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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 654 to 678 of 8406. Go back in thread:
Posted by pharmrep on October 7, 2002, at 19:37:09
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by CarolinaGirl on October 7, 2002, at 15:46:20
> I have now been on lexapro for three weeks. (5mgs)
> This dosage makes me drowsy. Tomorrow I go to see my doc and she will increase it to 10 mgs.
> I am still going to sleep without taking ambien, so it is really helping the insomnia. I feel a little less anxious.....there is still room for improvement though. No nausea. This is the first
> antidepressant I have been able take. I don't hate it! I do wonder about lexapro interacting with my toprol (for blood pressure). The doc didn't mention there could be an interaction. Found a website that mentioned it. Anybody here know anything about it....also mentioned that lexapro could lower your heart rate.** no...your heart rate/blood pressure shouldn't change...no lexapro will not interact with your medications. The drug to drug interaction profile for lexapro is awesome...the p450 system has 0 interactions. Celexa is very mild in only 2 of the 5 major pathways in the liver, zoloft is mild to moderate in all of the pathways, and both paxil and prozac are moderate to severe in the p450 system (very likely to interact with other meds).
Posted by jane d on October 7, 2002, at 23:14:02
In reply to Re: drug to drug interactions/bottom » CarolinaGirl, posted by pharmrep on October 7, 2002, at 19:37:09
> > I have now been on lexapro for three weeks. (5mgs)
> > This dosage makes me drowsy. Tomorrow I go to see my doc and she will increase it to 10 mgs.
> > I am still going to sleep without taking ambien, so it is really helping the insomnia. I feel a little less anxious.....there is still room for improvement though. No nausea. This is the first
> > antidepressant I have been able take. I don't hate it! I do wonder about lexapro interacting with my toprol (for blood pressure). The doc didn't mention there could be an interaction. Found a website that mentioned it. Anybody here know anything about it....also mentioned that lexapro could lower your heart rate.
>
> ** no...your heart rate/blood pressure shouldn't change...no lexapro will not interact with your medications. The drug to drug interaction profile for lexapro is awesome...the p450 system has 0 interactions. Celexa is very mild in only 2 of the 5 major pathways in the liver, zoloft is mild to moderate in all of the pathways, and both paxil and prozac are moderate to severe in the p450 system (very likely to interact with other meds).Pharmrep -
Are you aware that Lexapro's own prescribing information describes an interaction between Toprol and Lexapro? It may or may not be significant but I don't think it is appropriate for you to say or imply that it doesn't exist. I think you are misinterpreting the standard Lexapro advertising argument that it interacts with fewer other medications than do the other SSRI's to mean that it doesn't interact at all. That's a potentially dangerous misunderstanding.Jane
Posted by JLM on October 8, 2002, at 0:31:31
In reply to Re: Lexapro Toprol interaction - there may be one » pharmrep, posted by jane d on October 7, 2002, at 23:14:02
> > > I have now been on lexapro for three weeks. (5mgs)
> > > This dosage makes me drowsy. Tomorrow I go to see my doc and she will increase it to 10 mgs.
> > > I am still going to sleep without taking ambien, so it is really helping the insomnia. I feel a little less anxious.....there is still room for improvement though. No nausea. This is the first
> > > antidepressant I have been able take. I don't hate it! I do wonder about lexapro interacting with my toprol (for blood pressure). The doc didn't mention there could be an interaction. Found a website that mentioned it. Anybody here know anything about it....also mentioned that lexapro could lower your heart rate.
> >
> > ** no...your heart rate/blood pressure shouldn't change...no lexapro will not interact with your medications. The drug to drug interaction profile for lexapro is awesome...the p450 system has 0 interactions. Celexa is very mild in only 2 of the 5 major pathways in the liver, zoloft is mild to moderate in all of the pathways, and both paxil and prozac are moderate to severe in the p450 system (very likely to interact with other meds).
>
> Pharmrep -
> Are you aware that Lexapro's own prescribing information describes an interaction between Toprol and Lexapro? It may or may not be significant but I don't think it is appropriate for you to say or imply that it doesn't exist. I think you are misinterpreting the standard Lexapro advertising argument that it interacts with fewer other medications than do the other SSRI's to mean that it doesn't interact at all. That's a potentially dangerous misunderstanding.
>
> JaneIts my understanding that beta blockers may have an effect on 5HT, I think acting as an agonist. There has been some stuff published about beta blocker potientiation of SSRI's. I believe it was done by Ivan Goldberg.
