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Posted by RM73 on November 12, 2007, at 13:11:51
In reply to Lexapro/Celexa: The Best for Anxiety? Differences?, posted by RM73 on November 12, 2007, at 13:08:05
Oops! I hope my title makes sense. What I am wondering is which of the 2 medications is better for Anxiety. Lexapro or Celexa.
I apologize for any confusion this may have caused. Thanks! :)
Posted by kaleidoscope on November 12, 2007, at 15:20:03
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differences?, posted by RM73 on November 12, 2007, at 13:11:51
Neither Celexa nor Lexapro is better, they're are equal in effectiveness for anxiety. I would urge you to take generic citalopram and thus avoid wasting your money.
Celexa (racemic citalopram) and Lexapro (escitalopram) are the same drug. 20mg generic citalopram (or Celexa) contains 10mg of R-citalopram and 10mg of escitalopram (Lexapro). R-citalopram is inactive. 10mg Lexapro is therefore equivalent to 20mg generic citalopram.
Lexapro was brought to the market as a patent-extender when Celexa was going to go generic. Lexapro exists to make money for the manufacturer. There is no justification for using Lexapro as a first-line SSRI, generic citalopram should do just fine.
Posted by RM73 on November 12, 2007, at 16:48:56
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differences? » RM73, posted by kaleidoscope on November 12, 2007, at 15:20:03
Thank you so very much! I have read this numerous times but there are so many people who say that the R-part (inactive) of Celexa causes more side effects but I truly believe that many Pharmaceutical Companies do these sort of things once their medication goes Generic.
I truly appreciate your honesty and your answer! Thank you! I'm definitely going to go with the Celexa then. Unless of course someone comes here and scares me with some awful story. LOL
Take good care!
> Neither Celexa nor Lexapro is better, they're are equal in effectiveness for anxiety. I would urge you to take generic citalopram and thus avoid wasting your money.
>
> Celexa (racemic citalopram) and Lexapro (escitalopram) are the same drug. 20mg generic citalopram (or Celexa) contains 10mg of R-citalopram and 10mg of escitalopram (Lexapro). R-citalopram is inactive. 10mg Lexapro is therefore equivalent to 20mg generic citalopram.
>
> Lexapro was brought to the market as a patent-extender when Celexa was going to go generic. Lexapro exists to make money for the manufacturer. There is no justification for using Lexapro as a first-line SSRI, generic citalopram should do just fine.
>
>
>
Posted by tecknohed on November 12, 2007, at 18:50:46
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differences? » kaleidoscope, posted by RM73 on November 12, 2007, at 16:48:56
I basically agree with kaleidoscope. I've taken both & found little difference. Escitalopram did feel a little 'cleaner', but there may have been other factors involved. They basically 'did' the same thing, though personally I found them of little benifit. I also share most of your symptoms.
But dont be discouraged! I've witnessed someone with VERY bad social phobia become ENTIRELY FREE of there symptoms with 40mg of citalopram.
Hope it works well for you!
Posted by tecknohed on November 12, 2007, at 19:03:23
In reply to Lexapro/Celexa: The Best for Anxiety? Differences?, posted by RM73 on November 12, 2007, at 13:08:05
Are you taking the Klonopin long term or just to help you become accustomed to the SSRI (for start-up anxiety)?
Posted by Phillipa on November 12, 2007, at 19:34:52
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differen » RM73, posted by tecknohed on November 12, 2007, at 19:03:23
Wierd again celexa made me tired and lexapro reved me up. Well I am a med wierdo. Phillipa
Posted by RM73 on November 12, 2007, at 19:40:08
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differen » RM73, posted by tecknohed on November 12, 2007, at 19:03:23
Hey there! Thank you so very much for your response. I so appreciate it! :) And it sounds as though most people agree that these 2 meds are pretty much the same.
And yes I take Klonopin 5x a day! .5mg each time. My anxiety is so bad and I'm such a fast metabolizer of meds that I can feel breakthrough anxiety if I don't take it AT LEAST every 5 hours. Right now I'm taking it about every 4 hours or so.
