New Antidepressant !!!!!!!

Discussion in 'Fibromyalgia Main Forum' started by MarilynK, Sep 6, 2002.

  1. MarilynK

    MarilynK New Member

    WASHINGTON (AP) -- Starting next week, psychiatrists will be able to prescribe an eagerly awaited new antidepressant called Lexapro. It's being promoted as more potent and possibly safer than older competitors -- but there's little evidence that it's much better.

    Still, Lexapro promises to be a big player in the $12 billion antidepressant market. So how do patients and doctors choose whether to try it or another of the bewildering array of depression drugs?

    "You're playing the odds," is the blunt way Dr. Philip Ninan of Emory University puts it: Each antidepressant comes with a different set of pros and cons, and there's little way to know in advance which will work best for which patient.

    While patients today have better drugs than ever to fight depression, a huge swath of the 19 million Americans afflicted at some point in their lives fail to get relief. Experts estimate up to half of patients who try an antidepressant stop altogether or switch to another within three months. Some can't handle the side effects; others get little or no benefit -- likely because there are different causes of depression that require novel treatments.

    Today's medications emphasize balancing brain levels of the feel-good neurochemical serotonin. Ninan is excited about a radically different approach, targeting hormones believed to cause patients with depression to have exaggerated responses to stress. But it will take years more research to prove if these experimental "CRF antagonists" fulfill that promise.

    With potential breakthroughs so far away, any new option causes excitement -- even if, like Lexapro, the drug isn't very different chemically from its predecessors. Indeed, Lexapro is a fine-tuned version of the popular drug Celexa, the latest in the Prozac-spawned class of "selective serotonin re-uptake inhibitors," or SSRIs.

    Lexapro is "not God's answer to this illness, but it is a step forward," Ninan says. "The word I'd use is an incremental advance."

    Forest Laboratories Inc., maker of both Celexa and Lexapro, argues that even an incremental advance means Lexapro can make a meaningful difference. So when Lexapro hits pharmacy shelves September 5, the company will virtually end its Celexa marketing -- meaning few if any free samples anymore -- in favor of Lexapro, which will sell for 5 to 10 percent less than its roughly $2-a-pill predecessor.

    "We're arguably taking a little bit of a gamble on this, but we believe we have a better drug," says Forest vice president Dr. Lawrence Olanoff.

    Why? Celexa consists of molecules with mirrored halves. Only the left-hand side is believed to enhance brain serotonin levels; the right side is thought to be inactive or perhaps linked to some side effects. Lexapro is Celexa cut in half to get the presumed good side.

    The Food and Drug Administration cautions that Lexapro hasn't been proved superior to any antidepressant. But in a 491-patient study, 10 milligrams of Lexapro once a day worked as well as 40 mg of Celexa. A few patients felt better about a week sooner than Celexa users. And while Lexapro causes the same side effects seen with most SSRIs -- from nausea and sexual dysfunction to insomnia and daytime fatigue -- about 5 percent fewer Lexapro users experienced them.

    But there are numerous other choices, and psychiatrists advise considering dosing, side effects, even prices:


    SSRI granddaddy Prozac, for example, is available as a cheaper generic and as the only once-a-week antidepressant. Even the once-daily version stays in the body longer than any other SSRI, possibly good if the patient skips pills but not if they take other medicines that can interact with Prozac, says Dr. Christopher Colenda of Michigan State University. The SSRI Paxil, conversely, clears out of the body so fast that patients suffer side effects if they quit cold turkey.


    The SSRI alternative Serzone helps balance serotonin through a different brain mechanism, meaning fewer sexual and sleep-related side effects. The trade off is occasional liver toxicity.


    Effexor targets both serotonin and the similar brain chemical norepinephrine, and thus is popular when SSRIs fail. Wellbutrin also affects both brain chemicals, although not as powerfully; it carries a risk of seizure.


    Depression often is accompanied by other mental health problems so look for drugs that have more than one effect. Luvox, for example, is an SSRI sold to treat obsessive/compulsive disorder; Paxil also treats anxiety.

    And Colenda says always ask how other relatives with depression fared on different drugs, because a new patient will likely fare similarly.

  2. MarilynK

    MarilynK New Member

    WASHINGTON (AP) -- Starting next week, psychiatrists will be able to prescribe an eagerly awaited new antidepressant called Lexapro. It's being promoted as more potent and possibly safer than older competitors -- but there's little evidence that it's much better.

