![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1342 to 1366 of 8406. Go back in thread:
Posted by Mr.Scott on November 24, 2002, at 17:41:12
In reply to Re: PoppyCock! » Mr.Scott, posted by Squiggles on November 24, 2002, at 16:12:59
Unless of course I am genuinely more skilled that is... And I have met only one psychiatrist in 12 years that truly out knew me in terms of pharmacology. Another one was truly compassionate but not super-knowledgable(unfortunately he passed away). My current one is pretty good, yet I was actually truly 'sociopathed' on two occassions as well.
The talent pool is not that good out there.
Posted by Mr.Scott on November 24, 2002, at 17:44:45
In reply to fiery rhetoric, poppycock everything in between, posted by ayuda on November 24, 2002, at 16:32:25
I enjoy your input and couldn't agree more!
You are your only true advocate besides a few family members and friends who will never really know what's it like to be you anyways.
Posted by Squiggles on November 24, 2002, at 17:46:20
In reply to Re: PoppyCock!, posted by Mr.Scott on November 24, 2002, at 17:41:12
Consciousness - the final frontier;
I think it is more mysterious and more
difficult to understand, let alone change
or correct, than nuclear physics.Squiggles
Posted by Mr.Scott on November 24, 2002, at 17:47:38
In reply to Re: Fiery Rhetoric » Geezer, posted by Squiggles on November 24, 2002, at 17:37:54
I hear you...
If my best friend could write scripts I'd be in pretty good shape...
Scott
Posted by Mr.Scott on November 24, 2002, at 17:50:36
In reply to Re: PoppyCock! » Mr.Scott, posted by Squiggles on November 24, 2002, at 17:46:20
I like NASA and all, but they should spend that money (and much other moneys) on elucidating the secrets of the mind before we bother venturing into outerspace to study rocks and gas.
Obviously I am biased!
Scott
Posted by ayuda on November 24, 2002, at 17:53:37
In reply to Re: Fiery Rhetoric » Squiggles, posted by Mr.Scott on November 24, 2002, at 17:47:38
> I hear you...
>
> If my best friend could write scripts I'd be in pretty good shape...
>
> ScottIf my best friend could write scripts, he'd tell me I don't need one -- it's the rest of the world that needs to chill! (At least, that's what he'd better tell me!)
Posted by Alan on November 24, 2002, at 19:51:49
In reply to Fiery Rhetoric, posted by Mr.Scott on November 24, 2002, at 14:35:27
> I think this thread will serve as a fine place to insert my fiery rhetoric...
>
>
> Some psychiatrists are stupid (even though they excel at algebra & geometry).
>
> Some pharmreps are interested only in commissions generated from scripts written for their drug. They are tenaciously persistent sociopaths disguised as helpers (yet are actually minions). They are line items in a marketing budget and human advertising vehicles sent from evil and self-serving corporate entities.
>
> Look at all they provide with extreme caution and generality. The doctors conducting the studies are 'generally' without conscience.
>
> You will do best to be your own doctor in many ways. How many of you are so passionate about your jobs that you would be comfortable letting people entrust their lives to you. Do you think these wise scholars are any different?
>
> Don't let them (MD's and large corporations) make you fat, impotent, and sedated and then send you the bill. They are your employees. Make them do their job of making you feel better (numb and too full of side-effects to care doesn't count). If they can't do their jobs fire them and move on. Ultimately your destiny is in your hands. Do not relinquish it to the self-serving.
=============================================
The docs aren't all to blame, the system is moreso in my opinion.Well, how would one improve the FDA regulatory process for instance, and what would be the practical consequence to patients via their doctors of such improvement?
First of all, take oversight of clinical trials away from the FDA and give it to the NIH. That is, accept as evidence only trials designed and supervised by the NIH.
Failing that, ban cross-employment between the FDA and any company that it regulates for 10 or 15 years in either direction. Right now, there is a revolving door between the fox's house and the henhouse. It's bad enough that regulators are hired directly from the regulated companies. It's even worse that the FDA's "internal advocate" for a drug can and often does leave the FDA after approval of the drug to earn hundreds of thousands of dollars a year working for the maker of the drug.
Actually, we probably need both of the steps above.
And of course we need a law placing all directly or indirectly maker-funded research about a drug into the public domain when that drug receives FDA approval.
I also believe the "control groups" in the research should be better defined.
