![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1310 to 1334 of 8406. Go back in thread:
Posted by Kairos on November 22, 2002, at 17:04:53
In reply to Re: New user, posted by Roger Santiago on November 22, 2002, at 15:45:51
My GOD Man - My heart goes out to you! Did you ever - ever take this to the media? Would you PLEASE do so now? Even tho it is years later - this is CRUCIAL!
The general public needs to know of the abuses and God Syndrome of Physicians - This COST YOU physical function AND negatively affects your life quality!
Please respond - even if via my personal e-mail: [email protected]. I am in a professional ield that is closely related and am seriously hoping you WILL contact a media outlet for this story!
In Sincerest Regret & Hopes For Repairation -
Kairos
> > I too am a new user 4 days. I felt great for day 1-3, but today I had an intense feeling that I was on fire thoughout my body. (Lasted 20 minutes)Even my hair folicles expeienced a burning feeling. Is this normal?
> Dear BuzzLightyr:
> since im new here i do not know if you asked me or were asking somebody else to comment on the intense feeling you experienced feeling you were on fire. I do not think it is unusual for people who experience a severe episode of nerves/anxiety.
> In the late 1980's, I communicated to a Fam. Dr., that i was having intense and sudden anxiety. Well in a heartbeat, he nodded yes and told me it was a panic attack, left the exam room bless his heart and brought me a magazine article on that subject and how the body or its muscles release
> "lactic acid" which causes a burning and uneasy feeling. The recommended treatment by that particular MD who authored the article was to get on Xanax doses of 4mg daily minimum and take it "religiously" my Fam Dr., advised me and gave me samples and wrote a script for 120/ 1 mg tablets with 5 refills. I figured it was non-addicting/non-controlled. I had never heard of it and was introduced to this med., as a specific remedy for panic attacks. I continued to read the article and it also had Inderal listed with Calan both heart meds., so I stayed away from those and
> "religiously" took the Xanax even if I felt well
> like the doctor directed me. When I called a pharmacy to ask if it was a benzodiazepine after I felt relaxed, the pharmacist answered in a technical manner stating "NO. Its a triazolobla-bla. I could not understand it all but was positive I was not taking tranquilizers and felt good about myself. In 1988 many FamDr's were talking about Xanax helping depression !!!! So I figured I was taking a new smart drug state of the art for my panic disorder. But what happened when this patient took 4mg, Xanax daily as directed and filled each of the 5 refills authorized with religious precision as directed ran out and did not think twice of more "therapy"?
> When I was running out of pills, the last thought on my mind was suffering any degree of withdrawl.
> I started to feel detached, sweating, feeling hinky and my whole body started twitching badly.
> I went to a late clinic not wanting to bother my regular Dr. The Physician there was astonished when I showed him the Xanax 1mg., 4 tabs, per day quantity 120 supply for 6 months. I finally finally learned it was scheduled Rx and it was addictive. I asked the temp/ Physician if he would or could ween me off as I had no desire to continue medicating for the sake of suppresing withdrawl. The Physician's demeanor changed and
> spoke in a sarchastic tone advising me that he was going to do for me "something he would not do for a member of his own family". He wanted me to fill 10 (ten) tabs of 0.25mg to take twice a day steadfastly to avoid serious withdrawl, that could
> result in a critical convulsion. Some form of triazolobenzodiazepine withdrawl he planned. I soon realized I was duped and that this Physician
> was not prescribing a therapeutic dose to start a
> legitimate weening process. The Physician, was taking advantage of my will asking me to return every 5th day after 8 p.m., to receive a refill of
> 8 (eight) more tabs., and stretch them over 5 days
> I was charged $57.00., for each visit and was having a 2 tab reduction every 5th day to 6 (six)
> tabs for 5 days as it was my responsibility to make the pills last and pay my $57.00. The fourth visit and 20 days later, I was still twitching and
> now stuttering. I get an Rx for 4 (four) 0.25mg tabs and held to the make them last 5 days cut-in half if need be away he goes and I am charged $57.00 again. Fifth visit, while a nurse is taking my blood pressure she opens up and in so doing gives me a speech about how that clinic has
> to turn "seekers" of 'prefered medications" and it is so obvious the nurse states, that I have been going to the clinic every 5 days to get more
> of my prefered sought medication because I was an addict to Xanax and would do "GOD knows what for it" !!!! ???