I'm hoping once the Lexapro or Celexa kicks in and hopefully works on my anxiety, that I can either lower my dose of Klonopin or just take it as needed. But we'll have to see as I only just started and I do feel that "start-up anxiety."
Thanks again for your comment and I hope you're well. Take care!
> Are you taking the Klonopin long term or just to help you become accustomed to the SSRI (for start-up anxiety)?
Posted by torachan on November 12, 2007, at 20:12:18
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differen » tecknohed, posted by RM73 on November 12, 2007, at 19:40:08
It seems I'm in the same boat as you. Pretty rough waters, wouldn't you say? Except I only take 3 .5mg a day. I've noticed however over time the effectiveness of benzo treatment wears thin.
So, I'm currently attempting to find a suitable SSRI to deal with anxiety. I've read rave reviews about Lexapro which led me to give it a try 3 months ago. I lasted about a month give or take a week, but found my anxiety to be greatly aggravated, despite continued use of clonazepam, with no relief in sight, or so I felt.
Right now I'm trying Celexa at an equivalent dose, and it seems more subtle, yet I still have that feeling of the drug not treating anxiety. I've been exposed to the drug long enough I believe to have adjusted to its effects, but the results remain unsettling.
It puzzles me why these drugs are indicated for anxiety disorders. The drugs, to my understanding, have a stimulating effect, hence their effectiveness with depression. Maybe I haven't given them enough time, but I can't see how time allows the drug to become less stimulating and more sedating.
Posted by elanor roosevelt on November 12, 2007, at 20:12:48
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differen » tecknohed, posted by RM73 on November 12, 2007, at 19:40:08
I find Lexapro and Celexa to be the same.
At first you do need a benzo to keep your head on straight but that lessens over time.
They both provided new elements in my life that helped to reduce anxiety promoting emotions.
1) a sense of future
2) a pro-social attitude
3) less fear
Posted by Glydin on November 13, 2007, at 7:41:57
In reply to Lexapro/Celexa: The Best for Anxiety? Differences?, posted by RM73 on November 12, 2007, at 13:08:05
Not an unusual circumstance for me.....
For me, there was a difference in my response to Lex versus generic Celexa. I had a better, more robust response to Lex with fewer side effects.
I suggest, for ecomonic reasons, you do begin with generic Celexa, however, if you don't receive the response you desire, do not discount that Lex might indeed work or upramp your desired findings JUST because you didn't find that with Celexa.
I do not find Lex activating and I dose at night without any sleep problems with doing that. Startup was a bit rough with an increase in anxiety symptoms that were held fairly at bay with the use of Klonopin.
I have been in remission for 2 1/2 years and weaned off a benzo 1 1/2 years ago. Lex, the only head med I take, has been truly a Godsend for me.
Good Luck
Posted by tecknohed on November 13, 2007, at 8:48:10
In reply to Re: Lexapro/Celexa: The Best for Anxiety? RM73, posted by torachan on November 12, 2007, at 20:12:18
> It puzzles me why these drugs are indicated for anxiety disorders. The drugs, to my understanding, have a stimulating effect, hence their effectiveness with depression. Maybe I haven't given them enough time, but I can't see how time allows the drug to become less stimulating and more sedating.
Treating anxiety isn't really about attempting to sedate a patient. Some stimulants are excellent for anxiety. I myself used to self-medicate my social phobia with amphetamines and/or caffein.
Treating anxiety has more to do with disinhibition, confidence, cognitive enhancement & feeling optimistic. Less to do with sedation. For example, with continued use a benzo will loose it's sedative effects but at the same time become MORE effective for the anxiety. Personally, my social phobia worsens when I'm sedated because my cognitive abilities are hindered - I cann't think straight. I suspect other anxiety disorders are similar.
Posted by torachan on November 13, 2007, at 12:13:13
In reply to Re: Lexapro/Celexa: The Best for Anxiety? RM73 » torachan, posted by tecknohed on November 13, 2007, at 8:48:10
I found your response interesting to the point that I may consider different anxiety disorders in the same class to be of a different nature and pathological origin. Just a personal theory, but since recent research findings have noted a strong association between anxiety and depression which had long been suspected, I'm inclined to think some anxiety is more rooted in depression than others.
