Posted by Ritch on February 2, 2002, at 15:13:43
In reply to Re: Mitch: r versus s!, posted by ben on February 2, 2002, at 10:10:56
> No. r-citalopram is supposed to responsible for the side-effects, at least for more side effects than s-citalopram. Thats why they leave the r-isomere away. Lilly is planning this with Prozac (fluoxetine) too.
>
>
> > I have always wondered about the "mechanism" of SSRI's being responsible for their antidepressant effects AND the side effects you get from sertonin reuptake inhibition versus the medicine itself that "happens" to be an SSRI.
> >
> > In other words, if the "R" isomer of citalopram is a therapeutic dud (depression, etc.-wise) and the "S" isomer is responsible for the therapeutic effects. Could it also mean that the dud isomer causes *less* side effects than the active one because it doesn't do much to block 5-HT reuptake? In that case, there shouldn't be much therapeutic or side-effect advantage to taking escitalopram. The only advantage would be less medication for your liver to get rid of. I will try it and see as well and post the results.
> >
> > Mitch
Thanks, Ben. The proof will be in the pudding, so to speak. It would be interesting to see the results of twin trials (one with the R-isomer and the other with the S). It would be interesting to see what the discontinuation rates are...I just brought this up because I get the same side effects from *all* the SSri's for the most part. Some are worse for one side effect more than another-but they are fairly similar.
Mitch
poster:Ritch
thread:91928
URL: http://www.dr-bob.org/babble/20020131/msgs/92630.html