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Generics drugs don't always work the same

MedicineInsuranceMergers, Acquisitions and Takeovers

Q: The generic form of Xanax, alprazolam, does not work for me. It is at best 50 percent effective.

A few years ago, I was given alprazolam in place of Xanax. My panic attacks came back with a vengeance. I kept thinking I had missed a dose. After three refills over three months and a visit to my doctor, I asked him if other people had complained. He said yes and wrote the prescription for Xanax only. It made a noticeable difference.

My insurance company recently stopped allowing this, and now I can only afford alprazolam. My anxiety is back. What's going on?

A: Whenever a benzodiazepine drug like alprazolam, clonazepam, diazepam or lorazepam is stopped suddenly, the patient can experience withdrawal symptoms. These include anxiety, panic, insomnia, muscle spasms, shocklike sensations, dizziness and headache.

It seems as though you may have had a withdrawal reaction when you switched to the generic alprazolam. That suggests that the generic is not truly equivalent for you. Perhaps your doctor can intervene with the insurance company on your behalf.

Q: Does sunscreen interfere with vitamin D levels? My doctor diagnosed me as seriously deficient in vitamin D even though I take calcium with D every day. I wear sunscreen whenever I go outside and wonder whether that could be a factor.

A. Sunscreen hinders the skin's ability to help create vitamin D. The amount you get from your supplement (typically 400 IU) is probably not adequate to overcome a deficiency. You will either need to spend 10 to 15 minutes in the sun without sunscreen a few times a week or take a vitamin D supplement that provides a higher dose (closer to 2,000 IU of vitamin D-3).

One reader reported the following: "I moved from the sunny Mediterranean region to overcast Washington state. I gradually started to fall apart, with body aches and pains and depression. Since starting 2,000 to 4,000 IUs of vitamin D daily, I feel a lot better. The aches and pains are much less of a problem, and my mood is much better."

Q: I was skeptical about liquid bandage to get rid of a skin tag, but when I found out my doctor's office would charge me $95 for removal, I decided to try your remedy first. The only brand at my store was New-Skin. I started treating the skin tag yesterday, applying New-Skin twice a day. The top half of the skin tag is shriveled up.

This is working, and I am going to keep at it until the skin tag is gone!

A: Skin tags are small, fleshy growths the same color as the surrounding skin. They are not dangerous, but they can be annoying.

Years ago, we heard from a reader who kept small adhesive bandages on skin tags for about 10 days to get rid of them. Another used castor oil once daily on skin tags. Some people tie the skin tag off tightly with dental floss, and it shrivels and falls off after several days.

Other readers have had success with liquid bandage. Here is one recent comment on our website: "I have removed several skin tags from my neck with store-brand liquid bandage. It worked every time."

In their column, Joe and Teresa Graedon answer letters from readers. Send questions to them via

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