For instance, social phobia is, I'd speculate, more closely linked with depression perhaps, where the patient, as you say, requires something of a stimulating effect to propel them into social interaction, thus allowing them to reduce the anxiety of knowing their reluctance to perform in social situations.
If my diagnosis is correct, GAD, and pending a much needed re-diagnosis in the near future, I believe my issues mainly stem from an overly active central nervous system which requires a slight suppressing effect, but not too much as to cause depression, and the depression associated with this disorder is more residual/situational caused by the patient knowing they have a debilitating anxiety disorder.
Please remember this to be idle speculation, and in no way am I confirming its accuracy.On another note, I find it interesting you mentioned benzo's become more effective for anxiety over time as in my 15+ years of use, I've noticed my anxiety bubbling up to the surface more, in the form of limb and facial tremor, but perhaps this is due to other factors like advancing age or attrition of my illness.
Posted by tecknohed on November 13, 2007, at 12:30:08
In reply to Re: Lexapro/Celexa: The Best for Anxiety?tecknohed, posted by torachan on November 13, 2007, at 12:13:13
> I found your response interesting to the point that I may consider different anxiety disorders in the same class to be of a different nature and pathological origin. Just a personal theory, but since recent research findings have noted a strong association between anxiety and depression which had long been suspected, I'm inclined to think some anxiety is more rooted in depression than others.
> For instance, social phobia is, I'd speculate, more closely linked with depression perhaps, where the patient, as you say, requires something of a stimulating effect to propel them into social interaction, thus allowing them to reduce the anxiety of knowing their reluctance to perform in social situations.
> If my diagnosis is correct, GAD, and pending a much needed re-diagnosis in the near future, I believe my issues mainly stem from an overly active central nervous system which requires a slight suppressing effect, but not too much as to cause depression, and the depression associated with this disorder is more residual/situational caused by the patient knowing they have a debilitating anxiety disorder.
> Please remember this to be idle speculation, and in no way am I confirming its accuracy.
>
> On another note, I find it interesting you mentioned benzo's become more effective for anxiety over time as in my 15+ years of use, I've noticed my anxiety bubbling up to the surface more, in the form of limb and facial tremor, but perhaps this is due to other factors like advancing age or attrition of my illness.torachan, that make lots of sense. I guess I was mainly refering to social anxiety. You're probably right that other anxiety disorders like 'TRUE' GAD requires a more calming med. Saying that, I bet that if there is any social anxiety AT ALL then it would be the main culprit and treating THAT with something like an SSRI, tricyclic or MAOI would be the best option.
When I was talking about benzos becoming more effective as time past I was really talking about the onset of action. Every time I've taken a benzo the first week is normally a nightmare (too much sedation). After that the sedation goes & they simply seem disinhibiting to me. However, I'm sure that after 15 years some positive effects would have faded, making it neccessary for a dose increase.
teck
Posted by torachan on November 13, 2007, at 12:35:13
In reply to Odd one out, posted by Glydin on November 13, 2007, at 7:41:57
May I ask Glydin, were you perhaps being treated for GAD with moderate to long term benzo therapy. If so, I'd be interested in asking a few questions since my condition correlates very well.
When you started your Celexa/Lex, did you begin to reduce your benzo dosage immediately or after a week or two following an interval schedule, or did you simply wait to feel the effects of the Lex and then simply follow your gut/mental instincts. I ask because this is what I am attempting to do; wean off a benzo with the use of an SSRI, in this case Celexa. Before I tried with Effexor and came close, but didn't feel quite right and dumped it and upped the benzo.
Also, how long did it take for you to feel the anti-anxiety effects? And when you say it doesn't disturb your sleep, is this after these effects had taken hold?
If all the above assumptions hold true, if you don't mind, what was you dose of Klonopin--mine is 1.5 mg daily-- before Lex, and what is your dose of Lex in remission?
