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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by shadowmon on July 4, 2004, at 4:23:42
Does anyone know the difference between what paxil afects and what lexapr affects? Is there any difference?
Posted by holymama on July 4, 2004, at 6:53:24
In reply to chemical difference between paxil and lexapro, posted by shadowmon on July 4, 2004, at 4:23:42
sorry, I don't know the chemical differences, but my doctor did say that lexapro is more stimulating, paxil more calming. I'm making the switch from lexapro to paxil right now since I have far too much anxiety on the meds I am on right now. Good luck to you!
Posted by pellmell on July 4, 2004, at 12:41:15
In reply to chemical difference between paxil and lexapro, posted by shadowmon on July 4, 2004, at 4:23:42
> Does anyone know the difference between what paxil afects and what lexapr affects? Is there any difference?
Check out Dr. Sheldon Preskorn's old columns here:
http://www.preskorn.com/column2.htmlThey shed a whole lot of light on the differences between the SSRIs. The info on citalopram is applicable to Lexapro, since citalopram and escitalopram are essentially the same drug (escitalopram is citalopram without the inactive enantiomer).
For some reason -- perhaps related in vitro pharmacology, perhaps not -- I respond best to SSRIs that hit the dopamine or norepinephrine reuptake pumps in the test tube, e.g. Prozac (fluoxetine) and Zoloft (sertraline). Though for whatever reasons Effexor just raised my blood pressure slightly and made me really foggy-headed.
My depressive symptoms are mainly cognitive, and involve lots of social withdrawal and the like.
Hope this is of some help to you..
-pm
Posted by chemist on July 7, 2004, at 22:57:11
In reply to chemical difference between paxil and lexapro, posted by shadowmon on July 4, 2004, at 4:23:42
> Does anyone know the difference between what paxil afects and what lexapr affects? Is there any difference?
hello there, chemist here...lexapro is the (S) enantiomer of citalopram. one of the posters refers to the other enantiomer as being ``inactive,'' but that is not correct: the (R) enantiomer of citalopram is the cause of the unwanted side effects of the racemate (R,S)-citalopram (celexa) and the binding affinity is about 1% that of the (S) enantiomer, but it is hardly inactive. the downside is that along with unwanted side effects some of the *wanted* side effects go away, such as inhibition of reuptake of dopamine and norepinephrine (minor). as for paroxetine, it reads more or less like lexapro with the exception that there are so many nasty problems due to the route by which it is metabolized, specifically the cyp4502D6 isoenzyme. lexapro/celexa do not inhibit, act as substrates, or autoinduce cyp4502D6, which is one of the enzymes that many other drugs are metabolized by, anbd hence the potential for interactions is increased. also, paxil just plain appears to have a lengthy track record of unwanted side-effects, regardless of the SSRI activity.....hope theis helps, and all the best, chemist
Posted by pellmell on July 8, 2004, at 21:19:04
In reply to Re: chemical difference between paxil and lexapro » shadowmon, posted by chemist on July 7, 2004, at 22:57:11
You know, I try not to use ignorance as a research tool, but sometimes it's just right there, so convenient...
In other words, I apologize for my laziness. I pledge to be more careful in the future. :)
Best,
-pm
> hello there, chemist here...lexapro is the (S) enantiomer of citalopram. one of the posters refers to the other enantiomer as being ``inactive,'' but that is not correct: the (R) enantiomer of citalopram is the cause of the unwanted side effects of the racemate (R,S)-citalopram (celexa) and the binding affinity is about 1% that of the (S) enantiomer, but it is hardly inactive. the downside is that along with unwanted side effects some of the *wanted* side effects go away, such as inhibition of reuptake of dopamine and norepinephrine (minor). as for paroxetine, it reads more or less like lexapro with the exception that there are so many nasty problems due to the route by which it is metabolized, specifically the cyp4502D6 isoenzyme. lexapro/celexa do not inhibit, act as substrates, or autoinduce cyp4502D6, which is one of the enzymes that many other drugs are metabolized by, anbd hence the potential for interactions is increased. also, paxil just plain appears to have a lengthy track record of unwanted side-effects, regardless of the SSRI activity.....hope theis helps, and all the best, chemist
Posted by chemist on July 8, 2004, at 21:44:56
In reply to Re: chemical difference between paxil and lexapro » chemist, posted by pellmell on July 8, 2004, at 21:19:04
hello there, chemist here....have i offended you? please explain......all the best, chemist
> You know, I try not to use ignorance as a research tool, but sometimes it's just right there, so convenient...
