Psycho-Babble Medication | about biological treatments | Framed
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Knowledge dr. dave

Posted by Anyuser on August 20, 2002, at 16:37:24

In reply to Receptor affinity profiles of s- and r-citalopram, posted by dr. dave on August 20, 2002, at 16:02:00

A recurring theme on this board is how to obtain reliable information about ADs. As among (1) scientific papers, both pre- and post- governmental approval, (2) clinical experience reported by practitioners, and (3) individual experiences, I would value (2) over (1) and (3). With respect to escitalopram, in the US there is no clinical experience and no individual experience. We patients, at the moment, are limited to the scientific papers. Most knowledgeable patients, and there are many on this board, know that drug applications are written by lawyers for lawyers. The prescribing information for Celexa, for example, is false and misleading with respect to the incidence of sexual side effects. I think a sensible attitude toward escitalopram is to be hopeful but sceptical. It might be enough of an improvement in reducing side effects to keep some number of patients on the drug longer.

You, on the other hand, as a practicing physician in the UK, have access not only to the scientific papers but also to the individual experience of Cipralex users. Moreover, you can get in the game and test the veracity of the scientific papers and the marketing raps by prescribing Cipralex. You say you prescribe Cipramil. You must have patients that suffer sexual side effects. Haven't any of such patients asked you to prescribe Cipralex instead? Let's say you have a patient who's been taking 40mgs of Cipramil and can't have an orgasm and tells you she is going off the drug. Why wouldn't you test Lundbeck's rap by writing a scrip for 10mgs of Cipralex and seeing how it worked for your patient? You don't have to rely on the papers, you can generate your own clinical experience. Why wouldn't you do so?

I'm not arguing the merits of escitalopram here. I don't know the truth. I'll be interested to hear what people say after they try it. You have a chance to try it on your patients and (apparently) choose not to, apparently in reliance meta-surveys. Why? I value your opinion now, but I think your opinion would carry even more weight if you were to say that you've tried Cipralex on your patients and they tell you it's better/worse/the same compared to Cipramil.




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