Alan
Posted by Squiggles on November 24, 2002, at 20:35:07
In reply to Re: Fiery Rhetoric » Mr.Scott, posted by Alan on November 24, 2002, at 19:51:49
Assuming that a drug has successfully
passed the FDA, and is truly a benign
drug with a good safety margin, there
is another problem in health care in
general, which i believe is totally
ignored.The tests that are taken for a certain
condition are not frequent enough; take
for example blood tests for diabetes--
if a test is taken once a year, then it
is not likely that a true, rounded picture
of the blood condition will show. All
the good drugs in the world will not help
if you don't check the gas or the water
frequently enough.I really think that this is a serious
problem in medicine. If we could have
something analogous to a gas pump station
to even self-monitor for a myriad of blood
pictures, much misery and disease could
be prevented.Squiggles
Posted by Donna Louise on November 24, 2002, at 20:44:06
In reply to Re: Side-effects - best data » dr. dave, posted by ayuda on November 24, 2002, at 12:20:36
I think I know what you are talking about with the disconnection. I have thought of it as depersonalization. It is hard to describe,but I had it with paxil. I would tell people it felt like I was dreaming. I am taking Lexapro now and am happy to tell you that I am not having this side effect. As a matter of fact, the only side effects I am having are the sexual ones and a slight emotional numbing. Of course that may be what normal feels like, I wouldn't know!
Donna Louise
Posted by ayuda on November 24, 2002, at 20:58:35
In reply to Re: Fiery Rhetoric » Alan, posted by Squiggles on November 24, 2002, at 20:35:07
People need to be monitored constantly on these meds. My gyn was shocked that my shrink hadn't ordered blood tests with all the meds I'm on. Even though the ones he ran showed no problems, no one ruled out physical problems OR checked to make sure that I was okay physically. The thought hadn't even crossed my mind.
Another issue that I have is with what they consider to be adverse events worth mentioning. You can't measure, or even test for, some of the worst s/e's, and they don't give enough time during these trials to catch many of the adverse events that happen over time.
Plus the information that does come out can be interpreted in so many different ways, and what it means for different people is not clear. If only 11% of people in a trial had "x" s/e, that doesn't mean that I won't, or will, have that s/e, so it is kind of useless information. If I'm a person who does have that s/e, then it doesn't matter if I'm the only one or if I'm one of a several hundred who've experienced it. And doctors misinterpret those numbers and their meanings all the time.
Again, that's why online groups such as this can be important. We find out what other people are experiencing, even if it isn't our experience or it turns out it isn't related to the drugs we are taking. Who's to say that we don't constitute a "control group" of our own?
> Assuming that a drug has successfully
> passed the FDA, and is truly a benign
> drug with a good safety margin, there
> is another problem in health care in
> general, which i believe is totally
> ignored.
>
> The tests that are taken for a certain
> condition are not frequent enough; take
> for example blood tests for diabetes--
> if a test is taken once a year, then it
> is not likely that a true, rounded picture
> of the blood condition will show. All
> the good drugs in the world will not help
> if you don't check the gas or the water
> frequently enough.
>
> I really think that this is a serious
> problem in medicine. If we could have
> something analogous to a gas pump station
> to even self-monitor for a myriad of blood
> pictures, much misery and disease could
> be prevented.
>
> Squiggles
Posted by Squiggles on November 24, 2002, at 21:08:39
In reply to Re: Fiery Rhetoric » Squiggles, posted by ayuda on November 24, 2002, at 20:58:35
Yes, I agree with what you say; i am not
sure what a significant result in a trial
test is, but for myself, i am pretty sure
that i am now getting hyponatremia as a result
of sodium excretion from chronic lithium use;
that is just a hunch from reading and matching
my symptoms which are recent - constant thirst,
fevers, head sensations, orthostatic hypotension,
peripheral neuropathy, and salt, salt, salt,
all over my body - where is it coming from?
