Posted by dr dave on October 10, 2002, at 12:20:11
In reply to Re: Lexapro and Celexa relative side-effects » dr. dave, posted by johnj on October 10, 2002, at 8:59:25
This is the combined data for everyone on any dose of either drug. The average doses were equivalent, in that the average dose of Celexa was about twice that of Lexapro. It is Lundbeck's view, not only mine, that these doses were equivalent. The data show that whether you take s-citalopram alone (eg Lexapro 10mg) or in combination with an equal amount of r-citalopram (eg Celexa 20mg), there is no difference in the side-effects you are likely to experience. So as far as side-effects go, there is no justification for preferring Lexapro over Celexa.
I don't hate Celexa at all. I prescribe it all the time, and started at least one person on it today, because it is an effective antidepressant which I think is remarkably well-tolerated. If I had to take any antidepressant, I think I would take Celexa. What I dislike is what I see as unjustified claims which mislead desparate people. I can see no pharmacological reason why Lexapro should work any differently from Celexa, and I'm not convinved by the results of clinical trials. I think this is reasonable given the long history of new drugs being promoted as new and different and experience showing the advantages have been wildly overstated.
I don't think Lexapro can be any worse than Celexa - it therefore must be an effective and well-tolerated drug, and so I would probably choose it over Paxil, Zoloft etc. However I suspect it's very existence has more to do with extending patent protection than it being any different to Celexa. Here in Europe Celexa has come off-patent and is available at about 50% of the price of the patented version. I'm not going to prescribe a drug that's twice the price of something I already use if it doesn't seem to offer any advantages.
> Were these numbers based on equivalent doses? For example, if you need less lexapro than celexa maybe the side effects are less. Isn't this true for most AD's? The higher I go on pamelor the WORSE the s/e. So, is this a fair comparison because I don't know??? If the %'s that you stated were for 20 mg of lexa and 20 of celexa how fair a comparison is this? Am I missing something Dr. Dave? Sometimes I really get the feeling you hate celexa and lexapro.
> johnj
>
poster:dr dave
thread:109458
URL: http://www.dr-bob.org/babble/20021006/msgs/123076.html