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Dr. Bob is Robert Hsiung, MD,
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Posted by nutsy on September 2, 2001, at 19:34:10
Does it have less side effects as promised?
Posted by Kathleen6674 on September 2, 2001, at 21:06:59
In reply to Celexa - anyone tried it?, posted by nutsy on September 2, 2001, at 19:34:10
> Does it have less side effects as promised?
I've only been on it for about three weeks - it does have some side effects. By "less" I'm not sure what is meant. My pdoc told that, contrary to what is commonly believed, Celexa doesn't actually have "fewer" side effects - that depends on one's individual makeup, varies from patient to patient, etc. What he did say is that there was no one side effect profile. Which means: certain meds, such as Prozac and Wellbutrin, are "activating" and tend to make people hyper. Or certain drugs, such as SSRI's, tend to cause sexual dysfunction (Celexa is among these, and I've definitely noticed this as a problem); Certain other drugs are sedating. Others cause weight gain. I've heard that Celexa sometimes causes weight gain, sometimes loss; sometimes diarrhea, sometimes constipation, sometimes tiredness, sometimes jitters, etc. Also, it's a very "pure" SSRI - it targets seritonin receptors and few others in the brain, whereas many other meds primarily target seretonin but residually (or deliberately, as the case may be) target other sites - neurepinephrine, dopamine, what-have-you.
The "purity" may lead to fewer side effects based on those other receptor sites, perhaps less hyperness than if dopamine receptors are directly effected.
In practice, all of this may or may not mean anything. The old "your mileage may vary" statement from the front page of this site.
One thing that always makes me skeptical about "purity" - once the seretonin mechanisms are working better, my understanding is that this can often cause other parts of the brain to change, i.e., the dopamine, neurepinephrine, whatever sites worked one way, based on "depressive" brain chemistry; it would make sense to me that they might change their tunes, or the way they respond to the presence or absence of transmitters, once the overall balance is changed via an SSRI, be it Celexa or anything else. Hence, even if the med itself only directly hits one type of neurotransmitter, others may end up eventually coming into play, for better or for worse.
Plus, I've heard how certain parts of the brain become less active and perhaps degenerate a bit when depressed, then they start to regroup and rebuild once treated; I'd guess that just how this regrouping and rebuilding occurs might differ according to the meds used, plus the side effects of whatever the regrouping means for the body, or behavior, or emotions, might all play to a different tune depending on the med(s) being used.
And those side effects, in my limited personal experience, Celexa has:Made me lose my sense of taste, completely and totally, for about three days. I've since gotten it back. It's made me crave sweets and carbs and eat damn near everything that isn't nailed down. It's made it difficult for me to become sexually aroused and damn near impossible to have an orgasm. IF I'm lucky enough to have one, it feels markedly dulled in intensity and duration. It's also caused me to feel emotionally numb, not very motivated, and not especially interested in much of anything.
I am going to see my pdoc in a few days - but you will notice that these side effects are hardly few in number - they are pretty much the same in number as those I've experienced on other meds, they are just different - each med is different for each person, so it's more a game of try and see than "this one has 3 side effects, this one has 5" kind of thing.
The Celexa is helping a little bit, too: I no longer have crying jags (I do suppose it is better to feel numb than to feel downright awful); I have a little more energy, and I sleep a normal 7 to 8 hours a night, as opposed to way too much or way too little (problems I've had with other meds).I think some of the "fewer" discussion may be because perhaps people find some Celexa side effect easier to deal with than those of other meds: I don't love the stuff so far, but right now it's better than heart palpitations, panic attacks, or sleeping 2/3rds of every day away, battling muscle weakness and leg cramps. None of those have occured with Celexa, but I sure had them with other meds.
As far as being a "miracle drug," though, free of side effects, that's just not the case for me.
Posted by SalArmy4me on September 2, 2001, at 21:49:41
In reply to Celexa - anyone tried it?, posted by nutsy on September 2, 2001, at 19:34:10
The American Journal of Psychiatry
Volume 156(5)May 1999 p 796
Citalopram and Sexual Side Effects of Selective Serotonin Reuptake InhibitorsTO THE EDITOR: The sexual side effects of selective serotonin reuptake inhibitors (SSRIs) may adversely affect compliance. Loss of libido, anorgasmia, and delayed ejaculation in males seem to occur far more frequently than is indicated in package inserts and may affect as many as two-thirds of patients [1]. Although SSRIs may differ in propensity to cause sexual dysfunction, this has not been studied in comparative controlled trials. We report two cases in which the highly selective serotonin reuptake inhibitor citalopram did not cause sexual impairment in patients who had experienced such events with other SSRIs.
"Ms. A, a medically healthy 65-year-old woman with a history of depression, presented with severe depression, anhedonia, guilt, lack of concentration and appetite, and obsessive thoughts. Despite successful treatment of two earlier depressive episodes with clomipramine, Ms. A refused a regimen of clompiramine because of the sexual dysfunction she had experienced. We prescribed a regimen of fluoxetine, at 40 mg/day, and after 45 days, her depression was resolved. Two months later, Ms. A discontinued her fluoxetine because of side effects including absent libido, anorgasmia, and pain during coitus. Citalopram was initiated and titrated to a dose of 40 mg/day. At 2 months, Ms. A reported no depressive symptoms or obsessive thoughts and no sexual impairment or side effects."
