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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 8 to 32 of 42. Go back in thread:
Posted by JaneB on July 31, 2002, at 10:24:45
In reply to Lexapro rep pushes Lexapro, what a shock! » pharmrep, posted by katekite on July 31, 2002, at 9:45:20
Kate,
My pdoc said exactly the same thing as pharmrep 2 months ago. He is the head of psychiatry at a large teaching university. Should I question his motives?
JaneB
Posted by pharmrep on July 31, 2002, at 10:34:47
In reply to Lexapro rep pushes Lexapro, what a shock! » pharmrep, posted by katekite on July 31, 2002, at 9:45:20
Part of me wants to say blah blah blah, and the other part wants to find out why
you are so pessimistic. I am rather new to this forum and want to play fair, so
no more smack-talk ok? You dont know me, and to judge me as a "sales" rep only, and
think my perspective is purely biased is not fair. I can see you might think so, but
try to use me as a resource for info instead of a punching bag, and you will get more info.
In response to your statements/questions... "controlled" is not from me, this is how Dr's
talk, you are a person, but you are scored on tests, and lowering those scores is the goal,
trying to influence those scores is what they meen by control. I meant no insult, and will
apologize for that (I am not insensitive). The non-bias opinion smack you gave was harsh, but
you dont know me yet...I can understand your position (I am only trying to share info here
that I have and most others dont). Respect. Again, you dont know me, but I can tell you I am
respected by mey physicians. I carry myself professionally, and am not "salesy" and they
appreciate it. I do not misinform anyone..it is to no benefit, and for you to insinuate I do
is wrong. Kickbacks? I am a paid Pharmaceutical rep. I happen to work for a company that has
some great products...many companies do. I dont know what you meen by that. Anyway, I propose a
new beginning, a truce, or whatever you want so that my fingers will stop cramping from so much typing.
We have been quite prolific here, and should try to keep the novels to 1 page. ok?
PS Regarding the "better" statement. I'm afraid I wont be taking that back. I will answer any
questisons you have to support that...including the over 1300 patients studies, etc.
Posted by Dr. Bob on July 31, 2002, at 11:47:12
In reply to Lexapro rep pushes Lexapro, what a shock! » pharmrep, posted by katekite on July 31, 2002, at 9:45:20
> Well I'm so shocked. Someone (me) said something critical about a new not yet marketed drug, and now a person who wants to sell that drug is disagreeing.
> You would like everyone to believe that you have some magic information that is only available to you.
> I can't think that anyone already being a drug rep would care...
I understand your skepticism, but please don't be sarcastic, jump to conclusions about others, or post anything that could lead them to feel accused or put down:
http://www.dr-bob.org/babble/faq.html#civil
Thanks,
Bob
PS: Follow-ups regarding posting policies should be redirected to Psycho-Babble Administration; otherwise, they may be deleted.
Posted by katekite on July 31, 2002, at 12:08:50
In reply to Re: Lexapro rep pushes Lexapro, what a shock » katekite, posted by JaneB on July 31, 2002, at 10:24:45
No, I think you should trust in someone's opinion based on how honest, intelligent, experienced, and educated they are, their credentials, and how unbiased they seem. Your psychiatrist sounds like all of those things and I would trust him if he suggests one drug over another. I do think its weird that a psychiatrist would say that any un-marketed drug is 'better' than any other. I would think it more likely they would say it was "promising" or "might be great". My own psychiatrist thinks similarly to yours, that it sounds good.
Please understand I have nothing against Lexapro itself. I have high hopes that it will turn out to be a great drug.
What bugs me is someone who has something financial to gain making overgeneralizations or using their authority to plug a drug. Especially using studies and facts and putting them all together to make it sound as if they can prove something will work or be better when the numbers of people who have tried it are still so small.
Like saying that because one isomer competes with another that a drug that is a single isomer will work better for that reason. The drug may work better in a study than the other drug. They may show that the two isomers interact in another separate study. But they don't show a causal connection between the two so they can't say the one thing causes the other. The drug rep is trying to confuse people into just trying the drug hoping that people will like it. I wish they would instead say "we don't know how Lexapro would affect you but we wish you would try it. It seems to help some people." That would at least be honest.
Kate
Posted by katekite on July 31, 2002, at 12:17:31
In reply to Re: please be civil » katekite, posted by Dr. Bob on July 31, 2002, at 11:47:12
I think its the dexamethasone suppression test I'm doing today making me overly fiesty. It's a low dose but has my pulse up about 30 points. I apologize, Pharmrep, for being sarcastic and accusing you of getting kickbacks. I appreciate you taking it in stride. I can argue my points in another post.
