Talk:Escitalopram: Difference between revisions
Line 250: | Line 250: | ||
Google "Lexapro suicide" to see how much talk there is about Lexipro and suicide. Even if you don't take any of it seriously, you have to assume that the edit referred to by l'aquatique is good faith and not vandalism. [[Special:Contributions/24.36.35.188|24.36.35.188]] ([[User talk:24.36.35.188|talk]]) 23:40, 18 April 2008 (UTC) |
Google "Lexapro suicide" to see how much talk there is about Lexipro and suicide. Even if you don't take any of it seriously, you have to assume that the edit referred to by l'aquatique is good faith and not vandalism. [[Special:Contributions/24.36.35.188|24.36.35.188]] ([[User talk:24.36.35.188|talk]]) 23:40, 18 April 2008 (UTC) |
||
:Agree, content disputes are not [[WP:VANDAL|vandalism]] - even if it's trolling, which, in this case, it obviously is not. Please be careful when labeling something vandalism. [[User:Wisdom89|'''<font color="#660000">Wisdom89</font>''']] <sub>([[User_talk:Wisdom89|<small><sub><font color="#17001E">T</font></sub></small>]] / [[Special:Contributions/Wisdom89|<small><sup><font color="#17001E">C</font></sup></small>]])</sub> 00:35, 19 April 2008 (UTC) |
|||
== Evaluating weight gain with antidepressants == |
== Evaluating weight gain with antidepressants == |
Revision as of 00:35, 19 April 2008
![]() | This article is of interest to the following WikiProjects: | |||||||||||||||||||||||||||||||||||||||
Please add the quality rating to the {{WikiProject banner shell}} template instead of this project banner. See WP:PIQA for details.
Please add the quality rating to the {{WikiProject banner shell}} template instead of this project banner. See WP:PIQA for details.
Please add the quality rating to the {{WikiProject banner shell}} template instead of this project banner. See WP:PIQA for details.
|
Stub
I'm labelling this a stub until a very important side effect profile can be given, as well as more general information about this drug. This article is mostly useless as is.J. M. 19:35, 28 March 2006 (UTC)
- I disagree that this article is useless. It has loads of useful info, like the structure of the molecule, its class as an antidepressant, the disorders it is indicated for and the licence holders in various countries. I also think that the withdrawal effects should be checked against that reported in the medical literature, because it seems many users of escitalopram are reporting what they're experienced first hand here. Some of the symptoms described may be due to the recurrence of the underlying disorder, and some thought should be given to the relative frequency of each side effect - the information leaflet that comes with the drug has plenty of information on this. Ben 22:48, 28 March 2006 (UTC).
- I also disagree that this article is useless. I used this article and the external links before I went on this medication, and they helped me immensely. While I did add withdrawal and side effects based on my personal experiences, I added a source which contained the information for validity. -Varco 23:30, 28 March 2006 (UTC)
Odd observance: there seems to be a link to a site wherein you can by Lexapro and other drugs at the end of the "Pharmacology" section of the Lexapro article. Is there any reason for it to be there? No capital letters or punctuation, so I wonder if someone snuck it in there. -FS —Preceding unsigned comment added by 74.192.115.15 (talk) 06:54, 6 January 2008 (UTC)
Addiction
This article sidesteps the issue of addiction. It should be made clear whether Lexapro is addictive or is not addictive, but instead the issue is mostly avoided and partly finessed.
Prescription drug addiction is no joke-- it is not like other kinds of 'mild' addictions--
Prescription drug addiction does tremendous damage to peoples lives and a lot of medical schools don't teach the full story about addiction (the implicit message is-- it's OK to turn a patient into an addict in order to 'treat anxiety or depression'). This is not so. Anxiety and depression can be successfully treated through therapy and / or non-addictive meds and there is NEVER a good reason to turn an anxiety or depression patient into a prescription drug addict in order to 'help' them.
The pharmaceutical industry is one of the most powerful and corrupt political lobbies in the country. Pharmaceutical company executives who try to cover over or minimize the harm caused by prescription drug addiction (and irresponsible Doctors who do the same) should be prosecuted. Any Doctor or Psychiatrist who thinks it's OK to turn a psych patient into a drug addict should have to spend years in jail. Ditto for drug company execs who do the same.
