![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1063 to 1087 of 8406. Go back in thread:
Posted by dr. dave on October 31, 2002, at 8:26:26
In reply to Re: Citalopram pharmacology » dr. dave, posted by SLS on October 30, 2002, at 7:26:31
Dear Scott,
> Do you feel you know enough about the brain, physiology, organic chemistry, and the pharmacology of these two drugs to state anything about getting down to science? I admit that I don't (not such a revelation). I just like doing thought experiments - you know - theory. My theories are constructed with great care but with insufficient knowledge for them to be worth a damn.I'm sorry if anything I've said seems arrogant. The main point I've been trying to make on this board is that claims are being made on very weak evidence about this drug, and there is no clear reason why, pharmacologically, the claims would be true - by which I mean there's no plausible mechanism of action (for any superiority over citalopram) that's been substantiated at all.
I feel qualified to comment on the science as it's what I've been educated in for many years, and it's my job to have an understanding of it - but I'm only commenting, which is not to say I don't get things wrong sometimes.
I couldn't agree more that what matters is what happens in real life, whatever the theories. Obviously Lexapro helps a lot of people and I'm not sure I have ever suggested otherwise. Whether it turns out to be significantly different from Celexa time will tell.
David
Posted by fiddlepuppy on October 31, 2002, at 17:54:02
In reply to Re: Citalopram pharmacology » SLS, posted by dr. dave on October 31, 2002, at 8:26:26
Lexapro at even 5 mg has made my anxiety, restlessness and agitation intolerable. I have been on it for 4 weeks. I am begging my doc to take me off it now.
Posted by SLS on October 31, 2002, at 19:57:13
In reply to Re: Citalopram pharmacology » SLS, posted by dr. dave on October 31, 2002, at 8:26:26
Hi, Dr. Dave.
> > Do you feel you know enough about the brain, physiology, organic chemistry, and the pharmacology of these two drugs to state anything about getting down to science? I admit that I don't (not such a revelation). I just like doing thought experiments - you know - theory. My theories are constructed with great care but with insufficient knowledge for them to be worth a damn.
> The main point I've been trying to make on this board is that claims are being made on very weak evidence about this drug,
I haven't been following the posts closely enough. What are the claims being made? What evidence has been offered to cooraborate these claims? Thanks.
> by which I mean there's no plausible mechanism of action (for any superiority over citalopram) that's been substantiated at all.
How would you critique my hypothesis regarding antagonistic stereochemisty between the enantiomers? How might this relationship be viewed with respect to the actions of partial agonists at neurotransmitter receptors?
> I feel qualified to comment on the science as it's what I've been educated in for many years, and it's my job to have an understanding of it - but I'm only commenting, which is not to say I don't get things wrong sometimes.
What is your background, and how are you applying it today?
I wish I had more. I might be able to help figure out this MF.
Be well.
Sincerely,
Scott
Posted by grace on October 31, 2002, at 21:53:08
In reply to Re: Anyone taking lexapro for GAD?, posted by wharfrat on October 29, 2002, at 9:55:20
> Is anyone out there taking lexapro for general anxiety disorder?
I am diagnosed with anxiety disorder & panic attacks, which I guess is pretty close to GAD. I was recently switched from Celexa to Lexapro due to the side effects I've had on Celexa. So far (week 3) I feel GREAT...actually really great except that I'm still really tired all the time, which was part of my prob with Celexa. Sexual side effects are another prob, but that's another story. A lot of the drugs that are prescribed for depression seem to have a lot of anti-anxiety properties as well and usually are pretty effective. Celexa has worked for me, as has Serzone and now Lexapro. I also take .5mg of Klonopin twice a day. Good luck!
Posted by Jaycee on November 1, 2002, at 6:23:18
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
5 weeks now on lex, increased sex drive, very very weird dreams, less headaches, have dizzy feeling in the morning which is relieved by 2 ibuprofen (can't figure that one out), seems to wear off around 7pm, start feeling slight anxiety. Eating like crazy..crave carbs/sweets, gained 4 lbs in 5 weeks. See doc on monday, will evaluate then.
