Firstly you seem to have got confused
40 cit = 20 escit
40 escit = 80 cit
those are comparable dosages. Simply put escit (lexepro) is twice as potent per mg than citrolapram.
the UK's advice is that 20 escit is the max daily dose
however it did start out dosing higher than that but had more undesirable effects than from others on let's say 60 cit compared to 30 escit
after noticing the problems with people dosed over 20mgs of escit(lexepro) it stated no one should be prescribed more than 20 escit.
therefore the NHS would rather perscribe the more known drug (as it has been around longer ) at higher equivalent doses instead of lexepro.
i think the highest level of cit is 60mgs a day(equivalent of 30 lexepro)
Now I know for one thing. There is no point saying the UK is stupid for having that recommendation, but on the other hand I am not saying the U.S. Are stupid for having there's.
both products are passed patent and made generically so there is no real cost advantage to pushing either drug especially in the UK when it's all NHS and we use our own generics for everything. If lexepro was still in patent and owned by the U.S. Pharma company that owned it . That may have been different. The nhs's change happened after it was generic...I understand this is obviously a huge debate in your country as you have insurance and they pay for this or that or not this or that...
neither of us are chemists with complex data ..But all I can say is I preferred 10 msg of escitrolpam to 20mgs of citrolapram(which I changed from and then came of escitrolopram after a few months). I am of both now. I would never want to go as high as 40 or 80 anyway but either away I am past the need for ssri's
recommendations on doses and what drugs are treated for are different all over world. One country may have better data on one drug than another.
there is also no reason to make an argument over this. I am just telling you the NHS's recommendations. You are calling them stupid. Maybe because in your case 40mgs of lexepro helps you out. And good on you if thAts the case.
but let's be honest anyone on an Ssri should not be on them for life. They are not diagnosed with major depressive order, bi polar or schizophrenia and should be looking to taper down anyway. They are the very first line in minor depression and have very small effects especially at low doses.. These are not addictive, they are not life threatening, they are relatively Easy to taper of or just come down a notch..and if they don't do the job you may need something stronger.
and lets not start any argument due to our countries different recommendations.
Sorry man I was in no way trying to argue over this at all.
I guess the way I said it was "stupid" was kind of far fetched, in fact I'm not quite sure why I said that in the first place lol.
I think I just misunderstood what you were saying.
Of course, different studies are coming out all the time and this one you mentioned I guess is against prescribing as high a dose as I am on, other studies will be for it, etc.
So far I haven't noticed any negative side effects and it's helping.
The only point i'd even comment on was your bolded comment.
While I wouldnt' say anyone SHOULD be on an SSRI for life I would also not argue that everyone SHOULDN't be on an SSRI for life.
Of course they can have side effects, as can almost any medication, but some people benefit from being on certain medications for life.
I'd argue that IF POSSIBLE I would guess most people would prefer not to be on a medication with possible strong side effects for life, unless of course they just happen to really like what it is doing for them.
SSRIs don't actually have an *acute* effect though like benzos, or even less so than any drug which might produce euphoria or a high though, so I would have a hard time seeing any reason anyone would WANT to stay on an SSRI if they no longer need it.
But I wouldn't necessarily say everyone on an SSRI needs to be constantly trying to taper off either.
I've been on SSRIs for 20 years now, from prozac to Lexapro now, and WISH I didn't need them, but have found that without I get anxiety and sometimes depression that lessens the quality of my life, so unless I TRULY feel I no longer need it, I won't try to get off, even though of course I would prefer not to need it and get off it if possible.
Regardless, good convo, I just happened to like debating about things and typing excessively haha, not arguing.