Posted by pharmrep on September 21, 2002, at 23:59:42
In reply to Question for PharmRep Re: Dosage Equivalent Celexa, posted by hawkeye on September 21, 2002, at 19:40:53
> Does this data mean that approx. 7mgs of Lexapro is the functional equivalent of 40mgs of Celexa?
>
> [7mgs of Lex. raises brain seretonin by %2100;
> 40mgs of Cel raises brain seretonin by %2000
>
> "The new study shows that Lexapro (the S-enantiomer of citalopram), when given at 2 mg/kg subcutaneously (s.c.), was more than twice as potent as Celexa at 4 mg/kg s.c. (2.0 mg/kg S-enantiomer + 2.0 mg/kg R-enantiomer) in increasing brain serotonin levels (about 300 percent vs. 200 percent, respectively). In contrast to Lexapro, the R-enantiomer of citalopram, when given at 2.5 mg/kg s.c., did not increase brain serotonin levels."
>
> http://biz.yahoo.com/prnews/020624/nym009_1.html
>
> It has been my understanding that while 40mgs of Celexa is the recomended dosage, that comparable results may also be obtained at 20mgs.
>
> "In a 6-week fixed-dose study, patients received citalopram, 20 or 40 mg/day, or placebo (n=64 to 70 per group). Patients treated with citalopram 40 mg/day, showed significantly greater improvement than placebo-treated patients. The difference between the lower dose of citalopram and placebo was not significant. "
>
> "The effectiveness of citalopram in preventing relapse was assessed in two long-term studies. Depressed patients who responded to citalopram during an initial 6 or 8 weeks of acute treatment (fixed doses of 20 or 40 mg/day in one study and flexible doses of 20-60 mg/day in the second study) were randomized to continue on citalopram or receive placebo. The number of patients who received citalopram and placebo was 257 and 116, respectively. In both studies, patients who continued on citalopram experienced significantly lower relapse rates over the subsequent 6 months compared to those receiving placebo. In the fixed-dose study, the relapse rates were similar at the 20 and 40 mg/day doses, namely 10% and 12%, respectively. "
>
> http://www.mentalhealth.com/drug/p30-c04.html#Head_3
>
> So, maybe 5mgs of Celexa Professional Edition will be more than enough.** great question. 10mg of Lex is at least as efficacious as 40mg of cx...but with less s/e, less drug to drug interactions, and less discontinuation due to adverse events, and will work as fast as 1-2 weeks for most people. It is linear, however...5mg will not work as fast, and is not the recommended starting dose. In general, for most drugs many doctors reduce dosages to avoid side effects, but since Lexapro at 10mg is "comparable to placebo" it shouldnt be needed. In the Dr's I've seen...I would say 95%+ are starting w/ 10mg...only a few have gone to 20mg (only 2 weeks out now) and maybe a few Dr's are just "set in there ways" and are starting with 5mg (for a week or so...then up to 10mg) So far...I have only heard good responses from them, but most of their patients havent been back for their "monthly" visit...I'll hear more in about 2 weeks or so.
PS...the starting dose for celexa was 20mg (62% of patients stayed there)...40mg was at about 30% (for a total of 92% of all Celexa prescriptions...the last 8% were at 60mg or higher.) I think Lexapro at 10mg will be effective for 80%+ of patients...then 15mg+ will make up the last 20%
poster:pharmrep
thread:109458
URL: http://www.dr-bob.org/babble/20020914/msgs/120680.html