> I was embarrased. Felt foolish and disgusted with
> myself for trusting that Physician who was acting
> in bad faith and treated me like a rag of the dope addict "I was hot on the seeking trail for a coupple of 0.25mg Xanax tabs." Suffering from serious neurologic twitches, spasms and stuttering and summoning all the tranquility i could to prevent what felt like my brain having electric sensations, that would end with my body
> having one whole quick body twitch so intense I jumped. I could not beleive that either the nurse and specially the Physician would follow that line of beleifs based on receiving a prescribed course of 1mg Xanax tabs, w/ 5 refills and authorization by my usual doctor to take 4mg a day. If I was intent on the theory of seeking drug behavior for Xanax, why would I keep returning to the Physician taking advantage of my
> steadfast will to withdraw and cease another repeat of neurological symptoms caused by that RX
> Once the nurse purged her soul about her theory
> about me and my motives, I got up, went to the window to pay before the Dr., came in to write a
> 2 tab quantity 0.25mg strength Xanax. I was charged $57.00 again. I saw a business card dispenser with the name of the Medical Director, took one card and soon I showed up at an alternative Medical Clinic, with the same Medical Branch, where the Director/Physician was substituting. It was a commercial chain of Med-Clinics. I made him aware through a receptionist of who I was and my purpose for visiting him, When I was asked what the purpose of my visit to
> the Director/Dr., was, I advised the staff to tell the Director, that I traveled an appreciable distance in hope of discussing a verbal grievance regarding an affiliate Physician, who endangered my well-being at a crucial time, when I was relying on a course of therapeutic medical care .
> Furthermore, that despite that fact, the Physician in question continued to endanger my well-being after the initial visit in which I furnished answers to questions asked of me and
> listed my Chief Complaint clearly & further provided my medical history in detail w/ medical diagnosis rendered by my usual doctor , medication he prescribed, dosage, strength and quantity and exhibited the duplicate labels reflecting my information plus the Name of my regular doctor, business address, phone numberand explained I chose not to telephone my regular doctor because regardless of my medical urgency,
> it would require a visual examination due to the nature of twitching muscles and neck spasms visible to the eye. When I sat in the Office of the Director/Physician, I provided my picture
> DL, a report from the State police which reflects
> No moving citations and No arrest record. Also, a copy of a document reflecting my authorization for said Physician to contact my regular doctor,
> if he so desired. Finally, I furnished the Director/M.D., with a photocopy authored and printed by the Medical State Board setting forth
> minimal standards of medical practice, that should be rendered in the presence of listed symptomology which was entirely consistent with
> my Chief Complaint. In closing, I refered to another section of the Medical Practice Act, which described step by step in plain English, how
> to examine a patient given visible symptoms, that
> when considered in whole that a patient advises
> the attending Physician of material value that can be reasonablly ascertained for medical reasons it is incumbent upon the attending to act
> accordingly with the intent to form therefrom a
> plan therapeutic in medical nature that is reasonably medically expected based on medical education, training and or experience to comfort a patients in medical distress by effective means,
> primarily implimenting the utilization of pharmatherapeutic agents which are recognized for the potential therapeutic value and benefit to a
> patient who can be releived of physical pain,
> psychological fear or disturbance, trauma, immediate sedation for emergency intubation of an airway where invasive procedures or surgical intervention is indicated or obstetrical emergencies arise with similar urgency and require
> similar administration of pharmacological agents
> for the constant medical goal of prescribing a therapeutic course of medecine to any patient in medical need. The out dated bias and prejudice held against MMP and are therefore deprived of additional analgesia is subject to disciplinary
> action, including but not limited to XYZ. The medical standard and scope of medicine has branched out to the treatment of chronic non-malignant pain, if a patient so chooses and requests a pain management physician, although any
> medical practitioner can provide immediate relief
> for a patient in pain. Addiction medicine will be
> observed in its protocols and medical treatment
> offered to voluntary patients as well as Parole
> Officer and or Court mandate for a specified period of time. After advising the Director of the medical facts in my case, the manifestations
> visible neurological disturbance such as the twitching of several muscles including my neck and
> the latent speech disturbance, I was sent to a
> neutral neurology practice who determined that the failure to provide adequate doses of Xanax for
> the purpose of gradually weening me off was negligent and reflected incompetent treatment of
> a patient. EEG and other studies show damage to
> certain portions of the brain ( aseries of small strokes it was explained ) due to the failure to control the neurological complications expected from the abrupt withdrawl of benzos or triazolobenzos. The Physician was reported to the State Board by his peers. The disbelief this
> neglect and conduct caused affected field agents resulting in the promptual paging by a State Board Officer to a local field agent assigned to
> the area I was mistreated. The field agent visited me in record time, left me a yellow legal pad to record my treatments and resulting problems
> were verified through interviews with neurologists
> and several major investor Physicians from the chain of medical clinics. The chain was fined 20K
> and the incompetent physician who would not even offer to do the favorfor his Mother that he did
> for me was suspended 2 years , fined $25K and was
> ordered to attend a series of medical courses prior to being eligible for reinstatement. I hope this helps somebody, anybody from the same nightmare.
