Jump to content
CrazyBoards.org

From Paxil, to Celexa, to Cipralex... Is there really a damned difference?


Recommended Posts

So I have a long history of depression (since I can remember) and about I year after my first attempted suicide (when I turned 18) they threw me on Paxil. I went NUTTERS. Not good, and I thought I had been emotionally crazy before (lots of freaking out and crying and obsessive phone calling...)

 

Then I was switched onto Celexa which I kept on until earlier this year after my third suicide attempt. I asked my doctor for a medication that was more for anxiety than depression so she threw Cipralex at me because she had free samples.

 

So far, the only differences between the three (besides no more freak outs) is the dosage. I am beginning to wonder... Am I taking the right medications? I have so many other things... not quite right about me. MAJOR touch sensitivity, obsessive counting and even numbers, HORRIBLE social anxiety, and I have two other people in my head...

 

Thoughts anyone? I just... Ack, I don't even know...

Link to comment
Share on other sites

There's definitely a difference between all of those medications.  They're all in the same class of antidepressant, but they all act in their own ways - different receptors, different metabolic pathways, stuff like that.  Add to that that every person who takes them is different and it can be complicated.  For me, Paxil was totally a sugar pill.  Lexapro (aka Cipralex) made me tired.  Prozac turned me into a raging psychobitch.   Cymbalta made me so nauseous that it wasn't even funny.  The only one that seems to have even scraped the depression I'm in right now is the Remeron.

 

Definitely agreeing with werehorse - it sounds like you haven't found the right meds yet.  You need to mention all of those symptoms you're having so your doctor knows about them and can try to find something that may help with them or at least won't aggravate them. 

Link to comment
Share on other sites

AwkwardPenguin,

Hmmmm, here's my 2 cents! You mentioned social anxiety and sensory issues and 'other people' in your head. Have you been tested for Aspergers, or as they now call it: Autism Spectrum Disorder? I'm 53 years old...something has not been right with me since birth! I have horrible sensory sensitivity issues, major social anxiety (probably all the other anxieties, as well), nasty depression that won't go away, no matter what I take or how much of it I take. First I was dx'd with Major Depression, then Social Anxiety, then GAD, then ADD, was put on all kinds of meds (at 36 yrs old!!!! no one noticed, or cared about how much I was suffering, just that I was "selfish, dramatic, and a pain in their ass). It was the sensory sensitivities that got so bad that I started getting physically ill: ulcer, chronic fatigue, IBS. I started to go thru jobs like candy. Then I moved to The Town from Hell and just started to get fired and could not get re-hired anywhere else. So, after many visits to many doctors, I started a major research mission on my sensory issues...........and nothing matched all my symptoms as completely as Asperger's Syndrome. So, at 53 years old, I finally know I have Asperger's!!!!      Can't tell from your avatar if you are male or female....my guess is female.....there is a huge difference between female Aspies and male Aspies. Also, it wasn't until 1994 (50 years after Asperger's was discovered) that females with Aspergers were discovered to exist. We existed all along, but no one noticed us. We cope differently, we were raised differently, and we show/present our symptoms differently......hence all the different dx's we are often given. There is an awesome test/quiz out there you can take online called The Aspie Quiz, I suggest taking it. It is long, but it is thorough and at least you can rule it out if your scores are very low. The quiz provides a very detailed "results summary" for you that you can print out for your p-doc. I scored a 177/200 in the Aspie traits and a 44/200 in the NeuroTypical traits. So "I'm very likely to be an Aspie".

It is the sensory issues which I've lived with all my life, that were never addressed or were swept under the rug, that made me wonder if there was something more going on. And also that I'm so treatment resistant to all the anti-depressants out there (tho' I've had some success with Lamictal, but in the lower dosages....I'm on 75 mg per day, split into 2 doses, am and pm). I've also discovered that lower doses work better.......I'm already hyper-sensitive to everything, stands to reason that medications and their doseages should be lower, as I'm probably going to be sensitive to those too. None of the SSRI's or the SNRI's (effexor, celexa) work for me, in fact they make everything 100 times worse!!!! Was on Effexor for 15 years, it did nothing!!! Then went on Prozac to get off the effexor due to the horrible withdrawls, Prozac made me extremely angry, all the time, so the p-doc put me on Paxil, now I'm paranoid and angry and still very depressed and anxious!! Going off that, tapering down slowly, as there are withdrawls to going off most SSRI's........ Tricyclics are out too!!!!

Most p-docs don't really know that much about females with Asperger's.....and they have way too many patients, so they just hand out the head candy and boot your butt out the door, so the next poor sap can get their meds, and so on.....      I'd take the test...Google it and make sure you take the one called The Aspie Quiz!

Like I said.........at least you can rule it out, if nothing else. There's also a great book out there by Rudy Simone called "Aspergirls", it's a great read and really explains what it's like to be a girl with Aspergers. Aspergers is something you have for life, it is neurological, as opposed to psychological, you don't "grow out of it" and it is NOT just a "children's disorder" .       Good luck and let us know how the test turns out!

-gail-

Edited by AspieQueen
Link to comment
Share on other sites

The ones you mentioned are all SSRI's but there are differences. Paxil is the most potent out of all the SSRI's out there at inhibiting serotonin reuptake. Which probably helps explain why it has a rep for being a bitch to get off of for a lot of folks. As far as celexa(citalopram) and cipralex(escitalopram)......they technically are two different SSRI's. But also aren't. Cipralex is the stereoisomer of celexa. Instead of going into super technical detail about what that means, basically they looked at the chemical make up of celexa, found the half that really does anything, and stripped it out. Cha ching(literally)....you have cipralex. This means that you can take a smaller dose of cipralex compared to what you would have to take of celexa and side effects are supposedly less. Another example of this in a totally different medication is Prilosec and nexium. Nexium is the follow up to Prilosec and is its stereoisomer.