Sean7phil 19:45, 5 May 2007 (UTC)
128.138.230.144 19:39, 5 May 2007 (UTC)
- To quote SSRI discontinuation syndrome, which is linked from this article and does address the issue:
- SSRIs are not addictive in the conventional medical use of the word (i.e. animals given free access to the drug do not actively seek it out and do not seek to increase the dose), but suddenly discontinuing their use is known to produce both somatic and psychological symptoms, as described by researchers.
- None of the symptoms listed in the article on discontinuation seem to be actively life-threatening either (unlike withdrawal of many genuinely addictive drugs), though some may be quite hard to bear.
- Of course antidepressants and other such drugs should not be prescribed lightly by any means, and I do agree that the pharmaceutical industry is one of the most powerful and corrupt political lobbies, though I disagree that its malignant influence is limited to just your country (or indeed your continent). I disagree with your When-I-am-King penalties for doctors and psychiatrists, though. There are unfortunately many cases where turning the patient into an addict is better than any alternative course of action, and may even be the only feasible one. However, those who would make this decision lightly in cases where addictive medication is not the only feasible option should in my opinion have their licence to practise medicine revoked, at the very least.82.111.241.126 08:38, 15 October 2007 (UTC)
- Withdrawal symptoms are not synonymous with addiction with regards to prescription drugs. Simple as that. Wisdom89 08:41, 15 October 2007 (UTC)
Other
Deleting references to "Allan Mason" pending any citations. I can find no references to his involvement in the development of Escitalopram, and "Jocette Docherty" shows up exactly 0 times in Google. --JohnRDaily 06:04, 31 Jul 2004 (UTC)
Heck, removing everything but the bare minimum, since I can't verify anything, and clearly the original author was careless at best, and disingenuous at worst. Even the trademark information was incomplete; Forest Pharmaceuticals has the Lexapro trademark in the U.S., Lundberg in Australia. --JohnRDaily 06:18, 31 Jul 2004 (UTC)
I'm coming off Escitalipram now, I'd like a section for withdrawel symptons since the doctor didn't warn me about them. I'm going to add one now (electric shock-like nervous system pulses), I hope this is considered valid. The effects described are based on personal experience and consultation with a professional who has witnessed the same effects in other patients. --rgc
- It would be good to make sure that those symptoms are cited in the linked web pages, and if not, find one that does, so that the information is properly sourced. It would also be great if you could include more side-effects and withdrawal symptoms, again with sources. -JohnRDaily 01:56, 18 February 2006 (UTC)
- I too am coming off of the drug; I've added mroe withdrawal symptoms based on my own experience, but I've also included a source. --Varco 05:37, 8 March 2006 (UTC)
- I also had the "little electric shocks" when coming off of Cipralex quite fast. In fact, that was exactly how I described them. Quite relieving to read this and find out that I wasn't the only one. The description concerning the shocks in the article is accurate according to my experience.
Escitalopram is now also available under the name Esipram in Australia. See [1]. 59.101.230.61 11:30, 12 February 2007 (UTC)
Questionable claims
The following unconfirmed statements are doubtful and not acceptable within the article.
Re: "They are not by definition untrue if there is no reference, they are waiting for that."
ReRe: They've already got their waiting time. Now, let them wait on the talkpage (until the end of time(?)) ;-)
- "R-citalopram has been shown to counteract[citation needed] the antidepressive effect. Escitalopram is the most selective SSRI.[citation needed]"
- "However, preclinical and clinical data have shown differentiated effects of citalopram and escitalopram.[citation needed] In particular escitalopram has shown to be more effective in depressive patients and particularly shows higher efficacy[citation needed] vs. citalopram and other SSRI in severely depressed patients."