Posted by maririp on November 1, 2002, at 7:11:06
In reply to 5 weeks lexapro, posted by Jaycee on November 1, 2002, at 6:23:18
> 5 weeks now on lex, increased sex drive, very very weird dreams, less headaches, have dizzy feeling in the morning which is relieved by 2 ibuprofen (can't figure that one out), seems to wear off around 7pm, start feeling slight anxiety. Eating like crazy..crave carbs/sweets, gained 4 lbs in 5 weeks. See doc on monday, will evaluate then.
I have been on lexapro 2 months. My sex drive is good but no orgasms..My appetite is better and I do crave sweets more but I dont find myself eating 24/7 like I did with other antidpressants. I felt dizzy and zoned out only the first few days..Iam not noticing any real bad side effects and I feel great. Mari
Posted by dr. dave on November 1, 2002, at 7:11:50
In reply to Re: Citalopram pharmacology » dr. dave, posted by SLS on October 31, 2002, at 19:57:13
Dear Scott,
> > The main point I've been trying to make on this board is that claims are being made on very weak evidence about this drug,
>
> I haven't been following the posts closely enough. What are the claims being made? What evidence has been offered to cooraborate these claims? Thanks.
The basic claim is that it is significantly different from Celexa in terms of side-effects and efficacy. I'm not sure there's been any particular evidence cited to support the idea that it has fewer side-effects, it's just one of those things that is claimed and then gets repeated and repeated. The evidence from the three trials from the initial development programme that Forest and Lundbeck ran clearly show there is no significant difference. I've quoted the figures in a previous post.In terms of efficacy, the main evidence cited is a meta-analysis of the three initial trials that compared citalopram and escitalopram. On the outcome measure that was defined at the outset of the trials, there was no significant difference. By analysing the data differently they have come up with some results which show a marginal but statistically significant difference in favour of escitalopram. I am highly skeptical of the clinical significance of this result, given that it is in the context of so many other results which show no difference, and the small magnitude of the difference.
> How would you critique my hypothesis regarding antagonistic stereochemisty between the enantiomers? How might this relationship be viewed with respect to the actions of partial agonists at neurotransmitter receptors?The affinity of r-citalopram for the serotonin re-uptake transporter is much much less than that of s-citalopram, by an order of about thirty times. There is therefore little chance of significant competition. The r-citalopram molecules have just too weak an affinity for the transporter to stop the s-citalopram molecules muscling in.
> > I feel qualified to comment on the science as it's what I've been educated in for many years, and it's my job to have an understanding of it - but I'm only commenting, which is not to say I don't get things wrong sometimes.
>
> What is your background, and how are you applying it today?
>
I studied natural sciences and medical science at Cambridge University in the UK, and I'm now a practicing psychiatrist.David
Posted by wharfrat on November 1, 2002, at 9:35:05
In reply to Re: Week 5 » wharfrat, posted by ANXIETY ANN on October 28, 2002, at 14:39:17
> > Ann,
> > Thanks for the support. Lexapro is the first antidepressant I've ever taken and I'm on other meds. I'm a 41 year old male. My new doctor (Family Physician)Is trying them on me. After other Doc's have told me over the past five or six years that there's nothing wrong with me I'm just to uptight, need to relax and not let things bother me. Easy for them to say! My new Doc thinks from talking with him, that I have a case of mild depression (mild?). Looking at some web sites I think I might have general anxiety disorder. 9 out of 10 symptoms are me. Worry about everything, insomnia, weight loss, anxiety, restlessness, irritabilty and so on. And this is nothing new. My wife told me the other day that I'm reminding her of how I was when we met 18 years ago, Happy, funny, less irritable, angry etc. But I think I've had a problem since I was a kid and it's just gotten worse. Actually I think it's inherited. My Mom took valium for years and my Dad was such an ill tempered tyrant, that my sister got married just to get away & I could'nt hardly stay through High School. Dad got on Paxil a couple of years ago but I don't think he takes them like he should. He's happy on them and meaner than hell off them. Anyway, that's my story and I don't intend to stop Lexapro or missing a dose. Don't want to take a chance of slipping back to the oldself. Myself and my family don't like him.