Here's this too re: pindolol a common beta blocker:
"Thirty to forty per cent of patients will not respond to their initial antidepressant treatment. The augmentation of antidepressants is an important strategy for these treatment resistant patients (Thase & Rush, 1995). A new augmentation strategy, the use of pindolol, has been reported to potentiate the clinical effects of the selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors by enhancing serotonin function (Artigas et al, 1994, Blier & Bergeron, 1995). Pindolol, a known beta blocker, also blocks 5-HT1A receptors, thereby increasing the available amount of serotonin in the synaptic cleft (by preventing autoreceptor inhibitory regulation) (Hjorth & Auerbach, 1994).
There is also evidence of a role for serotonin in aggression (Mann, 1995). Perturbations in serotonergic system may exacerbate irritability and possibly trigger violent behavior. This could be a shortcoming of pindolol augmentation of SSRIs. We report a case of a patient who had an unexpected worsening of irritability after receiving pindolol to augment sertraline antidepressant action.
Case report
A 26-year-old male with a long history of dysthymic disorder presented for treatment after months of worsening of depressive symptoms (insomnia, anhedonia, irritability, poor concentration, low energy, and suicidal ideation), consistent with the diagnosis of major depression, -moderate. He also described episodes of physical aggression towards his spouse with increased irritability leading to violence. He was very regretful of his aggressive behavior, and reported a relation between irritability and proneness to violence. Despite the occurrence of violent behavior, the patient did not fill criteria for antisocial personality disorder. There was no evidence of alcohol or substance abuse during the treatment.
The patient was begun on sertraline 50mg/day and trazodone 50mg at bedtime with disappearance of irritability, partial improvement of insomnia and energy level, but persistence of sadness and anhedonia. A sertraline blood level was 17ng/ml (normal range 10-100ng/ml for our laboratory) after three weeks. His sertraline dose was increased to 150mg/day and trazodone was increased to 150mg/night in the following two weeks without improvement of sadness, anhedonia or residual insomnia. The patient developed anorgasmia. His sertraline dose was then decreased over one week to 50mg/day. There were no complaints of irritability, but patient still reported some anxiety and had transient withdrawal symptoms (mainly a flu-like syndrome for two days) during the one-week taper of sertraline from 150mg/day to 50mg/day.
At that point the patient was started on pindolol 5 mg twice a day (in addition to 50mg/day of sertraline). The patient reported an exacerbation of irritability and anxiety after two days, but no worsening of sadness, loss of concentration, decrease of energy, appetite or sleep. He missed work for the first time in two months and asked his spouse to leave him alone because he was afraid of becoming violent. Pindolol was discontinued at the end of the second day. Resolution of the irritability and anxiety occurred within 24 hours. On 50mg/day of sertraline there was no further irritability. The patient remained on 150mg/day of trazodone throughout these events.
Discussion
Our patient’s irritability was stable for two months on sertraline prior to the addition of pindolol. As a result of the augmentation, there was an unexpected exacerbation of irritability and anxiety. Despite the good results of Artigas et al. and Blier & Bergeron, increasing irritability was one of the reported shortcomings of this treatment. In our patient increased irritability occurred soon after adding pindolol (to sertraline and trazodone) and rapidly dissipated after pindolol was discontinued. He did not report worsening of sadness or other depressive symptoms. This strongly implies that in this patient augmentation with pindolol was associated with increased irritability without affecting antidepressive activity. We hypothesize that pindolol’s role in changing the serotonergic system caused this occurrence.
The complexity of the serotonergic system precludes an easy explanation of these phenomena. In a recent review of the neurobiology of violence, Mann (1995) pointed at the inverse relation between CSF 5-HIAA and irritability and aggression. This implies decreases in serotonergic function may relate to irritability. This contradicts the association between irritability/aggressiveness and pindolol augmentation in our patient (which implies increased serotonergic function). We currently know of a multitude of serotonergic receptor subtypes. These subtypes likely correspond to different systems. Our patient was also receiving trazodone, which blocks 5-HT2 receptors. Trazodone inhibits serotonin reuptake and may have a serotonomimetic action through its major metabolite, m-chlorophenylpiperazine (m-CPP) and we could not rule out a putative fluctuation on anxiety and irritability due to the interaction of pindolol and trazodone (Hyman et al, 1996). Therefore, augmentation with pindolol altered the function of the serotonergic system in a complicated way and it is unlikely that simple increases or decreases of the serotonergic neurotransmitter system adequately explain these phenomena. We agree with Coplan et al. (1995) that dysfunction of interdependent 5-HT pathways, possibly secondary to pathological receptor sensitivities, might account for disparate aggressiveness, anxiety and mood effects of 5-HT related compounds."