Posted by torachan on November 13, 2007, at 12:51:03
In reply to Re: Lexapro/Celexa: The Best for Anxiety?tecknohed » torachan, posted by tecknohed on November 13, 2007, at 12:30:08
I'd have to say there is likely a strong social component attached to my GAD, heck, I may even have SA and I will be going for reevaluation fairly soon. Hopefully they can nail it down with further testing. I'm an odd case as I was once suspected by one psych as having a personality disorder, possibly schizoid, but another said this was unlikely since I was conversing too well and displayed fairly appropriate emotional reaction, along with being in a close interpersonal relationship. Mind you, these were brief encounters.
Anyways I hope your suggestion of attacking the main component is correct, and my Celexa treatment takes effective action. I think it's high time I augment this with psycho/CBT/talk therapy. I've never accorded them much merit, but my self medication, meditation, and exercise needs a boost.
Posted by kaleidoscope on November 13, 2007, at 14:11:46
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differences? » kaleidoscope, posted by RM73 on November 12, 2007, at 16:48:56
>there are so many people who say that the R-part (inactive) of Celexa causes more side effects
Citalopram and Lexapro both cause typical SSRI side effects. If you suffer side effects with citalopram it would be better to try a different type of med rather than switching to Lexapro.
>I truly believe that many Pharmaceutical Companies do these sort of things once their medication goes generic
It is a fact that the majority of 'new' meds are (minor) modifications of existing meds eg. single isomers, controlled-release formulations, active metabolites and minor chemical modifications. We rarely see truly novel drugs in psychiatry.
>Unless of course someone comes here and scares me with some awful story.
There are millions of SSRI scare stories all over the internet (including both Celexa and Lexapro......although you will probably find more scare stories for Lexapro because it is currently remarkably overprescribed). The fact is.... all SSRIs can cause side effects and some people react badly. On the other hand, some people do well on them.
All SSRIs cause frequent sexual side effects, all SSRIs can cause emotional numbing, all SSRIs can cause initial agitation and anxiety. There is no difference here between Lexapro and Celexa.
It is unlikely to make any difference to your mental state whether you start with generic citalopram or Lexapro. The major difference is that Lexapro is a great deal more expensive. Also, don't worry about which generics company makes the citalopram. It is highly unlikely to make a difference unless you convince yourself that there is a difference - which some people do.
In the treatment of anxiety, it is usual to start with 10mg citalopram. The dose can be increased to 20mg after 1-2 weeks if tolerated. You should try 20mg for a couple of months before considering whether you need to increase the dose further. Doses above 40mg are not normally necessary.
Take care
Posted by Glydin on November 13, 2007, at 17:07:34
In reply to Re: Odd one out, posted by torachan on November 13, 2007, at 12:35:13
> May I ask Glydin,
~~~ Sure, see new post to you currently at page bottom.
Posted by tecknohed on November 14, 2007, at 4:11:57
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differences? » RM73, posted by kaleidoscope on November 13, 2007, at 14:11:46
Hi K!
I understand what you say about theres little (if any) difference between citalopram & escitalopram. But are you talking soley about 'theraputic' actions/response? I mean, isn't it possible that the R-isomer can still cause unwanted side effects even though its not the 'theraputic' part of citalopram? Also, isn't it true that BOTH isomers of some meds are both active 'theraputically' (I forget which ones). Hope that makes some sense.
Kev.
Posted by Questionmark on November 15, 2007, at 2:22:05
In reply to Re: Lexapro/Celexa: The Best for Anxiety? RM73 » torachan, posted by tecknohed on November 13, 2007, at 8:48:10
Woah! You explained all of that really really well. I have always had trouble trying to describe those things in words, whether in my head or to others. They were also really important points that people need to keep in mind. Yeah like I could take a Remeron and be sedated as all get out but I wouldn't want to interACT with people.