Not to mention the d word ( yuch, every morning );So, i am experimenting and lowering my lithium
every week by a small amount as i have asked
to have it lowered but i got the reply (3x) that
i am in the safe range (0.50 to 1.2). And that
range is taken once a year and was shown to me;
I wanted to say but but but, the level may change,
but i am so shy.You see my point. Very frustrating as i am
not a doctor and yet i am sure something is
going wrong.Squiggles
Posted by ayuda on November 24, 2002, at 21:15:26
In reply to Re: Side-effects - best data » ayuda, posted by Donna Louise on November 24, 2002, at 20:44:06
> I think I know what you are talking about with the disconnection. I have thought of it as depersonalization. It is hard to describe,but I had it with paxil. I would tell people it felt like I was dreaming. I am taking Lexapro now and am happy to tell you that I am not having this side effect. As a matter of fact, the only side effects I am having are the sexual ones and a slight emotional numbing. Of course that may be what normal feels like, I wouldn't know!
> Donna Louise
Thank you so much for that info. You and JLM have given me the name for that -- depersonalization. It is so appropriate. It makes life feel like being at an IMAX movie, or like you said, like you are dreaming. I am really hoping that I don't experience it with the Lexapro -- and it is heartening to hear that you haven't had it with the Lex. But speaking of dreaming, are you having vivid dreams that feel real with the Lex? I'm having some really zany dreams, which is not like me, but they aren't unpleasant. Just vivid.The emotional numbing, do you mean as if you were taking a mood-stabilizer? If you've never taken one, it pretty much puts you in one mood -- which was necessary for me when I had a tyrant of a supervisor at the time this depression started and I needed to not harm her -- for legal and ethical reasons -- before I could change jobs. I didn't get extremely anything, which I usually do.
And I understand your point about normal -- I actually was feeling "normal" for most of my 20s and into my early-30s, so I have this vague memory of what it felt like, which is how I know I'm not it. Then again, even that idea changes over time. The closest I ever came to putting a finger on it was when I started Zoloft the first time, my first SSRI. I was driving down the road and someone attempted to turn left from the right lane, and I was in the left lane, so they almost creamed me. I blew on my horn, pointed my finger at them, then went on, and 3 blocks later I realized that I wasn't still shaking and screaming about it, in fact, I was over it, and I thought, "so this is what it's like to be a normal person." So, as long as I'm not a raving maniac, I figure I, and the rest of the world, am lucky.
I'm not completely only on the Lexapro yet -- my doctor increased my Effexor to a slower taper because I was becoming an anxiety-ridden screaming maniac late last week. So I don't know what life will be like when I am only on the Lex.
Thanks again for the info and support where the depersonalization is concerned -- since you've experienced it, you know why I don't want to mess with it for a minute. Defeats the purpose of getting my life back from the depression and anxiety!
Posted by Geezer on November 24, 2002, at 21:15:46
In reply to Re: Fiery Rhetoric » Alan, posted by Squiggles on November 24, 2002, at 20:35:07
> Assuming that a drug has successfully
> passed the FDA, and is truly a benign
> drug with a good safety margin, there
> is another problem in health care in
> general, which i believe is totally
> ignored.
>
> The tests that are taken for a certain
> condition are not frequent enough; take
> for example blood tests for diabetes--
> if a test is taken once a year, then it
> is not likely that a true, rounded picture
> of the blood condition will show. All
> the good drugs in the world will not help
> if you don't check the gas or the water
> frequently enough.
>
> I really think that this is a serious
> problem in medicine. If we could have
> something analogous to a gas pump station
> to even self-monitor for a myriad of blood
> pictures, much misery and disease could
> be prevented.
>
> SquigglesSquiggles,
Now you have it, this is the very problem with psychiatry, NO MEDICAL TESTING.....plenty of meaningless psychological hokus-pokus but no testing leading to a definitive DX and effective treatment. We need to see the genetic markers, intra-cellular ADs, etc. - not likely to occur in my life time. Stay with your GP and read this board.....you will be as well off as anyone else.
Best of luck to you,
Geezer
Posted by Geezer on November 24, 2002, at 21:24:27
In reply to Re: Fiery Rhetoric » ayuda, posted by Squiggles on November 24, 2002, at 21:08:39
> Yes, I agree with what you say; i am not
> sure what a significant result in a trial
> test is, but for myself, i am pretty sure
> that i am now getting hyponatremia as a result
> of sodium excretion from chronic lithium use;
> that is just a hunch from reading and matching
> my symptoms which are recent - constant thirst,
> fevers, head sensations, orthostatic hypotension,
> peripheral neuropathy, and salt, salt, salt,
> all over my body - where is it coming from?