Pharmrep, with all due respect, to say that the drug to drug interaction profile is 'awesome' is grossly premature. The drug hasn't been in use in cliniical practice for long enough to say that with any degree of certainty, regardless of what the studies might have shown.
I'd like to ask you, how many TOTAL studies were done for Lex, and how many showed no improvement over placebo, out of that total amount?
Posted by pharmrep on October 8, 2002, at 0:43:06
In reply to Re: Lexapro Toprol interaction - there may be one » pharmrep, posted by jane d on October 7, 2002, at 23:14:02
> > > I have now been on lexapro for three weeks. (5mgs)
> > > This dosage makes me drowsy. Tomorrow I go to see my doc and she will increase it to 10 mgs.
> > > I am still going to sleep without taking ambien, so it is really helping the insomnia. I feel a little less anxious.....there is still room for improvement though. No nausea. This is the first
> > > antidepressant I have been able take. I don't hate it! I do wonder about lexapro interacting with my toprol (for blood pressure). The doc didn't mention there could be an interaction. Found a website that mentioned it. Anybody here know anything about it....also mentioned that lexapro could lower your heart rate.
> >
> > ** no...your heart rate/blood pressure shouldn't change...no lexapro will not interact with your medications. The drug to drug interaction profile for lexapro is awesome...the p450 system has 0 interactions. Celexa is very mild in only 2 of the 5 major pathways in the liver, zoloft is mild to moderate in all of the pathways, and both paxil and prozac are moderate to severe in the p450 system (very likely to interact with other meds).
>
> Pharmrep -
> Are you aware that Lexapro's own prescribing information describes an interaction between Toprol and Lexapro? It may or may not be significant but I don't think it is appropriate for you to say or imply that it doesn't exist. I think you are misinterpreting the standard Lexapro advertising argument that it interacts with fewer other medications than do the other SSRI's to mean that it doesn't interact at all. That's a potentially dangerous misunderstanding.
>
> Jane
**** I stand by my last note...I am not referring to ssri's, I am referring to the Greenblatt study presented at the Society of Biological Psychiatry Annual Meeting May 2001 (New Orleans, La) that shows how Lexapro metabolizes (with very very little inhibitory effects in the p450system.)
Did you read the Package Insert? it states "coadministration of lexapro and metoprol had no clinically significant effects on blood pressure or heart rate." Under the "drug interactions" section...10+ "common" meds are mentioned to show that they were specifically looked at...and none of them had "interactions." So what are you referring too?
Posted by pharmrep on October 8, 2002, at 0:51:44
In reply to Re: Lexapro Toprol interaction - there may be one » jane d, posted by JLM on October 8, 2002, at 0:31:31
> I'd like to ask you, how many TOTAL studies were done for Lex, and how many showed no improvement over placebo, out of that total amount?
>
**** I love your input as well as others, but dont make them so long...my eyes hurt. I have seen 9 full studies for Lexapro so far, and only posters/brief abstracts for 2 more...all of them have "positive" results, showing a statistically significant separation from placebo....I bet I know why you're asking....it's never been done before...there's usually at least 1 "negative" study, but so far lexapro has none.
Posted by Ippopo on October 8, 2002, at 1:26:49
In reply to Re: my eyes hurt » JLM, posted by pharmrep on October 8, 2002, at 0:51:44
Pharmrep, I'm relativly new to this site. I'm so spacy I really can't give a time frame but...
Who are you? Not to really know who you are but who you are. Are you actually a Pharmrep? Someone who's interested in psychotropics(sp). Someone who is actually taking meds? or Are you here to help monitor the site?....
You comments are interesting.
I am happy. I woke up late, at 11am this morning so I took 1/2 dose of adderall. Right now I'm actually rather tired and it's only 1.30am. I've been falling asleep around 4am or 5am. I am so happy to be able go to sleep early.
Honestly, I'd be happier if lexapro was more effective.
Posted by pharmrep on October 8, 2002, at 1:41:13
In reply to Re: my eyes hurt » pharmrep, posted by Ippopo on October 8, 2002, at 1:26:49
> Pharmrep, I'm relativly new to this site. I'm so spacy I really can't give a time frame but...
