Posted by psychobot5000 on January 30, 2009, at 15:04:36
In reply to Re: Remeron rules--but lexapro's data may be suspect, posted by desolationrower on January 30, 2009, at 0:32:53
> > > > > From TheLancetcom:
> >
> > > Mirtazapine, escitalopram, venlafaxine, and sertraline were significantly more efficacious than duloxetine, fluoxetine, fluvoxamine, paroxetine and reboxetine.
> > >
> > > X-ray
> >
> > In my experience Remeron was also somewhat more potent than other meds, venlafaxine included. Not that one experience is enough to draw conclusions from.
> >
> > (digression warning)
> > One conclusion of this study I am suspicious of, though, is their conclusion that lexapro is more efficacious. You never can tell, of course, but I suspect that this is based in part on various studies the industry pushed through showing lexapro was faster-acting and slightly more potent than its parent, celexa. I view this conclusion as highly suspect, and possibly rigged up in some way, to help market lexapro. Are there another seven unpublished studies on celexa vs lexapro that failed to show similar conclusions?
> >
> > As far as I'm aware, lexapro is usually dosed at one-half the dose of its racemic parent, meaning that it's just Celexa without the inactive isomer. If this is true (and maybe the studies used differing doses...), and if the data shows lexapro more effective in some way (such as the much-touted study showing quicker AD onset)...then this would mean the other isomer in citalopram/celexa was not only completely ineffective, but actually counterproductive. It's hard to believe. Thus I suspect the lexapro data might be bent a little, (to produce a few more billions for its manufacturer after the parent drug expired), and further conclusions such as the ones this study comes to might be suspect.
> >
> > Though of course, that doesn't rule out the potential that celexa and lexapro were both just better drugs than other ADs. I suppose that's possible. But 'es' drugs put me in a suspicious mood in the first place, since in most cases a drug developer who had the patients' best interests at heart would be developing a new drug with a new mechanism, rather than repatenting a portion of the old drug.
> >
> > Interesting conclusions of the meta-analysis, though--thanks for posting them,
> > Psychbot
> >
>
> supposedly the r-citalopram binds to a allosteric site on the sert which hinders its effect. still, the publication bias problems make me suspicious of these metaanlyses
>
> -d/rInteresting--I hadn't heard that. It's good to know that at least someone has a reasonable theory that could explain the difference--it makes me somewhat less skeptical about it. Still does seem very convenient,but I suppose these things do happen.
poster:psychobot5000
thread:876946
URL: http://www.dr-bob.org/babble/20090104/msgs/877237.html