"Mr. B, a 58-year-old man with no significant organic disease, received benzodiazepines for 10 years for panic disorder with agoraphobia. In 1992, presenting with moderate depression, Mr. B was prescribed a regimen of fluoxetine, 20 mg/day. After 3 weeks, and despite good response, Mr. B discontinued fluoxetine, complaining of delayed ejaculation and dry mouth. In 1997, presenting with depression, sleep disturbance, anhedonia, decreased libido, and asthenia, Mr. B was treated with a regimen of paroxetine, at 20 mg/day, and temazepam, at 20 mg/day. After 45 days, Mr. B said that he intended to stop treatment, reporting decreased libido, absence of ejaculation, nocturnal priapism with emission of seminal fluid, and emission of seminal fluid on defecation. Treatment was changed to a regimen of citalopram, at 20 mg/day, and temazepam, at 20 mg/day. During the 4 months of citalopram treatment, Mr. B has had no sexual side effects, and his mood and anxiety symptoms have been in remission."
Serotonergic influences on sexual function are poorly understood. SSRIs have been associated not only with impairment of sexual function but with restoration of sexual potency [2]. The effects of serotonergic drugs on sexual function may relate to drug dose, serotonin receptor subtypes affected, and the relative effect on serotonergic versus other receptors [1]. Citalopram is the most selective SSRI studied [3] and, in our experience, appears less likely than other SSRIs to cause sexual dysfunction (S. Pallanti et al., unpublished report, 1997). Controlled clinical studies are warranted to evaluate the incidence of sexual side effects caused by citalopram and other SSRIs.
LORRIN M. KORAN, M.D.
Stanford, Calif.
REFERENCES
1. Modell JG, Kattholi CR, Model JD, DePalma RL: Comparative sexual side effects of bupropion, fluoxetine, paroxetine, and sertraline. Clin Pharmacol Ther 1997; 61:476-487 [Medline Link] [Context Link]
Posted by Janelle on September 2, 2001, at 22:30:29
In reply to Celexa - anyone tried it?, posted by nutsy on September 2, 2001, at 19:34:10
Well, I tried it (twice!) and I'd say yes and no. Lemme explain this: for me (and I can only give my individual experience) ... I would say yes, it does have less side effects as promised in terms of my having had less side effects, i.e., I did not have any of the "traditional" ones, meaning I did not get dry mouth, constipation, or agitation, which I have gotten from other SRI a-d's.
Also, Celexa is supposed to be the "purest" of the SRI a-d's, meaning the most targeted to Serotonin, with less impact than other SRI's on other neurotransmitters.
HOWEVER, I would also say "no" it does not necessarily have less side effects, because I did have some and they did not go away as side effects usually do. Specifically, I found Celexa to be sedating, it put me in a brain fog/haze and it gave me bad headaches, and I rarely get headaches. None of these symptoms are listed as common side effects of Celexa. In fact, I've read that it is "neither sedating nor activating," so it did puzzle me why I found it sedating.
I even tried it twice (went off, cleared it out of my system, went on again) in the hope that maybe the second time I would not get any side effects, but I got the exact same ones as the first time I went on it.
Hope this might be of some help.
Posted by nutsy on September 3, 2001, at 7:17:33
In reply to Re: Celexa - anyone tried it? » nutsy, posted by Janelle on September 2, 2001, at 22:30:29
Doesn't seem all that pure and natural! Just another in the crap shoot that is antidepressants. Thx for all the replies.
Posted by KB on September 3, 2001, at 9:58:24
In reply to Celexa - anyone tried it?, posted by nutsy on September 2, 2001, at 19:34:10
I have been taking Celexa since June - at first I felt a little spacey and had weird anxieties but that wore off after about a week and the only side effect that's really persisted for me is an increased tendency to sweat.
Posted by Krazy Kat on September 3, 2001, at 12:51:27
In reply to Celexa - anyone tried it?, posted by nutsy on September 2, 2001, at 19:34:10
Bad sexual side effects for me....
- K.
Posted by Daveman on September 3, 2001, at 18:40:45
In reply to Celexa - anyone tried it?, posted by nutsy on September 2, 2001, at 19:34:10
> Does it have less side effects as promised?
I've been on Celexa 40 mg./day since February. Very effective at controlling my depression/anxiety/obsessions. Side effects: Interruption of sleep cycle (i.e. frequent nocturnal awakenings- Remeron 15 mg. was added to help counteract this); loss of sex drive (though much less so than was the case with Paxil); weight gain (which may be due to Remeron more than Celexa). A fair trade in my book:)
Dave
Posted by Bill L on September 4, 2001, at 11:01:48
In reply to Celexa - anyone tried it?, posted by nutsy on September 2, 2001, at 19:34:10
I have been on it for a year and a half. I take 20 mg. It has had less side effects for me than Prozac but it may not be a fair comparison because I am taking 2 other drugs with Celexa that I did not take with Prozac. They are a small dose of SAM-e and Ginkgo. Ginkgo helps a lot with the sexual side effects. The amount of Ginkgo recommended to reverse SSRI induced sexual side effects is 240 mg per day but I only take 120. You should consult your doctor and avoid Ginkgo if you have bleeding problems.
> Does it have less side effects as promised?
This is the end of the thread.
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