What drug is best?

[solly]

Hi all

Just a quickie, what drug is better for anxiety Fluoxetine or citalopram?

Thanks
Solly

[nomorepanic]

Well there is no right and wrong answer but personally for me Prozac never touched my anxiety - just the depression.

[alias_kev]

I wrote on this topic here (http://www.nomorepanic.co.uk/showpost.php?p=479849&postcount=3)
The UK seems especially obsessed with using SSRIs (predominantly anti-depressants) to treat anxiety. I think its because they and cheap and some have a benefit. Unfortunately they then seem to pick one at Random. If you go to emc.medicines.org.uk and look at the documentation then Fluoxetine makes NO anxiety claims: it's so not listed for GAD or anxiety its untrue! (Allegedly its good for depression, bulimina and OCD).
Of the two Citalopram has better anecdotes of helping but even it claims only:
4.1 Therapeutic indications

Treatment of depressive illness in the initial phase and as maintenance against potential relapse/recurrence.
Cipramil is also indicated in the treatment of panic disorder with or without agoraphobia.
So it doesn't actually claim GAD or broad anxiety.

Its more expensive cousin Escitalopram does claim GAD, but the NHS dislike it as its 10x as expensive and contains the same active ingredient (but NOT the biologically active 50% wrong chemical thats in Citalopram!). If you can get it I'd suggest Esc' as better for GAD than Cit'.

My linked thread does include most of what I could find about proper meds for anxiety.

The flip side of this is that Drs don't really know whats actually wrong with our individual (or group) brain chemistry and mostly they don't even know HOW most of the meds work or benefit us. So any medication is really a random test to see what helps you (like Nik said).

[CJH86]

From personal experience ive had both of these drugs. In a Pharmacological sense Fluoxetine is more of a 'dirty' drug and citalopram is more specific (to put it simply) ultimately both drugs have the same biological outcome. Citalopram theoretically would have the least side effects out of the two!

When someone in diagnosed with anxiety and the Doctor thinks that there is underlying depression, they will treat the depression initially rather than the anxiety....that is where the fluoxetine will come in. Undoubtably its a very effective drug for depression! I think some doctors do assume because you have anxiety you are depressed, yes in in a lot of cases one potentiates the other but by no means always.....personally fluoxetine didnt touch my anxiety either and it gave me anger issues.

Citalopram liscensed for depressive illness and panic disorder as mentioned, not for GAD. But i can say i know several people who have GAD and claim the drug has changed their life. From the evidence ive seen on pharmacology journals and elsewhere id say citalopram was the better drug! It didnt work for me either as had the one in a million side effect and cant take any SSRIs.

Im not a big fan of some doctors approaches to prescribing in general! Im very familiar with the NICE guidance algorithms and know it states dont treat panic disorder with benzodiazepines....i have Panic disorder and my doctor sends me away diazepam every time :doh:

[tom1]

Funnily enough, the first med I was prescribed for my anxiety was Fluoxetine. I remember for the first week it made me very, very happy and quite energetic and then on the second week, I was extremely anxious, nauseas, and could barely function. Needless to say, not long after I came off it.

Citalopram on the other hand in my experience was far more effective for my anxiety, but it made me more depressed. I'm not sure how exactly but I just didn't care about anyone or anything. I was also sleeping every opportunity I could. I was also eating everything in sight.

Paroxetine was the by far the most effective, it works tremendously well for my anxiety and good for my depression. I actually stayed on this for a very long time until it pooped out on me.

Sertraline claims to treat anxiety or so I read somewhere and I was switched to this after Paroxetine. I can't really say whether this helped much - certainly when I compare it to Paroxetine the benefits seemed quite small. It also strangely gave me some headaches, made me have worse insomnia and slightly paranoid.

I'm now on Venlafaxine which is somewhat similar to Paroxetine in terms of its effectiveness in treating anxiety. I'd say it works nearly as good but I have more 'off' days that good ones. But, when it is working good, it works good. I get more side-effects on this med than Paroxetine though.

[Cassa63]

I was put on Murelax yesterday for the short term. I have a visit to a cardio specialist tomorrow and I'm petrified. It was bad enough yesterday just visiting my doctor.

Carol.