It is the therapeutically active S-enantiomer of citalopram. It has been shown, compared with placebo, to be an effective and well-tolerated treatment for major depressive disorders MDD in both primary and specialist care settings. A recent meta-analysis has found that escitalopram-treated patients showed significant higher response rates and increased mean change from baseline in the Montgomery-Asberg Depression Rating Scale MADRS total scores at weeks 1 and 8 compared with citalopram-treated patients.
Each of these active drugs shares similar safety profiles. Serotonin is a substance in your brain that helps control your mood. These medications work by increasing serotonin levels to help treat symptoms of depression. For both drugs, it may take some time for your doctor to find the dosage that works best for you. They may start you at a low dosage and increase it after one week, if needed. It may take one to four weeks for you to start to feel better and up to eight to 12 weeks to feel the full effect of either of these drugs.
Do not stop taking Celexa or Lexapro without talking to your doctor. Stopping either drug suddenly can cause withdrawal symptoms. These can include:. The prices are similar for Celexa and Lexapro.
Both medications are available in most pharmacies, and health insurance plans normally cover both drugs. However, they may want you to use the generic form. Keep reading: Complete drug information for escitalopram, including dosage, side effects, warnings, and more ».
Celexa is the brand-name version of the generic drug citalopram. Lexapro is the brand-name of the generic drug escitalopram. Brand-name products tend to be more expensive then the generic forms. Keep reading: Complete drug information for citalopram, including dosage, side effects, warnings, and more ».
Celexa and Lexapro both have a warning for an increased risk of suicidal thoughts and behavior in children, adolescents, and young adults ages 18—24 years , especially in the first few months of treatment and during dosage changes. Stay safe: What to know about antidepressants and suicide risk ».
However, a statistically significant difference between two treatments may not reflect clinical benefits that are evident or relevant when treating individual patients. Separate tests are usually applied to the data to test if statistical differences are likely to have clinical relevance. There are several approaches to determining clinical relevance. In regulatory terms the most important are the responder analysis, the remitter analysis and the treatment effect the difference between two treatments in the improvement from baseline to endpoint on a standard assessment scale EMEA, The criteria used to establish a clinically relevant difference have almost all been focused on a comparison of drug and placebo.
Comparing differences between two active treatments applying the same criterion used to define a clinically relevant difference on the pivotal scale between active drug and placebo is very stringent, since this means that the difference to placebo of the superior treatment must be at least twice that of the comparator antidepressant.
The studies included in the present meta-analysis included large regulatory studies sponsored by H. Even if no robust conclusions can be drawn from these smaller studies individually, the results are consistent with those from the larger trials. This is an effectiveness study with an open non-randomized design and the bias of the investigator in the choice of treatment and assessment might have influenced the result. There is some evidence of possible investigator bias in the allocation of patients to different treatments, since the escitalopram group were significantly more severely depressed at baseline than those on citalopram.
This might have been a chance finding but it might also reflect the clinical view, which was already current, that escitalopram was a more effective treatment in severe depression. All effectiveness studies are open to these sorts of biases. Nevertheless, for the sake of completeness, the study was included Anderson, , but was excluded from the meta-analysis of the randomised controlled studies.
The overall treatment difference between escitalopram and citalopram was 1. A direct measure of the clinically relevant difference may be taken from the difference observed between placebo and citalopram. On the basis of an analysis of the positive antidepressant studies submitted to the FDA, Kirsch et al. In the case of citalopram this difference was 1.
In a more recent meta-analysis of placebo controlled studies for all antidepressants, including a range of other non-regulatory studies, the reported difference on HAMD 17 was 1. Since the present analysis included a wide range of non-regulatory studies, a 1. It could therefore be concluded that this difference is clinically relevant. Since the treatment difference between escitalopram and citalopram was 1.
