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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Anyuser on July 29, 2002, at 9:15:14
Escitalopram is Cipralex in Europe, and will be Lexapro in the US soon. The manufacturer has put up a website at Cipralex.com. For those hoping that Lexapro will have fewer side effects that Celexa, the forecast is not good. Here are a couple of Q&A from the Cipralex site.
What are the most frequent adverse events reported for Cipralex?
The most frequent adverse events are those expected for a SSRI: nausea, ejaculatory disorder in men, insomnia, somnolence. None of the adverse events occur much in excess of placebo (<10%). As with citalopram, most adverse events decline in frequency and intensity after the first few weeks of treatment. In practice: Cipralex has the same excellent tolerability as citalopram.
Why don't you see any clear differences in the side-effect profile of Cipramil and Cipralex?
The side-effects seen with Cipramil are mild and transient, and largely of the same nature as those seen with other SSRIs. For this reason they are generally assumed to be related to the serotonin uptake inhibiting property of this class of antidepressants. With Cipralex, the serotonin reuptake inhibition has been retained whilst the presumably inactive enantiomer has been removed. It is not surprising, therefore, that the side effect profile remains largely unchanged.
Posted by jaby on July 29, 2002, at 18:15:51
In reply to Escitalopram, posted by Anyuser on July 29, 2002, at 9:15:14
Great find. Funny about all this since it was get rid of the other isomer was supposed to reduce the side effects so dramtically. Anything's worth a try though
Posted by Bill L on July 30, 2002, at 13:20:53
In reply to Escitalopram, posted by Anyuser on July 29, 2002, at 9:15:14
I saw in your post that the side effects are the same between the 2. And that makes sense. But you didn't mention the percent of people who get these side effects.
I think that the percent of people and the severity of side effects was clearly shown to be lower in escitalopram than in citalopram in a number of clinical studies.
Posted by Anyuser on July 30, 2002, at 15:42:41
In reply to Re: Escitalopram, posted by Bill L on July 30, 2002, at 13:20:53
Good point, and I hope you're right. I guess one essential benefit escitalopram is that the therapeutic dose of escitalopram is 10mg, which is supposed to be equivalent (in efficacy) to 40mg of citalopram. One of the earliest clinical studies, the one that got everyone (at least me) excited, said that side effects from 10mg of escitalopram were roughly equal to side effects from placebo, and that side effects from 20mg were roughly equal to side effects from 40mg of citalopram.
I gather from what's posted on cipralex.com that the approval for cipralex was piggybacked on the approval for cipramil (celexa). Because the manufacturer's main premise is that cipralex is the same as cipramil and therefore should be approved, it's really prevented from saying that cipralex is different from cipramil, even if the difference is better.
One thing that makes me suspicious is that the manufacturer way understates the sexual side effects of celexa. On celexa.com, the manufacturer states that the incidence of ejaculation disorder is 6%, and that's got to be a flat out lie. I read that of all SSRIs celexa causes the highest incidence of sexual side effects, in excess of 70%.
We really won't know until people start taking the stuff and putting the word out. There must be patients in europe and the UK who went from cipramil to cipralex and now know if escitalopram is a big improvement. Some weeks ago I posted on this board a shout out to Brits taking Cipralex, but got no response.
Posted by Bill L on July 31, 2002, at 9:21:20
In reply to Re: Escitalopram » Bill L, posted by Anyuser on July 30, 2002, at 15:42:41
When the SSRI companies report the low incidence of sexual side effects they are not being honest. Their stats are based on 6 week studies. Soem people don't have bad sexual side effects by 6 weeks but develop them later. Many more people do have sexual side effects by 6 weeks but are embarassed about reporting it to the investigator who is conducting the 6 week study.
The actual percent of people who get some degree of sexual side effects from SSRI's is probably around 70% to 90%. The percent who get severe sexual side effects is lower and it also depends on the dosage and on the SSRI. Celexa probably has the least severe sexual side effects of the SSRI's from what I have read.
Posted by Anyuser on July 31, 2002, at 9:43:55
In reply to Re: Escitalopram, posted by Bill L on July 31, 2002, at 9:21:20
All I know is, I'll be the first on my block to try it. I'm very interested in what "pharmrep" has to say, and how this board will treat an agent of the reviled pharmaceutical industry.
This is the end of the thread.
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