Posted by Mr.Scott on November 22, 2002, at 17:43:49
In reply to Re: So what's the scoop on anxiety and Lexapro? » Mr.Scott, posted by ayuda on November 22, 2002, at 16:31:22
Yeah...unfortunately I think you're right. When it's all said and done after futzing around for over a decade I generally have wound up feeling a bit more numb, more tired, fatter, and still feeling like sh*t. I suppose if I could afford to stay in bed all day and didn't mind ballooning up then maybe psychiatry could claim me as a success by numbing me out, but really I can do that on my own with alcohol and drugs anyways if i want. Unfortunately not everyone can be Anna Nicole Smith.
I could do a much better job of being a psychiatrist than any I've ever had the general displeasure of doing business with. I'm not good at Algebra or Geometry and I'm sure my shrinks have been, but alas one day the AMA and APA will finally understand that the qualities they test and train their physicians in have almost zero clinical relevance and that they have done little other than create a bunch of crappy shrinks!
Scott
Posted by JLM on November 22, 2002, at 17:44:45
In reply to Re: really crazy, posted by Roger Santiago on November 20, 2002, at 12:11:20
> Celexa is the first SSRI Ant-dep., I could tolerate from 20mg to 40mg. However, after being
> on Celexa 40mg at bedtime for slightly over 2 months, I have not noticed improvement of sleep patterns, "feeling good", appetite..... Its like a
> dry drill. The only other ant-dep., I can tolerate
> is trazodone at bedtime. Here again, after 6 weeks of taking 100mg to 150mg at bedtime for over 6 weeks, I feel no better. I have developed
> daily anxiety with agoraphobia since starting the
> Celexa and later taking the trazodone. I had a sample of Serzone 100mg., and was confident I would benefit and or tolerate it due to its close
> chemical relation to trazodone. I was wrong . The serzone caused visual problems the day after with vertigo. What would be a way to manage the daily anxiety and agoraphobia ? I can not even go to the doctor , sit in the office then wait to be
> seen due to the severity of this anxiety.Hey!
Did i hear you right when you said that you developed these anxiety symptoms AFTER being on Celexa? If so, your pill may be your problem.
Since you can't seem to tolerate drugs, I would suggest a book:
The Feeling Good Handbook by Dr. David Burns.
www.feelinggood.com
This has been of enormous help to me.
Before you balk, Burns has a PhD in psychiatry.
Good luck :)
Posted by emmalie on November 22, 2002, at 23:55:04
In reply to Re: So what's the scoop on anxiety and Lexapro? » ayuda, posted by Mr.Scott on November 22, 2002, at 0:32:29
has anyone out there ever taken Celexa and Effexor at the same time?
Posted by pharmrep on November 23, 2002, at 15:19:16
In reply to Believe It or Not! Switching from one to another., posted by Mr.Scott on November 21, 2002, at 23:55:12
>
> Any SSRI or Effexor will substitute perfectly for one another. You should be able to go right from Effexor or Paxil to Lexapro without any withdrawal or uneasiness. And then I suspect but have not confirmed Lexapro is easier to taper than Effexor or Paxil. It's all about short half life and the brain experiencing too rapid a change. Prozac withdrawal in minimal only because it lasts sooo long.
