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Dr. Bob is Robert Hsiung, MD,
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Posted by Alan on October 8, 2002, at 23:48:34
In reply to Re: there is no Lexapro-Toprol interaction /bottom » jane d, posted by pharmrep on October 8, 2002, at 0:43:06
Q:
It seems to me (from this bulletin board and several others)that the preferred option of people suffering from anxiety for a long period seems to be to either take Xanax or another benzo daily, or on an as needed basis. Why is it then that most doctors seem to recommend ADs as the first (and many times only) choice for anxiety? It can't just be marketing by the pharmaceutical companies can it?
A:
Well, it isn't JUST marketing. The makers also performed unprecedented numbers of clinical trials (mostly outside the US) in order to get a handful that were complimentary. They couldn't afford to be satisfied with the first overwhelmingly negative results, as there was too much money already invested. So they persevered and persevered, gradually learning how to design studies with more favorable outcomes. They also changed some data and hid other studies away in company vaults where they weren't "found" until a decade later, and then only under court order.But yes, antidepressants do seem, according to the little independent research that exists, to be useful against anxiety in maybe 30-50% of cases. Still, it's no coincidence that most manufacturers don't provide data on SSRIs in anxiety that would allow actual percentage calculations to be made. They just say their med was so-and-so % much better than placebo.
Meanwhile, benzodiazapines have proven for 40+ years to be at least 75% - 85% effective by conservative estimates with little side effect comparatively speaking. Plus they are usually added to take with an AD in the end anyway since AD's are most often overstimulating or do not provide adequate releif of symptoms as the anxiolytics do.
You have to understand that the FDA has incestually high employment overlap, among its movers and shakers, with the industries that it regulates. In the pharmaceutical arena, it is common for someone who pushes through an approval at the FDA to then go work for the company that developed the approved product. The financial temptations are nearly irresistible.
There's a rule of thumb in law enforcement that the more highly educated a person is, the more gullible he becomes. You get more Ph.D.s falling for street scams than people whose daily life is closer to the street. Doctors are no exception. They seldom imagine that a drug company would lie and cheat about the information shown to doctors, or that so many of the articles written about SSRIs have been ghost-written by pharmaceutical company hacks who then paid an "independent" MD to put his name on it, or that the respected MD who writes or speaks about a medication neglects to mention that he is earning not only some but the majority of his income from the drug company that makes the medication. They are amazed and outraged when individual cases get exposed, but they don't get it that this is business as usual in the pharmaceutical industry today.
Pharmrep:Besides the "what's your source" company line, any comments? If you dispute it, what are YOUR sources?
Posted by shakingoscar on October 9, 2002, at 1:10:43
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by mudbunny on October 8, 2002, at 12:17:11
Ive been on lex 6 weeks now.. Admittedly, I have had to reduce my dose because my doctor overprescribed... However, in the last 6 weeks, I have gained around 7 pounds...
Cheers
Posted by horridmonster on October 9, 2002, at 1:10:56
In reply to Re: Proofsource » pharmrep, posted by dr. dave on October 8, 2002, at 6:15:06
> I'm glad to read that you always have a proof source to support your statements. I wonder whether you could give the proof source for your statement that Lexapro has fewer side-effects than Celexa. I've asked a few times, but haven't seen it from you yet.
>
> The other interesting statement recently has been
>
> ' ...celexa can cause both insomnia and somnolence...usually people are tired...you are doing the right thing in taking early in day, but you still stay up at night. Lexapro doesnt have the somnolence, but a little insomnia for some'
>
> Lundbeck say that 6.9% of people taking Lexapro had somnolence in recent trials, compared to 4.7% in the Celexa group. The difference was not statistically significant. Could you tell us your proof source for the statement that Lexapro 'doesn't have somnolence.'
>
> I hope this doesn't make you feel 'beat up' - it's just a matter of making sure accurate information is being given out.
>
>
> > *** I am a pharmaceutical rep for Forest (makers of Celexa and Lexapro). I found this site about 2-3 months ago...I used to get beat up a lot...you know...all the hype on Lexapro coming out. And a lot of bad info going around. I was really just trying to get rid of the bad info, and give the correct info since I had already been trained on Lexapro. It soon turned into a nice info room for all to ask and share what they knew/experienced (especially since Lexapro launched.) I have been cautious to not come off as "salesy", but more informative..always having a proofsource to support my statements...I still get some "stiff" posts, but I dont take it personal. I am more interested in learning more about the field I work in (the people here, and the meds/combos, and lots more) and how I can better serve the DR's I see and share with them how Lexapro can help their patients...I hope you can give lexapro more time...how long for you now?