> Who are you? Not to really know who you are but who you are. Are you actually a Pharmrep? Someone who's interested in psychotropics(sp). Someone who is actually taking meds? or Are you here to help monitor the site?....
> You comments are interesting.
> I am happy. I woke up late, at 11am this morning so I took 1/2 dose of adderall. Right now I'm actually rather tired and it's only 1.30am. I've been falling asleep around 4am or 5am. I am so happy to be able go to sleep early.
> Honestly, I'd be happier if lexapro was more effective.*** I am a pharmaceutical rep for Forest (makers of Celexa and Lexapro). I found this site about 2-3 months ago...I used to get beat up a lot...you know...all the hype on Lexapro coming out. And a lot of bad info going around. I was really just trying to get rid of the bad info, and give the correct info since I had already been trained on Lexapro. It soon turned into a nice info room for all to ask and share what they knew/experienced (especially since Lexapro launched.) I have been cautious to not come off as "salesy", but more informative..always having a proofsource to support my statements...I still get some "stiff" posts, but I dont take it personal. I am more interested in learning more about the field I work in (the people here, and the meds/combos, and lots more) and how I can better serve the DR's I see and share with them how Lexapro can help their patients...I hope you can give lexapro more time...how long for you now?
Posted by dr. dave on October 8, 2002, at 6:15:06
In reply to me » Ippopo, posted by pharmrep on October 8, 2002, at 1:41:13
I'm glad to read that you always have a proof source to support your statements. I wonder whether you could give the proof source for your statement that Lexapro has fewer side-effects than Celexa. I've asked a few times, but haven't seen it from you yet.
The other interesting statement recently has been
' ...celexa can cause both insomnia and somnolence...usually people are tired...you are doing the right thing in taking early in day, but you still stay up at night. Lexapro doesnt have the somnolence, but a little insomnia for some'
Lundbeck say that 6.9% of people taking Lexapro had somnolence in recent trials, compared to 4.7% in the Celexa group. The difference was not statistically significant. Could you tell us your proof source for the statement that Lexapro 'doesn't have somnolence.'
I hope this doesn't make you feel 'beat up' - it's just a matter of making sure accurate information is being given out.
> *** I am a pharmaceutical rep for Forest (makers of Celexa and Lexapro). I found this site about 2-3 months ago...I used to get beat up a lot...you know...all the hype on Lexapro coming out. And a lot of bad info going around. I was really just trying to get rid of the bad info, and give the correct info since I had already been trained on Lexapro. It soon turned into a nice info room for all to ask and share what they knew/experienced (especially since Lexapro launched.) I have been cautious to not come off as "salesy", but more informative..always having a proofsource to support my statements...I still get some "stiff" posts, but I dont take it personal. I am more interested in learning more about the field I work in (the people here, and the meds/combos, and lots more) and how I can better serve the DR's I see and share with them how Lexapro can help their patients...I hope you can give lexapro more time...how long for you now?
Posted by shakingoscar on October 8, 2002, at 7:39:23
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by fishgirl on September 16, 2002, at 14:55:16
I am getting more weight gain on lexapro than I ever did on celexa... And I know why too... Celexa is far more stimulating than lexapro (for me at least). I am very sensitive to SSRIs and feel everything. I have to take trazodone to prevent the celexa stimulant effects. With lexapro I dont. Stimulants keep you thin so I have only put on weight with three ADs - paxil, lexapro, and immipramine.
Cheers
Posted by CarolinaGirl on October 8, 2002, at 8:39:11
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by CarolinaGirl on October 7, 2002, at 15:46:20
I have found that when I smoke, now that I am on lexapro....I get very anxious, very quick.....in fact it is making me not want to smoke. The anxious feeling lasts about and hour. Has anyone had this experience.
Posted by shakingoscar on October 8, 2002, at 8:52:52
In reply to Re: Anyone switched to Lexapro? « ggrrl--Tobacco, posted by CarolinaGirl on October 8, 2002, at 8:39:11
YUP! And for me the anxiety is worse now than when I was on celexa... Still, I am getting used to a new dose so I am waiting a couple more weeks before I decide my next move. (Been on lexapro for 6 weeks now... and Im still trying to find a dose that works for me. I was on 60mg celexa and that was fine.