As soon as scientific references are provided, you can of course add information into the article. Note, that otherwise anyone could write contributions such as: "this stuff is extremly toxic and the ingestion of nanograms of it leads to death within seconds.[citation needed]". Such a style is inappropriate and based on the intention to spread misinformation; it weakens article quality.--84.136.220.223 19:11, 7 September 2006 (UTC)
- Three days is not what I call 'they've already got their waiting time.' I must confess, I am not a specialist in this area, but the main reason why I reinserted the claims was, that they were deleted by an anon-IP without a good reason. Wikipedia would soon go down in volume if all unreferenced data would be removed. When the deletion is performed by an anon IP (nothing personal, sometimes IP-numbers are shared between nonrelated people) that could be because someone with a lot of knowledge on the subject knows they are untrue, it could be plain vandalism, or it could be a company trying to hide information! (the same is not necessarily true for a named account, one can then check what other edits this person has done, and guess the persons expertise .. new named accounts may still have to build some faith). Things that do not have a reference, are not by definition untrue, and I have the good faith that the sentences were put there because someone with some knowledge thought them true (I will have a look who added the info, anyway). I would have had no objection if you would have questioned the facts on the talk page, given it a couple of weeks, and then deleted the sentences. And I can also be OK with the solution that you have chosen now. The best solution would of course be, provide facts which counter the data, though I know that 'un-proof' is sometimes hard to find. I hope I did not bite too hard (see WP:BITE), I come across a lot of vandalism, sometimes it is difficult to separate vandalism/spam from genuine edits. --Dirk Beetstra T C 20:05, 7 September 2006 (UTC)
To say it forthright: It's advertisement. There is not the slightest hint that esc. actually is so unequally better than c., as the claims suggest. It is an info page and not a stage for advertisement. If the studies were provided (if they exist at all!), the reader could judge himself and he could also have a close look at their (potential) weak points.
I have no problem with unreferenced texts, but my credo is: provide reliable refs or remove the passages (to the talkpage or nirvana resp.) if there is a single one who mistrust them! Quality comes first!
P.S.: I am (quite) well aquainted with WP.--84.136.247.196 02:23, 8 September 2006 (UTC)
- I know, I have not checked who put these lines there, so they may be. I see your point, this is not about whether or not your edit was genuine, they way you edit may as well be vandalism as genuine. If you create an account, people would be able to check. Now I see two edits from this very IP (84.136.247.196), so if you would have deleted a line without providing a reason, and send them to walhalla, it would have been vandalism to me! You might be well aquainted with WP, I have no way to check. I am sorry. --Dirk Beetstra T C 07:25, 8 September 2006 (UTC)
The entire assertion that escitalopram is in any way superior to citalopram, especially in the abscence of any references to studies that support such claims, seems highly questionable. Frankly it reeks of either guerillia promotion by the manufacturers or escitalopram or promotion by someone that has been influenced elsewhere by drug company materials... the latter being more likely as even drug companies usually at least cite their own biased in-house studies. Will attempt to search the literature for a more definitive source on this myself now. --Condolini 14:56, 10 March 2007 (UTC)
- The Australian Medicines Handbook 2007, and independently published source of prescribing information for medical doctors (as opposed to the more common drug company sponsored MIMS Handbook) states that escitalopram is the active isomer of citalopram; no significant advantage over the other SSRIs has been demonstrated. While this is not a direct source it does come from an independant publication produced jointly by three of Australia's major professional societies, most notably the Royal Australian College of General Practitioners. Will keep looking for a primary source. --Condolini 15:18, 10 March 2007 (UTC)
- Right found it, not to sure myself how to put references into a wiki yet however I did find this review article by Manfield et al. that states that The manufacturer has claimed that the entantiomer has a larger effect with a faster onset of benefit. However, intention-to-treat analysis of pooled data has found no clinically important efficacy or safety advantages. Elsewhere they go on to say that while some studies have shown a slight advantage of escitalopram over citalopram, those studies have been only of very small samples and that the improved efficacy of escitalopram stated in them did not prove to be statistically significant. Full reference: Mansfield P, Henry D & Tonkin A. Single-enantiomer drugs: elegant science, disappointing effects. [Review] [23 refs] Clinical Pharmacokinetics. 43(5):287-90, 2004. --Condolini 16:05, 10 March 2007 (UTC)
- Ok I replaced previous erroneous claims with information supported by direct quotes from the source I have referenced in my last post (and indeed in the article itself). Unfortunately only the abstract of the article is available to those without a subscription to the journal, but fortunately I was able to access the full version of the article through my university. --Condolini 16:25, 10 March 2007 (UTC)
Escitalopram is the most selective SSRI
Regarding citation needed for "Escitalopram is the most selective SSRI": There are plenty hits associated with escitalopram if one searches the web with a web search engine using the phrase "most selective SSRI". Most seem to reference J. Hytell (January 1994), "Pharmacological characterization of selective serotonin reuptake inhibitors (SSRIs)", Int Clin Psychopharmacol 9(suppl.):19-26, which I do not have access to. — fnielsen 10:11, 15 March 2007 (UTC)
- I found the author is actually J. Hyttel and it is listed in PubMed [2] — fnielsen 10:14, 15 March 2007 (UTC)
- Well, the above reference was actually for citalopram not escitalopram. A reference for escitalopram is [3].— fnielsen 20:53, 15 March 2007 (UTC)
- Citalopram is the same substance as escitalopram. Escitalopram merely refers to the one optical isomer in citalopram that is medically active, whereas the other does nothing. —Preceding unsigned comment added by 82.111.241.126 (talk) 08:43, 15 October 2007 (UTC)
Additional Information for Wiki
Lexapro: (taken straight off the PI) http://www.lexapro.com/pdf/lexapro_pi.pdf
Lexapro® (escitalopram oxalate) is an orally administered selective serotonin reuptake inhibitor (SSRI).