>
> Scott*** SCOTT...have you ever heard of "discontinuation syndrome" or "withdrawal side effects?" Ask any Dr. who has had patients on Paxil or Effexor, and had them switch to something else...they will undoubtedly say it exists..particularly for these 2 drugs....In fact, GSK is in court right now regarding the "addictiveness" of Paxil because it is so difficult for a person to stop taking it due to the side effects. Not everybody will experience it, but a majority of the people do. As for Prozac, Celexa, Lexapro...you can stop without a taper, and start another without the "withdrawal" problem.
Posted by dragonfly on November 23, 2002, at 16:23:45
In reply to New user, posted by BuzzLightyear on November 21, 2002, at 18:27:39
i have been on lexapro for a little over a week now. I only wake up once at night(always around 4am)now. I was only sleeping for 3 hours at a time to begin with.I still feel depressed but I haven't had any crying spells for a couple days now. My question is has anyone had any problems with UTI's
Posted by dragonfly on November 23, 2002, at 16:26:09
In reply to New user, posted by BuzzLightyear on November 21, 2002, at 18:27:39
i meant urinary tract infections
Posted by Mr.Scott on November 23, 2002, at 17:09:35
In reply to Re: Believe It or Not?/ Switching..SEE BOTTOM » Mr.Scott, posted by pharmrep on November 23, 2002, at 15:19:16
You can go from Effexor or Paxil to Lexapro without ANY withdrawals. It's about serotonin receptors being up and down regulated too quickly. There's no magic other than half life length.
Posted by Alan on November 23, 2002, at 18:22:32
In reply to Re: Believe It or Not?/ Switching..SEE BOTTOM » Mr.Scott, posted by pharmrep on November 23, 2002, at 15:19:16
> *** SCOTT...have you ever heard of "discontinuation syndrome" or "withdrawal side effects?" Ask any Dr. who has had patients on Paxil or Effexor, and had them switch to something else...they will undoubtedly say it exists..particularly for these 2 drugs....In fact, GSK is in court right now regarding the "addictiveness" of Paxil because it is so difficult for a person to stop taking it due to the side effects. Not everybody will experience it, but a majority of the people do. As for Prozac, Celexa, Lexapro...you can stop without a taper, and start another without the "withdrawal" problem.
================================================
http://www.guardian.co.uk/Archive/Article/0,4273,4201752,00.htmlI will try to find the other AD's on this list but besides the two mwntioned ALONG with Prozac, it seems, according to the World Health Organisation, there are more problems with the euphemistically termed "discontinuation syndrome" (withdrawal) than one might perhaps be aware of.
Alan
Posted by pharmrep on November 23, 2002, at 19:40:26
In reply to Re: AD withdrawal » pharmrep, posted by Alan on November 23, 2002, at 18:22:32
>
> > *** SCOTT...have you ever heard of "discontinuation syndrome" or "withdrawal side effects?" Ask any Dr. who has had patients on Paxil or Effexor, and had them switch to something else...they will undoubtedly say it exists..particularly for these 2 drugs....In fact, GSK is in court right now regarding the "addictiveness" of Paxil because it is so difficult for a person to stop taking it due to the side effects. Not everybody will experience it, but a majority of the people do. As for Prozac, Celexa, Lexapro...you can stop without a taper, and start another without the "withdrawal" problem.
> ================================================
> http://www.guardian.co.uk/Archive/Article/0,4273,4201752,00.html
>
> I will try to find the other AD's on this list but besides the two mwntioned ALONG with Prozac, it seems, according to the World Health Organisation, there are more problems with the euphemistically termed "discontinuation syndrome" (withdrawal) than one might perhaps be aware of.
>
> Alan
>
>***** euphemistic? Do you think I made this topic up? This is a big deal these days...maybe more of a hot topic than sexual side effects.
Posted by Geraldo Quesada on November 23, 2002, at 20:03:19
In reply to Re: Wish I could, posted by Scit on November 21, 2002, at 19:41:47
After using Luvox for 2 months, I still had sexual side-effects, but like the mellowness it created. I also experience some weird ticks when going to sleep, but nothing big.
The doctor switched me to Zoloft, which made me very nauseous the first few days, and I still had serious sexual side effects.