    Still, Lexapro promises to be a big player in the $12 billion antidepressant market. So how do patients and doctors choose whether to try it or another of the bewildering array of depression drugs?

    "You're playing the odds," is the blunt way Dr. Philip Ninan of Emory University puts it: Each antidepressant comes with a different set of pros and cons, and there's little way to know in advance which will work best for which patient.

    While patients today have better drugs than ever to fight depression, a huge swath of the 19 million Americans afflicted at some point in their lives fail to get relief. Experts estimate up to half of patients who try an antidepressant stop altogether or switch to another within three months. Some can't handle the side effects; others get little or no benefit -- likely because there are different causes of depression that require novel treatments.

    Today's medications emphasize balancing brain levels of the feel-good neurochemical serotonin. Ninan is excited about a radically different approach, targeting hormones believed to cause patients with depression to have exaggerated responses to stress. But it will take years more research to prove if these experimental "CRF antagonists" fulfill that promise.

    With potential breakthroughs so far away, any new option causes excitement -- even if, like Lexapro, the drug isn't very different chemically from its predecessors. Indeed, Lexapro is a fine-tuned version of the popular drug Celexa, the latest in the Prozac-spawned class of "selective serotonin re-uptake inhibitors," or SSRIs.

    Lexapro is "not God's answer to this illness, but it is a step forward," Ninan says. "The word I'd use is an incremental advance."

    Forest Laboratories Inc., maker of both Celexa and Lexapro, argues that even an incremental advance means Lexapro can make a meaningful difference. So when Lexapro hits pharmacy shelves September 5, the company will virtually end its Celexa marketing -- meaning few if any free samples anymore -- in favor of Lexapro, which will sell for 5 to 10 percent less than its roughly $2-a-pill predecessor.

    "We're arguably taking a little bit of a gamble on this, but we believe we have a better drug," says Forest vice president Dr. Lawrence Olanoff.

    Why? Celexa consists of molecules with mirrored halves. Only the left-hand side is believed to enhance brain serotonin levels; the right side is thought to be inactive or perhaps linked to some side effects. Lexapro is Celexa cut in half to get the presumed good side.

    The Food and Drug Administration cautions that Lexapro hasn't been proved superior to any antidepressant. But in a 491-patient study, 10 milligrams of Lexapro once a day worked as well as 40 mg of Celexa. A few patients felt better about a week sooner than Celexa users. And while Lexapro causes the same side effects seen with most SSRIs -- from nausea and sexual dysfunction to insomnia and daytime fatigue -- about 5 percent fewer Lexapro users experienced them.

    But there are numerous other choices, and psychiatrists advise considering dosing, side effects, even prices:


    SSRI granddaddy Prozac, for example, is available as a cheaper generic and as the only once-a-week antidepressant. Even the once-daily version stays in the body longer than any other SSRI, possibly good if the patient skips pills but not if they take other medicines that can interact with Prozac, says Dr. Christopher Colenda of Michigan State University. The SSRI Paxil, conversely, clears out of the body so fast that patients suffer side effects if they quit cold turkey.


    The SSRI alternative Serzone helps balance serotonin through a different brain mechanism, meaning fewer sexual and sleep-related side effects. The trade off is occasional liver toxicity.


    Effexor targets both serotonin and the similar brain chemical norepinephrine, and thus is popular when SSRIs fail. Wellbutrin also affects both brain chemicals, although not as powerfully; it carries a risk of seizure.


    Depression often is accompanied by other mental health problems so look for drugs that have more than one effect. Luvox, for example, is an SSRI sold to treat obsessive/compulsive disorder; Paxil also treats anxiety.

    And Colenda says always ask how other relatives with depression fared on different drugs, because a new patient will likely fare similarly.

  3. JannyW

    JannyW New Member

    I've been on Lexapro since this past Tuesday ... the pharmacy I deal with had gotten their shipment in already. Hoping that this one helps with the anxiety better than Celexa ... maybe I'm imagining it, but I think I can already tell a slight difference.