Escitalopram is the pure S-enantiomer (single isomer) of the racemic bicyclic phthalane derivative citalopram.
Escitalopram oxalate is designated S-(+)-1-[3-(dimethyl-amino)propyl]-1- (p-fluorophenyl)-5-phthalancarbonitrile oxalate
Available as tablet or an oral solution – taken once daily Tablet available in 5, 10, 20mg dosages Identify each pill: 5mg – White/Off White, non-scored, film coated, imprint of “FL” on one side and “5” of the other side 10mg – White/Off White, scored, film coated, imprint on scored side with “F” on left and “L” on the right, on non-scored side there is a “10” 20mg – White/Off White, scored, film coated, imprint on scored side with “F” on left and “L” on the right, on non-scored side there is a “20” - overdose fatality is rare - even with 600mg+ per day
Pharmacodynamics: ie How it works The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT). In vitro and in vivo studies in animals suggest that escitalopram is a highly selective serotonin reuptake inhibitor (SSRI) with minimal effects on norepinephrine and dopamine neuronal reuptake.
A generic video explaining differences between Celexa and its newer counterpart Lexapro – also covers how the SSRI works in the brain: http://www.lexapro.com/english/about_lexapro/isomer_animation.aspx
Peak Blood Levels – 5 hours after ingestion (absorption not affected by food)
Bioavailability – approx. 80%
Gender importance: None
Label Use: Major Depressive Disorder Generalized Anxiety Disorder (GAD)
Off Label Use : taken from www.ncbi.nlm.nih.gov - each is referenced accordingly Panic http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16953656&itool=iconabstr&query_hl=2&itool=pubmed_docsum Social Anxiety Disorderhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16953656&itool=iconabstr&query_hl=2&itool=pubmed_docsum OCD http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16953656&itool=iconabstr&query_hl=2&itool=pubmed_docsum Alzheimer’s http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16477587&itool=iconabstr&query_hl=2&itool=pubmed_docsum
Side Effects:
Example of Side effect % from placebo controlled clinical trials for Major Depressive Disorder – for more graphs see PI http://www.lexapro.com/pdf/lexapro_pi.pdf
Body System/Adverse Effect Lexapro (N=715) Placebo (N=592) Dry Mouth 6% 5% Sweating Increased 5% 2% Dizziness 5% 3% Nausea 15% 7% Diarrhea 8% 5% Constipation 3% 1% Indigestion 3% 1% Abdominal Pain 2% 1% Influenza-like Symptoms 5% 4% Fatigue 5% 2% Insomnia 9% 4% Somnolence 6% 2% Appetite Decreased 3% 1% Libido Decreased 3% 1% Rhinitis 5% 4% Sinusitis 3% 2% Ejaculation Disorder 9% <1% Impotence (men) 3% <1% Anorgasmia (women) 2% <1% - for every side effect % increased with larger dosage size (ie 10mg -> 20mg)
Other more serious side effects-
- Abnormal Bleeding
- Hyponatremia
- Mania/Hypomania
- Seizures
- Interference with Cognitive and Motor Abilities
Effects of Immediate Discontinuation of treatment:
- Dysphoric Mood
- Irritability
- Agitation
- Dizziness
- Paresthesias
- Anxiety
- Confusion
- Headache
- Lethargy
- Emotional Lability
- Insomnia
- Hypomania
When possible a gradual decrease in dose rather than abrupt change is recommended
Other Important Things - Increased suicidal thoughts and actions in children and teenagers - Do not take while pregnant – can lead to increased risk of o respiratory distress o cyanosis o apnea o seizures o temperature instability o feeding difficulty o vomiting o hypoglycemia o hypotonia/ hypertonia o hyperreflexia o tremor o jitteriness o constant crying
- Nursing mothers are also discouraged as drug exists in breast milk and can effect the child - Not to be taken with MAOIs (allow 14 days before treatment)
