welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Friday, November 30, 2012

evergreening its not what you think it is

no this is not a blog today about organic green living or gardening
or about reforesting the burned out bastrop pines
its about the practice of evergreening

im sure if you have taken any prescription medication you have
been evergreened

not quite sure where the term came from
but i think its from the fact that the drug companies
are always making money from a drug by making slight
changes in it to keep in on patent and to keep it branded and
to keep it expensive

evergreening is where a drug when its close to losing its patent
is changed slightly or combined with another medicine so it
can be continued on a longer patent
prilosec (omeprazole) for stomach acid
was altered to nexium (esomeprazole)
commonly drugs are made extended relief and add xr or er to the name
paxil to paxil xr
verapamil to verapamil xr
ritalin to ritalin xr

what this means is the company can continue to charge higher prices and
maintain profit sometimes for years
and of course we know who pays for all that profit

thats evergreening

in 2010 aricept was evergreened
the aricept patent was due to expire and the aricept was about to go
generic so
a japanese company along with pfizer developed the aricept 23 pill
aricept comes in 5 mg and 10 mg doses and you cant add them
up to get to 23

if your doctor writes for aricept 23 then there is not a generic eqivalent
to that
pretty damn smart huh
and legal

but in my view very shameful
shame on pfizer and shame on the fda and shame on all those doctors
who succumb to the advertising blitz that occurred
yes even major alzheimers groups and medical groups and medical journals
had aricept 23 ads everywhere
yes shame shame

aricept 23 is indicated according to its own website for moderate to severe
alzheimers disease
in a little over 1000 patients there was a slight increase in cognition based
on testing but no clinical improvement was noted by physicians or by the
patients families

that is what its all about
does it work does it make a difference can you see your mom or dad
or brother get better on this
the answer is no it doesnt help better

most consensus is that generic donepezil works just as well with
much less side effects

remember if you have alzheimers you arent going to get better over time
and you will go down hill no matter what is done

aricept slows down the symptoms some at least for awhile
so you get some more time with your family as more like yourself
it doesnt cure it though

warning   if you stop donepezil (aricept) in a patient with alzheimers
you can see a rapid decline in their status as the drug wears off
if it was working to slow things down some

eg if i were to stop my donepezil (aricept) that im on now
i might fast forward up to 5 years so that my family would
notice a significant change in the progression of the disease
im not willing to do this

there was also an increase in side effects to the medicine dose of 23 mg
with more nausea and vomiting and decreased appetite
eating and appetite of course is a big problem with alzheimers patients
as they advance in their disease
many neurological advisors to the fda recommended that aricept 23 not
be approved

well it was 2 years ago and now pfizer has made millions of dollars of profits
off of us
those of us with family members with alzheimers
those of us with alzheimers

yes shame shame

form costoc pharmacy today a 90 day supply of
aricept 10 mg brand is $972.19
donepezil 10 mg generic aricept is $25.40
aricept 23 brand is $909.20

i personally pay cash for my donepezil and get 180 pills for a little over
since my insurance company will only let me get 30 days at a time for $5
i elected to go to costco and get the 180 day supply for cash
i hate going to the pharmacy so now i only go twice a year

yes shame shame
shame on the drug companies
shame on the fda
shame on the doctors who allow themselves to be influenced
shame on the politicians who allow all this to happen
and shame on you and i for not doing something about this

the oganicgreen doctor


  1. What can we do, besides keeping our eyes open for the evergreening? Where should we protest?
    Thank you for this blog.

    1. if you are on generics you are usually not evergreened
      the big pharma have such an influence on the fda it makes it hard to protest
      question your doctor when he or she writes you a brand medicine as there is more than likely a generic equivalent
      even i fight the battle with my meds with the two doctors who treat me
      it of course helps a lot that im a doctor and understand how the system works

  2. I'm on generics only. But I will tell my friends about this.
    (Also, I have no health insurance. I can't afford it. It scares me sometimes, then sometimes I just tell myself that it means only that I don't have access to late-20th-century or 21st-century diagnostic technology.)