Kate
Posted by katekite on July 31, 2002, at 12:26:47
In reply to Re: Lexapro rep pushes Lexapro, what a shock!, posted by pharmrep on July 31, 2002, at 10:34:47
Hi,
Thanks for offering to be a resource. I understand that you believe in the usefullness of Lexapro. I don't disbelieve that it may well be a way better drug than Celexa. I just feel I don't have enough information yet to make that judgement.
Could you give some details on actual clinical experience of the first 1300 people in the Lexapro trials versus the first 1300 people in the Celexa trials at an equivalent dose?
I guess what I object to when you said "better" is that you said that it was better because of a study that showed that people benefited clinically plus a separate study that showed that the two isomers competed. But the study that explains why people are doing so well clinically is likely in a dish or in rats -- it just doesn't seem like one thing proves the other. So you say, "better because" and I feel a sudden rush of skepticism.
Can you explain in more detail why you think it is better.?Once again, please don't think I disagree that it could be better. I've no personal problem with new drugs in general or with Celexa or Lexapro themselves, just wondering how you are so sure it is better?
Thanks,
Kate
Posted by Anyuser on July 31, 2002, at 12:54:37
In reply to Re: Lexapro rep pushes Lexapro, what a shock » JaneB, posted by katekite on July 31, 2002, at 12:08:50
I'd like to butt into your conversation, because I think the points you raise are interesting. Whom do you trust the most among (1) "scientific" drug studies posted on the internet, (2) your physician, and (3) complete strangers on the internet? If all three are in agreement, no problem, but what if they disagree? The drug studies are a necessary first step, but as you say they're really just a shot in the dark. All the talk about 5HT this and agonist that and down-regulation yada yada sometimes seems like witchcraft. Every bit as much of a metaphor as Freud talking about an Oedipus complex. A really good practicing doctor should have better practical knowledge as to what really works, but we've all encountered doctors who just write prescriptions for whatever was recommended at the most recent CME seminar without even trying to understand the science behind it. And what about doctors and psychologists that market long term talk therapy? Don't they have an economic intererst in talk therapy? In my case, my doctor is nuttier than I am. And what about people's actual experience related on the internet? I've learned a lot on PB, but posters on PB can't possibly be a representative sample. I only look at PB when I am down. My husband says I'm in "Psycho Babble mode." When I dispute something my doctor tells me on grounds that I heard different on PB, he wants to strangle me. How do we know pharmrep is really a pharmrep? When the Magic Pill we've all been waiting for is finally invented, won't it inevitably be delivered by a pharmrep? What's the alternative? I'm so confused about who or what to believe.
Posted by johnj on July 31, 2002, at 16:47:45
In reply to Re: mirror images: lexapro and focalin and dr.bob, posted by pharmrep on July 31, 2002, at 2:48:27
Can you tell me what the poop out rate has been on Celexa since it has been out so long in Europe. The poop out of ssri's makes me leary of them. Thank you
Posted by katekite on July 31, 2002, at 17:13:11
In reply to Whom do you trust? » katekite, posted by Anyuser on July 31, 2002, at 12:54:37
You raise good points. For all we know, I could be pharmrep arguing with myself to increase publicity... we'd go back and forth a few rounds and 'I' would finally say I was going to get on Lexapro. Some of the personal experiences here could really be drug reps. It's hard to know.
Here's what I trust: my own carefully chosen (recommended by other doctors I like) psychiatrist who never says he categorically "know's" something that is clearly impossible to know. And I also tend to trust studies that are meta-analyses: studies that are reviews of many other studies. They are good, I think, in that they look at many studies performed under many circumstances with all kinds of different funding and they determine an overall efficacy and side effect profile. I look at the journal title too: I tend to trust western european and north american journals most. I tend not to put much weight in studies other than in people. Then after that, if I'm going to try a drug, I look it up here to see what everyone's personal experience is so I'm not surprised and so if there is something new (like effexor withdrawal wasn't known about for a while) I will be up on it. So that's my attempt to rationalize trust.
It's a difficult field and even harder on the internet. My husband looks at me like that occasionally too when I quote something from psychobabble.
kate
Posted by Dr. Bob on July 31, 2002, at 18:45:28
In reply to apology for sarcasm , posted by katekite on July 31, 2002, at 12:17:31
Posted by Anyuser on August 1, 2002, at 10:06:52
In reply to Re: thanks! (nm) » katekite, posted by Dr. Bob on July 31, 2002, at 18:45:28
Here's a link to a recent Medscape article by the good Dr. Kramer entitled Drug Development: http://www.medscape.com/viewarticle/439156?mpid=1801.