>
>Is somnolence exhaustion? That's me - couldn't keep my eyes open the first week. Better now third week but still not my old energetic self. Keep waiting. Maybe i'm less than 1% in some study or two - but that still means SOMEBODY is gonna have that effect. pharmrep i find your comments helpful but only to a degree - i know my side effects whether thay show in tests in others or not. -monster
Posted by Dr. Bob on October 9, 2002, at 1:12:52
In reply to me » Ippopo, posted by pharmrep on October 8, 2002, at 1:41:13
> I love your input as well as others, but dont make them so long...my eyes hurt.
> I used to get beat up a lot...
Keeping in mind that the idea here is not to post anything that could lead others to feel accused or put down, could you please rephrase the above? Thanks,
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.
Posted by Ippopo on October 9, 2002, at 1:27:29
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by shakingoscar on October 9, 2002, at 1:10:43
Did you do anything different while gaining 7pds? I'm eatting like a pig. I don't think I gained weight. Food tastes sooooo good right now.
Did you feel the same way about food?
Posted by dr. dave on October 9, 2002, at 4:16:22
In reply to You Gained 7 pds from Lexapro?, posted by Ippopo on October 9, 2002, at 1:27:29
A new study has been reported which allegedly shows Lexapro to be more effective than Effexor. This is pretty serious stuff if it is true. There's a link to a story about it in a posting by Anyuser further down the board. If anyone manages to find the study itself I would be very grateful if they could direct me to it.
Posted by shakingoscar on October 9, 2002, at 6:28:47
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
Hi,
just to let you know, I am a disastified customer of lexapro!Ive been on it for 6 weeks now. First I was prescribed 30mg which was too high and made me really ill.. Then, a week ago, I went down to 15mg but my depression returned yesterday.
Today I took 20mg and feel very stimulated - uncomfortably so.
I dont know what else to do...
What do I do if 20mg is too much and 15mg is too low?
I wish now I had stayed on 60mg celexa which I was doing ok on (I only changed to see if the sexual side effects would be less).
Cheers
Posted by maririp on October 9, 2002, at 7:31:50
In reply to You Gained 7 pds from Lexapro?, posted by Ippopo on October 9, 2002, at 1:27:29
Ippopo..I have been on lexapro almost 3 weeks now..and the first few days i couldnt stand the thought of food. I have a good apetite now and i know i have gained a few pounds...Im hopin I dont gain too much too soon as i did with other antidepressants. Im thin so i enjoy having a nice appetite. I dont seem to feel the need to eat every minute like I did on other meds..Is still early tho so we will see.
Posted by Satori on October 9, 2002, at 11:06:34
In reply to You Gained 7 pds from Lexapro?, posted by Ippopo on October 9, 2002, at 1:27:29
My husband went to the doctor today and was given this drug. As soon as I got home I looked up all the contraindications, and then I found this board. However, I really need to ask something that I'm sure no one can answer, but I'm really thinking that it's the biggest part of the problem. Anyway, he has always been a regular user of marijuana, but lately, he hasn't gotten any, and it seems that ever since he decided to quit, he's been completely out of control with his emotions. He gets angry very easily, he's been depressed, he's been stressed, overwhelmed, and just everything has been too much for him. Now, we've been together for 20 years, and during that entire time, he's always used marijuana, and I truly feel like this is part of a withdrawal, but I had him go to the doctor who prescribed lexapro, and I'm just wondering if this drug can be helpful in this situation, and if this is just more of a short term thing to help him past the withdrawal.
Posted by momof3 on October 9, 2002, at 11:21:13
In reply to Re: I took one pill and no way will I ever try ano, posted by utopizen on October 8, 2002, at 15:40:58
Hi all!
I am just recently starting lexapro-10mg- and can't seem to shake this fog. I have headaches that last for days. The other day I could hardly function and I have three small children and run a business from my home. I am unsure of the next step I should take. I went from aggitated and borderline insomniac to a zombie-like state. How long does this last? This was a big step for me to even go to my Dr. in the first place and my husband doesn't even think I "need that stuff". But, when you want to get in the car and keep on driving when you are supposed to be going to the grocery store, there is a problem. I need some advice. Thanks for your help-this has helped just being able to tell people who understand!
