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Re: where's the evidence? » dr. dave

Posted by pharmrep on September 27, 2002, at 23:41:13

In reply to Lexapro side-effects - where's the evidence? » pharmrep, posted by dr. dave on September 27, 2002, at 6:13:23

> Again, the claim has been made that Lexapro has fewer side-effects than Celexa. This has been extensively discussed on this thread and the relevant data have been posted.
>
***** Nobody has ever said r-cit was inert or is where the side effects are...it just isnt contributing towards treating depressive syptoms (as seen in sanchez study). all of the studies show 10mg to have "s/e comparable to placebo" which is definitely less than celexa or any other AD. I'm not sure who you mean when you say "they"...but it's not just forest stating that claim...it's every study done so far...with the backing of the FDA.
>
> They clearly fail to demonstrate any significant difference. Despite repeated calls for any other research data which might back up the claim, none have appeared. So it is puzzling that this claim is again presented as fact.
>
> The repeated statement of unsubstantiated claims leads to confusion. For instance, it has been said that r-citalopram cannot be inert because it is blamed for side-effects from Celexa. While it is true that this is claimed, there is no evidence to show that it is true. Removing r-citalopram does not cause a significant decrease in side-effects. But if the claim is made often enough, people begin to take it as fact and make deductions which stray further and further from what the research actually shows.
>
> If there is now evidence that Lexapro has significantly fewer side-effects than Celexa, It would be very useful to see it.
>
>
> > ** great question. 10mg of Lex is at least as efficacious as 40mg of cx...but with less s/e, less drug to drug interactions, and less discontinuation due to adverse events, and will work as fast as 1-2 weeks for most people. It is linear, however...5mg will not work as fast, and is not the recommended starting dose. In general, for most drugs many doctors reduce dosages to avoid side effects, but since Lexapro at 10mg is "comparable to placebo" it shouldnt be needed. In the Dr's I've seen...I would say 95%+ are starting w/ 10mg...only a few have gone to 20mg (only 2 weeks out now) and maybe a few Dr's are just "set in there ways" and are starting with 5mg (for a week or so...then up to 10mg) So far...I have only heard good responses from them, but most of their patients havent been back for their "monthly" visit...I'll hear more in about 2 weeks or so.
> > PS...the starting dose for celexa was 20mg (62% of patients stayed there)...40mg was at about 30% (for a total of 92% of all Celexa prescriptions...the last 8% were at 60mg or higher.) I think Lexapro at 10mg will be effective for 80%+ of patients...then 15mg+ will make up the last 20%
>
>


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