> Not to mention the d word ( yuch, every morning );
>
> So, i am experimenting and lowering my lithium
> every week by a small amount as i have asked
> to have it lowered but i got the reply (3x) that
> i am in the safe range (0.50 to 1.2). And that
> range is taken once a year and was shown to me;
> I wanted to say but but but, the level may change,
> but i am so shy.
>
> You see my point. Very frustrating as i am
> not a doctor and yet i am sure something is
> going wrong.
>
> SquigglesThat Lithium is supposed to be checked a lot more often than once per year.
>
Posted by Squiggles on November 24, 2002, at 21:28:03
In reply to Re: Fiery Rhetoric » Squiggles, posted by Geezer on November 24, 2002, at 21:24:27
How often in your opinion? And how can
i bring that up without offending or
jeopardizing an otherwise good relationship
with my doctor?tx for paying attention to me;
Squiggles
Posted by Donna Louise on November 24, 2002, at 21:32:48
In reply to Re: Side-effects - best data » Donna Louise, posted by ayuda on November 24, 2002, at 21:15:26
I also know what you mean about the dreams. It was really bad with the paxil. Sometimes I felt like the dream world was more real than than the waking world. I felt like I floated in and out of a dream state all day. That felt like what I call disassociation. I also had it on Effexor. I still am having vivid dreams with the Lexapro but they are not following me into waking life as with the paxil and effexor. I have heard that vivid dreams are a result to something the SRI does to REM sleep. Not sure what it is exactly. By the way, I was on the paxil and effexor at the same time and went off them both while starting the lexapro, doing both over a period of 2 weeks I think it was, and I had very little withdrawal symptoms. I have detoxed from paxil before, without simultaneously starting another SRI and thought I was going to die.
I do not take a mood stablizer, I am just a run of the mill depressive/anxiety type. When I say emotional numbing, I am talking about what may very well feel like what a mood stablizer does, I don't know. I just don't feel as sensitive or reactive. I am thinking that is what a mood stablizer must do, as I type this. hmmm.
Also, to let you know, I also took Celexa for a few months and d/c'd it due to an extreme amount of tension in the neck and shoulders. I am sure there is a word for this...anyway, I do not have that on the lex. So I am a pretty satisfied customer, if I could just get the sex thing settled...Donna Louise
>
>
> Thank you so much for that info. You and JLM have given me the name for that -- depersonalization. It is so appropriate. It makes life feel like being at an IMAX movie, or like you said, like you are dreaming. I am really hoping that I don't experience it with the Lexapro -- and it is heartening to hear that you haven't had it with the Lex. But speaking of dreaming, are you having vivid dreams that feel real with the Lex? I'm having some really zany dreams, which is not like me, but they aren't unpleasant. Just vivid.
>
> The emotional numbing, do you mean as if you were taking a mood-stabilizer? If you've never taken one, it pretty much puts you in one mood -- which was necessary for me when I had a tyrant of a supervisor at the time this depression started and I needed to not harm her -- for legal and ethical reasons -- before I could change jobs. I didn't get extremely anything, which I usually do.
>
> And I understand your point about normal -- I actually was feeling "normal" for most of my 20s and into my early-30s, so I have this vague memory of what it felt like, which is how I know I'm not it. Then again, even that idea changes over time. The closest I ever came to putting a finger on it was when I started Zoloft the first time, my first SSRI. I was driving down the road and someone attempted to turn left from the right lane, and I was in the left lane, so they almost creamed me. I blew on my horn, pointed my finger at them, then went on, and 3 blocks later I realized that I wasn't still shaking and screaming about it, in fact, I was over it, and I thought, "so this is what it's like to be a normal person." So, as long as I'm not a raving maniac, I figure I, and the rest of the world, am lucky.
>
> I'm not completely only on the Lexapro yet -- my doctor increased my Effexor to a slower taper because I was becoming an anxiety-ridden screaming maniac late last week. So I don't know what life will be like when I am only on the Lex.
>
> Thanks again for the info and support where the depersonalization is concerned -- since you've experienced it, you know why I don't want to mess with it for a minute. Defeats the purpose of getting my life back from the depression and anxiety!
>
Posted by ayuda on November 24, 2002, at 21:35:41
In reply to Re: Fiery Rhetoric » ayuda, posted by Squiggles on November 24, 2002, at 21:08:39
> Yes, I agree with what you say; i am not
> sure what a significant result in a trial
> test is, but for myself, i am pretty sure
> that i am now getting hyponatremia as a result
> of sodium excretion from chronic lithium use;
> that is just a hunch from reading and matching
> my symptoms which are recent - constant thirst,
> fevers, head sensations, orthostatic hypotension,
> peripheral neuropathy, and salt, salt, salt,
> all over my body - where is it coming from?