Posted by johnj on October 9, 2002, at 13:23:59
In reply to Weird question for anyone concerning lexapro, posted by Satori on October 9, 2002, at 11:06:34
Although I am not a user of weed anymore, it does cause depression and withdrawl in some. I have a friend who had a bad time after giving it up. Funny, he was a big proponent of legalization before he quit. Now, he is very against it because it is addictive. If lexapro helps or not I cannot say, but my friend benefited from medication (antidepressants), and then got off after things settled down. Does your doctor know the history? That is vital to getting the right help.
Posted by ramidel on October 9, 2002, at 13:33:19
In reply to Just started Lexapro 11 days ago, posted by momof3 on October 9, 2002, at 11:21:13
> Hi all!
> I am just recently starting lexapro-10mg- and can't seem to shake this fog. I have headaches that last for days. The other day I could hardly function and I have three small children and run a business from my home. I am unsure of the next step I should take. I went from aggitated and borderline insomniac to a zombie-like state. How long does this last? This was a big step for me to even go to my Dr. in the first place and my husband doesn't even think I "need that stuff". But, when you want to get in the car and keep on driving when you are supposed to be going to the grocery store, there is a problem. I need some advice. Thanks for your help-this has helped just being able to tell people who understand!I've been on Lexapro for two weeks, following several years on Paxil. At first, I did get headaches (some very bad) but these seem to have subsided now. Generally, I have felt better on 10mg of Lexapro than I did on 40mg of Paxil. I've even experienced ejaculation for the first time in several years! Not great, but at least something.
I've experienced some dizziness, but don't know if that is caused by a new BP med, or allergies. Too soon to separate.
Posted by Abacus on October 9, 2002, at 13:42:35
In reply to Re: Just started Lexapro 11 days ago » momof3, posted by ramidel on October 9, 2002, at 13:33:19
I started Lexapro (5 mg/day) a week ago and I feel like a zombie! Will this pass?
Posted by momof3 on October 9, 2002, at 14:37:12
In reply to Zonked, posted by Abacus on October 9, 2002, at 13:42:35
I feel better the last two days as far as s/e go but still have a sort of dull feeling. Nothing moves me too much. As far as sexual s/e go, I have noticed a decrease in libdo but am unsure if it still depression or meds.Is there anything to help with that feeling of nothingness? I hope I am making sense. The best way to describe it is I don't think about driving off a cliff anymore, I just don't feel much of anything.
Posted by Ippopo on October 9, 2002, at 14:54:05
In reply to Re: Zonked, posted by momof3 on October 9, 2002, at 14:37:12
My reaction has been different from yours. I've been on for (I think, though I really can't remember) 3 wks. At first I was very spacey, actually I still am! Then I went to mood rollercoaster. If someone became angry with me I'd cry. If I heard a joke within the next 30sec I'd laugh. I'm still sensitive but not as much. I finally woke up at a decent hour today and took meds on time(Lexapro and Adderall) I ate lunch and am going to go back to sleep. This never happens unless it's apart of pms.
Posted by Ippopo on October 9, 2002, at 14:59:38
In reply to Re: please rephrase that » pharmrep, posted by Dr. Bob on October 9, 2002, at 1:12:52
Dr Bob,
Thanks for your concern. Though I know PharmRep didn't mean anything by the comment other then shorten the response.... Had it been 2 wks ago I would have cried.
You do have a very interesting job.
Thank you
Posted by ajen on October 9, 2002, at 15:26:04
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
I was on Paxil 40mg a day for about a year and a half. I also had to take 12.5mg of Trazadone to get some restful sleep at night. I had horrible problems getting up in the morning. It caused some problems at work.
A few weeks ago my doctor was finally willing to switch me to something else. He put me on 10mg Lexapro, and had me lower the Paxil 10mg every 4 days until I was off.
The first time I tried to start taking the Lexapro, I stuck with it for 3 days. The side effects were awful. I constantly felt on the verge of throwing up, no appetite, and generally felt very out of it. It made work nearly impossible, I couldn't concentrate, I felt so crappy. So I decided, without talking to my doctor that I wasn't going to take Lexapro.
Fortunately, I had a change of heart after discussing the situation with various family members. I went back on Lexapro and got in to see my doctor ASAP about side effects. He asked if I was taking the Lexapro with food. Nothing I read said to take it with food, so I didn't. He told me to try. I took his advice, and guess what? It actually WORKED!