>
> In other words, I apologize for my laziness. I pledge to be more careful in the future. :)
>
> Best,
> -pm
>
>
> > hello there, chemist here...lexapro is the (S) enantiomer of citalopram. one of the posters refers to the other enantiomer as being ``inactive,'' but that is not correct: the (R) enantiomer of citalopram is the cause of the unwanted side effects of the racemate (R,S)-citalopram (celexa) and the binding affinity is about 1% that of the (S) enantiomer, but it is hardly inactive. the downside is that along with unwanted side effects some of the *wanted* side effects go away, such as inhibition of reuptake of dopamine and norepinephrine (minor). as for paroxetine, it reads more or less like lexapro with the exception that there are so many nasty problems due to the route by which it is metabolized, specifically the cyp4502D6 isoenzyme. lexapro/celexa do not inhibit, act as substrates, or autoinduce cyp4502D6, which is one of the enzymes that many other drugs are metabolized by, anbd hence the potential for interactions is increased. also, paxil just plain appears to have a lengthy track record of unwanted side-effects, regardless of the SSRI activity.....hope theis helps, and all the best, chemist
>
>
Posted by shadowmon on July 9, 2004, at 1:10:44
In reply to Re: chemical difference between paxil and lexapro » pellmell, posted by chemist on July 8, 2004, at 21:44:56
thanks for all the info, I guess I'm still trying to figure out why one works and the other one isint working as well.....
Posted by theo on July 9, 2004, at 16:22:09
In reply to Re: chemical difference between paxil and lexapro, posted by shadowmon on July 9, 2004, at 1:10:44
I don't know which one isn't working for you but I was on Paxil doing great and my doctor had the great idea for me to switch to Lexapro when it first came out. I went from happy go lucky and sociable on Paxil to scared to leave the house and full blown anxiety on Lexapro, even after 9 weeks. From personal experience and from the numerous threads on Lexapro, I don't see a very positive track record for it's use for someone with general or social anxiety. I think Lexapro is a POS, but that is just my opinion.
Posted by shadowmon on July 10, 2004, at 2:10:06
In reply to Re: chemical difference between paxil and lexapro » shadowmon, posted by theo on July 9, 2004, at 16:22:09
did you go back on the paxil? I'm debating telling my dr that I dont care of my mildly elevated liver enzyme levels. I've heard that it doesnt work the same, I'm scared. I just want to feel better.
Posted by theo on July 10, 2004, at 11:59:44
In reply to Re: chemical difference between paxil and lexapro, posted by shadowmon on July 10, 2004, at 2:10:06
I did but for some reason it didn't seem to work as good second time around and I had a bigger problem with sexual sides. Originally, I had a mild loss of libido but the second time I had erectile dysfuntion and was in a hot and heavy relationship, so I backed off the Paxil. Currently I'm trying Lamictal which doesn't do much for anxiety but with the whole "rash" thing, my doc wants me to get to a theraputic dose of the Lamictal, then I will probably add a low dose, 10-15mg of Paxil. I don't get sexual SE's from Paxil till I hit 20mg.
Posted by pellmell on July 10, 2004, at 12:10:25
In reply to Re: chemical difference between paxil and lexapro » pellmell, posted by chemist on July 8, 2004, at 21:44:56
chemist,
No, no, you haven't offended me at all! I was just giving myself a public flogging. A symptom of one the many unhelpful thought patterns that contributes to my pathology, I guess.
Thank you for your original post. I learned some new stuff...which is excellent, 'cause psychopharmaceuticals fascinate me. And I like to be in the company (virtual or otherwise) of people who know more and/or are smarter than I am.
-pm
> hello there, chemist here....have i offended you? please explain......all the best, chemist
>
>
> > You know, I try not to use ignorance as a research tool, but sometimes it's just right there, so convenient...
> >
> > In other words, I apologize for my laziness. I pledge to be more careful in the future. :)
> >
> > Best,
> > -pm
Posted by chemist on July 10, 2004, at 12:23:58
In reply to Re: no, you haven't offended me! » chemist, posted by pellmell on July 10, 2004, at 12:10:25
hello there....well, that's good to hear...your choice to ``publicly flog'' yourself is, naturally, your choice, but none of us are perfect, and i have a long track record in life and on this board (which is more readily accessed than my life history!) of being off-the-mark or just flat out wrong. i value accurate dissemination of information as do you, and i do hope you were not offended at my perhaps ham-handed manner in ``appending'' your quite accurate and insightful original post. all the best, chemist
> chemist,
>
> No, no, you haven't offended me at all! I was just giving myself a public flogging. A symptom of one the many unhelpful thought patterns that contributes to my pathology, I guess.
>
> Thank you for your original post. I learned some new stuff...which is excellent, 'cause psychopharmaceuticals fascinate me. And I like to be in the company (virtual or otherwise) of people who know more and/or are smarter than I am.
>
> -pm
>
> > hello there, chemist here....have i offended you? please explain......all the best, chemist
> >
> >
> > > You know, I try not to use ignorance as a research tool, but sometimes it's just right there, so convenient...
> > >
> > > In other words, I apologize for my laziness. I pledge to be more careful in the future. :)
> > >
> > > Best,
> > > -pm
Posted by shadowmon on July 11, 2004, at 0:33:51
In reply to Re: chemical difference between paxil and lexapro » shadowmon, posted by theo on July 10, 2004, at 11:59:44
The sexual side effects dont really bother me, I guess that's cause well, I can't even have a relationship with this....
I'm just praying for something to work.
This is the end of the thread.
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