> Not to mention the d word ( yuch, every morning );
>
> So, i am experimenting and lowering my lithium
> every week by a small amount as i have asked
> to have it lowered but i got the reply (3x) that
> i am in the safe range (0.50 to 1.2). And that
> range is taken once a year and was shown to me;
> I wanted to say but but but, the level may change,
> but i am so shy.
>
> You see my point. Very frustrating as i am
> not a doctor and yet i am sure something is
> going wrong.
>
> Squiggles
>I had a very good medical doctor once tell me that when a doctor says something is within the "normal" range, tell them, NOT for me. It was in the context of a medical condition, for which a doctor told me I was experiencing something normal. Well, it was not something I had ever experienced before, and it was something I should have had a long history of if it was "normal." And the better doctor I went to said, if you are telling me it's not normal for you, then it's not normal for you, and we need to find out what's going on.
I went into seratonin shock on 50 mgs of Zoloft a couple of years ago -- a VERY low dose of Zoloft, but I worked with a psychiatric nurse who noticed it for 2 days running and made me call my doctor, who promptly switched me to Celexa the next day. People will tell you that 50mg of Zoloft doesn't cause seratonin shock -- it did for me.
As for the courage, here's a possible backdoor way to it. Do you go to a shrink or an MD? If it's a shrink, try going to an MD with your symptoms, pretending to think it's a physical ailment, and list all the meds you are on, and see if they have a problem with your meds. Ask them if it could be your meds, tell them your history. Even getting a "maybe" is info to go back to your shrink and exaggerate -- tell them your physician is concerned with your physical symptoms because they can find nothing that would cause it except the medication, and that they want you off the medication to regain your health. Those doctors never cross-reference info (stupid of them), so that may help you get the care you need.
Posted by Squiggles on November 24, 2002, at 21:41:47
In reply to Re: Fiery Rhetoric, posted by ayuda on November 24, 2002, at 21:35:41
Thank you kindly,
I will think about it -- i have often thought
the best thing for me to do is to move to another
city - drastic as that sounds i think that
if you offend one doctor, you offend others too.I do not wish to offend, only get a little more
attention - i have had such a hard time and as
a female i believe i am perceived as a whiner with
nothing really wrong with me.Thank you for listening and your advice.
good night.
Squiggles
Posted by ayuda on November 24, 2002, at 21:46:29
In reply to Re: Side-effects - best data » ayuda, posted by Donna Louise on November 24, 2002, at 21:32:48
That's exactly what I had started experiencing with the Effexor -- I could not shake the dream world while I was awake. That happened when I went up to 225 mg. I had to keep telling myself while I was awake that I was awake -- but then again, I told myself that in my dreams, too. Kind of kept me on my toes in both worlds!
I'm lucky that I don't much care about any sexual side-effects -- I lost hope in men many years ago, and with the weight gain from the Effexor, I wouldn't want to put anyone through the trauma of seeing me naked anyhow. From Dr. Dave's info, it looks like Lex has an increased incidence of sexual s/e's from Celexa. Of course, our doctors don't particularly care if we're having satisfying sex lives or not -- only the Pfizer people care :)
> I also know what you mean about the dreams. It was really bad with the paxil. Sometimes I felt like the dream world was more real than than the waking world. I felt like I floated in and out of a dream state all day. That felt like what I call disassociation. I also had it on Effexor. I still am having vivid dreams with the Lexapro but they are not following me into waking life as with the paxil and effexor. I have heard that vivid dreams are a result to something the SRI does to REM sleep. Not sure what it is exactly. By the way, I was on the paxil and effexor at the same time and went off them both while starting the lexapro, doing both over a period of 2 weeks I think it was, and I had very little withdrawal symptoms. I have detoxed from paxil before, without simultaneously starting another SRI and thought I was going to die.
> I do not take a mood stablizer, I am just a run of the mill depressive/anxiety type. When I say emotional numbing, I am talking about what may very well feel like what a mood stablizer does, I don't know. I just don't feel as sensitive or reactive. I am thinking that is what a mood stablizer must do, as I type this. hmmm.