>
> Hi I can totally relate to your story. I was given Lexapro for extreme anxiety that started as a child. I started having full blown panic attacks in 1996 I too saw several docs who told me I needed to calm down (they should have a panic attack before they pretend to know what their talking about) I was put on xanax and was on that for 4 years but it didn't get rid of the generalized anxiety just the acute panic attacks. I am still in counseling and I take adivan for anxiety at least until I get adjusted to Lexapro. Anxiety does run in families my grandmother father and aunt all suffer from anxiety disorder. If your anxiety does not get better I would talk to your doc about maybe taking adivan to get you through. It soulds almost like what happened in the garage with the kids was the start of a panic attack. Did you feel like you had trouble breating , real nervous and dizzy ? Felt like you had to get out of there fast? All classic signs of panic. Talk to your doc if you like him or find on that specialzes in Anxiety and Depression. Good luck Ann
>
Ann, may have had small panic attacks and not really known what was going, the garage thing was probably a small one but Tues. at work, I'm working along minding my own business and suddenly start having butterflies in the stomach, dizzy,feel like I'm smothering and an urgent need to get away. I just left work without saying a word to anyone and it took about 45 min before it went away. Saw Doc Wed. he said definite panic attack, prescribed xanax,gave me 6 months scrip for lexapro (since It's working well for me) and sent me on my way. I wonder though if the Lex intensified the panic attack. I mean, it was a bad one. What do you think?
Posted by wharfrat on November 1, 2002, at 10:05:26
In reply to Re: 5 weeks lexapro, posted by maririp on November 1, 2002, at 7:11:06
> > 5 weeks now on lex, increased sex drive, very very weird dreams, less headaches, have dizzy feeling in the morning which is relieved by 2 ibuprofen (can't figure that one out), seems to wear off around 7pm, start feeling slight anxiety. Eating like crazy..crave carbs/sweets, gained 4 lbs in 5 weeks. See doc on monday, will evaluate then.
>
> I have been on lexapro 2 months. My sex drive is good but no orgasms..My appetite is better and I do crave sweets more but I dont find myself eating 24/7 like I did with other antidpressants. I felt dizzy and zoned out only the first few days..Iam not noticing any real bad side effects and I feel great. MariI know what Ya'll mean about the sweets. Reese's stocks should be going up. Plowed thru my kid's halloween candy after he went to bed (I ought to be ashamed! NOT!!)Never been a big guy, around 140 LBs. forever. Gained 5 in 5 weeks. Never really cared for candy before either. Sex drive of an 18 year old, but it's always been that way. Got to really relax to "complete the mission" wink, wink. Otherwise feeling great. Headaches went away after about a week. Did I say I'm feeling really great? This reality has woken me up to the fact that my job really sucks!! But I could care less - Wharf
Posted by Dkk1040 on November 1, 2002, at 11:27:05
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
> [Posted by ggrrl on June 11, 2002, at 1:19:51]
>
> > Seems like there are a lot of people on here who have talked about Lexapro's improved side-effects, specifically that it has less tiredness and sexual side effects than Celexa. Some have said that it has the same side effects as Celexa. However most people are quoting from press releases - does anyone here know from experience (theirs or others')?
>
>I've switched to Lexapro from two years on Celexa. Celexa gave me dry mouth and headaches Lexapro does not! I am very very grateful for Lexapro and wouldn't want to live life without it.
