Posted by Mtom on May 5, 2018, at 13:44:26
In reply to Re: More research: Celexa versus Lexapro, posted by rjlockhart37 on May 5, 2018, at 12:56:42
Hi rjlockhart37 and thank you for your information. I have read the citations you sent I had not previously read. I have also read a lot more papers/articles than the ones I posted above. In part I am expressing frustration with the contradictions between articles and research.
Some additional points:
The dosage of Lexapro is lower than that of Celexa in part to account for the fact that it does not contain the (by some presumably?) inactive enantiomer. I know some papers cite other postulated implications. Yet a good number of papers find negligible differences.It was pointed out in several papers (not all of which I cited) that most studies have been done on the individual drugs versus placebo, rather than direct comparisons.
Many studies were relatively short term.
I see some papers including your citations note faster onset and greater efficacy of Lexapro (but not all). However, I am hypersensitive to AD's, and therefore a "milder" slower onset one may be indicated for me. I am very concerned about advserse reactions as I have experienced quite intense ones with very small doses of other AD's.
Again, I did not include all I read, just enough to emphasize there are disagreements, unknowns, hypotheses (rather than certainties) and possible biases. I do agree it seems Lexapro may be a "stronger" AD based on some of these papers (although again, others question this).
I know 1 person who has been taking Celexa for years with excellent results who had tried a number of other AD's previously, unsucessfully (either ineffective or adverse effects which they did not experience with Celexa). This person has not tried Lexapro.
I know another who found Lexapro worked wonders for anxiety, but needs Wellbutrin for depression. This person has been on many AD's and other meds for many years, but has not tried Celexa.
> https://www.ncbi.nlm.nih.gov/pubmed/17675913 - "We then may conclude that R-citalopram antagonizes the antidepressive effects of escitalopram and that its presence limits the therapeutic effect and reduces the speed of action of citalopram. The antagonism of escitalopram by R-citalopram was not expected and one hypothesis is that a direct interaction between the 2 enantiomers may occur on a particular site of the serotonin transporter. Results have shown that R-citalopram has a significant affinity only for the allosteric site of the transporter, which regulates the affinity of the ligand for the active site at the origin of serotonin reuptake inhibition. Unlike citalopram, escitalopram's pharmacologic action is not blocked by R-citalopram explaining its greater therapeutic efficacy and more rapid mode of action"
>
> https://www.ncbi.nlm.nih.gov/pubmed/20730799 - "escitalopram, but not citalopram, improved recognition memory"
>
> https://www.ncbi.nlm.nih.gov/pubmed/17675913 - "Escitalopram is more powerful than citalopram in reducing anxiety but the presence of R-citalopram reduces the positive effects of escitalopram"
>
> these sources repeatedly say that the R-citalopram counter acts escitalopram, and it said many times....."escitalopram" is more potent as an anti-depressant, the "R-citalopram" counter acts, and it has low effect on serotonin re-uptake
>
> after reading all of these, it clearly is saying Lexapro is the better one, because it work better for anxiety and depression because the "R-citalopram" has nearly none AD activity
>
poster:Mtom
thread:1098520
URL: http://www.dr-bob.org/babble/20180331/msgs/1098544.html