Posted by johnj on October 8, 2002, at 10:51:17
In reply to Re: Anyone switched to Lexapro? « ggrrl--Tobacco, posted by shakingoscar on October 8, 2002, at 8:52:52
HI,
You posted on October 5th that Lexapro has worked great and has been the best med for you. What has happeneded? Is it the coffee and tobacco that has contributed to the downfall? I am somewhat confused. Some people have said Lexapro has been great for anxiety?? Thanks
johnj
Posted by mudbunny on October 8, 2002, at 12:17:11
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by shakingoscar on October 8, 2002, at 7:39:23
How long have you been on lexapro? In that time how much weight did you gain? I have been on lex for 1 week and love it. I have a little less appetite and a little more tired during the day. I also take 200 mg of welbutrin. thanks.
Posted by mudbunny on October 8, 2002, at 12:17:18
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by shakingoscar on October 8, 2002, at 7:39:23
How long have you been on lexapro? In that time how much weight did you gain? I have been on lex for 1 week and love it. I have a little less appetite and a little more tired during the day. I also take 200 mg of welbutrin. thanks.
Posted by ANXIETY ANN on October 8, 2002, at 13:28:48
In reply to Re: Question for Pharmrep regarding Lexapro Anxiety (nm), posted by ANXIETY ANN on October 8, 2002, at 13:14:45
I RECENTLY STARTED TAKING LEXAPRO (3DAYS) 10MG FOR ANXIETY. I HAVE SEVERE HEADACHES AND STOMACH UPSET AS WELL AS DIZZINESS AND HOT FLASHES FLUSHING. SHOULD I CUT MY DOSE DOWN TO 5MG OR STICK IT OUT ON 10 MG DO THE SIDE AFFECTS GO AWAY WITH TIME? IN THE PAST I HAVE HAD A HARD TIME WITH DEPRESSION MEDS. I ALSO TAKE ADIVAN NAD XANAX FO ANXIETY AND PANIC ATTACKS.THANKS FOR ANY ADVICE YOU CAN GIVE
Posted by hyperanxiety on October 8, 2002, at 14:04:17
In reply to Re: Pharmrep: A Week On Lexapro..., posted by Ippopo on October 4, 2002, at 12:28:48
I was told a year ago that I have severe anxiety but was told by a counselor, and she said it would be a month before I could see a doctor. Needless to say I never saw the doctor. I thought the problem I was having was adhd resurfacing but I know now it was not. Recently I have had leg pains and muscle spasm accompanied by tremors went to doctor he ran blood tests said everything was cool and said it was probably anxiety. To make a long story short I was prescribed lexapro and to a 10 mg tab mon the 7th of october. First 2 to 3 hours were ok I was a little spaced out feeling but that was only the start by 4 to 5 hours later I was having so much anxiety I thought I was gonna lose it. It was much greater than any I have ever experienced my legs started tightening up more got so shakey it was unreal and muscle spasms everywhere. Found myself bearing my teeth together. Called my doctor and he said to try taking it before bed. What do you peeps think? Saturday a friend gave me a xanex and that helped me not worry about all that is going on now but still had muscle pain and some spasms. Anyone got an answer about what they think I should do.
Posted by Ippopo on October 8, 2002, at 15:36:39
In reply to me » Ippopo, posted by pharmrep on October 8, 2002, at 1:41:13
Hi Pharmrep,
I'm falling in love with your dedication to your job. Your quest for knowledge is wonderful.
Anyway, I am on Lexapro 10 mg 1x/day and Adderall 5 mg (ADD) 2x/day. It's roughly 3 weeks now. I'm spacey so time sequence is questionable. I'm trying Lexapro in the mornings now. I have no idea what is doing what.
Before this it was Effexor XR 225 mg for 3 wks. Around 1.5 wks into it the Doc prescribed Adderall. I quit eating, lost weight, became depressed, with suicidal ideation becaming a regular part of my thought process. I don't know if it was lack of nutrition, inefficiency of Effexor XR, or absence of cable TV ( no HSN...joke) that contributed to the change of meds. Possibly all of the above.
Before all of that I was on Zoloft150 mg and Welbutrin 300 mg (3 yrs). When the current Doc heard of the combo he blew a gasket and switched me. Aside from the combo not doing anything the last 8/12 months, he said the combo didn't react well together.
This is my Med history aside from the antibiotics I take during dental work due to a Mitro Valve Prolapse.
Posted by utopizen on October 8, 2002, at 15:40:58
In reply to I took one pill and no way will I ever try another, posted by hyperanxiety on October 8, 2002, at 14:04:17
I am concerned that taking it at night would cause you to have dental bruxism-- I grind my teeth... you don't know you do it in your sleep until someone else tells you they heard it (like me) or the dentist notices abrasion (after it's severe).
