Psycho-Babble Medication | about biological treatments | Framed
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How do you act on that information? dr. dave

Posted by Anyuser on August 19, 2002, at 11:12:18

In reply to Re: Lexapro is no different from Celexa, posted by dr. dave on August 19, 2002, at 4:52:24

Let's say you're a practicing physician (no offense intended, this is after all the internet). A threshold question is whether you are dubious of antidepressant drugs in general, never prescribe 'em, and instead prefer talk therapy. Let's say you do indeed prescribe antidepressants in your practice. The next question is whether you prescribe Celexa. Let's say you do indeed prescribe Celexa, and find through experience that it works for some but not all of your patients.

Now here comes a Forrest Labs marketing rep who says that Lexapro is better than Celexa. Everybody and their dog knows that the data that comes out of any drug manufacturer is of limited value, subject to bias, etc. Even so, maybe Lexapro is a little bit better than Celexa. Who knows, maybe it's a lot better. Then again, maybe Lexapro's not better at all, but identical to Celexa. There would be nothing remarkable about a new SSRI that works no better than all the other SSRIs. That would be old news. Then again, who knows why Zoloft is more effective that Paxil for some, and the reverse is true for others?

I'm pretty sure my pdoc doesn't consult the Danish Institute for Rational Pharmacotherapy (although I am generally very nervous about where he gets his nutty ideas, but let's put that aside). The institute, according to its website, "has the task of ensuring the population the most rational utilisation of the range of medicinal products available on the basis of both effectual and financial points of view." The only time a financial point of view enters into my relationship with my pdoc is if there is an issue as to whether my insurance will cover a medicine that he prescribes. Fortunately for me, that is never an issue. Let's say insurance issues don't enter into your decisions as to what to prescribe (but let us know if that is a mistaken assumption, let us know if you work for an HMO controlled by an insurance company).

Now let's say you have a patient whom you think might benefit from Celexa. Why wouldn't you write the prescription for Lexapro instead?




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