40. Are All Generic Drugs Created Equal?

Marcus and Esme break down generic prescription drugs: what they are, how the FDA approves them, and why patients sometimes feel different effects when pharmacies switch manufacturers.

Marcus shares his personal experience with generic prescription meds to explore manufacturing differences, inactive ingredients, the nocebo effect, and the limits of current testing.

The episode also covers real-world impacts on neurodivergent people and a call-to-action resource about a federal executive order on involuntary commitment (5Calls).

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Sources for this episode include:

• “How Drugs Are Developed and Approved.” U.S. Food and Drug Administration, 24 Oct. 2022, https://www.fda.gov/drugs/development-approval-process-drugs/how-drugs-are-developed-and-approved 


• “The Generic Drug Approval Process.” U.S. Food and Drug Administration, 17 Mar. 2022, https://www.fda.gov/drugs/cder-conversations/generic-drug-approval-process 


• “What Is the Approval Process for Generic Drugs?” U.S. Food and Drug Administration, 17 Mar. 2022, https://www.fda.gov/drugs/generic-drugs/what-approval-process-generic-drugs 


• Wartolowska, Karolina. “The nocebo effect as a source of bias in the assessment of treatment effects.” F1000Research vol. 8 5. 3 Jan. 2019, doi:10.12688/f1000research.17611.2 

Shareable resources for this episode include:

• “Protect the Civil Rights of the Unhoused and Mentally Ill.” 5 Calls Civic Action, 2025, https://5calls.org/issue/unhoused-mental-illness-executive-order 

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