Posted by Charles carter on October 15, 2002, at 22:06:05
In reply to Lexapro side-effects , posted by dr dave on August 28, 2002, at 3:15:33
The primary advancement with respect to Lexapro resides in its increased selectivity for serotonin reuptake (100 x greater) and its increased potency (2 x more potent) versus Celexa....NOT some quantum leap in tolerability.
I would argue that Celexa was already one of the better tolerated SSRI's, if not the best of the bunch, with respect to side effects across all patient types and dosages.
The discontinuation rates with Lexapro in clinical trials are comparable to placebo at the starting dose of 10mg. In the comprehensive database, the only adverse event that occurred greater than 10% versus placebo AT BOTH DOSES was nausea, which occurred at a rate of 15%. In addition to that, the drop-out rates during the clinical trials including all patients AT BOTH DOSES was 6% versus 2% on placebo. I would suggest that most prescribers would be ecstatic if 94% of their patients on SSRI therapy not only were responders,but did not discontinue due to adverse events.
Comparing PI to PI is not an apples-to-apples; however, reps and physicians still do it to identify trends. The three most commonly reported adverse events with Celexa were nausea (21%), somnolence (18%) and insomnia (15%). Lexapro checks in at 15%, 6% and 9% respectively.
Indeed, there may not be conclusive data to suggest that Lexapro is some great leap forward versus Celexa on tolerability; however, it's not too hard to make the case that Lexapro appears to be AT LEAST as well tolerated as what many consider to be the best tolerated SSRI in the class in Citalopram.
Finally, there certainly is data to suggest efficacy, increased potency and earlier onset of action with Lexapro versus Celexa. The fact that the s-isomer is twice as potent as its racemate and still has a side effect profile that compares favorably to ANY other SRI on the market is a leap forward in and of itself.
Respectfully,
Carter
poster:Charles carter
thread:109458
URL: http://www.dr-bob.org/babble/20021012/msgs/123829.html