Celexa vs. Lexapro

[Junebabyaf]

Has anyone switched from Lexapro to Celexa? I am currently on Lexapro and it has been working well for me. I have no side effects at all. At first I felt a little foggy/emotional, but that went away in only a few days. I am very happy with Lexapro, however, I just found out how much it will cost! My psychiatrist gave me samples, so I have to start getting my own soon... My insurance will only cover Lexapro if other similar medications could not be used and requires special approval. Lexapro costs $100 a month at Walmart if I don't use the insurance! So it looks like I'm going to have to switch to generic Celexa, but I'm concerned about switching -- Has anyone experienced worse side effects from switching from Lexapro to generic Celexa?

[John_in_SF]

No, not at all. In fact, Celexa seems more tolerable to me than Lexapro. The difference may lie in the inactive ingredients, since both drugs share precisely the same active ingredient.

[arth67]

its claimed that both meds are actually the same and that lexapro was a clever way of extending the patent, you will do fine on generic celexa

[meyaj]

Celexa is generally considered to be the weakest SSRI. Yes, it is by definition 50% Lexapro, but clinically it really doesn't seem to work that way. The "R" enantiomer of the drug seems to counteract the "S" to some degree. Studies and meta-analyses comparing the drugs generally suggest that Celexa is significantly less effective.

Personally, I would see about switching to zoloft instead. Well, I'd try to see about getting special approval first, but I realize that's unlikely to happen. Zoloft ranks up there with Lexapro in terms of effectiveness and are for the most part equally tolerable.

[epril]

Generic Celexa, highest dose, works for me.

[jim_morrison]

Originally Posted by meyaj

Celexa is generally considered to be the weakest SSRI.

Actually thats a misconception, prozac is marginally weaker.

http://www.preskorn.com/books/ssri_s3.html

See table 3.1, and figure 3.3.

[meyaj]

Originally Posted by jim_morrison

Actually thats a misconception, prozac is marginally weaker.

http://www.preskorn.com/books/ssri_s3.html

See table 3.1, and figure 3.3.

That's interesting. Would have liked to see Lexapro compared there. I was speaking in a clinical sense though, that psychiatrists often find it to be the weakest.

This might be explained in part by its unbelievable selectivity, I think. Prozac is nearly 20 times more effective in terms of norepinephrine reuptake inhibition. I realize it's still a relatively minor effect, but with citalopram it's nearly non-existent.

Makes me even more interested to see Lexapro up there to get a sense of why it's considered to be so effective.

Edit: Just realized it's further down the page... doh

[Medline]

Efficacy:

1) Mirtazapine (Remeron)
2) Escitalopram (Lexapro)
3) Venlafaxine (Effexor)
4) Sertraline (Zoloft)
5) Citalopram (Celexa)
6) Buproprion (Wellbutrin)
7) Paroxetine (Paxil)
8 Milnacipran (Savella)
9) Fluoxetine (Prozac)
10) Duloxetine (Cymbalta)
11) Fluvoxamine (Luvox)
12) Reboxetine (Vestra)

Tolerability:

1) Sertraline (Zoloft)
2) Escitalopram (Lexapro)
3) Buproprion (Wellbutrin)
4) Citalopram (Celexa)
5) Fluoxetine (Prozac)
6) Milnacipran (Savella)
7) Mirtazapine (Remeron)
8 Venlafaxine (Effexor)
9) Paroxetine (Paxil)
10) Duloxetine (Cymbalta)
11) Fluvoxamine (Luvox)
12) Reboxetine (Vestra)

http://www.socialanxietysupport.com/...10-list-65291/

Data based on the following meta-analysis including 117 randomised controlled trials with 25.928 participants: http://www.ncbi.nlm.nih.gov/pubmed/19185342

[meyaj]

Word, still supports my recommendation of switching to zoloft instead

[jim_morrison]

Originally Posted by Medline

http://www.socialanxietysupport.com/...10-list-65291/

It always suprises me how poorly cymbalta faires in efficacy in that study. You'd think that being the potent dual acting drug that it is, it would atleast compare to a TCA for depression *shrugs*.

[Phobiker]

I switched vice versa, from Celexa to Lexapro and Lex works alot better. If I wouldn't be insured I would still pay for Lex than switching to Celexa.

