Posted by Anyuser on August 17, 2002, at 17:52:23
In reply to Lexapro: what to expect?, posted by Anyuser on August 17, 2002, at 15:51:04
"The fundamental concept underlying single-enantiomer drug development is chirality (derived from the Greek word for hand), which is the ability of some molecular structures to take on either a "left-handed" or "right-handed" configuration. In the same way we distinguish our left hand from our right hand, enantiomers in a chiral molecule may be differentiated as an S-enantiomer (from the Latin sinister meaning "left") and the R-enantiomer (from the Latin rectus for "right"). Since the enzymes in our cells are also chiral, as are other receptors that play an important part in how cells work, they typically prefer to bind to one of the enantiomers of a drug. In other words, only one of the enantiomers of a drug fits the receptor's site like a key that fits a lock."
I don't pretend to understand all this science. Could it be that all the benefit and all the side effects came from the S-enantiomer and the R half does nothing good or bad? In that case the benefit of Lexapro compared to Celexa would be in reduced dose only. But then, why is 10mg Lexapro equivalent to 40mg Celexa? 40mg Celexa should have twice as much of the good S half as 10mg Lexapro.
I am concerned by the possibility that the benefits of any SSRI are baked into the same cake with the detriments. That is, you can't have one without the other. Say, you've got to have more 5HT floating around to raise your mood, and more 5HT floating around makes you fat, apathetic, and sexually numb. Period.
Who knows? PsychoBabblers should be posting all the gory details by mid-September.
poster:Anyuser
thread:116724
URL: http://www.dr-bob.org/babble/20020814/msgs/116735.html