To the people that post on the board, a question.... What is your life like without this drug, is it better or worse? Some of the SE I'd rather live with than live life without the replacement of the brain chemical I lack, namely seratonin. Of all the side effects people state on this board MOST are treatable, tolerable, and improve over time. Give it a chance! Some take weeks to months, NOT just one dosage, or a day, or a week. This is not a "make me feel better now" drug. Best wishes to everyone, and if this drug does NOT work for you please don't give up hope, but be persistent and try something else.
Posted by dr. justin on November 1, 2002, at 12:32:24
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by Dkk1040 on November 1, 2002, at 11:27:05
> I've switched to Lexapro from two years on Celexa. Celexa gave me dry mouth and headaches Lexapro does not! I am very very grateful for Lexapro and wouldn't want to live life without it.
>
This is exactly the type of question I need answered... I tried to start another thread but it hasn't worked. Please... to all of you out there who have been on Celexa, and have switched to Lexapro for a length of time significant enough to judge the two, could you please share with me the benefits/problems you found with the switch?Here's my situation. A mixed bag anxiety/OCD/depression problem that has been treated well. But I'm developing a real problem leaving the house-- kind of a hermit complex. Business trips, too. So I’m supposed to make the switch to Lexapro. But besides some sexual SE, Celexa works well for me, just not well enough to stop my decent into "hermitism." But will Lexapro? Please share whatever you can. Thanks.
Justin
Posted by celesteloveage on November 1, 2002, at 12:36:51
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by Dkk1040 on November 1, 2002, at 11:27:05
My life before lexapro was a very colorless existence. I've been slowly progressing into depression for almost two years when I fractured my hip, lost my job due to downsizing, my dad died, and if all that weren't bad enough I developed something called osteonecrosis due to my hip fracture which has resulted in my femur dying and having to live with chronic pain until I can have a total hip replacement done. Don't mean to sound like a whiner...I'm not! My point is... I would never want to go back to that ever again and I too am willing to deal with side effects I didn't know how truly majorly depressed I was until the lights got turned back on in my brain. It's as if it seems to good to be true that a little pill can work such wonders. My only fear now is that it will come to an end!
Kind regards,
lori
Posted by celesteloveage on November 1, 2002, at 12:42:25
In reply to Re: Anyone taking lexapro for GAD?, posted by grace on October 31, 2002, at 21:53:08
I was prescribed lexapro for anxiety, agrophobia, and major depression. It started working wonders on the anxiety, panic, physical tension, excessive worry within two days of taking and that is 10 mg.'s once a day.
> > Is anyone out there taking lexapro for general anxiety disorder?
>
>
>
> I am diagnosed with anxiety disorder & panic attacks, which I guess is pretty close to GAD. I was recently switched from Celexa to Lexapro due to the side effects I've had on Celexa. So far (week 3) I feel GREAT...actually really great except that I'm still really tired all the time, which was part of my prob with Celexa. Sexual side effects are another prob, but that's another story. A lot of the drugs that are prescribed for depression seem to have a lot of anti-anxiety properties as well and usually are pretty effective. Celexa has worked for me, as has Serzone and now Lexapro. I also take .5mg of Klonopin twice a day. Good luck!
Posted by cannoli on November 1, 2002, at 13:51:26
In reply to 5 weeks lexapro, posted by Jaycee on November 1, 2002, at 6:23:18
I've just switched to Lexapro after several years away from SSRIs (was taking an MAOI, which was great while it lasted). With previous SSRIs (I tried several), I experienced ejaculatory delay in early weeks, but the real problems came after a year or so on a particular drug, at which time my sex drive would start to decrease until it was virtually nonexistent. It seems to me that the studies probably seriously underreport sexual side effects because they typically study people who have been on a drug for 8 weeks or less. I know no one has been on Lexapro for a long time, but what about Celexa? Anyone who has been on Celexa for a couple of years - has it killed your sex drive? Thanks.
Posted by dr. justin on November 1, 2002, at 14:09:39
In reply to Sexual side effects, posted by cannoli on November 1, 2002, at 13:51:26
> I know no one has been on Lexapro for a long time, but what about Celexa? Anyone who has been on Celexa for a couple of years - has it killed your sex drive? Thanks.