Also, I too usually have trouble dealing w/ my social phobia when I'm sedated, for the same reasons you mentioned, and, I also used to use caffeine and other stimulants to deal with my SP. Yet my 3 to 5 week (?) trial with Klonopin in the past wasn't helpful at all. I just felt more dead stupid and lazy and less confident. (Not that a stimulant by itself is sufficient by any means either, except for maybe a terribly brief time.)
> Treating anxiety isn't really about attempting to sedate a patient. Some stimulants are excellent for anxiety. I myself used to self-medicate my social phobia with amphetamines and/or caffein.
>
> Treating anxiety has more to do with disinhibition, confidence, cognitive enhancement & feeling optimistic. Less to do with sedation. For example, with continued use a benzo will loose it's sedative effects but at the same time become MORE effective for the anxiety. Personally, my social phobia worsens when I'm sedated because my cognitive abilities are hindered - I cann't think straight. I suspect other anxiety disorders are similar.
Posted by Questionmark on November 15, 2007, at 2:44:02
In reply to Re: Lexapro/Celexa: The Best for Anxiety?tecknohed, posted by torachan on November 13, 2007, at 12:13:13
Social phobia might (I stress might) be more (or just as) strongly linked to depression than anxiety-- and if so that is significant and you have a good point, if not completely accurate-- but 1) there is almost always if not always a significant anxiety component in social phobia, and 2) there are still a great many people in whom it is primarily anxiety based.
It's just another example of how the same disorders (/conditions/ whatever) could have different underlying biological roots and problems. I for one am actually made worse by taking a benzo alone (i *need* an antidepressant), yet I have a friend whose social phobia has never responded to anything as well as it does to daily Xanax. I also almost need caffeine to function, whereas his anxiety goes through the roof with it. We both have wasted our lives in large part due to social phobia though.> I found your response interesting to the point that I may consider different anxiety disorders in the same class to be of a different nature and pathological origin. Just a personal theory, but since recent research findings have noted a strong association between anxiety and depression which had long been suspected, I'm inclined to think some anxiety is more rooted in depression than others.
> For instance, social phobia is, I'd speculate, more closely linked with depression perhaps, where the patient, as you say, requires something of a stimulating effect to propel them into social interaction, thus allowing them to reduce the anxiety of knowing their reluctance to perform in social situations.
> If my diagnosis is correct, GAD, and pending a much needed re-diagnosis in the near future, I believe my issues mainly stem from an overly active central nervous system which requires a slight suppressing effect, but not too much as to cause depression, and the depression associated with this disorder is more residual/situational caused by the patient knowing they have a debilitating anxiety disorder.
> Please remember this to be idle speculation, and in no way am I confirming its accuracy.
>
> On another note, I find it interesting you mentioned benzo's become more effective for anxiety over time as in my 15+ years of use, I've noticed my anxiety bubbling up to the surface more, in the form of limb and facial tremor, but perhaps this is due to other factors like advancing age or attrition of my illness.
Posted by Nardilstarted2007 on November 16, 2007, at 1:30:11
In reply to Lexapro/Celexa: The Best for Anxiety? Differences?, posted by RM73 on November 12, 2007, at 13:08:05
> Hi everyone! I hope and pray you're all well and having a wonderful week (although it's only just begun! LOL) I have a couple of questions for you all and am optimistic that someone will be able to help. :)
>
> First off I guess I should mention my "diagnosis" and how I've been feeling. I have
> Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, Slight
> Obsessive-Compulsive Disorder, Major Depressive Disorder, Premenstrual Dysphoric Disorder and possible Post-Traumatic Stress Disorder. I'm sure there's more but these are the things I find troubling at this point in time.
>
> I started Lexapro at a whole 1.25mg per day 5 days ago and so far I'm doing all right other than I am feeling more anxious for a few hours after taking it in the morning. Thankfully I'm taking 2.5mg of Klonopin a day to help with my anxiety although I'm still feeling it. By the way I tend to respond better to medications if I
> start low and increase slowly, hence the tiny dosage. :)
>
> What I am wondering is if Celexa (well the Generic Form) is as good on anxiety as Lexapro as I have no insurance, no job and not a whole lotta money. I'm currently taking samples of the Lexapro but when it comes time to get a prescription, I'd sure like to go the Generic route if possible.