Apart from Off Label Section and generic video under the Pharmacodynamics section all information is found directly on the PI for Lexapro I realize its a bit of a laundry list - but with so many factors/topics it seemed the most concise way to deliver the infromation - Matt DeSousa - not sure why apon posting the graph and a few of the subjects became out of order - Im not sure how to fix this - sorry for the added difficulty in reading
More on side effects
Is there a direct source for the claim that it causes weight gain (it's added as a throwaway remark, not even a complete sentence, at the end of the side effects section)? I'm well aware of anecdotal reports to that effect, but you know what they say--the plural of anecdote is not data. —The preceding unsigned comment was added by 216.193.172.224 (talk) 22:34, 7 December 2006 (UTC).
- The Australian Medicines Handbook 2007 lists "weight gain or loss" as a side effect for all members of the SSRI drug class including escitalopram. "Weight gain or loss" is again stated to be a common side effect in the specific drug information in the AMH. --Condolini 15:08, 10 March 2007 (UTC)
-- There were a problem with the formatting of the Side effect section. It was:
- Citalopram and other SSRIs have been shown to cause sexual side effects in most patients, both males and femalesCite error: A
<ref>
tag is missing the closing</ref>
(see the help page).. Although usually reversible, these sexual side effects can sometimes last a very long time after discontinuation. This disorder is known as Post SSRI Sexual Dysfunction. It may also cause weight gain in certain people. It may cause dizziness after exercise in children.
I have now cleaned it up, but that means that the unsourced sentence "Another side effect is blurred or blended vision" is removed. Please put it in again if it is appropriate/sourced. -- fnielsen 09:42, 15 March 2007 (UTC)
Weight Gain/Loss
Does anyone know if this is a physiological response to the drug, or if it's because it affects appetite? I've put on weight whilst taking it, but I'm sure I haven't been eating anything extra Monkeyspearfish 17:20, 23 January 2007 (UTC)
- I am not a doctor nor even scientist, just a fellow patient who has also put on weight, but could it be that another side effect (e.g. drowsiness), or the condition that caused you to get it prescribed, may have caused you to exercise less than you normally do, or otherwise changed your behaviour in such a direction? I know I exercise a lot less than I did before I got clinically depressed, but I can't just blame that on the drug. :) 82.111.241.126 08:49, 15 October 2007 (UTC)
Patent status
A lot of visitors reading this page would probably like to know more information on the current patent status of Lexapro. Plus, links to articles about similar, related, or generic drugs might be nice 147.145.40.43 19:50, 19 March 2007 (UTC)
Lundbeck and Forest Roles in Escitalopram Development
62.66.255.77 made the following addition to the history chapter "Escitalopram, particularly the technology to separate the two enantiomers of citalopram was developed and patented by Lundbeck. The clinical development was done in a close cooperation between Lundbeck and Forest Laboratories"
This is a controversial statement and should have been sourced properly. All I was able to find regarding the history of development of escitalopram is Lundbeck's 2000 annual report which on p28 states: Escitalopram for the treatment of depression is being developed in close cooperation with Lundbeck’s American partner, Forest Laboratories,Inc., No particular role of Lundbeck in separation of enantiomers or Forest in clinical development is mentioned. Furthermore, the US Patent Application 2005/0065207 on method of manufacture of escitalopram, which comprises the separation of enantiomers of citalopram, lists as the inventors both Lundbeck (Sommer, Nielsen and others) and Forest scientists (Assenza, Hariharan).Paul gene 01:27, 14 April 2007 (UTC)
What does "Esertia" mean?