I've been on Celexa for almost three years now. Sorry; I've got nothing good to report when it comes to sex drive SE's. My sex drive is DEAD. It was a gradual process; it probably took 18 months. I didn't even notice the disappearance of my libido. On the bright side, with some effort, I can achieve and maintain an erection. And I don't have to work at it forever to achieve an orgasm. So, the equipment still works. And you can find ways around the “libido lowering”. For example, I've noticed if you force yourself to have sex (man, does it sound weird to say that!), your libido will increase for a few days afterwards. So, if you keep at regularly having sex (at least a couple times a week), it will help maintain the elevated libido. But if you stop... BAM! You're sex drive is off-line again. I hope this helps.
Cheers,
Justin
Posted by ANXIETY ANN on November 1, 2002, at 16:56:51
In reply to Re: Week 5Anxiety Ann, posted by wharfrat on November 1, 2002, at 9:35:05
> > > Ann,
> > > Thanks for the support. Lexapro is the first antidepressant I've ever taken and I'm on other meds. I'm a 41 year old male. My new doctor (Family Physician)Is trying them on me. After other Doc's have told me over the past five or six years that there's nothing wrong with me I'm just to uptight, need to relax and not let things bother me. Easy for them to say! My new Doc thinks from talking with him, that I have a case of mild depression (mild?). Looking at some web sites I think I might have general anxiety disorder. 9 out of 10 symptoms are me. Worry about everything, insomnia, weight loss, anxiety, restlessness, irritabilty and so on. And this is nothing new. My wife told me the other day that I'm reminding her of how I was when we met 18 years ago, Happy, funny, less irritable, angry etc. But I think I've had a problem since I was a kid and it's just gotten worse. Actually I think it's inherited. My Mom took valium for years and my Dad was such an ill tempered tyrant, that my sister got married just to get away & I could'nt hardly stay through High School. Dad got on Paxil a couple of years ago but I don't think he takes them like he should. He's happy on them and meaner than hell off them. Anyway, that's my story and I don't intend to stop Lexapro or missing a dose. Don't want to take a chance of slipping back to the oldself. Myself and my family don't like him.
> >
> > Hi I can totally relate to your story. I was given Lexapro for extreme anxiety that started as a child. I started having full blown panic attacks in 1996 I too saw several docs who told me I needed to calm down (they should have a panic attack before they pretend to know what their talking about) I was put on xanax and was on that for 4 years but it didn't get rid of the generalized anxiety just the acute panic attacks. I am still in counseling and I take adivan for anxiety at least until I get adjusted to Lexapro. Anxiety does run in families my grandmother father and aunt all suffer from anxiety disorder. If your anxiety does not get better I would talk to your doc about maybe taking adivan to get you through. It soulds almost like what happened in the garage with the kids was the start of a panic attack. Did you feel like you had trouble breating , real nervous and dizzy ? Felt like you had to get out of there fast? All classic signs of panic. Talk to your doc if you like him or find on that specialzes in Anxiety and Depression. Good luck Ann
> >
> Ann, may have had small panic attacks and not really known what was going, the garage thing was probably a small one but Tues. at work, I'm working along minding my own business and suddenly start having butterflies in the stomach, dizzy,feel like I'm smothering and an urgent need to get away. I just left work without saying a word to anyone and it took about 45 min before it went away. Saw Doc Wed. he said definite panic attack, prescribed xanax,gave me 6 months scrip for lexapro (since It's working well for me) and sent me on my way. I wonder though if the Lex intensified the panic attack. I mean, it was a bad one. What do you think?
>
Hi
I just read your post and it sounds like classic panic attacks. The Lexapro could make them worse as it seems like everytime I take ANY new meds I have a panic attack. The doc told me its because I get so uptight about the (possible) s/e of new meds that I have panic.
