From Escitalopram to Citalopram

[apricot75]

Hello everyone,

after 12 years escitalopram (first 10mg then 20mg ) does not work anymore and my psychiatrist has proposed me to go to citalopram (40mg).
Has anyone experienced this switch?

thank you, im very scared

[Victory2016]

Yes I did a switch a few years back from Celexa to Lexapro (opposite of you). I had no problems switching. I did not wean off the Celexa I just stopped taking it and starting taking the lexapro. I did have some minor side effects, but not as bad when first starting. I was on 20mg of Celexa and started on 10mg of Lexapro then went up to 20mg after a couple of weeks.

Are you on any other medications like a benzo or beta blocker?

Don't be scared you will be ok! There is a great group of people here to help and support you.

[Shazamataz]

I swappwd from citalopram to escitalopram at one stage a while back and didn't have any adverse effects.

[Mojo61]

What is the difference between the two?

[apricot75]

I do not understand if escitalopram no longer work how may Elopram can work again as it is a mixture of escitalopram + the same molecule but different chirality . you have changed from citalopram to escitalopram because citalopram was not working anymore ? how long you took citalopram before changing and why?

[MyNameIsTerry]

Escitalopram differs because it is the "left hand" molecule whereas Citalopram is "racemic" which means equal values of both the left and right molecules. The left and right are equivalent to reach other in their make up but occupying a different space in time. It's like a mirror image.

How that translates into being better is complicated unless you find an article that explains it to people like us and not a chemist!

Something to remember is that SSRI's ara a class of meds. They all differ to each other. If they didn't, they would all be the same drug within that class and switching between them would make no difference.

The difference is a finer point to look into. For instance, SSRI's are known to work on Serotonin as their primary action but they also have lesser impacts on other neurotransmitters (and their receptors) too. There is also the matter of selectivity to the Serotonin transporter (the protein shuffling it along).

In the case of Escitalopram, it is the most selective to the Serotonin transporter compared to the Norepinephrine transporter, which is said to lower the side effect profile.

With Escitalopram it is also supposed to increase it's potency because of how it binds to something else, that Citalopram doesn't, hence the lower dosage. I can't say I understand that part and from what I can tell, research has been contradictory so they still don't know themselves.

Escitalopram also kicks in quicker.

It's basically an update just without the daft names that Android give theirs!

[apricot75]

Escitalopram differs because it is the "left hand" molecule whereas Citalopram is "racemic" which means equal values of both the left and right molecules. The left and right are equivalent to reach other in their make up but occupying a different space in time. It's like a mirror image.

How that translates into being better is complicated unless you find an article that explains it to people like us and not a chemist!

Something to remember is that SSRI's ara a class of meds. They all differ to each other. If they didn't, they would all be the same drug within that class and switching between them would make no difference.

The difference is a finer point to look into. For instance, SSRI's are known to work on Serotonin as their primary action but they also have lesser impacts on other neurotransmitters (and their receptors) too. There is also the matter of selectivity to the Serotonin transporter (the protein shuffling it along).

In the case of Escitalopram, it is the most selective to the Serotonin transporter compared to the Norepinephrine transporter, which is said to lower the side effect profile.

With Escitalopram it is also supposed to increase it's potency because of how it binds to something else, that Citalopram doesn't, hence the lower dosage. I can't say I understand that part and from what I can tell, research has been contradictory so they still don't know themselves.

Escitalopram also kicks in quicker.

It's basically an update just without the daft names that Android give theirs!

Yes but I have to switch from esctalopram to elopram because escitalopram after 13 years no longer works. it makes sense to switch to Elopram ?

[MyNameIsTerry]

Yes but I have to switch from esctalopram to elopram because escitalopram after 13 years no longer works. it makes sense to switch to Elopram ?

It's still a different SSRI within that class of meds so it makes as much sense as swapping to another one like Sertraline, unless the med you are swapping to is because of something it is needed specifically for (e.g. some switch because one may work better for OCD, for example).

[apricot75]

It's still a different SSRI within that class of meds so it makes as much sense as swapping to another one like Sertraline, unless the med you are swapping to is because of something it is needed specifically for (e.g. some switch because one may work better for OCD, for example).

so if escitalopram no longer works the alopram can work even if similar molecule?

My problem is OCD + Anxiety and Panic, the switch can be useful?

[MyNameIsTerry]

Yes. SSRI's are quite similar to each other but doctors switch people between them if one doesn't work or gives intolerable side effects and a person can find a different SSRI works better for them. So, when they stop working, it's a matter if trying others in that class to see if they work. If not, they can opt for something like SNRI's instead or an atypical like a NaSSA and beyond into other older meds if needed.