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Originally Posted by cybermember
Is celexa *really* similar to lexapro?
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Celexa (citalopram) is a mixture of two molecules that have the same chemical formula but are mirror images of each other. Lexapro (escitalopram) is a pure forumula of just one of these molecules. So, yes, they are chemically very similar, and Celexa is actually "half" Lexapro since it contains both molecules. Even though they are chemically so similar, they can have different effects. The study below shows more people with depression respond to Lexapro (76%) than to Celexa (61%). In addition people on Lexapro showed higher decreases on a scale that measures depression (depression index decreased 22.3 pts) compared to Celexa (depression index decreased 20.4 pts). To me, this latter difference seems negligible. If you do well on Lexapro and want to save money, I think there is a good chance Celexa would work well too. However, you just have to try--there are no guarantees, as everyone's biochemical make-up is different.
http://www.ncbi.nlm.nih.gov/pubmed/15812262
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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.
Pre-clinical studies, active-control clinical trials and meta-analyses indicate that escitalopram (S-citalopram) might be more effective than citalopram, the racemic mixture of S- and R-citalopram. The present study aimed to confirm the superior efficacy of escitalopram over citalopram. A double-blind, randomized clinical trial was performed in which general practitioners and psychiatrists compared fixed doses of escitalopram (20 mg/day) with citalopram (40 mg/day) over 8 weeks in outpatients with major depressive disorder (MDD) [baseline Montgomery-Asberg Depression Rating Scale (MADRS) score > or =30]. Primary efficacy parameter was change from baseline to last assessment in the MADRS total score. Out of 138 (aged 44.1+/-10.9 years; initial MADRS score 36.3+/-4.8) and 142 (aged 46.2+/-11.1 years; initial MADRS score 35.7+/-4.4) evaluable patients who were randomized to escitalopram and citalopram, respectively, six and 15 withdrew prematurely (P=0.05). The MADRS score decreased more in the escitalopram than in the citalopram arm (-22.4+/-12.9 versus -20.3+/-12.7; P<0.05). There were more treatment responders with escitalopram (76.1%) than with citalopram (61.3%, P<0.01). Adjusted remitter rates were 56.1% and 43.6%, respectively (P<0.05). Tolerability was similar in both groups. This randomized double-blind trial confirms that escitalopram has a superior effect to citalopram in MDD.
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