Did you have panic attacks before you went on Lexapro? If not, Its possible that the Lex brought them on, but I would wait to see what happens before going off it. Let me know how it goes,
Ann
Posted by grace on November 1, 2002, at 18:44:16
In reply to Sexual side effects, posted by cannoli on November 1, 2002, at 13:51:26
> I've just switched to Lexapro after several years away from SSRIs (was taking an MAOI, which was great while it lasted). With previous SSRIs (I tried several), I experienced ejaculatory delay in early weeks, but the real problems came after a year or so on a particular drug, at which time my sex drive would start to decrease until it was virtually nonexistent. It seems to me that the studies probably seriously underreport sexual side effects because they typically study people who have been on a drug for 8 weeks or less. I know no one has been on Lexapro for a long time, but what about Celexa? Anyone who has been on Celexa for a couple of years - has it killed your sex drive? Thanks.
I have been on various SSRI's - mostly Celexa for about 2 years and the sexual side effects never went away or got better without additional help. First thing to go was the libido...I mean, no desire to have sex at all....if someone else brought it up, then I was up for it, but basically the thought just didn't enter my mind. Then, of course, there is the lack of orgasm. It's been next to impossible to achieve it without additional meds for me. Sorry to report this, but to me, it is worth it to feel like myself again.
Posted by Katarina on November 2, 2002, at 8:24:21
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
> [Posted by ggrrl on June 11, 2002, at 1:19:51]
>
> > Seems like there are a lot of people on here who have talked about Lexapro's improved side-effects, specifically that it has less tiredness and sexual side effects than Celexa. Some have said that it has the same side effects as Celexa. However most people are quoting from press releases - does anyone here know from experience (theirs or others')?
>
>
I started with Prozac in '98. No adverse side effects...nausea at first but it went away promptly. It seemed to erase the perpetual "dark cloud". However, I was nearly bouncing off the walls. People at work would say, "Wow, Kat is so happy! What is she on?", (not the effect I was going for). My daughter also noted that I was improved yet I would get very angry sometimes. I had previously been one to hold it in. My daughter is an adult now, so I greatly appreciate her input. She noted that now I had a tendency to "bite people's heads off" (not good). So my doc (not p-doc) switched me to Effexor. I got a bit too nauseated on that and found no real relief. Now I am on Lexapro. Again, no real relief yet (it's been 3 weeks). It is supposed to act quickly. I have very strange dreams, sweating and that dark cloud is back. Boo!
I understand how the mirror image isomer acts, and the proposed efffect, yet I don't understand what makes one SSRI better than another, and why they would make me feel so strange. Is it like acetominophen vs. ibuprofen for a fever...both reduce it yet each works differently in the body? I've read so much about this stuff, yet am not further enlightened, plus doc gets tired of my armchair doctor-babble.
Any thoughts, suggestions, etc. are welcome.
Thanks,
Kat
Posted by bridgette on November 2, 2002, at 10:14:16
In reply to Re: Anyone switched to Lexapro? ?ggrrl, posted by Katarina on November 2, 2002, at 8:24:21
what are we supposed to feel---how do we know it's working? I have been on Lexapro for 5 1/2 weeks and have added Buspar this week to see if no1 it will enhance it and no 2 help w/sexual side effects. Maybe, I'm feeling as good as I can feel. That's scary. There are some days I feel pretty good, calm too, but I still have social anxiety and I'd like for that to go away. Sound like I want a designer drug to cure all ills. My Dr wanted to try Paxil because he said it would be better w/social anxiety but I wouldn't because I heard it is likely to cause weight gain.
Posted by jakeny on November 2, 2002, at 17:08:40
In reply to Re: Sexual side effects, posted by grace on November 1, 2002, at 18:44:16
I've been on Celexa 20mg for about two years. While there has been significant decreased sex drive, it never went to non existant (thankfully). It also took more than six months until ejaculations and sensitivity came closer to normal. Went i tried to go off Celexa and went down to minimal dose and then went back (due to depression coming back) it took another six months for sexual side effects to subside.
