Posted by Caleb462 on June 24, 2003, at 9:35:36
In reply to CALEB, Re: Celexa Users/SSRI Users/Anybody!!! , posted by McPac on June 24, 2003, at 1:31:53
> > Caleb, just the dude I was hoping would respond!
> > Check this out...I don't get this at all....Dr. Heller said that the ssri's all can raise, or overstimulate, the 5HT1a receptor site.....now, I found this info on Celexa AND Zoloft where it said that neither showed an effect at the 5HT1 site (I'm pretty sure I interpreted that right but I'm NOT sure)....HOW CAN THAT BE? Could you tell me what Celexa AND Zoloft each do at that 5HT1a site?
> >
>
> Celexa and Zoloft... the chemicals themselves, have no effect on the 5-HT1a site. It is the extra serotonin in the synapse, provided by Zoloft/Celexa, that activates 5-HT1a receptors.
>
> >>>>>>>>Thank you for that explanation!
>
> Buspar, on the other hand, and I'm talking about the chemical itself here (buspirone), directly bonds to and activates 5-HT1a receptors. I don't understand Dr. Heller's logic.
>
> >>>>>>>>>>I don't either! Not at all!
>
> > McPac... have you thought about adding a mild sedative or anxiotylic to your regimen in order to lessen the anger on Zoloft? Neurontin perhaps? Or maybe Gabitril?
> >
> > >>>>>>>I've thought about Klonopin; but I KNOW that the Zoloft causes/exacerbates this problem and IF I could substitute the Zoloft for, perhaps Celexa, and NOT get that anger s/e then I might not even NEED the Klonopin....I'd like to try without it first.
>
> Quite understandable.
>
>
> >
> > Did you have anger problems with Anafranil? Just curious.
> >
> > >>>>>>>>>>>>NO!! And I don't know why (I would have thought its effects would be very similar to Zoloft but I've had different effects between the two meds....but NO anger at all from Anafranil...go figure???
> >
>
> Well... there could be a lot of reasons Anafranil did not. The sedating anti-histaminic/anti-adrenergic effects may have helped. 5-HT2a antagonism could have been a factor... anti-chollinergic effects could also be a factor I would imagine.
>
> >>>>>>>Caleb, Remeron is one of the VERY few non-ssri anti-ocd meds that there is....I would LOVE to try to see if Remeron could replace the Zoloft! Some folks w/ ocd HAVE been helped by Remeron (usually higher doses of Remeron seems to be indicated).....what effect does Remeron have on 5HT1a receptors (at higher doses)? Any idea?
>Remeron, being an alpha-2 antagonist, increases serotonin release. Remeron also blocks the 5-HT2 and 5-HT3 serotonin receptors. Thus much of the increased serotonin that is released, not able to bond to 5-HT2 or 5-HT3, gets directed to the 5-HT1a site. Remeron itself has no direct effect on 5-HT1a.
> > Or maybe try using Niacinamide?
> >
> > >>>>>>>>>>I can't (long story) take niacinamide.
> > At this point I really don't care what s/e's Celexa would cause as long as I don't get this anger-induced crap! Would Lexapro have even LESS s/e's than Celexa (isn't it 'supposed' to?) ANY truth to Lexapro having less s/e's...due to the fact that I believe you only need a LOWER DOSE?
> > ANY help is appreciated!
> >
> >
> >
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> Personally, I don't believe there is ANY truth at all in the whole "lexapro has less side effects" thing. It's a marketing ploy. Check the side effect profiles of the two drugs... they don't look much different do they? The only advantage to Lexapro is that it requires a lower dose... and uh, that is not much of an advanatage in my opinion.
>
> >>>>>>>>>>Lower dose often means less side effects doesn't it? For example, 50 mg of Zoloft gives me less s/e's than 100? Thanks!!!!
>Well... yes. Let me see if I can explain this right... ok Celexa contains citalopram. It contains both the S- and R-enantiomers of the chemical. 50% of a celexa pill is the S- enantiomer and 50% is R-enatiomer. So 40 mg of Celexa would be 20 mg S, and 20 mg R. The R-enatiomer is inactive. Lexapro removes the R-enatiomer and leaves only S-citalopram. So instead of taking 40 mg of Celexa to get 20 mg of S-citalopram, you simply take 20 mg of Lexapro.
Understand? Sorry if it isn't explained well.
So anyway... there should be no difference in side effects whether you are taking 40 mg Celexa or 20 mg Lexapro - either way you are taking 20 mg of S-citalopram.
The whole "less side effects" is based on the assumption that R-citalopram causes additional side effects. Which I find unlikely. R-citalopram has no affinity for the serotonin uptake pump, thus it causes no serotonergic side effects nor does it cause any theraputic effect. If R-citalopram causes any side effects, they would have to be mediated through some other action - and no action has been discovered.
So basically, the only advantage with Lexapro is that you are removing 10 or 20 mg of inactive material from the pill... I say, who cares?
poster:Caleb462
thread:236481
URL: http://www.dr-bob.org/babble/20030624/msgs/236620.html