Posted by ed_uk2010 on March 28, 2018, at 17:16:52
In reply to Re: Cognitive Impairment, lack of motivation, etc. » ed_uk2010, posted by SLS on March 28, 2018, at 16:45:05
Thanks Scott. Good summary.
Due to the strong tendency to favour generic drugs here, escitalopram never really caught on. That has remained the case even though it is now generic itself and extremely inexpensive.
Citalopram and sertraline were both extremely widely used, but there has been a strong shift to sertraline recently. It's mainly due to concern about QT prolongation with citalopram, especially because a lot of pts take multiple medications which could potentially do the same and interact. The same may apply to escitalopram to some extent. In addition, sertraline seems less toxic in overdose, and a good choice in cardiac disease too. So, sertraline has become favoured. Fluoxetine and paroxetine have so many more drug interactions, they aren't generally used first line. And of course, the tendency of paroxetine and venlafaxine to have difficult withdrawal has pushed them firmly into second/third line territory. Sertraline has come out of all this unscathed.
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URL: http://www.dr-bob.org/babble/20180212/msgs/1097802.html