My Dr. has just given me Lexapro to try which is how i wound up on this site. Based on posts on this site im not too encouraged.
Posted by pharmrep on November 2, 2002, at 17:58:28
In reply to Sexual side effects, posted by cannoli on November 1, 2002, at 13:51:26
I hate getting booted by Dr Bob...let's all play nice so nobody disappears for awhile again...ok.
Posted by pharmrep on November 2, 2002, at 18:02:40
In reply to Sexual side effects, posted by cannoli on November 1, 2002, at 13:51:26
> I've just switched to Lexapro after several years away from SSRIs (was taking an MAOI, which was great while it lasted). With previous SSRIs (I tried several), I experienced ejaculatory delay in early weeks, but the real problems came after a year or so on a particular drug, at which time my sex drive would start to decrease until it was virtually nonexistent. It seems to me that the studies probably seriously underreport sexual side effects because they typically study people who have been on a drug for 8 weeks or less. I know no one has been on Lexapro for a long time, but what about Celexa? Anyone who has been on Celexa for a couple of years - has it killed your sex drive? Thanks.
*** Yeah...the 8wk FDA studies only take "volunteered" info for sexual side effects...they never acutally ask the question...so most drugs tested report between 4-12% when in reality it's 20-60%. For SSRI's they are mostly similar...although Paxil seems to be the worst of the bunch.
Posted by pharmrep on November 2, 2002, at 18:24:52
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by Katarina on November 2, 2002, at 8:24:21
> I understand how the mirror image isomer acts, and the proposed efffect, yet I don't understand what makes one SSRI better than another, and why they would make me feel so strange. Is it like acetominophen vs. ibuprofen for a fever...both reduce it yet each works differently in the body? I've read so much about this stuff, yet am not further enlightened, plus doc gets tired of my armchair doctor-babble.
> Any thoughts, suggestions, etc. are welcome.
> Thanks,
> Kat
>*** You are correct...the 6 SSRI's before Lexapro were very similar. (Prozac,Paxil,Zoloft,Celexa,Luvox,Serzone) All showed similar efficacy in trials against each other...they would just differ in side effect profiles, and Drug-to-drug interactions, and other secondary features...(dosing, etc.) Lexapro is the 1st SSRI to demonstrate greater efficacy, while not having "baggage" to go with it..like side efx. Lexapro works in 1-2 weeks for most people, has side effects comparable to placebo (per the FDA in the package insert), has a 10mg starting and maintenace dose (titrating is minimized), has the best p450 profile (lack of drug-interactions), it is the least expensive as well. There are many reasons to like Lexapro, it has many advantages over other SSRI's. It's new, yet many Dr's are using it already because they are seeing what is mentioned above and how it helps their patients
Posted by dr. justin on November 2, 2002, at 18:33:33
In reply to Re: differences in SSRI's/see bottom » Katarina, posted by pharmrep on November 2, 2002, at 18:24:52
pharmrep,
I have 2 questions. 1) Has Lexapro been shown to have any advantages over Celexa where anxiety or SAD's are concerned?, and 2) It sounds from other posts that the sexual side-effects are similar; so, if that is your chief concern, is there any reason to switch from Celexa to Lexapro? Thank you.
~ Justin
Posted by karanan on November 2, 2002, at 20:07:29
In reply to Re: differences in SSRI's/see bottom » pharmrep, posted by dr. justin on November 2, 2002, at 18:33:33
> pharmrep,
>
> I have 2 questions. 1) Has Lexapro been shown to have any advantages over Celexa where anxiety or SAD's are concerned?, and 2) It sounds from other posts that the sexual side-effects are similar; so, if that is your chief concern, is there any reason to switch from Celexa to Lexapro? Thank you.
>
Caution: Sure....lets rush and switch everyone over to Lexapro as it has "less side effects." "Less side effects"......remember Paxil??
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