> Also, to let you know, I also took Celexa for a few months and d/c'd it due to an extreme amount of tension in the neck and shoulders. I am sure there is a word for this...anyway, I do not have that on the lex. So I am a pretty satisfied customer, if I could just get the sex thing settled...
>
> Donna Louise
Posted by pharmrep on November 25, 2002, at 2:00:19
In reply to Side-effects - best data » pharmrep, posted by dr. dave on November 24, 2002, at 4:38:06
> Dear Pharmrep,
>
> Good to see you back! The idea that Lexapro has fewer side-effects than Celexa seems to be floating around again. I presented the most recent and accurate data on this a while back and invited your comments. I may have missed them so forgive me if I am needlessly repeating myself, but it would be good to be clear about your views on this.
>
> > The relative side-effects of Lexapro and Celexa are as follows
> >
> >
> > Side effect..........................Lexapro..............Celexa
> >
> > Headache............................15.8%..............19.9%
> > Nausea................................15.0%..............17.2%
> > Ejaculation disorder..............9.3%(of men)...8.8%
> > Insomnia..............................9.2%................8.6%
> > Diarrhoea.............................8.0%...............10.8%
> > Somnolence.........................6.9%................4.7%
> > Mouth dry............................6.2%...............8.1%
> > Upper resp tract infection.....6.2%...............3.9%
> > Dizziness..............................6.0%...............5.6%
> > Flu-like symptoms................5.0%...............6.1%
> > Rhinitis.................................4.9%...............5.6%
> > Sinusitis................................4.3%...............5.1%
> >
> >
> > 'Overall, the type and frequency of TEAEs (treatment-emergent adverse events) reported with escitalopram and citalopram were very similar, and are in line with AEs reported for citalopram previously. For the TEAEs listed (above) there were no statistically significant differences for incidences of these events between the escitalopram and citalopram treatment groups.'
> >
> >
> > This is the official information from Lundbeck about relative side-effects. I wonder if you still stand by the comments that Lexapro has fewer side-effects than Celexa, and that Celexa causes somnolence while Lexapro does not?
> >
> >
>***** I'm not sure i agree with all those %'s...i need to get my package inserts for both and will post (ie...Celexa nausea was 21%, not 17, and I know somnolence for celexa was 18%, not 4...but I will post what the U.S. P.I's state)...as for Lundbeck...the European studies and #'s are done separately from the U.S....I dont think they should be much different, it depends on the parameters of the study.
Posted by pharmrep on November 25, 2002, at 2:18:28
In reply to Re: PoppyCock! » Squiggles, posted by Mr.Scott on November 24, 2002, at 17:50:36
I love poppycock...you know, that caramel coated popcorn stuff. (sorry, couldn't resist it)
Posted by pharmrep on November 25, 2002, at 2:27:13
In reply to Fiery Rhetoric, posted by Mr.Scott on November 24, 2002, at 14:35:27
> Some pharmreps are interested only in commissions generated from scripts written for their drug. They are tenaciously persistent sociopaths disguised as helpers (yet are actually minions). They are line items in a marketing budget and human advertising vehicles sent from evil and self-serving corporate entities.
>
> Look at all they provide with extreme caution and generality. The doctors conducting the studies are 'generally' without conscience.
>
> You will do best to be your own doctor in many ways. How many of you are so passionate about your jobs that you would be comfortable letting people entrust their lives to you. Do you think these wise scholars are any different?
>
> Don't let them (MD's and large corporations) make you fat, impotent, and sedated and then send you the bill. They are your employees. Make them do their job of making you feel better (numb and too full of side-effects to care doesn't count). If they can't do their jobs fire them and move on. Ultimately your destiny is in your hands. Do not relinquish it to the self-serving.*** I agree that there are plenty of bad apples with impure intentions out there (but I hope "pharmrep" wasnt being aimed at me.)
Posted by dr. dave on November 25, 2002, at 3:10:50
In reply to Re: %'s/see bottom » dr. dave, posted by pharmrep on November 25, 2002, at 2:00:19
> > Dear Pharmrep,
> >
> > Good to see you back! The idea that Lexapro has fewer side-effects than Celexa seems to be floating around again. I presented the most recent and accurate data on this a while back and invited your comments. I may have missed them so forgive me if I am needlessly repeating myself, but it would be good to be clear about your views on this.