Then again, Adderall gave me the elastic jaw clamp feeling for a few days and never since... it may just be how your nerves are adjusting to it all.
Still, if that's what the case is, I don't see the harm in going on Klonopin or Xanax (pyschs. prefer Klono because it leaves the blood later) for your anxiety from Lexapro.
If you can ride out the anxiety storm with a benzo, maybe after a few weeks you can stop taking it and by then the clouds of anxiety are too tired to rain down on you anymore and everything's cleared up.
Posted by JLM on October 8, 2002, at 16:01:47
In reply to Re: Proofsource » pharmrep, posted by dr. dave on October 8, 2002, at 6:15:06
> I'm glad to read that you always have a proof source to support your statements. I wonder whether you could give the proof source for your statement that Lexapro has fewer side-effects than Celexa. I've asked a few times, but haven't seen it from you yet.
>
> The other interesting statement recently has been
>
> ' ...celexa can cause both insomnia and somnolence...usually people are tired...you are doing the right thing in taking early in day, but you still stay up at night. Lexapro doesnt have the somnolence, but a little insomnia for some'
>
> Lundbeck say that 6.9% of people taking Lexapro had somnolence in recent trials, compared to 4.7% in the Celexa group. The difference was not statistically significant. Could you tell us your proof source for the statement that Lexapro 'doesn't have somnolence.'
>
> I hope this doesn't make you feel 'beat up' - it's just a matter of making sure accurate information is being given out.
>
>
> > *** I am a pharmaceutical rep for Forest (makers of Celexa and Lexapro). I found this site about 2-3 months ago...I used to get beat up a lot...you know...all the hype on Lexapro coming out. And a lot of bad info going around. I was really just trying to get rid of the bad info, and give the correct info since I had already been trained on Lexapro. It soon turned into a nice info room for all to ask and share what they knew/experienced (especially since Lexapro launched.) I have been cautious to not come off as "salesy", but more informative..always having a proofsource to support my statements...I still get some "stiff" posts, but I dont take it personal. I am more interested in learning more about the field I work in (the people here, and the meds/combos, and lots more) and how I can better serve the DR's I see and share with them how Lexapro can help their patients...I hope you can give lexapro more time...how long for you now?
>
>
Once again, I too, would like to see something to validate this claim other than the small, statistically insignificant difference between citalopram and escitalopram.
Posted by chad_3 on October 8, 2002, at 22:20:38
In reply to Re: Proofsource » dr. dave, posted by JLM on October 8, 2002, at 16:01:47
Hi Sir -
This is a 2 part question:
1) Do you believe Celexa is as effective as Paxil across comparable dose ranges, especially for dysthymia, major depression, and general anxiety (all 3 disorders) ... If indeed LexaPro potently blocks s2 and s3 receptors, would this drug not be highly effective in treating certain a host of movement disorders (aka; clozapine)... ?
2) It is now common for urologists to use Paxil to treat premature ejaculators, and for psychiatrists to prescribe Zoloft to tame males who are overly sexually agressive.
In your personal opinion, do you believe that LexaPro will be as effective as Paxil (for premature ejactulation / excess libido) and/or as effective as Zoloft for sexual overaggression.
Any official info on the above greatly appreciated.
Sincerely,
Chad
> > I'm glad to read that you always have a proof source to support your statements. I wonder whether you could give the proof source for your statement that Lexapro has fewer side-effects than Celexa. I've asked a few times, but haven't seen it from you yet.
> >
> > The other interesting statement recently has been
> >
> > ' ...celexa can cause both insomnia and somnolence...usually people are tired...you are doing the right thing in taking early in day, but you still stay up at night. Lexapro doesnt have the somnolence, but a little insomnia for some'
> >
> > Lundbeck say that 6.9% of people taking Lexapro had somnolence in recent trials, compared to 4.7% in the Celexa group. The difference was not statistically significant. Could you tell us your proof source for the statement that Lexapro 'doesn't have somnolence.'
> >
> > I hope this doesn't make you feel 'beat up' - it's just a matter of making sure accurate information is being given out.
