому

    Did Trump actually take a cognitive test? Pathological liar.

  • @DJ-mj5pq
    @DJ-mj5pq 2 дні тому

    no comment about Kennedy, Harris or Newsome ?

  • @DavidDuVivier
    @DavidDuVivier 2 дні тому

    A painfully mumbling, even rambling presentation. Torture to listen to, absolutely pathetic.... and very typical of politicized pseudoscience. In every way just as bad as Trump and Biden were in their horrific debate fiasco. Kruse himself needs to have his head examined. One can tell he got his seemingly flashy degrees from trashy diploma mills, not Tier 1 U.S. medical and graduate schools. Excuse my arrogance, but I say that as someone who also collected countless As and A+s, summa cum laudes and Phi Beta Kappas - junior year inductee! - from institutions brimming with Ivy- and Ivy-equivalent trained professors in Tier 1 U.S., European and Russian colleges and universities... all courses BTW were conducted in the institutions' respective languages: English, German, Russian and French. And who worked for years in management roles at DJIA30 and S&P 500 corporations. Bottom line? If you made a presentation like this at a serious U.S., European or Russian university or corporation you'd be thrown out before you could say "Hop scotch"! No serious medical professional could make such a dismal clip. Thumbs down! I'm moving on. PS "Dr." Kruse, before you do anything else, see a speech therapist!

  • @viveviveka2651
    @viveviveka2651 2 дні тому

    Attempting to imply equivalency?

  • @danielbegg6968
    @danielbegg6968 3 дні тому

    Hi doctor, appreciate the video. How would you recommend coming off 25mg sertraline after being on for 16 months? I already halve a a 50mg tablet and this is the minimum tablet dosage in Australia. Should I quarter to 12.5mg? I don't think I can realistically do the 5-10% taper that most people seem to recommend.

  • @arbaadamsavila2409
    @arbaadamsavila2409 3 дні тому

    Thank you for doing so many videos on ADHD. They're so helpful for a late-diagnosed adult. Strattera was horrible for me. Lots of side effects, almost no benefits. Wellbutrin has benefits but does not help me focus. Doc does not want to give me stimulants, unfortunately. Nice blue-green color coordination!

  • @joyfultrails
    @joyfultrails 3 дні тому

    This video is ridiculous. Trump acts like a pro athlete compared to Biden.

  • @MultiBuzzzer
    @MultiBuzzzer 3 дні тому

    Only one of these two men has tried relentlessly to put his opponent in jail by having him indicted 4 times - an unprecedented assault on our democracy that should disqualify him from having control of our DoJ, as jailing your opponent is done only in banana republics. Only one of these two men has allowed an unprecedented invasion across our southern border of perhaps 10,000,000 people , including a number of potential terrorists, all in willful violation of the president’s duty to enforce our laws. We had peace and prosperity and almost no inflation under Trump; once Covid hit Trump’s Operation Warp Speed delivered a vaccine in record time. His record is a good one; Biden’s is not.

  • @diegotejera2742
    @diegotejera2742 3 дні тому

    Trump could be the worst human ever but there's still no comparison to cognitive decline.

  • @MarkSmith-sk2yx
    @MarkSmith-sk2yx 3 дні тому

    13 families lost loved ones at the disgraceful surrender at Kabul. Sleepy Joe lied about them.

  • @tinahalle3575
    @tinahalle3575 3 дні тому

    I feel like moderate to extreme narcissism should be something that means you can’t be president but then we have other narcissistic leaders in other countries that might take advantage of that to so who knows . I feel like a narcissist president isn’t stable enough to run a country though and might make terrible or destructive decisions and fuel the fires of polarization in a country which leads to wars and economic downfalls , injustices , attacks on the capitol buildings , etc. I guess though it’s all a matter of , like you said , how impaired it makes them in their abilities . I had a thought once . Dangerous 😂 I know lol but what would the world be like if everyone all over the world required psychological evaluation before becoming president? Is that too naive and idealistic to think we could get every country on board once the current narcissist leaders die off ? Of course there’s always more minions to follow behind them in death who won’t give up 🙄 but what would happen if there were no narcissistic leaders beyond the mild ones who tend to be reachable when it comes to listening to advice . ( I’ve read we all have some small amount of narcissism in us in different ways just for the sake of survival so that’s why I wonder if it’s all about what end of the scale from mild to moderate that exists on )

  • @rockfrangrances1
    @rockfrangrances1 3 дні тому

    2 seconds in and obvious liberal bias. The fact you are even making a video tells us how disastrous this was for Biden

  • @clasgolf
    @clasgolf 3 дні тому

    You need help yourself dude..just listen to yourself 😮

  • @MarkSmith-sk2yx
    @MarkSmith-sk2yx 3 дні тому

    My assessment is that you suffer from dementia driven by tds

  • @MarkSmith-sk2yx
    @MarkSmith-sk2yx 3 дні тому

    So the focus post debate has been on biden's mental abilities and you choose to prattle on about Trump. Biden's impairment has been obvious for years.

  • @videowatchaccount7551
    @videowatchaccount7551 3 дні тому

    Kruse is clearly biased against Trump. Biden brought up golf and then blatantly about his handicap. LOL!