 

*rant on*

So with that said let me offer my personal opinion..... I think medications like Lexapro and nexium do more to line pharmaceutical companies pockets than anything else. There is a name for pharma companies creating new medications from existing medications stereoisomer and not coincidently bringing those medications to market right as the original medications patent expires and go generic. Its called "Evergreening". Its basically patenting(and raking in $$$) a new molecule that is not at all a new molecule. I'm sure there are folks out there who found cipralex better for them than celexa and had less side effects, etc........But I believe there's also a whole lot of folks out there who paid out the butt for years(Cipralex is now generic I believe) for cipralex when generic celexa would've worked just fine. Same thing with nexium. 

 

 *rant off*

 

But anyway, what's your official diagnosis(s)? Are you on any other medications? Are you seeing a doctor or a psychiatrist? Zoloft is another SSRI that has a good rep for anxiety. If you're bipolar or are and don't know it you definitely don't want to be on an AD by itself. Bad shit happens.

Edited by quiet storm
Link to comment
Share on other sites

Personal opinion validated by my pdoc years ago as he is very down to earth; there is (was) Prozac 1, 2 , 3 and 4 at that time, being Prozac, Zoloft, Paxil and Celexa and they all do the same thing but in different ways with Prozac 1 being more likely to be stimulating and not sedating, 2 more likely to not stimulate or calm, 3 being more likely to calm/sedate and 4 (at that time as it was brand new out) being a mixture of stimulating and calm/sedating.

 

This was of course years ago with only four SSRI out but having been on them all I found it to be true for me. But each person is different. 

 

I can't tolerate any AD and have tried them ALL giving each one a reasonable try in at least one solid month usually two solid months. 

 

With Eli Lilly in Indiana making so much from Prozac each pharm. manufacturer wanted their share of the buck so each came out with a slightly different drug and marketing campaign. 

 

We are each unique and all you can do is to keep trying.  I wish you the best.  

Link to comment
Share on other sites

Actually the reason Paxil is a bitch to get off of is not its potency, it's its half life - the shorter the half-life the crappier the withdrawals.

 

Personally, I tried 2 SSRIs and then decided that I wanted to try something else.  The two of them were basically the same - they worked for a while then crapped out, and I had a lot of anxiety/agitation.  The answer is probably somewhere in between - people do respond differently to them, but once you've tried enough of them, it's worth moving on.

 

Maybe mention to your doctor your concerns about continuing to stay on SSRIs.

Link to comment
Share on other sites

Paxil's half life is 21 hours I believe. Not saying you're wrong, but I don't find that to be a really short half life compared to other AD's. Lexapro and Zoloft are somewhere around 26 hours I believe. Does that five hours make that much of a difference? I've always thought it was a bitch to get off of because of its potent SSRI effects.

Edited by quiet storm
Link to comment
Share on other sites

The half life theory I believe is partly based in the fact that Prozac, which has a completely ridiculously long half life, has the least bad discontinuation, and Paxil, with the shortest half life, has the worst.  This is why people can cross-taper to Prozac as a way of getting off of other antidepressants when the withdrawal is terrible.

 

If you read this article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627130/

 

It suggests that the reason is the shorter half life, and possibly that there may be non-serotoninergic effects which contribute.  I do not believe that it mentions the potency as a factor.  I mean, potency is a measure of how much of a drug you need to give to get a given response.  I think potency is more related to target dose than to withdrawal.

Edited by tryp
Link to comment
Share on other sites

You could be right. When I say potency, I mean that I've read that paxil has the highest affinity for the 5-HT transporter. I've always thought that's what gave it the rep for having the worst sexual side effects and harshest discontinuation of all the SSRI's.

Link to comment
Share on other sites

If you can find a citation for that, I would be glad to see it, but as far as I know that is not the primary cause of the withdrawal problems that Paxil has.  The sexual side effects, I don't know about.

Link to comment
Share on other sites

AspieQueen -

 

Aside from the touch sensitivity is nothing in the OP's initial post that particularly points toward the OP being on the autism spectrum.  The other symptoms described can be comorbid with other conditions and some are not indicative of ASD at all.  I must also point out that neither "The Aspie Quiz" nor the Baron-Cohen EQ/SQ evaluations nor any of the similar kinds of  multiple-choice assessments you can find online are considered diagnostic by psychiatric professionals, and you should not suggest to members here that they can discover that they are on-spectrum by taking one.  A finding of autism can only be made by a trained professional using the full range of observational and diagnostic tools available.  I am also an Aspie, and one of our greatest difficulties in gaining understanding in a neurotypical world is that too many people self-diagnose themselves when they in fact are dealing with problems unrelated to ASD.

 

All this being said, none of this seems very topical to the OP's original post, so perhaps we should let the thread get back to its originally scheduled programming.

 

 

Cerberus

Link to comment
Share on other sites

I just want to pop in as the patient who came off paxil 80mgs. At the time I was seeing a Psychiatric Nurse Practioner and  she came up with a plan to get me off the paxil by lowering dosage, of course. And then in the middle I started taking lexapro. I don't exactly remember the plan we used because it was years ago (i.e. 2 days paxil, 1 day lexapro, etc). I don't know why she suggested lexapro but it seemed to work.

 

I can't imagine coming off paxil without somekind of additional ssri added to help. It took about 2-3 months. And when I was finished I started xoloft.

 

db

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...