>
> Also I've read a lot about the 2 meds online and have noticed many people saying that Lexapro is more activating than Celexa. Does anyone have any input on this as well? I would appreciate anything anyone would be willing to share about their experience and/or knowledge of either or both of these medicines.
>
> Thank you all for your time and I hope to hear from someone soon. Take good care and have a wonderful day! :)Hi, I have SAD which manifests into depression. I've had experience with both Celexa and lexapro. everybody is differnt when it comes to AD's and their effectiveness. I tried celexa 2 years ago with minimal side effect, I could feel it slightly kicking in after 2 weeks with a bit of AD effectiveness and antianxiety.. I stayed on it for about 6 weeks with no better results (up to 40mgs/day. I then Immediately switched to Lexapro 10mgs/day, then 15mgs/day. Right away Lexapro made me sooo tired I would fall asleep anywhere, even on the floor for hours during the day. it was like being on a strong hypnotic. the tirednss never went away so I had to quit and move on to the next med because all lexapro did was make me sleep for 15 hours a day at differt times throughout the day. I dont know why it had this effect but I guess for some people celexa and Lexapro just arn't the same. I went back to my previous ssri paxil which never worked again. (I can switch between ssri's without washout period or withdrawl from the previous, as they all boost my seratonin so I dont go through withdrawl but some work and some dont) Just my experience with Lex and Celexa. Keep us posted
Posted by tecknohed on November 16, 2007, at 4:21:49
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differences?, posted by Nardilstarted2007 on November 16, 2007, at 1:30:11
And hows the Nardil doing? I assume you're on it 'cause of your name?
Posted by kaleidoscope on November 18, 2007, at 16:46:53
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differen » kaleidoscope, posted by tecknohed on November 14, 2007, at 4:11:57
Hi K
>I mean, isn't it possible that the R-isomer can still cause unwanted side effects even though its not the 'theraputic' part of citalopram?
Yes, it's possible, although I don't think it's a problem for most people. The major side effects and the therapeutic effects of both escitalopram and citalopram are both mediated via serotonin reuptake inhibition eg. by the S-isomer.
>Also, isn't it true that BOTH isomers of some meds are both active 'theraputically' (I forget which ones)
Yes, this is true for some meds. An example is mirtazapine - its isomers are both pharmacologically active but have different effects.
It is common for people to say that Lexapro and citalopram have affected them differently ......but........it's important to remember that the exact same med can affect people differently at different times in their life. A good example is that someone can respond well to an AD at one point but not when they try it again at a later date. In most cases, I do not believe that the reported differences between Lexapro and citalopram are pharmacological in nature. It is also important to bear in mind that some of the reported differences between the two products may be the result of non-equivalent doses.
Posted by tecknohed on November 18, 2007, at 17:03:29
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differen » tecknohed, posted by kaleidoscope on November 18, 2007, at 16:46:53
Thanks for the response - you helped put things in perpective for me :)
> >Also, isn't it true that BOTH isomers of some meds are both active 'theraputically' (I forget which ones)
>
> Yes, this is true for some meds. An example is mirtazapine - its isomers are both pharmacologically active but have different effects.This is very interesting! Do you know which isomer is responsible for it's sedative effects? Or is it both? Would be such a better med if it wasn't for the damn sedation! And if it is just one isomer which causes it, would taking it away make the drug less effective?
p.s. Haven't heard from you since we last spoke - hope you are well. Email me any time. I like to know how you're getting on & any plans you have, med-wise or otherwise.
Kev. :)
Posted by kaleidoscope on November 19, 2007, at 14:49:18
In reply to Re: Lexapro/Celexa: The Best for Anxiety? Differen » kaleidoscope, posted by tecknohed on November 18, 2007, at 17:03:29
>Do you know which isomer is responsible for it's sedative effects?
As far as I know, the S-isomer is responsible for the sedation. Unfortunately, the S-isomer is also thought to be responsible for most of the antidepressant activity.
>hope you are well
Thank you! I am - will email you soon :)
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