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Re: Lexapro side-effects/dosage

Posted by yeltom on September 27, 2002, at 22:18:05

In reply to Lexapro side-effects , posted by dr dave on August 28, 2002, at 3:15:33

But your conclusion is based on the idea that 10 mg. of Lexapro is equivalent to 20 mg. of Celexa, whereas the company claims that it's equivalent to 40 mg. Am I wrong? I am curious, however, why isolating one of the isomers would make it 4 times stronger. I assumed that the two isomers in celexa were present in a ratio of 1:1, in which case you'd assume (assuming that the less active isomer is not active at all) that the isomer would be twice as strong, not 4 times as strong. Unless the non-active component actually INHIBITS the active component. Or perhaps the assumption that they are present in a ratio of 1:1 is wrong.

> It is repeatedly claimed Lexapro has fewer side-effects than Celexa. What does the data show? In the Burke et al trial 85.6% of those on Lexapro 20mg had side-effects compared to 86.4% on Celexa 40mg (not statistically significant). Not impressive, I would suggest. 10.4% of those on Lexapro 20mg discontinued because of side-effects compared to 8.8% of those on Celexa. So in fact more discontinued Lexapro than Celexa. But the result is not statistically significant and therefore likely to be a chance result.
>
> The incidence of discontinuations on Lexapro 10mg a day was 4.2% compared to 2.5% on placebo. Again, not statistically significant. The overall rate of side-effects on Lexapro 10mg was 79.0% compared to 70.5% on placebo (not statistically significant). The comparison between Celexa 20 mg and placebo is not available as this dose was not used.
>
> So the Burke study provides no data to support the claim that Lexapro has fewer side-effects than Celexa.
>
> Gorman gives discontinuation rates for Lexapro in both doses as being 5.9% versus 2.2% for placebo (not statistically significant). No equivalent rate for Celexa is available. No more detail on side-effects is given in this, the most comprehensive analysis of the data currently available. Myself, I ask why not, if this is such a step forward in terms of side-effects.
>
> These results are entirely consistent with the hypothesis that there is no statistically significant difference in side-effects between Lexapro and Celexa, and provide no evidence of the difference that is so widely claimed as being an established fact.
>
> If there is other evidence to fit into this overall picture, this must be considered, but these results seem to suggest very powerfully that there is no significant difference in side-effects.
>
> Decide for yourself on the basis of actual hard facts.


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poster:yeltom thread:109458
URL: http://www.dr-bob.org/babble/20020922/msgs/121326.html