I have now been on Lexapro for 2 months and I am really amazed! I feel great. The fatigue and high anxiety has gone away. The side effect is waking up at 3:30AM instead of 5:30 AM, but even that went away after the first few weeks. No sexual side effects.
This really shows that different SSRIs really affect people differently. I am now calm, much more collected, and not always losing my train of thought. It is wonderful. What a miracle!
Posted by JaneB on November 23, 2002, at 22:26:43
In reply to Re: AD withdrawal » Alan, posted by pharmrep on November 23, 2002, at 19:40:26
There are definite "withdrawal symptoms" with many ADs. But doctors label the same symptoms when tapering off benzos as "addiction" withdrawal. It is just calling the same predicament by different terms.
I am still hesitant to switch from celexa to lexapro but I am watching threads closely to see if celexa tiredness is remedied with lexapro. I keep my dose so low that I sometimes wonder if the tiredness is from depression or side effect of celexa. Hearing that others have the same problem is reassuring.
JaneB
Posted by Alan on November 24, 2002, at 2:18:43
In reply to Re: AD withdrawal » Alan, posted by pharmrep on November 23, 2002, at 19:40:26
> >
> > > *** SCOTT...have you ever heard of "discontinuation syndrome" or "withdrawal side effects?" Ask any Dr. who has had patients on Paxil or Effexor, and had them switch to something else...they will undoubtedly say it exists..particularly for these 2 drugs....In fact, GSK is in court right now regarding the "addictiveness" of Paxil because it is so difficult for a person to stop taking it due to the side effects. Not everybody will experience it, but a majority of the people do. As for Prozac, Celexa, Lexapro...you can stop without a taper, and start another without the "withdrawal" problem.
> > ================================================
> > http://www.guardian.co.uk/Archive/Article/0,4273,4201752,00.html
> >
> > I will try to find the other AD's on this list but besides the two mwntioned ALONG with Prozac, it seems, according to the World Health Organisation, there are more problems with the euphemistically termed "discontinuation syndrome" (withdrawal) than one might perhaps be aware of.
> >
> > Alan
> >
> >***** euphemistic? Do you think I made this topic up? This is a big deal these days...maybe more of a hot topic than sexual side effects.
++++++++++++++++++++++++++++++++++++++++++++++Gee I didn't think that would be taken personally - but here goes anyway....
Regarding the use of AD's in the treatment of anxiety disorders - and significantly, depression that's commonly being driven by a primary evaluation of anxiety disorder (if the evaluating doc has the skill to recognise the difference):
The pharmecutical co's have "wordsmithed" this phenomenon into the medicaleese lexicon since the test results that showed that these withdrawals were in truth actual withdrawals (and were not presented to the FDA as such since the results of those test results were thrown out) the companies had to come up with something to call it instead of "withdrawal". If you're going to compete with drugs that are off patent and that produce the dependence/withdrawal phenomenon (bzds) then you're going to have to come up with some pretty newwords to describe essentially the same thing so marketing will not be by definition, legally contradictory.
"Poop out" - another euhpemism for "tolerance" is similarly being dressed up to be something other than tolerance.
Most AD's have a worse complaint rate about "discontinuation syndrome" than any of the bzds (bzds being the boogey man drug that the pharmecuticals are trying to take the market share away from in the treatment of anxiety disorders), claiming to be non-habit forming or non-addictive.
People need to choose their meds according to what works best in their own case. SSRIs and benzodiazepines are both serious medicine. Both types of medication can cause the user to develop tolerance, requiring periodic increases in dosage to maintain effect, although that is certainly a minority experience. Both types commonly require weeks or months of gradual tapering to discontinue comfortably. Both types can (rarely) make someone so dependent that discontinuation feels next to impossible.
The success rate in anxiety disorders is higher for benzodiazepines, but a number like that has only predictive and statistical value. It is pretty much irrelevant in any individual case, since what works is what works.
The complaint rate for dependence is currently much higher for SSRIs (in fact, globally the absolute numbers are unprecedented in recorded medical history), but that's probably the result of overoptimistic expectations created by misleading marketing. The manufacturers' unpublished rates of withdrawal in trials with healthy volunteers were equivalent to those for benzodiazepines.
