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Medical Forum / General / Pharmacy / January 2007Celexa versus Lexapro
My Insurance changed and I have to SWITCH from Celexa to Lexapro. I was taking a 10 mg dose of Celexa and the Dr. put me on a 5 mg dose of Lexapro. Question to Pharmacologist's or Pharmacists on this list... Do these drugs have the same effect STRENGTH wise or is one or the other stronger? And then too, do you ascribe any value to Anti-depressants beyond the placebo effect? SERIOUSLY. Ned > My Insurance changed and I have to > SWITCH from Celexa to Lexapro. [quoted text clipped - 13 lines] > > Ned I don't understand why you can't take the generic version of Celexa. It is not real expensive and should cost the insurance company less than paying for brand named Lexapro. I would not be afraid to take the generic Celexa and I would expect it to work as well as the brand name. > My Insurance changed and I have to > SWITCH from Celexa to Lexapro. [quoted text clipped - 13 lines] > > Ned Drugs are not the same on a mg/mg basis. As an example, if you substutite ACE inhibitors you would give 5 mg of Vasotec to get the same effect as 2.5 mg of Altace. I haven't looked at the dosing of Lexapro vs Celexa, but I would not worry about the dose change. Your Dr. may just want to start with a low dose then increase it if necessary. I'm sure that there is some placebo effect with all drugs, but remember that these drugs were tested in double blind studies to make sure that the placebo "bias" is eleminated.  SignatureThere is something fascinating about science. One gets such wholesale returns of conjecture out of such a trifling investment of fact. --Mark Twain On 1/13/07 6:51 AM, in article 1168700254_4629@sp6iad.superfeed.net, "John Smith ®" <someone@microsoft.com> wrote: >> My Insurance changed and I have to >> SWITCH from Celexa to Lexapro. [quoted text clipped - 23 lines] > these drugs were tested in double blind studies to make sure that the > placebo "bias" is eleminated. While I am not a pharmacist, the answer is pretty clear based upon fundamental chemistry. If you start out with nonchiral (no distinction based upon molecular handedness) ingredients to make chiral molecules, you will almost always get a racemic mixture of molecules. That is, half will be right handed and half will be left handed. Living entities, because they are composed of chiral chemicals, will respond differently to handedness as well as be able to synthesize chiral molecules. Celexa is a racemic (half left and half right) mixture, while Lexapro (as indicated by its name) is composed purely of the left handed form. Thus Lexapro is fully active, while only half of Celexa is therapeutic. If the right handed form were totally inert, there would be no problem. The right handed form may be detrimental, but whether it is is beyond my knowledge. Bill -- Fermez le Bush >>> Ned >> [quoted text clipped - 34 lines] > >Lexapro is just the racemic half of celexa and because both halves have activity, the usual dose of lexapro is half that of celexa. In my area most insurance companies will pay for celexa and not the more expensive lexapro. Of course some patients for one reason or another may do better on lexapro and thus a medically necessary indication may be used, but the cost in this area will be higher in most cases. Lexapro seems to be currently in vogue as one of the main choices in patients who have been on long term SSRI's like prozac and seem to be failing therapy. We will have to see how all this works out. On 1/15/07 2:02 PM, in article K8qdnfhZI7BzZDbYnZ2dnUVZ_uiknZ2d@comcast.com, > Lexapro is just the racemic half of celexa and because both halves have > activity, the usual dose of lexapro is half that of celexa. In my area most [quoted text clipped - 5 lines] > like prozac and seem to be failing therapy. We will have to see how all > this works out. I think you would want to rewrite this paragraph. It is Celexa that is racemic while Lexapro is optically active (chiral). Is dextrapro, to coin a drug name, detrimental? Bill -- Fermez le Bush > On 1/15/07 2:02 PM, in article > K8qdnfhZI7BzZDbYnZ2dnUVZ_uiknZ2d@comcast.com, [quoted text clipped - 24 lines] >half of a racemic mixture based on its left or right positioning a chiral >group? ??? >In my area most >insurance companies will pay for celexa and not the more expensive lexapro. >Of course some patients for one reason or another may do better on lexapro My INSURANCE COMPANY is the only reason I switch from Celexa to Lexapro each year. One year they will pay for Celexa as a Generic, (LAST YEAR) and THIS YEAR they cancelled Celexa but will pay portions of Lexapro but I have to buy it as a BRAND drug. So I dutifully switch from one to the other with no ill effects year after f'ing year to placate some lamebrained GAME that Secure Horizons plays in even and odd years with their drug suppliers. Just one of the ADDED BENEFITS of surviving in our convoluted health care system. (Not that I have any REAL complaints mind you.) Ned |
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