What does "Esertia" mean? I just noticed the text on my box of Cipralex. Could it be a Spanish trade name of something like that? --81.227.68.28 15:44, 4 July 2007 (UTC)
- [4] sez that it's Almirall Prodesfarma's version of escitalopram. --moof 23:18, 4 July 2007 (UTC)
Escitalopram in Southern California?
I have recently switched from private insurance over to Medi-Cal, and if anyone here is a Medi-Cal + Lexapro patient, you already know that Lexapro is not covered by Medi-Cal. However, my privately-insured psychiatrist is nice enough to still work with me, and he told me Lexapro has a generic, and that's when I learned about Escitalopram. Nonetheless, approximately 2 mos. ago I went into my privately-insured pharmacy where I was told by the pharmacy assistant helping me out that Lexapro's generic counterpart does not exist yet. I insisted that, perhaps my psychiatrist knows what he's talking about, but that only directed me right back to where I began.
Last Friday, Nov. 16, 2007, I contacted my local Medi-Cal-accepting pharmacy in order to place a refill for my Lexapro prescription. When I was told it would cost me nearly $130.00 for 7-days worth of Lexapro I asked about Lexapro's generic, to which I was again told how no generic exists yet for Lexapro. I asked the pharmacy assistant how long it might be before the generic would be available and she replied as follows, "Let's see, Lexapro came out maybe 3-years ago and it takes about 7-years for a generic to be released, therefore, Lexapro's generic will most likely be available within the next 4-years."
Can anyone please tell me whether or not he or she has been prescribed and received Escitalopram recently at a pharmacy located in Southern California? I only have a remaining 3-day supply of my Lexapro and I cannot afford to pay for my medication out of my pocket; my anxiety level is heightening due to the fact that I am anticipating, in a bad way, the sudden withdrawl symptoms of Lexapro, which is, what I was told by my pharmacist when I began taking Lexapro in 2005, some form of a heart condition.
I will greatly appreciate any help and/or information within the next week, please.
Thanks for reading!
KJCook1980 (talk) 19:07, 18 November 2007 (UTC) e-Mail Me, Kristen]
- Wikipedia is not a doctor or a pharmacist. You need to take this question up with a professional. l'aqúatique talktome 21:00, 18 November 2007 (UTC)
- I am not a doctor or pharmacist, but I can tell you that the formularies of at least two major insurance companies (Aetna, United Healthcare) treat citalopram as the generic equivalent of Lexapro/escitalopram; citalopram is off-patent and a big money-saver if it works for you. IMO it is not a true equivalent because of its greater side-effect profile (see footnote 2 of the Escitalopram article) for some people. Some have asked their doctor to switch them from Lexapro to Celexa (citalopram) to save money, but decided the side effects were not worth it. Of course, YMMV (your mileage may vary). Regards, --CliffC (talk) 21:16, 18 November 2007 (UTC)
I'm not so sure...
I don't think this was vandalism. I have family in the field and the problems with SSRIs and Suicide have been relatively well documented. It needs a citation, though. :D l'aqùatique talk 03:58, 12 December 2007 (UTC)
- Thanks to Fnielsen who added references proving that the research to date has shown no significant association between escitalopram and suicide. So, clearly it was vandalism. Paul gene (talk) 11:06, 14 December 2007 (UTC)
Google "Lexapro suicide" to see how much talk there is about Lexipro and suicide. Even if you don't take any of it seriously, you have to assume that the edit referred to by l'aquatique is good faith and not vandalism. 24.36.35.188 (talk) 23:40, 18 April 2008 (UTC)
- Agree, content disputes are not vandalism - even if it's trolling, which, in this case, it obviously is not. Please be careful when labeling something vandalism. Wisdom89 (T / C) 00:35, 19 April 2008 (UTC)
Evaluating weight gain with antidepressants
One has to keep the following points in mind when evaluating weight gain with antidepressants:
- People taking placebo, gain 0.5-1% weight over a 1-2 years, so the weight gain with the antidepressant should be compared to placebo and not to the original weight
- Similarly, 3-6% of people taking placebo over 1-2 years experience clinically significant weight gain, usually defined as 7% weight gain (3.5 kg for a 70-kg person)