> >
> >
> > > *** I am a pharmaceutical rep for Forest (makers of Celexa and Lexapro). I found this site about 2-3 months ago...I used to get beat up a lot...you know...all the hype on Lexapro coming out. And a lot of bad info going around. I was really just trying to get rid of the bad info, and give the correct info since I had already been trained on Lexapro. It soon turned into a nice info room for all to ask and share what they knew/experienced (especially since Lexapro launched.) I have been cautious to not come off as "salesy", but more informative..always having a proofsource to support my statements...I still get some "stiff" posts, but I dont take it personal. I am more interested in learning more about the field I work in (the people here, and the meds/combos, and lots more) and how I can better serve the DR's I see and share with them how Lexapro can help their patients...I hope you can give lexapro more time...how long for you now?
> >
> >
>
>
> Once again, I too, would like to see something to validate this claim other than the small, statistically insignificant difference between citalopram and escitalopram.
>
>
>
Posted by JLM on October 8, 2002, at 22:26:24
In reply to Technical questions for Celexa/LexaPro Rep, posted by chad_3 on October 8, 2002, at 22:20:38
> Hi Sir -
>
> This is a 2 part question:
>
> 1) Do you believe Celexa is as effective as Paxil across comparable dose ranges, especially for dysthymia, major depression, and general anxiety (all 3 disorders) ... If indeed LexaPro potently blocks s2 and s3 receptors, would this drug not be highly effective in treating certain a host of movement disorders (aka; clozapine)... ?
>
> 2) It is now common for urologists to use Paxil to treat premature ejaculators, and for psychiatrists to prescribe Zoloft to tame males who are overly sexually agressive.Good god, that just shows how totally out of control the practice of medicine has gotten. It seems like SSRI's work for almost anything you would care to prescribe them for. Its also a good
argument for the non specificity of their effects.
>
> In your personal opinion, do you believe that LexaPro will be as effective as Paxil (for premature ejactulation / excess libido) and/or as effective as Zoloft for sexual overaggression.
>
> Any official info on the above greatly appreciated.
>
> Sincerely,
> Chad
>
>
> > > I'm glad to read that you always have a proof source to support your statements. I wonder whether you could give the proof source for your statement that Lexapro has fewer side-effects than Celexa. I've asked a few times, but haven't seen it from you yet.
> > >
> > > The other interesting statement recently has been
> > >
> > > ' ...celexa can cause both insomnia and somnolence...usually people are tired...you are doing the right thing in taking early in day, but you still stay up at night. Lexapro doesnt have the somnolence, but a little insomnia for some'
> > >
> > > Lundbeck say that 6.9% of people taking Lexapro had somnolence in recent trials, compared to 4.7% in the Celexa group. The difference was not statistically significant. Could you tell us your proof source for the statement that Lexapro 'doesn't have somnolence.'
> > >
> > > I hope this doesn't make you feel 'beat up' - it's just a matter of making sure accurate information is being given out.
> > >
> > >
> > > > *** I am a pharmaceutical rep for Forest (makers of Celexa and Lexapro). I found this site about 2-3 months ago...I used to get beat up a lot...you know...all the hype on Lexapro coming out. And a lot of bad info going around. I was really just trying to get rid of the bad info, and give the correct info since I had already been trained on Lexapro. It soon turned into a nice info room for all to ask and share what they knew/experienced (especially since Lexapro launched.) I have been cautious to not come off as "salesy", but more informative..always having a proofsource to support my statements...I still get some "stiff" posts, but I dont take it personal. I am more interested in learning more about the field I work in (the people here, and the meds/combos, and lots more) and how I can better serve the DR's I see and share with them how Lexapro can help their patients...I hope you can give lexapro more time...how long for you now?
> > >
> > >
> >
> >
> > Once again, I too, would like to see something to validate this claim other than the small, statistically insignificant difference between citalopram and escitalopram.
> >
> >
> >
>
>
Posted by Alan on October 8, 2002, at 23:48:34
In reply to Re: there is no Lexapro-Toprol interaction /bottom » jane d, posted by pharmrep on October 8, 2002, at 0:43:06
Q:
It seems to me (from this bulletin board and several others)that the preferred option of people suffering from anxiety for a long period seems to be to either take Xanax or another benzo daily, or on an as needed basis. Why is it then that most doctors seem to recommend ADs as the first (and many times only) choice for anxiety? It can't just be marketing by the pharmaceutical companies can it?