Bottom line: dependence is a wash. Neither type of drug can claim dependence doesn't happen. If a case is serious enough or sufficiently biological in manifestation to require medication, the medication should be chosen according to individual response.
In regards to drug-seeking behaivor:
As long as doctors are pushing an SSRI at every patient who even looks at 'em cross-eyed, there's not going to be any opportunity to observe drug-seeking behavior. In fact, what they see right now is SSRI-avoidant behavior in anxiety disorders.
But let the doctors start withholding SSRIs and doing all they can to get people off of them (a day that may well come), and then we will see drug-seeking behavior from people who might even prefer to be off but can't possibly quit over the two week period now recommended as a taper.
Of course it is always important to remember that differences in individuals' reactions to antidepressants are so big that it is difficult to state meaningful generalizations about the statistical difference between one anti-depressant and another.
I guess "Lexapro" sounds better for sales of the drug than "CelexaMinus," which would more accurately describe its chemical relationship to Celexa. It's just Celexa with the less active molecular isomers purified out.
Of course now they're trying to say all the side effects resided in the removed components and all the therapeutic effects reside in the remaining component. (As though all effects could be absolutely categorized as either "therapeutic" or "side," but that's another issue.) Such a convenient coincidence is highly unlikely from a biochemist's perspective, since most of the biological activity of any kind resides only in the component that remains in Lexapro. A lot of the putative difference between the two drugs is carefully orchestrated statistical noise.
Finally, in order to keep revenues up, Lexapro doesn't give you anything you weren't already getting in Celexa, it's just sort of "purified". By doing that, they can get a new patent for what is essentially the same medication. And by investing many times as much money in marketing as they do in development, the drug companies can convince an amazing number of naive doctors that Lexapro actually IS newer, better, and amazingly free of most of the others' side effects and withdrawal phenomena that have emerged with all previous miracle drugs for the mind.
And speaking of side effects, get a load of the statistics cited on for instance sexual dysfunction. You wonder how a doctor can cite numbers like that without smirking all the way to the bank. He HAS to know they're fictitious. He can't be that blind to his own patients. Can he?
The whole thing is pretty close to putting new paint on an old pill and selling it again. The makers of Prozac tried to do the same thing but had to abandon it before getting to market because the "purified" Prozac turned out to cause dangerous heart arrhythmias.
The patent on Prozac was close to expiring and its manufacturer was scrambling to hold on to revenues and came out with a "new" prozac to treat PMS.
It makes you think. If they can get a patent on Prozac Weekly, the same active ingredient as normal Prozac in a different delivery matrix, they're not patenting medications -- they're patenting the physical pills!!!
So why don't they just patent something like a 2 mg (or whatever size) pill of every med to begin with? Then when that patent is about to expire, they can "invent" a 1 mg pill and patent that as a new medication that needs only half the dosage of the old one. Hell, with enough money spent on marketing, they can probably persuade tens of thousands of doctors that the 1 mg pill has less than half the side effects of the old, obsolete, addictive 2 mg pill.
It's a good thing for the drug companies that the FDA exists to keep a short leash on the patent office and other arms of government. Otherwise all kinds of rational thinking might break loose.
To make a profit these days, the co's have to differentiate. The best way to do that within a single class of drugs is to claim to have fewer side effects. Because of a serious loophole in our laws about drug research, they just keep doing trial after trial until they figure out how to get some of them to come out as desired. Then they negotiate with the FDA about what trials to include and how to summarize them in the prescribing info.We need to change our laws so that as part of the price for approval of a drug, *ALL* studies on its use in humans (at the least) get placed into the public domain...no matter what you hear information here to the contrary. That way it won't be as easy to make distorted claims. For instance, the public and the FDA have seen only a small fraction of SKB/GSK's studies on Paxil. In the majority of them it worked worse than placebo to a statistically significant degree*. At least that's what plaintiffs in one of the class-actions suits alleged, promising to provide supporting evidence. It just shouldn't be legal to hide things like that. And now that scandals like the HRT and cox-2 inhibitor surprises are emerging (i.e. it affects more than just us "head cases") I think there's some chance the regulatory environment may change.