    Jan ^v^
  4. Holly_RN

    Holly_RN New Member

    Jumpng on the bandwagon..
    I am switching over tomorrow. :)
    Got my supply yesterday, and will switch tomorrow. Hope it helps. I never could really up the dose much due to side effects, so I hope I can up it to a more effective dose without the side effects.
    With friendship,
    ~Holly_RN
  5. PaulMark

    PaulMark New Member

    I've gotten my TIANeptine, the european anti depressant taht doesn't fry the brain like ssri's per dr. cheney
    my shrink in w. ky. said wouldn't prescribed it since not fda in us but will monitor, see him the 9th, been so sick with reflux, binginging cfs # l problems as cheney said stomach gi problems scared of acid blockers after endoscopeif gi dr. carter recommneds it (hav voiced my concerns abut them with cheny's rx of hypochlorida) that i've been afraid to take th TIAN. main side effects are les than ssris but can inclusde nausea, and drowniness, and gastralgia??? what's that holly????

    anyways, with worries, pain, scared of acid blockers was intoleratnt to pre cfs rx and they are contra to hypochlorida, i need nausea and drowniness (in bed now l6 or l7 hrs of 24) like a hole in head

    but maybe worth a try what do you all think mar.? holly rn ?? god bless and thnaks Paul Mark in KY
  6. MarilynK

    MarilynK New Member

    Evrything new is of interet i think and if we are not satisfyed with what we use i would defenetly try it.
    I live in Norway and they dont let med. in easaly , i tryed ordering some products from the store here but was stoped in customss, and is on the way back.Hope i get a refund....
    I just started on Remeron and so far so good, i hope to cut back on the Ultram, since i take full dose and also i have cut the sleep med. witch made me have weard dreams.
    I also take Sobril , it is called something else uk and us.
    I been taking that for depp. and anxiety and i hope to cut that one out to_Ones the Remeron workes.

    I would defenatly try Lexapro if they had it here.
    As long as they dont know exactly what FMS is and dont have med. for it ,we can only treat the symptoms as best as we can. Thanks for replying guyes. Keep intoutch....

    God Bless
    Marilyn
  7. Deb*NC*

    Deb*NC* New Member

    Does this new antidepressant come in generic??? Im having problems with my insurance ove brand name drugs..Thanks.
  8. klutzo

    klutzo New Member

    ...so there can be no generic for 17 years. Drug companies can take an older and perfectly good drug, alter one molecule, and market it as an expensive new drug with patent protection from competition. I have had much better luck with really old drugs...sometimes the original drug was better but the company wasn't able to make enough $ off it once the patent expired. Benadryl is a perfect example of this. There are tons of expensive prescription allergy pills on the market now, but none comes close to Beandryl in effectiveness. I was given expensive blood pressure lowering drugs that almost killed me. After reading some research, I had my doctor put me on an old drug that also calms the sympathetic nervous system, so it should help FMS. It is the only one I've been able to tolerate and it costs me only $9 for a 3 month supply!
    Anyone taking antidepressants should read Dr. Cheney's article at this site about the effects they have on the brain, so you can hear the other side of the story and make an informed decision. Also, keep in mind that all of these drugs lose their effectiveness and require higher and higher doses to work until you reach the max dose allowed and when that doesn't work you're SOL.
    I am a former Psychiatric Social Worker, and I do not think these drugs should be prescribed unless a person has severe clinical depression (not the secondary kind you get with FMS), and then only for a short time. I also think giving a tricyclic antidepressant like Elavil, should be malpractice if the patient is not underweight. I've seen way too many FMS patients end up obese in only a few months from these drugs and obesity will kill you, even if FMS won't. Whatever happened to "first, do no harm?" Not only that, but many are not helped at all by the drugs, and some are even made worse.
    That's my opinion and of course, you are welcome to take it or leave it. :) Klutzo
  9. garlinbarb

    garlinbarb New Member

    I take Lexapro now. I started on it aout a month and a half ago.The main prob with it is I feel better but it's deceptive! I have hurt myself so mant times already.

    teach6 gave me the name of a local doc that I've only seen 1 time, but he was very up on everything that's wrong with me. My RA is already much better now. If I can just get better pain cotrol for my FMS I'll be happy.

    You guys have been on it a while now, any comments? I haven't had any except I think it has given me a false sense of security. I guess that's not a problem!

    Barb
  10. garlinbarb

    garlinbarb New Member

    How's it going with the Lexapro?