[John_in_SF]

Originally Posted by jim_morrison

It always suprises me how poorly cymbalta faires in efficacy in that study.

But it does have a very pretty name. Like a character from Shakespeare.

[jim_morrison]

Originally Posted by Freesix88

Because the dual acting only means it increases serotonin and norepinephrine. Good for depression but norepinephrine should people make a bit more anxious I think, therefore it's not the best choice for SA. The serotonin effects starts to work after several weeks while the norepinephrine effects almost work immediately. This was the case for me however.
Cymbalta is really energizing and therefore it's good for bedridden depressive people.

Yeah but depression was what I was referring too. The study medline posted was done for Depression, not SA.

[Junebabyaf]

Thanks for all the feedback this is helpful. I began trying Celexa, so far I have had some adverse side effects, but I am going to give it some time to see if they go away. My doctor will try to call the number to get Lexapro approved if the adverse side effects continue. If not, then I'm going to try Zoloft. My doctor mentioned trying either Prozac or Zoloft if Celexa doesn't work and Lexapro isn't approved, however, I'm leaning more toward the Zoloft. I see Zoloft is rated highly

[meyaj]

Originally Posted by Junebabyaf

Thanks for all the feedback this is helpful. I began trying Celexa, so far I have had some adverse side effects, but I am going to give it some time to see if they go away. My doctor will try to call the number to get Lexapro approved if the adverse side effects continue. If not, then I'm going to try Zoloft. My doctor mentioned trying either Prozac or Zoloft if Celexa doesn't work and Lexapro isn't approved, however, I'm leaning more toward the Zoloft. I see Zoloft is rated highly

I don't know how old you are, but if you're not an adult Prozac is probably the best choice.

However, Prozac tends to be agitating for anxious people, especially in the first few weeks. And while most drugs are able to build up to a stable level in 2 weeks or so (and consequently get cleared from your system in a few weeks), Prozac is unique in that it takes FIVE weeks. So if you're an adult, I'd strongly suggest the zoloft.

[Junebabyaf]

I'm a young adult, I'm 24. I think I may try the Zoloft if the Celexa doesn't work and if Lexapro isn't approved by my insurance. Thanks for the feedback.

[Junebabyaf]

So I experienced the differences between Lexapro and Celexa. I thought I would share them... I had some minor side effects with Celexa that I didn't have with Lexapro. Other than that, I preferred Lexapro over Celexa. I noticed that Celexa made me VERY tired and sedated. I didn't have the energy to do many things. With Lexapro, I felt like my energy was at a good level and I felt more awake. With Celexa I needed a lot of caffeine even when I got plenty of sleep. Did anyone experience this as well?

[Bluemeow]

I too prefer Lexapro over Celexa, mostly because Lexapro doesn't interfere with my amorous relations with my husband to the extent that Celexa did.

I did not have a good experience with Mirtazapine (Remeron), as many on this forum have had. I felt sedated and unsocialable, so I guess it doesn't work with whatever is out of whack in my neurochemistry.

[Makaveli]

Been on Celexa since 2002 except for a month when I was on effexor-xr in about 05. Most I've taken is 2 tabs which is 40mg a day. It doesn't react well to alcohol, makes me very tired and lethargic and gives me a bit of weight gain. It helped a little with SA but the underlying probs were still there. I also got depressed every 4-6 weeks for like a few days.

I made an earlier thread this week about tapering off meds completely but it seems the general consensus is to keep trying different ones and find the right dosage. I just can't help but find this a bit stupid. Sorry to patronise anyone but it seems pointless to me.

My doctors and previous psychiatrist have said different ones work for different people and I know that but for some reason I find it futile and it's really making me very disheartened.

Zoloft, Lovan, Lexapro have been suggested to me but I just don't like the side effects of getting used to them.

[fcbfcb]

Originally Posted by Makaveli

I made an earlier thread this week about tapering off meds completely but it seems the general consensus is to keep trying different ones and find the right dosage. I just can't help but find this a bit stupid. Sorry to patronise anyone but it seems pointless to me.

I do find it pointless to keep trying meds of the same class (SSRI/SNRI). Being unaltered and side-effect free is currently my preferred state until I can get a hold of something different as monotherapy or combined with the above.