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Lexapro vs. Celexa--conversion


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Okay, so I take 40 mg of Lexapro each night (prescribed, that is).  I have major depression, generalized anxiety disorder, and obsessive-compulsive disorder. 

When I last saw a pdoc in February, he told me that this was the highest that we could go on the Lexapro.  He did say that 40 mg of Lexapro was like 80 mg of Celexa, and that another treatment option would be to switch to Celexa, and increase it up to 160 mg/day.

However, according to Mr. Jerod Poore's conversion guide, the 40 mg/day of Lexapro I am taking is equivalent to 160 mg of Celexa. 

Who is right?

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I think the jury's still out on that one. Most of what I read supports the 4:1 ratio of Lexapro to Celexa strength. But, [link=http://www.psychopharmacology.com/pt/re/jclnpsychopharm/abstract.00004714-200404000-00015.htm;jsessionid=C4uAae29nuCDdVj1ExA4FBV1yPhhWyvaQwvQzDJ77LYd3uPFQ1VW!541047

48!-949856144!9001!-1" target="_blank]here[/link] is an abstract of an article supporting the 2:1 ratio.

If Lexapro is supposed to be so much "cleaner" than Celexa, then why can you take proportionately more Celexa than Lexapro? At first glance, that just doesn't make sense.

Must read more.....

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my pdoc said he wasn't finding the 1:2 ratio between lexapro and celexa to be accurate and most of his patients were on proportionally more lexapro. I was taking 50mg of Lexapro... and I haven't grown scales and horns yet I think...by the way I found lexapro quite useless and the celexa much much better. Does anyone else?

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I think the jury's still out on that one. Most of what I read supports the 4:1 ratio of Lexapro to Celexa strength. But, here is an abstract of an article supporting the 2:1 ratio.

If Lexapro is supposed to be so much "cleaner" than Celexa, then why can you take proportionately more Celexa than Lexapro? At first glance, that just doesn't make sense.

Must read more.....

<{POST_SNAPBACK}>

It has been found that not only is the other enantiomer inactive, but counteractive as well.

http://www.ncbi.nlm.nih.gov/entrez/query.f...261&query_hl=15

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any chance someone could translate that for me?  <blink>

btw, i liked celexa much better too, no fatigue, weight gain or loss of libido.  <sigh>

new does not equal better.

<{POST_SNAPBACK}>

Basically, not only is the R(-)-enantiomer useless, it works against the S(+)-enantiomer.

I've read that the letters, "R" and "S" have nothing to do with the direction it rotates, but the - and + do. + = dextro (right), - = levo (left).

Oh, and according to answers.com, allosteric means:

Of or involving a change in the shape and activity of an enzyme that results from molecular binding with a regulatory substance at a site other than the enzymatically active one.

Hope that helps.

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that paper isnt really any proof for some kind of inhibition of the escitalopram.  its just a review of the efficacy of the two drugs.. fewer side effects might lead to the same result, since usually you get a good response to a drug when the side effects are mild enough and the drug is working.  im skeptical  ;)

any chance someone could translate that for me?  <blink>

btw, i liked celexa much better too, no fatigue, weight gain or loss of libido.  <sigh>

new does not equal better.

<{POST_SNAPBACK}>

Basically, not only is the R(-)-enantiomer useless, it works against the S(+)-enantiomer.

I've read that the letters, "R" and "S" have nothing to do with the direction it rotates, but the - and + do. + = dextro (right), - = levo (left).

Oh, and according to answers.com, allosteric means:

Of or involving a change in the shape and activity of an enzyme that results from molecular binding with a regulatory substance at a site other than the enzymatically active one.
Hope that helps.

<{POST_SNAPBACK}>

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that paper isnt really any proof for some kind of inhibition of the escitalopram.  its just a review of the efficacy of the two drugs.. fewer side effects might lead to the same result, since usually you get a good response to a drug when the side effects are mild enough and the drug is working.  im skeptical  ;)

<{POST_SNAPBACK}>

Here's some more concrete evidence, complete with free full text article:

R-Citalopram caused a 10-fold rightward shift in escitalopram's dose-effect curve, suggesting that R-citalopram inhibits escitalopram's anxiolytic-like effects.

I wonder if the counteraction isn't responsible for some people reporting less side effects with Celexa.

There are some drugs where you really do need to lose one or more isomers, like methohexital, a barbiturate that has four isomers, one set of which causes seizures in people with no prior history of epilepsy. The other set only does that in people with psychomotor epilepsy (i.e. you get complex partial seizures).

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