I'm now only on Lexapro. I have experienced more bruxism than usual, but I can deal with that. I have more energy, eventhough I'm still having issues getting out of bed. I'm going to try taking Lexapro in the morning.
Oh yeah, my sex drive is much higher than it has been in a long time!
Posted by pharmrep on October 9, 2002, at 16:18:08
In reply to Re: Technical questions for Celexa/LexaPro Rep » chad_3, posted by JLM on October 8, 2002, at 22:26:24
> > Hi Sir -
> >
> > This is a 2 part question:
> >
> > 1) Do you believe Celexa is as effective as Paxil across comparable dose ranges, especially for dysthymia, major depression, and general anxiety (all 3 disorders) ... If indeed LexaPro potently blocks s2 and s3 receptors, would this drug not be highly effective in treating certain a host of movement disorders (aka; clozapine)... ?
> >
> > 2) It is now common for urologists to use Paxil to treat premature ejaculators, and for psychiatrists to prescribe Zoloft to tame males who are overly sexually agressive.
>
> Good god, that just shows how totally out of control the practice of medicine has gotten. It seems like SSRI's work for almost anything you would care to prescribe them for. Its also a good
> argument for the non specificity of their effects.
>************* #1 Celexa/Paxil share similar efficacy at the same doses..20mg =20mg/40=40 etc as for the lexapro blocking/cloz question..help me understand what youre asking.
>
> > In your personal opinion, do you believe that LexaPro will be as effective as Paxil (for premature ejactulation / excess libido) and/or as effective as Zoloft for sexual overaggression.************** #2 Since efficacy between ad's was so similar in the past I do know of some dr's who rx on the basis of side effects, but that is not usually the primary reason for choosing a med.
************** #3 In my personal opinion...sexual side effects for ssri's are a class effect, and the one that seems to be the worst is paxil. It is too soon to tell, but Lexapro shouldnt be any worse that celexa. Maybe one day a study will be done to see where they rank among each other.
> >
> > Sincerely,
> > Chad
> >
> >
> > > > The other interesting statement recently has been
> > > >
> > > > ' ...celexa can cause both insomnia and somnolence...usually people are tired...you are doing the right thing in taking early in day, but you still stay up at night. Lexapro doesnt have the somnolence, but a little insomnia for some'
> > > >
> > > > Lundbeck say that 6.9% of people taking Lexapro had somnolence in recent trials, compared to 4.7% in the Celexa group. The difference was not statistically significant. Could you tell us your proof source for the statement that Lexapro 'doesn't have somnolence.'************* Sure, in the PI...Lexapro had 4% somnolence at 10mg & 9% at 20mg, 20mg Celexa had 18%.(ps, the 4.7% above was placebo, not celexa)
> > >
> > > Once again, I too, would like to see something to validate this claim other than the small, statistically insignificant difference between citalopram and escitalopram.
> > >
************ small? There is a "statistically signficant difference" between lexapro and placebo, and the studies didnt have to but did include the higher titrated dose of 40mg of celexa to show the advantage of lexapro, in both efficacy and quicker onset of action. It's still only 1 month out and many more studies are on the way, so keep reading them and let's keep discussing the findings and also sharing any info or questions for those currently taking Lexapro.
Posted by pharmrep on October 9, 2002, at 16:21:04
In reply to Re: New data about Lexapro, posted by dr. dave on October 9, 2002, at 4:16:22
> A new study has been reported which allegedly shows Lexapro to be more effective than Effexor. This is pretty serious stuff if it is true. There's a link to a story about it in a posting by Anyuser further down the board. If anyone manages to find the study itself I would be very grateful if they could direct me to it.
**** i know the study exists...whether it is done yet or what the results are if done...i dont know, but will see when results are expected
Posted by pharmrep on October 9, 2002, at 16:26:09
In reply to I AM GOING BACK TO CELEXA!!!, posted by shakingoscar on October 9, 2002, at 6:28:47
> Hi,
> just to let you know, I am a disastified customer of lexapro!
>
> Ive been on it for 6 weeks now. First I was prescribed 30mg which was too high and made me really ill.. Then, a week ago, I went down to 15mg but my depression returned yesterday.
>
> Today I took 20mg and feel very stimulated - uncomfortably so.
>
> I dont know what else to do...
>
> What do I do if 20mg is too much and 15mg is too low?