A:
Well, it isn't JUST marketing. The makers also performed unprecedented numbers of clinical trials (mostly outside the US) in order to get a handful that were complimentary. They couldn't afford to be satisfied with the first overwhelmingly negative results, as there was too much money already invested. So they persevered and persevered, gradually learning how to design studies with more favorable outcomes. They also changed some data and hid other studies away in company vaults where they weren't "found" until a decade later, and then only under court order.But yes, antidepressants do seem, according to the little independent research that exists, to be useful against anxiety in maybe 30-50% of cases. Still, it's no coincidence that most manufacturers don't provide data on SSRIs in anxiety that would allow actual percentage calculations to be made. They just say their med was so-and-so % much better than placebo.
Meanwhile, benzodiazapines have proven for 40+ years to be at least 75% - 85% effective by conservative estimates with little side effect comparatively speaking. Plus they are usually added to take with an AD in the end anyway since AD's are most often overstimulating or do not provide adequate releif of symptoms as the anxiolytics do.
You have to understand that the FDA has incestually high employment overlap, among its movers and shakers, with the industries that it regulates. In the pharmaceutical arena, it is common for someone who pushes through an approval at the FDA to then go work for the company that developed the approved product. The financial temptations are nearly irresistible.
There's a rule of thumb in law enforcement that the more highly educated a person is, the more gullible he becomes. You get more Ph.D.s falling for street scams than people whose daily life is closer to the street. Doctors are no exception. They seldom imagine that a drug company would lie and cheat about the information shown to doctors, or that so many of the articles written about SSRIs have been ghost-written by pharmaceutical company hacks who then paid an "independent" MD to put his name on it, or that the respected MD who writes or speaks about a medication neglects to mention that he is earning not only some but the majority of his income from the drug company that makes the medication. They are amazed and outraged when individual cases get exposed, but they don't get it that this is business as usual in the pharmaceutical industry today.
Pharmrep:Besides the "what's your source" company line, any comments? If you dispute it, what are YOUR sources?
Posted by shakingoscar on October 9, 2002, at 1:10:43
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by mudbunny on October 8, 2002, at 12:17:11
Ive been on lex 6 weeks now.. Admittedly, I have had to reduce my dose because my doctor overprescribed... However, in the last 6 weeks, I have gained around 7 pounds...
Cheers
Posted by horridmonster on October 9, 2002, at 1:10:56
In reply to Re: Proofsource » pharmrep, posted by dr. dave on October 8, 2002, at 6:15:06
> I'm glad to read that you always have a proof source to support your statements. I wonder whether you could give the proof source for your statement that Lexapro has fewer side-effects than Celexa. I've asked a few times, but haven't seen it from you yet.
>
> The other interesting statement recently has been
>
> ' ...celexa can cause both insomnia and somnolence...usually people are tired...you are doing the right thing in taking early in day, but you still stay up at night. Lexapro doesnt have the somnolence, but a little insomnia for some'
>
> Lundbeck say that 6.9% of people taking Lexapro had somnolence in recent trials, compared to 4.7% in the Celexa group. The difference was not statistically significant. Could you tell us your proof source for the statement that Lexapro 'doesn't have somnolence.'
>
> I hope this doesn't make you feel 'beat up' - it's just a matter of making sure accurate information is being given out.
>
>
> > *** I am a pharmaceutical rep for Forest (makers of Celexa and Lexapro). I found this site about 2-3 months ago...I used to get beat up a lot...you know...all the hype on Lexapro coming out. And a lot of bad info going around. I was really just trying to get rid of the bad info, and give the correct info since I had already been trained on Lexapro. It soon turned into a nice info room for all to ask and share what they knew/experienced (especially since Lexapro launched.) I have been cautious to not come off as "salesy", but more informative..always having a proofsource to support my statements...I still get some "stiff" posts, but I dont take it personal. I am more interested in learning more about the field I work in (the people here, and the meds/combos, and lots more) and how I can better serve the DR's I see and share with them how Lexapro can help their patients...I hope you can give lexapro more time...how long for you now?
>
>Is somnolence exhaustion? That's me - couldn't keep my eyes open the first week. Better now third week but still not my old energetic self. Keep waiting. Maybe i'm less than 1% in some study or two - but that still means SOMEBODY is gonna have that effect. pharmrep i find your comments helpful but only to a degree - i know my side effects whether thay show in tests in others or not. -monster
Posted by Dr. Bob on October 9, 2002, at 1:12:52
In reply to me » Ippopo, posted by pharmrep on October 8, 2002, at 1:41:13
> I love your input as well as others, but dont make them so long...my eyes hurt.
> I used to get beat up a lot...
Keeping in mind that the idea here is not to post anything that could lead others to feel accused or put down, could you please rephrase the above? Thanks,
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.
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