  • @beatrizrosado898
    @beatrizrosado898 3 дні тому

    TRUMP 2024

  • @beatrizrosado898
    @beatrizrosado898 3 дні тому

    TRUMP 2024

  • @beatrizrosado898
    @beatrizrosado898 3 дні тому

    TRUMP 2024

  • @howardwunderlich6323
    @howardwunderlich6323 3 дні тому

    Trump has moderately severe ADHD and probably takes Adderal. Biden has Parkisons and probably takes Sinemet ( by the way not all Parkinsons patients have a resting tremor). Is there a difference? It is all about the management, and the degree of impairment and prognosis. Trump also has a severe personality disorder (narcissism) and has sociopathic tendencies. I will take the Biden condition if it can be managed. Biden may have mild ADHD based on a few criteria but this would not be debilitating.

  • @BunnyKeene
    @BunnyKeene 4 дні тому

    Wow! I’m in Never-Trump Whacko world.

  • @BunnyKeene
    @BunnyKeene 4 дні тому

    I hope he sues you for lying.

    • @chrisstone1200
      @chrisstone1200 2 дні тому

      HAAAAAAAAAAAAAA!!!!!!!!!!! Coming in defense of a carbon life form that lies every time he opens his mouth! We should sue HIM! 😂🤣😂😂😂😂😂

  • @BunnyKeene
    @BunnyKeene 4 дні тому

    It is severely obvious you are a Biden fan. 😂 If he has Parkinson’s, it is additional to dementia!

  • @amykarnehm3602
    @amykarnehm3602 4 дні тому

    Fascinating!! Thanks for doing this!! (ADHD’er here)

  • @lillianspiezio1787
    @lillianspiezio1787 4 дні тому

    How much you getting paid for your B S

  • @lillianspiezio1787
    @lillianspiezio1787 4 дні тому

    How did Trump pass the cognitive test and will to take another one. Biden refuses. I wonder why.

    • @jasonr8364
      @jasonr8364 4 дні тому

      No proof trump did nothing

  • @raec.9615
    @raec.9615 4 дні тому

    Lol. This is a leftist Chanel . You realise that a politician for 50 years are not honest and I mean all politicians lie. You’re all delusional

  • @MikeStallings2023
    @MikeStallings2023 4 дні тому

    Making Mexico pay for the border wall was genius marketing. It caused liberals to keep repeating it, giving Trump free advertising as the guy who would close the border. Seriously this doctor is a tool.

  • @MikeStallings2023
    @MikeStallings2023 4 дні тому

    Millions of people saw these two men side by side. Stop gas lighting it's ridiculous.

  • @phoenixash8285
    @phoenixash8285 4 дні тому

    I lived in NYC back in the 80s when T was always in the news. To me he seems like the same but then again I filter out most of what he says hahaha. B, on the other hand, is just….not there anymore. Muscle memory, canned phrases and teleprompters carry him along 😢

    • @videowatchaccount7551
      @videowatchaccount7551 3 дні тому

      compare Biden from just 4 years ago. It's stunning how much h's declined. Trump? Not so much if at all.

  • @ginabrenneman5012
    @ginabrenneman5012 4 дні тому

    This was very interesting and fairly presented! Bravo! Thanks!

  • @hedysheppard
    @hedysheppard 4 дні тому

    ladies get trump out of your health care destroy the supreme court of trump . Wipe your feet on this loser, wheres Weinstien and Crosby thats where trump needs to be JAIL put him there. stand behind Biden let him finish the job. Your lucky to have someone who will fight for the soul of your country.TRUMP and all of the TRUMP trash will destroy your country don't let this happen

  • @stringologymchugh4245
    @stringologymchugh4245 4 дні тому

    I'd rather have an old sincere president over a convicted rapist, thief felon; call me old-fashioned but I have a conscience! What will YOU tell your grandchildren?

  • @barbaracorso2022
    @barbaracorso2022 4 дні тому

    Neither candidate is fit to lead period. It’s sad that this is where we are.

  • @lindakautzman7388
    @lindakautzman7388 4 дні тому

    Thank you for your expertise

  • @snipermanizationify
    @snipermanizationify 5 днів тому

    Your political biases shine brightly during this diatribe. Diagnosing anyone without having examined them is the height of irresponsibility and unethical professionalism, especially for a “doctor.” You’re obviously attempting to not only slander Trump but you’re trying to persuade people to vote against him. While it was obvious to anyone with two brain cells to rub together that Biden has serious cognitive issues, such is not the case with Trump. I truly hope you don’t treat any patients. I have a child with psychiatric problems and I would run from someone like you ! I hope Trump sees this and rightfully sues you! You whack!

  • @ruthbanon6049
    @ruthbanon6049 5 днів тому

    In minute 5:20 you said "more deteriorated". Not good english. How old are you? (not that I disagree with your assessment).

  • @robertmccarrick8410
    @robertmccarrick8410 5 днів тому

    Please increase volume

  • @marthaking6779
    @marthaking6779 5 днів тому

    By far the most straightforward, information-based discussion on this subject I've encounteref. Thank you.