>
> I wish now I had stayed on 60mg celexa which I was doing ok on (I only changed to see if the sexual side effects would be less).
>
> Cheers
****** sorry so hard so far...I wish your dr hadnt switched you to start with, Lexapro is supposed to be for new patients, or those who are not happy with their current AD due to s/e or lack of efficacy...you were not a candidate to switch. (at least not for sex s/e reasons only). Plus your dr didnt even rx the right dose. Even though you have reduced the mg...it might still take time to adjust to that specific mg for a wk or so...can you give it some more time at 15mg? Or do you want to still go back to Celexa?
Posted by pharmrep on October 9, 2002, at 16:33:41
In reply to Re: You Gained 7 pds from Lexapro? » Ippopo, posted by maririp on October 9, 2002, at 7:31:50
> Ippopo..I have been on lexapro almost 3 weeks now..and the first few days i couldnt stand the thought of food. I have a good apetite now and i know i have gained a few pounds...Im hopin I dont gain too much too soon as i did with other antidepressants. Im thin so i enjoy having a nice appetite. I dont seem to feel the need to eat every minute like I did on other meds..Is still early tho so we will see.
*** I am hearing both gaining appetite back, and loss of appetite. (mostly loss of appetite so far) Lexapro is supposed to be weight-neutral (same as Celexa). It should not be a weight factor inherently (like paxil can.) The change in appetite and eating habits might be why a persons weight changes...I know it's been a few weeks now, but can you evaluate your eating habits and attribute the weight change to that?
Posted by pharmrep on October 9, 2002, at 16:44:45
In reply to Just started Lexapro 11 days ago, posted by momof3 on October 9, 2002, at 11:21:13
** I havent heard of that one before..I would guess that the dr is using Lexapro because it is fast acting, low side effects, low drug interactions... but unless the dr is just trying out a theory....most antidepressants are not for short term use...did the dr say it would be for a short time? (ps..I know breaking the habit is very hard, if he can keep up the "just say no" actions, I'll bet he will improve. good luck and keep us posted.)
Posted by Satori on October 9, 2002, at 16:45:06
In reply to Re: Weird question for anyone concerning lexapro » Satori, posted by johnj on October 9, 2002, at 13:23:59
No, we didn't say anything about the drug use, mainly just keeping to specifics about his behaviors and how he's been feeling. He didn't want to talk about it, and that's the main reason I wanted to post the question just to see if anyone knew anything about this. Thanks johnj for your input, and I feel better knowing that your friend was able to get back to normal after a short term period of antidepressants instead of having to be on them continuously. Thanks.
Posted by pharmrep on October 9, 2002, at 16:49:23
In reply to Re: please rephrase that » pharmrep, posted by Dr. Bob on October 9, 2002, at 1:12:52
*** sorry JLM...no harm intended, and no, Im not really beat up, just a few verbal jabs here and there, but DR BOB is pretty fair about it.
> > I love your input as well as others, but dont make them so long...my eyes hurt.
>
> > I used to get beat up a lot...
>
> Keeping in mind that the idea here is not to post anything that could lead others to feel accused or put down, could you please rephrase the above? Thanks,
>
> Bob
>
> PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.
Posted by pharmrep on October 9, 2002, at 17:02:02
In reply to Re: Question for Pharmrep regarding Lexapro Anxiety, posted by ANXIETY ANN on October 8, 2002, at 13:28:48
> I RECENTLY STARTED TAKING LEXAPRO (3DAYS) 10MG FOR ANXIETY. I HAVE SEVERE HEADACHES AND STOMACH UPSET AS WELL AS DIZZINESS AND HOT FLASHES FLUSHING. SHOULD I CUT MY DOSE DOWN TO 5MG OR STICK IT OUT ON 10 MG DO THE SIDE AFFECTS GO AWAY WITH TIME? IN THE PAST I HAVE HAD A HARD TIME WITH DEPRESSION MEDS. I ALSO TAKE ADIVAN NAD XANAX FO ANXIETY AND PANIC ATTACKS.THANKS FOR ANY ADVICE YOU CAN GIVE
**** hang in there at 10mg...I have heard this dozens of times both here and in dr's offices with their patients...the 1st 3-5 days you are adjusting to a new med in your body...it can take awhile. I have heard from the same people with a tough time in the 5 days, that they felt much better at 1 wk. If you can hang in there a little longer, it should go away...keep us posted.
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