Posted by dr dave on October 3, 2002, at 2:44:58
In reply to Re: Logic and evidence » dr dave, posted by yeltom on October 2, 2002, at 15:52:34
I'm not suggesting there was no such study - that's why I quoted it and discussed the meaning of its results. Nor am I suggesting the study is fraudulent. What I am suggesting is that 'instructing' psychiatrists to treat escitalopram as four times as potent by weight does not bear examination when you look closely at the evidence. If there has been another study apart from the Burke study which indicates this, I would be glad to know of it.
I have used citalopram extensively for many years and it is extremely useful. I am waiting for convincing evidence, or one independent body to review the evidence and state there is a significant difference, before using escitalopram. It is a generally accepted principle (at least with the psychiatrists I know) that you don't start using new drugs unless a case can be made for doing so. I don't think the case has been made. This appears to be the opinion of all four independent bodies that I know of which have reviewed the data.
> The study that Forest did and that the FDA oversaw indicated that 10 mg Lexapro was equivalent in antidepressant effect to at least 40 mg. (Are you suggesting that there was no such study and that Forest's claims are fraudulent?) This is why psychiatrists (American ones at least) have been instructed to prescribe at a 1 to 4 ratio. And so far, it seems to be working. It's the patients who've been prescribed at a 1 to 2 ratio that are reporting problems. That's why I'm comparing 10 and 20 mg lex to 40 and 80 celex. I thought it was strange at first as well and certainly did not expect to feel any changes when I switched meds. The hypothesis is that the inactive isomer inhibits the effectiveness of the active one. Have you tried both drugs?
poster:dr dave
thread:109458
URL: http://www.dr-bob.org/babble/20020930/msgs/122077.html