- Due to their side effects (nausea) SSRIs usually cause a weight loss during the first 1-2 months. This is then followed by weight normalization or gain. That is why it is important to evaluate weight gain after at least 3 months of SSRI therapy. Otherwise, even notorious paroxetine, for which a long term weight gain has been shown unequivocally, may appear to result in a weight loss. Paul gene (talk) 01:39, 5 January 2008 (UTC)
Gold standards and POV
This article says something to the effect that escitalopram (Lexapro) has advantages over an equal amount of the same drug, supplied as a 50:50 enantiomeric mixture (generic Celexa), and says something the effect that such studies are the "gold standard" in clinical trials. Well, not quite. The gold standard is where at least two such studies (one to confirm) show something, where at least one is funded by people with nothing to gain, like a government, not a pharm company. Single controlled study findings funded by the drug company with most to gain from the finding should always be suspect, and the one quoted, the only one I can find that shows this effect clearly, was funded by none other than H. Lundbeck A/S, licencers of escitalopram and holders of the patent. This is Int Clin Psychopharmacol. 2005 May;20(3):131-7. Prospective, multicentre, randomized, double-blind study of the efficacy of escitalopram versus citalopram in outpatient treatment of major depressive disorder. Moore N, Verdoux H, Fantino B. Département de Pharmacologie, INSERM U657, Université Victor Segalen, Bordeaux, France. nicholas.moore@pharmaco.u-bordeaux2.fr, referenced in this Wiki. This group has also argued recently that escitalopram is expected to be cost effective because it results in fewer hospitalizations! (by calculation from the earlier study). Also a calculation funded by H. Lundbeck A/S. This is not to claim that the Moore group is corrupt, but it's a known fact that studies funded by drug companies are more likely to find positive results for the drug than studies of the same drug funded independently. People find a way to see what they want to. How "double blind" the data analysis is, sometimes takes a magician like Randi to figure out. In the meantime, I'm skeptical. That's MY POV. But not being a drug company, I haven't published this. And thus does money influence Wikipedia, WP:N standards or not. Studies and publication cost $. SBHarris 02:16, 5 January 2008 (UTC)
Lundbeck or Forest Labs
I'm noticing a revert war brewing regarding the development of citalopram. A discussion should take place here about it, instead of the edit summaries. Cheers. Wisdom89 (T / C) 19:49, 17 April 2008 (UTC)
- Indeed, revert wars are bad for the quality of the article. The citalopram article states that Lundbeck originally developed citalopram, and gives a reference, whereas no-one is providing references here. I'll check the citalopram reference now.
The citalopram reference, here, simply states that citalopram was developed in 1989, but doesn't say who did it!
Ben (talk) 19:55, 17 April 2008 (UTC)
- Is this any help? (from lundbeck 1998 annual report) 24.36.35.188 (talk) 21:20, 18 April 2008 (UTC)
From a quick search of the patent literature, the earliest patents I can find mentioning citalopram (EP171943 in 1986 and EP347066 in 1989) were granted to scientists at Lundbeck. Deli nk (talk) 20:20, 17 April 2008 (UTC) ... Editing Wikipedia from a university library has its advantages. :)
- Thanks for checking those for us, Deli. Is there one that we can reference?
- Ben (talk) 20:48, 17 April 2008 (UTC)
- Here they are:
- Bogeso, Klaus Peter. Intermediate in the preparation of 1-(3-dimethylaminopropyl)-1-(4'-fluorophenyl)-1,3-dihydroisobenzofuran-5-carbonitrile. Eur. Pat. Appl. (1986), 12 pp. EP171943
- Boegesoe, Klaus Peter; Perregaard, Jens. Preparation and isolation of antidepressant drug citalopram enantiomers and their pharmaceutical compositions. Eur. Pat. Appl. (1989), 11 pp. EP347066
- Deli nk (talk) 21:07, 17 April 2008 (UTC)
There is no doubt that citalopram (Celexa) was developed solely by Lundbeck, Forest just did the paperwork for its FDA approval in the US. It is a bit more complicated with escitalopram. While Lundbeck separated the enantiomers first, it appears that Forest was involved in the development of the commercial process and its clinical development, see Talk:Escitalopram#Lundbeck and Forest Roles in Escitalopram Development above.
- This says that Lundbeck supplied escitalopram to Forest. Articles in Pharma Times Jan 11 and 16 indicate that escitalopram is licensed by Forest from Lundbeck. 24.36.35.188 (talk) 22:02, 18 April 2008 (UTC)