The European Medicines Agency EMEA normally uses a responder analysis to determine whether a statistically significant difference is also clinically relevant. A statistically significant advantage on the responder analysis in favour of an antidepressant compared with placebo is normally considered by the Committee for Medicinal Products for Human Use CMPH to be clinically relevant EMEA, In a review of placebo-controlled antidepressant studies submitted for regulatory approval over a year period, Melander et al.
The present analysis of two antidepressants shows a response advantage of 8. These differences translate into NNTs of approximately 12 for response and six for remission. The treatment effect for citalopram compared to placebo was constant with increasing baseline severity measured on the MADRS, but the effect increased for escitalopram. The advantage for escitalopram over citalopram became greater and was more strikingly clinically relevant in treating patients with increasing severity of depression.
These data confirm that escitalopram has different properties as an antidepressant compared to citalopram. Based on treatment difference, and NNTs derived from response and remission rates, the statistically significant superiority of escitalopram vs. The authors thank D. Simpson H. The authors are entirely responsible for the scientific content of this article.
Thomas Hansen is an employee of H. Anderson IM Psychopharmacology , — Google Scholar. Anon Cipralex escitalopram [in Swedish]. Comparison of escitalopram and citalopram efficacy: a meta-analysis. International Journal of Psychiatry in Clinical Practice 7 , — A comparative study of the efficacy of long-term treatment with escitalopram and paroxetine in severely depressed patients.
Current Medical Research and Opinion 22 , — Fixed-dose trial of the single isomer SSRI escitalopram in depressed outpatients. Journal of Clinical Psychiatry 63 , — Current Medical Research and Opinion 21 , — EMEA Note for guidance on clinical investigation of medicinal products in the treatment of depression.
European Medicines Agency. Depression can be treated in a variety of ways. Counseling and exercise may be effective on their own in a large number of cases.
Other patients may require medication. There are several classes of antidepressant drugs, and one of the most common of these are the selective serotonin reuptake inhibitors SSRIs.
There are several drugs in this class including Prozac fluoxetine , Zoloft sertraline , and Paxil paroxetine. Here we will discuss Celexa citalopram and Lexapro escitalopram. Celexa is a prescription medication indicated in the treatment of major depressive disorder. It is available generically as citalopram and belongs to the group of antidepressants known as SSRIs.
Celexa blocks the reuptake of serotonin at the neuronal membrane. By blocking serotonin reuptake by the transport pump, the drug is effectively leaving more free serotonin in the neuron synapse. Higher levels of serotonin are associated with improved mood and energy levels. The active ingredient, citalopram, has two isomers: R-citalopram and S-citalopram.
The S-isomer is primarily responsible for the serotonin blockade that makes citalopram effective. Celexa What is Celexa? Lexapro is another prescription medication indicated in the treatment of depression. The generic form of Lexapro is escitalopram, and it contains the more active isomer S-citalopram. Lexapro works in the same manner as Celexa by blocking serotonin reuptake. Lexapro What is Lexapro?
Sign up for Celexa price alerts and find out when the price changes! Get price alerts. Celexa and Lexapro are both indicated in the treatment of major depressive disorder.
MDD is characterized by prolonged two weeks or more feelings of low mood and decreased energy levels. Patients may not find joy in things they enjoyed previously.
Lexapro is also indicated in the treatment of generalized anxiety disorder GAD. GAD is characterized by prolonged and obsessive worrying about a variety of topics. Celexa and Lexapro are both used off-label in a variety of disorders that are closely related to depression and anxiety. These include obsessive compulsive disorder, panic disorder, and post traumatic stress disorder. The following is not intended to be a complete listing of potential uses for Celexa and Lexapro.
Only your healthcare provider can diagnose your disorder and decide which treatment option is best for you. A randomized, double-blind study was done to compare Celexa to Lexapro in the outpatient treatment of MDD.
A daily dose of 40 mg of Celexa was compared to a 20 mg daily dose of Lexapro. Lexapro also had more people respond to treatment overall.
0コメント