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R-Citalopram versus S-Citalopram

B

Biochemistry

Greenlighter
Joined
Jan 4, 2012
Messages
18
I was a long term user of escitalopram (Cipralex UK/Lexapro US) for major depression. After four years of daily usage, this medication simply stopped working entirely. I am now taking citalopram and it is working much better than the escitalopram ever did, particularly in the area of anxiolysis. Although escitalopram is pretty good for depression, I found it to be hugely anxiogenic, and I also found that tolerance builds very quickly. However, I find citalopram to be equally as good for depression and equal to diazepam for generalised anxiety.

I believe that Lundbeck/Forest Laboratories, due to a desire to extend the patent life of its product, have utterly manipulated the academic literature and clinical trials data in relation to the S and R enantiomers of citalopram. Although I have no evidence to back up my theory (because it seems like all of the academic research has been sponsored by Lundbeck/Forest Laboratories), from personal experience and intuition, I believe that R-citalopram is largely responsible for the anxiolytic properties of citalopram. If you read the academic literature about S-citalopram and R-citalopram, they all mention that R-citalopram counteracts the "antidepressant and anxiolytic" properties of S-citalopram based 5HT release in the frontal cortex. This is entirely disingenuous because it does not mention other potential modes of action that R-citalopram has on other neurotransmitter systems, such as gamma-Aminobutyric acid (GABA), for example.

What are your thoughts?
 
Indeed, it is pure evergreening. The thing I have a problem with is the fact that escitalopram appears to be an inferior product, certainly from personal experience anyway. The R enantiomer clearly has therapeutic utility, but the aggressive marketing of "Lexapro" has completely infiltrated and distorted real science, all in the name of profit margins. Having read through some of the scientific literature, it is so transparent and blatantly obvious that the data in these papers is being used for marketing purposes only, which I find rather shocking. What an insane world we live in! Now we cannot even trust peer reviewed scientific journals, especially in the area of pharmacology.
 
I'd give Effexor or Remeron, and their combo, a trial, though I'm not sure about the two isomers, and did find S isomer to be superior, big pharma is indeed a lying greedy detriment to society.
 
The "California Rocket Fuel" does seem like it would work wonders for my severe melancholic depression. I am actually on mirtazapine and citalopram at the moment, which I am finding to be an excellent combination. In my opinion, citalopram monotherapy is good for depression, but not quite enough for melancholic depression; I believe that my serotonin and norepinephrine systems are knackered, for which both mirtazapine and citalopram are helpful. If eventually I feel that the citalopram is no longer doing its job, I will ask my psychiatrist to replace it with venlafaxine. The mirtazapine is fantastic for insomnia, of which I am have an extreme case.
 
I wasn't aware that Citalopram (R or S) had actions on the GABA system. Can you post a study showing it does?
 
Any one want to know the price differential between the two?

citalopram - low to mid two digit price

Lexapro- more than 4 times more

:-/ the pharmaceutical industry has brought us truly remarkable drugs but this is it's massive, disgusting greed.


A pharmaceutical representative made me delivery free pizza to a doctors office with stickers on the boxes advertising an extended release antibiotic (one which lost its patent decades ago.) This was a walk in clinic, the kind that hands out antibiotics like candy.

I want to hear from negrogesic, are doctors really swayed by bullshit bribes like that or are they receiving kickbacks?

I can always tell the paramedical rep when at the doctor. He's the guy with the rolling case full of new patent/old drug medicine. He sweet talks the staff with a fake smile while handing out pens and samples.

If any doctor prescribed that extended release version to anyone, except people who have trouble swallowing pills and would rather take 1/day ideas of two, then they are stupid asshole who care not about the patient. People coming into that clinic would not be able to afford non-generics.

Every wonder why doctors offices are filled with pens with patented drugs advertised on them?

thankfully there are decent doctors who will make sure to get you the cheapest version if the effective drug. My doctor uses the samples to offset writing a full prescription, saving people money. :)
 
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