Here's the concluding paragraph:
"The studies that are done in clinical trials must demonstrate that the drug is safe and effective but nothing more. The idea is to test a potentially commercial product, not to find out scientific truth. Thus, the studies are not designed to gather the most or the best data; they are designed to tell the FDA what they need to know and nothing more. Issues of different pharmaceuticals being more or less effective in different kinds of patients are unable to be determined by the kind of studies that are done for drug trials. While there is much virtue in drug development in that it brings us new pharmaceuticals, it is important to note that these clinical trials are not a substitute for real scientific research done outside of the context of pharmaceutical company drug development. It is only with studies separate and apart from drug development that we will find out information about comparative treatments and the complicated, comorbid, usual patients that are actually seen in practice."
Posted by pharmrep on August 1, 2002, at 11:01:16
In reply to Truth, posted by Anyuser on August 1, 2002, at 10:06:52
I was all over...but have combined all my threads to 1...find me and my last few posts so we can keep going.
Posted by katekite on August 1, 2002, at 20:16:26
In reply to Kate...find me, posted by pharmrep on August 1, 2002, at 11:01:16
Can you post a link to your message? I don't see it. Thanks -- kate
Posted by utopizen on August 1, 2002, at 20:25:30
In reply to Kate...find me, posted by pharmrep on August 1, 2002, at 11:01:16
All I got on my 6 months of Celexa was this:
first few days:
I felt like I was stoned. I sometimes got disinhibition for a few minutes now and then, saying things out of myself without any thought process, while feeling very happy at the same time- same thing I did when I was stoned.few days after going off:
same thingplus:
vivid dreams, very happy vivid dreams,
for first few weeks of taking itgoing off, I paid back I guess, getting
vivid NIGHTMARES!If you guys controlled this whole vivid dream
thing, and isolated the isomer responsible
for making happy vivid dreams and not nightmares,
and made it so I always got them, I'd buy it
and worry about blood clotting later.I like happy dreams, it's why I don't use Klonopin much. When I take lots of Klonopin (repeated dosing during day as prescribed) I get vivid nightmares after coming off it, and that's only after a few days of being on the stuff!
I get vivid nightmares from anything when I go off it, even during my vikodin withdrawls.
Posted by BekkaH on August 2, 2002, at 1:40:26
In reply to Lexapro rep pushes Lexapro, what a shock! » pharmrep, posted by katekite on July 31, 2002, at 9:45:20
Hey Lexapro-pusher:
I get the feeling that you're a salesperson, a con artist and a sleazeball. Other than spin-doctoring Lexapro, which is nothing more than yet another SSDD SSRI (same s**t, different day SSRI), I get the feeling that you don't know what the heck you're talking about.
Have you ever taken Organic Chemistry? What grade did you get in it? At what school was the course offered? What is your background/training? How much is Forest paying you to infiltrate Psychobabble? By the way, I have taken Cipralex, which is exactly the same as Lexapro. Cipralex is the proprietary name for escitalopram in Europe. I think it's even worse than Celexa. The most positive thing I can say about citalopram and escitalopram is that neither of them is as sickening as your dishonest posts.
Posted by pharmrep on August 2, 2002, at 2:05:55
In reply to Lexapro-rep. Did you ever take Organic Chem?, posted by BekkaH on August 2, 2002, at 1:40:26
Ouch. Where's the love? 1st of all, I haven't "pushed" Lexapro at all, I have only jumped into topics pertaining to Celexa/Lexapro with what unique information/perspective I have. My input has been purely educational, and I am entitled to my opinion as much as you. And before you continue to rant some more and get a "civil" note from DR. BOB, what exactly have I done to appear dishonest? Nothing. So if you have something constructive to share/say...great. Actually, I'm sorry to hear about your Cipralex experience...how long did you try it? I thought it just came out 3 months ago? PS...have you read any studies on it? (to know how it's different)
Posted by pharmrep on August 2, 2002, at 2:09:24
In reply to Re: Kate...find me, posted by katekite on August 1, 2002, at 20:16:26
Not sure how to connect you...I just wrote a post "isomer science is more like it" find me on this thread.
Posted by johnj on August 2, 2002, at 10:28:36
In reply to Re: PBE, not PBC + poll to answer too. , posted by pharmrep on August 2, 2002, at 10:13:06
And I read a study done at Nebraska(?) I think that says Lexapro has tested very well. Anyone know about this or can link it? Thanks for joing PB.
johnj
Posted by Anyuser on August 2, 2002, at 10:33:03
In reply to I appreciate your time » pharmrep, posted by johnj on August 2, 2002, at 10:28:36
http://www.docguide.com/dg.nsf/PrintPrint/3D2F400704F0675A85256BA7004DA503
Posted by pharmrep on August 2, 2002, at 11:24:17
In reply to thanks all...so far good stuff, posted by pharmrep on August 2, 2002, at 11:07:16
Hey all...I am still new at this. How can I combine my threads so I can stay here, but let others know that.