> >
> > > The relative side-effects of Lexapro and Celexa are as follows
> > >
> > >
> > > Side effect..........................Lexapro..............Celexa
> > >
> > > Headache............................15.8%..............19.9%
> > > Nausea................................15.0%..............17.2%
> > > Ejaculation disorder..............9.3%(of men)...8.8%
> > > Insomnia..............................9.2%................8.6%
> > > Diarrhoea.............................8.0%...............10.8%
> > > Somnolence.........................6.9%................4.7%
> > > Mouth dry............................6.2%...............8.1%
> > > Upper resp tract infection.....6.2%...............3.9%
> > > Dizziness..............................6.0%...............5.6%
> > > Flu-like symptoms................5.0%...............6.1%
> > > Rhinitis.................................4.9%...............5.6%
> > > Sinusitis................................4.3%...............5.1%
> > >
> > >
> > > 'Overall, the type and frequency of TEAEs (treatment-emergent adverse events) reported with escitalopram and citalopram were very similar, and are in line with AEs reported for citalopram previously. For the TEAEs listed (above) there were no statistically significant differences for incidences of these events between the escitalopram and citalopram treatment groups.'
> > >
> > >
> > > This is the official information from Lundbeck about relative side-effects. I wonder if you still stand by the comments that Lexapro has fewer side-effects than Celexa, and that Celexa causes somnolence while Lexapro does not?
> > >
> > >
> >***** I'm not sure i agree with all those %'s...i need to get my package inserts for both and will post (ie...Celexa nausea was 21%, not 17, and I know somnolence for celexa was 18%, not 4...but I will post what the U.S. P.I's state)...as for Lundbeck...the European studies and #'s are done separately from the U.S....I dont think they should be much different, it depends on the parameters of the study.
>
=====================================================================
You can't really compare package inserts (is that what P.I.s are?) as they are measuring incidences of side-effects in different populations. The best way to get an accurate comparison is to compare incidences in the same population, as I have described above.If you want to disregard non-US studies, you will have to disregard the Gorman paper as it includes non-US data.
Whether you personally agree with the percentages is arguably not the issue - the issue is what is the most accurate scientific data. I don't mean to offend by that, but it is really important that we rely on scientific data rather than personal opinions.
As an employee of Forest, I assume you will have access to full safety data - could you let us see it?
Posted by pharmrep on November 25, 2002, at 3:49:47
In reply to Re: %'s/see bottom » pharmrep, posted by dr. dave on November 25, 2002, at 3:10:50
> > > Dear Pharmrep,
> > >
> > > Good to see you back! The idea that Lexapro has fewer side-effects than Celexa seems to be floating around again. I presented the most recent and accurate data on this a while back and invited your comments. I may have missed them so forgive me if I am needlessly repeating myself, but it would be good to be clear about your views on this.
> > >
> > > > The relative side-effects of Lexapro and Celexa are as follows
> > > >
> > > >
> > > > Side effect..........................Lexapro..............Celexa
> > > >
> > > > Headache............................15.8%..............19.9%
> > > > Nausea................................15.0%..............17.2%
> > > > Ejaculation disorder..............9.3%(of men)...8.8%
> > > > Insomnia..............................9.2%................8.6%
> > > > Diarrhoea.............................8.0%...............10.8%
> > > > Somnolence.........................6.9%................4.7%
> > > > Mouth dry............................6.2%...............8.1%
> > > > Upper resp tract infection.....6.2%...............3.9%
> > > > Dizziness..............................6.0%...............5.6%
> > > > Flu-like symptoms................5.0%...............6.1%
> > > > Rhinitis.................................4.9%...............5.6%
> > > > Sinusitis................................4.3%...............5.1%
> > > >
> > > >
> > > > 'Overall, the type and frequency of TEAEs (treatment-emergent adverse events) reported with escitalopram and citalopram were very similar, and are in line with AEs reported for citalopram previously. For the TEAEs listed (above) there were no statistically significant differences for incidences of these events between the escitalopram and citalopram treatment groups.'
> > > >
> > > >
> > > > This is the official information from Lundbeck about relative side-effects. I wonder if you still stand by the comments that Lexapro has fewer side-effects than Celexa, and that Celexa causes somnolence while Lexapro does not?
