Posted by dr dave on October 2, 2002, at 12:07:31
In reply to Re: I TAKE 30MG LEXAPRO - ALSO, posted by Cletus2 on October 2, 2002, at 10:31:52
This is really interesting. The '4 to 1' story first emerged from Forest because the Burke study failed to show any difference in efficacy between escitalopram 10mg, escitalopram 20mg and citalopram 40mg. This led to the statement that escitalopram 10mg was at least as effective as citalopram 40mg.
But if escitalopram 10 mg and 20 mg come out the same in this trial, isn't it likely citalopram 20mg and 40mg would as well? There is, it seems, a little added efficacy for 20mg rather than 10mg of escitalopram, which is seen in other studies. This study wasn't sensitive enough to pick it up. There is no reason to think it would have been picked up for citalopram 20mg and 40mg. It's just they didn't collect this data.
No other data supports this '4 to 1' idea. Plenty of data support the much more logical '2 to 1' ratio. Escitalopram is twice as potent as citalopram in several studies. There is no explanation of how this could translate into a 4 to 1 difference in efficacy.
The problem is that if the 2 to 1 ratio is true, which logic and the overwhelming body of evidence points to, it has to be admitted that there is no difference in side-effects. I have received Lundbeck's data on relative side-effects in all comparative studies and I quote '...there were no statistically significant differences for incidences of these events between the escitalopram and citalopram treatment groups.' These data are from 1123 patients treated in trials, and refer to the twelve commonest side-effects. Not one of these was different.
> My doctor told me that he finds the ratio to be 4 to 1 between Celexa and Lexapro.
poster:dr dave
thread:109458
URL: http://www.dr-bob.org/babble/20020930/msgs/121959.html