I cant find Kate, LLL, Phil and a few others. I want to tell them I'm staying here. Thanks
Posted by mist on August 2, 2002, at 11:34:11
In reply to rookie question, posted by pharmrep on August 2, 2002, at 11:24:17
I'm not sure if I understand your question correctly (the "combine threads"?) but if you want to let certain people know you're here then post a new message with their names in the subject line. You could do it on this thread or a new one. That's what I would do, although someone else may have better advice.
> Hey all...I am still new at this. How can I combine my threads so I can stay here, but let others know that.
> I cant find Kate, LLL, Phil and a few others. I want to tell them I'm staying here. Thanks
Posted by katekite on August 2, 2002, at 12:04:16
In reply to thanks all...so far good stuff, posted by pharmrep on August 2, 2002, at 11:07:16
Hi,
Thought I posted this question already but seem to have misplaced it...
I know you said Lexapro would be 10-15% less than Celexa. I understand now that its impossible to know the exact cost because its not out yet. However I'm still confused on what 10-15% less means?
Does it mean that:
a. a 20 mg pill of Lexapro would be about 10-15% less than a 20 mg pill of Celexa?
b. a roughly equivalent dose would be 10-15% less, ie a 20 mg pill of Lexapro would be about 10-15% less than a 40 mg pill of Celexa?
c. something else?
Ok, thanks,
Kate
Posted by pharmrep on August 2, 2002, at 12:58:42
In reply to cost -- pharmrep, posted by katekite on August 2, 2002, at 12:04:16
Sorry if not clear...it's not carved in stone with a "price-sheet" but this is what I know. Celexa (cx) 20mg is about $60/mo at places like Costco...40mg is about $66/mo. Lexapro (lex) 10mg is supposed to be 10-15% less. So I guess that means 10mg of lex is should be between $55-60/mo. If I can get more specific info, I will post it
Posted by BekkaH on August 2, 2002, at 13:47:23
In reply to Lexapro rep pushes Lexapro, what a shock! » pharmrep, posted by katekite on July 31, 2002, at 9:45:20
As most of you know, the generic name for Lexapro is escitalopram. It hasn't been marketed in the U.S. yet, but it is available in Europe under the brand name Cipralex. I ordered Cipralex from Victoria Pharmacy in Switzerland. Some months ago, Dr. Bob told me it was OK with him for me to post information on Victoria Pharmacy in Zurich, Switzerland. It is one of the only reputable online pharmacies in the world, according to my psychopharmacologist. Victoria Pharmacy's website is www.pharmaworld.com. You MUST have a doctor's prescription to order from them, and they do not ship any illegal drugs, narcotics, etc. If you are truly interested in trying escitalopram, why don't you do your own research (I assume you have access to the Internet, if you are reading here), THINK for yourselves, make up your own minds, discuss your findings with your psychiatrists and, perhaps, order escitalopram from overseas.
Drug responses are highly individual, and I can only speak from my own experience. For me, escitalopram (Cipralex/Lexapro) was worse than citalopram (Celexa); however, I tend to not do well on SSRIs in general. I can't speak for anyone else or predict how anyone else will respond, but I would venture to guess that if you have not done well on Celexa, then Lexapro/Cipralex will probably be worse. For me, escitalopram felt like a more intense, faster-acting version of Celexa, which meant that the negative things about Celexa were greatly magnified. Only you can decide for yourself. I suggest all of you should THINK for YOURSELVES. Do your own research, preferably in OBJECTIVE sources. Then, discuss your findings with INTELLIGENT, medically and scientifically knowledgeable people who are NOT trying to sell you a bill of goods or take advantage of your suffering. By the way, keep in mind, when doing research and reading clinical studies of drug trials, that you should always check to see who sponsored/paid for the research. If a drug trial was sponsored by the pharmaceutical firm that is marketing the drug, you should take the information with a HUGE grain of salt. Also keep in mind that, in the U.S., 51% of doctors who run clinical drug trials receive financial remuneration from the drug companies, so there is a huge CONFLICT of INTEREST problem. I realize this is not pleasant, but it is the truth. LET THE BUYER BEWARE.
Posted by Dr. Bob on August 2, 2002, at 13:53:07
In reply to Lexapro-rep. Did you ever take Organic Chem?, posted by BekkaH on August 2, 2002, at 1:40:26
> I get the feeling that you're a salesperson, a con artist and a sleazeball.
Please don't jump to conclusions about others or post anything that could lead them to feel accused or put down, thanks.
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration; otherwise, they may be deleted.
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