> > > >
> > > >
> > >***** I'm not sure i agree with all those %'s...i need to get my package inserts for both and will post (ie...Celexa nausea was 21%, not 17, and I know somnolence for celexa was 18%, not 4...but I will post what the U.S. P.I's state)...as for Lundbeck...the European studies and #'s are done separately from the U.S....I dont think they should be much different, it depends on the parameters of the study.
> >
> =====================================================================
>
>
> You can't really compare package inserts (is that what P.I.s are?) as they are measuring incidences of side-effects in different populations. The best way to get an accurate comparison is to compare incidences in the same population, as I have described above.
>
> Whether you personally agree with the percentages is arguably not the issue - the issue is what is the most accurate scientific data. I don't mean to offend by that, but it is really important that we rely on scientific data rather than personal opinions.
>
> As an employee of Forest, I assume you will have access to full safety data - could you let us see it?************* Where did those %'s come from...(they look like P.I. #'s) If they are from a study...can you cite it?...otherwise it looks like it is your opinion...which is why I gave mine.
What "full safety" data are you talking about? I doubt I am privy to any material you aren't able to get.
Posted by JLM on November 25, 2002, at 5:18:12
In reply to Re: %'s/see bottom » dr. dave, posted by pharmrep on November 25, 2002, at 3:49:47
> > > > Dear Pharmrep,
> > > >
> > > > Good to see you back! The idea that Lexapro has fewer side-effects than Celexa seems to be floating around again. I presented the most recent and accurate data on this a while back and invited your comments. I may have missed them so forgive me if I am needlessly repeating myself, but it would be good to be clear about your views on this.
> > > >
> > > > > The relative side-effects of Lexapro and Celexa are as follows
> > > > >
> > > > >
> > > > > Side effect..........................Lexapro..............Celexa
> > > > >
> > > > > Headache............................15.8%..............19.9%
> > > > > Nausea................................15.0%..............17.2%
> > > > > Ejaculation disorder..............9.3%(of men)...8.8%
> > > > > Insomnia..............................9.2%................8.6%
> > > > > Diarrhoea.............................8.0%...............10.8%
> > > > > Somnolence.........................6.9%................4.7%
> > > > > Mouth dry............................6.2%...............8.1%
> > > > > Upper resp tract infection.....6.2%...............3.9%
> > > > > Dizziness..............................6.0%...............5.6%
> > > > > Flu-like symptoms................5.0%...............6.1%
> > > > > Rhinitis.................................4.9%...............5.6%
> > > > > Sinusitis................................4.3%...............5.1%
> > > > >
> > > > >
> > > > > 'Overall, the type and frequency of TEAEs (treatment-emergent adverse events) reported with escitalopram and citalopram were very similar, and are in line with AEs reported for citalopram previously. For the TEAEs listed (above) there were no statistically significant differences for incidences of these events between the escitalopram and citalopram treatment groups.'
> > > > >
> > > > >
> > > > > This is the official information from Lundbeck about relative side-effects. I wonder if you still stand by the comments that Lexapro has fewer side-effects than Celexa, and that Celexa causes somnolence while Lexapro does not?
> > > > >
> > > > >
> > > >***** I'm not sure i agree with all those %'s...i need to get my package inserts for both and will post (ie...Celexa nausea was 21%, not 17, and I know somnolence for celexa was 18%, not 4...but I will post what the U.S. P.I's state)...as for Lundbeck...the European studies and #'s are done separately from the U.S....I dont think they should be much different, it depends on the parameters of the study.
> > >
> > =====================================================================
> >
> >
> > You can't really compare package inserts (is that what P.I.s are?) as they are measuring incidences of side-effects in different populations. The best way to get an accurate comparison is to compare incidences in the same population, as I have described above.
> >
> > Whether you personally agree with the percentages is arguably not the issue - the issue is what is the most accurate scientific data. I don't mean to offend by that, but it is really important that we rely on scientific data rather than personal opinions.
> >
> > As an employee of Forest, I assume you will have access to full safety data - could you let us see it?
>
> ************* Where did those %'s come from...(they look like P.I. #'s) If they are from a study...can you cite it?...otherwise it looks like it is your opinion...which is why I gave mine.
> What "full safety" data are you talking about? I doubt I am privy to any material you aren't able to get.
I think by 'full safety data' Dr. Dave means ALL the data on the incidence of SE's taken as a whole, and not just the data disseminated to the public in the PI's. This would include data from published and more importantly UNPUBLISHED studies. That way we can see if there is any 'publication bias' wink wink...
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.