Posted by dr dave on October 2, 2002, at 15:14:56
In reply to Re: I TAKE 30MG LEXAPRO - ALSO » dr dave, posted by yeltom on October 2, 2002, at 13:07:26
No, logic doesn't explain everything but it's pretty useful in trying to sort out complicated issues. I'm sure no-one would advocate deliberately not being logical.
It's difficult to generalise from the individual experience of a relatively few people, which is why scientific trials exist. It's an attempt to answer questions without bias as far as possible. My view is that if research has been done which fails to support a given argument, one should not treat it as proven fact, and I am concerned that this is what is happening. If there were clear evidence for the 4 to 1 argument I would of course accept it, as I accept very many things in psychiatry for which a mechanism is unknown. But the evidence isn't really there.
I'm not sure I really follow your argument about the implications of the results for 10 and 20mg of escitalopram being the same. I compare them with 20 and 40 mg of citalopram because these represent the same amounts of escitalopram, just in the presence of r-citalopram.
80mg of citalopram would be 40mg of escitalopram plus 40mg r-citalopram, and we have no 40mg escitalopram group to compare it to. I'm not sure why one would pick this particular dose to compare with anything.
> I'm afraid logic doesn't explain everything. If 10 mg of lexapro was found to be equivalent to 40 mg of Celexa (which my and a lot of other people's experience confirms), you need to accept this. Perhaps the inactive isomer affects the absorption or otherwise interferes with the effectiveness of the active isomer. Just because we don't understand the reason does not make it not so. And your comparison is not valid. If 20 mg lexapro is no more effective in the study than 10 mg, that doesnt suggest that 40 mg of celexa would be no more effective than 20 mg. Rather, it suggests (but does not necessarily mean) that 80 mg of Celexa would be no more effective than 40.
poster:dr dave
thread:109458
URL: http://www.dr-bob.org/babble/20020930/msgs/121986.html