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Thread: Citalopram to escitalopram

  1. #1
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    May 2015
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    Citalopram to escitalopram

    Hello. I’ve been in a bad place in the recent months. Doc has moved from 20 citalopram to 15 escitalopram as he thinks it might work better for my anxiety. I’ve been on citalopram for 4 years. It’s been helpful but it’s always made me grind my teeth. I’m fretting about the switch. Anyone else switched?

  2. #2
    Join Date
    Jan 2017
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    Re: Citalopram to escitalopram

    Quote Originally Posted by Mr Polite View Post
    Hello. I’ve been in a bad place in the recent months. Doc has moved from 20 citalopram to 15 escitalopram as he thinks it might work better for my anxiety. I’ve been on citalopram for 4 years. It’s been helpful but it’s always made me grind my teeth. I’m fretting about the switch. Anyone else switched?
    Citalopram and escitalopram share the same active drug. Celexa (citalopram) is made up of two isomers, the 'S' form of citalopram, which is the active component, and a 'R' mirror image form which is a poorer fit biologically and so is mostly inactive. Lexapro (escitalopram) is more refined and only contains the 'S' isomer.

    However, this small change often produces differences in the side-effects each med produces. No guarantees, but given this is an easy switch with rarely any downsides it is worth a shot.

    Another thing which may help with SSRI induced teeth grinding (bruxism) - if you can get your GP to prescribe it which can be difficult - is adding a small dose of buspirone (Buspar). Buspirone is a GAD specific med which works for some, but not at all for most, however, when taken with SSRIs and other serotonergic antidepressants it often reduces the ADs side-effects, including bruxism and sexual dysfunction. It also often increases the effectiveness of these meds. It will likely take 2-3 weeks to become effective.
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  3. #3
    Join Date
    May 2015
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    62

    Re: Citalopram to escitalopram

    Quote Originally Posted by panic_down_under View Post
    Citalopram and escitalopram share the same active drug. Celexa (citalopram) is made up of two isomers, the 'S' form of citalopram, which is the active component, and a 'R' mirror image form which is a poorer fit biologically and so is mostly inactive. Lexapro (escitalopram) is more refined and only contains the 'S' isomer.

    However, this small change often produces differences in the side-effects each med produces. No guarantees, but given this is an easy switch with rarely any downsides it is worth a shot.

    Another thing which may help with SSRI induced teeth grinding (bruxism) - if you can get your GP to prescribe it which can be difficult - is adding a small dose of buspirone (Buspar). Buspirone is a GAD specific med which works for some, but not at all for most, however, when taken with SSRIs and other serotonergic antidepressants it often reduces the ADs side-effects, including bruxism and sexual dysfunction. It also often increases the effectiveness of these meds. It will likely take 2-3 weeks to become effective.
    Thanks pdu. That’s helpful. Just worried about the switch and increase in s form increasing my anxiety even further at the mo. I’m already taking diazepam 2x 5 per day to help with accute feelings but will mention buspirone if teeth grinding continues. Ta

  4. #4
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    Re: Citalopram to escitalopram

    Quote Originally Posted by Mr Polite View Post
    I’m already taking diazepam 2x 5 per day to help with accute feelings
    Definitely take the diazepam if you need it, but avoid doing so 'just in case' as benzodiazepines inhibit the process by which ADs work.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

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