=============
* Still, that's an average response. It doesn't negate the fact that some people respond and some of those respond extremely well. Statistical truth and statistical inference, important as they are, have considerable limits. The closer you narrow it down to an individual case, the fuzzier the picture gets until there is no statistical picture at all when dealing with a sample of one. Just because the number of people doing well on a drug is less than the number doing well on placebo does not prove that all those people are experiencing a placebo effect or spontaneous remission. Some of them may very well be experiencing a bona fide pharmacologically therapeutic effect. It's just that one can't prove it statistically. With the right tools, one could hypothetically prove it chemically or by doing repeated double-blind crossover trials on one or more individuals.Alan
Posted by dr. dave on November 24, 2002, at 4:38:06
In reply to Re: AD withdrawal » Alan, posted by pharmrep on November 23, 2002, at 19:40:26
Dear Pharmrep,
Good to see you back! The idea that Lexapro has fewer side-effects than Celexa seems to be floating around again. I presented the most recent and accurate data on this a while back and invited your comments. I may have missed them so forgive me if I am needlessly repeating myself, but it would be good to be clear about your views on this.
> The relative side-effects of Lexapro and Celexa are as follows
>
>
> Side effect..........................Lexapro..............Celexa
>
> Headache............................15.8%..............19.9%
> Nausea................................15.0%..............17.2%
> Ejaculation disorder..............9.3%(of men)...8.8%
> Insomnia..............................9.2%................8.6%
> Diarrhoea.............................8.0%...............10.8%
> Somnolence.........................6.9%................4.7%
> Mouth dry............................6.2%...............8.1%
> Upper resp tract infection.....6.2%...............3.9%
> Dizziness..............................6.0%...............5.6%
> Flu-like symptoms................5.0%...............6.1%
> Rhinitis.................................4.9%...............5.6%
> Sinusitis................................4.3%...............5.1%
>
>
> 'Overall, the type and frequency of TEAEs (treatment-emergent adverse events) reported with escitalopram and citalopram were very similar, and are in line with AEs reported for citalopram previously. For the TEAEs listed (above) there were no statistically significant differences for incidences of these events between the escitalopram and citalopram treatment groups.'
>
>
> This is the official information from Lundbeck about relative side-effects. I wonder if you still stand by the comments that Lexapro has fewer side-effects than Celexa, and that Celexa causes somnolence while Lexapro does not?
>
>
Posted by ayuda on November 24, 2002, at 12:20:36
In reply to Side-effects - best data » pharmrep, posted by dr. dave on November 24, 2002, at 4:38:06
The worst side effect I had from Celexa, and the number one reason I had to go off of it, was a feeling of what I called "disconnection." That is, I felt like I wasn't part of the experiences I was going through. It's kind of hard to explain, but it isn't one of those things that is usually listed from any study, because you can't measure it physically. I just felt like I wasn't there, that my "self" had left me. If anyone has ever seen Jerry Seinfeld's stand-up routine about being in a NYC taxi-cab -- or if you've ever been in a NYC taxi-cab -- it's a similar thing: you know you are there, and (intellectually) that you are part of the experience, but emotionally or psychically you are just watching.
So my point is this: my doctor (a psychiatrist) is under the impression that Lexapro has NONE of the side effects that Celexa has. From Dr. Dave's post, I can see that that is not true, and in some cases (such as insomnia) it has a higher instance of adverse effects. When I told my doctor last week that several people on this site have been experiencing insomnia, she said that that has not been her experience. I don't know who else she has on this medication, or how comfortable they are with telling her about their s/e's, but I think that she is buying into the idea that this medication has NO s/e's, and will be unwilling to listen to my complaints about it. Especially if I start to experience that disconnection again.
Does anyone have any experience with the side effect I am talking about, or something similar? What are the chances that it is something that I will also find in Lexapro? I know that that is an unfair question, but I am also not all that knowledgeable about what s/e's the scientists think are not a part of Lexapro that are present in using Celexa -- I have read the website for the medications, etc., and still don't have a clue. I am a PhD student and my mom's a nurse -- if I can't figure out what these things are saying, I can't imagine what anyone who is less familiar with this kind of information will get out of it.
> Dear Pharmrep,
>
> Good to see you back! The idea that Lexapro has fewer side-effects than Celexa seems to be floating around again. I presented the most recent and accurate data on this a while back and invited your comments. I may have missed them so forgive me if I am needlessly repeating myself, but it would be good to be clear about your views on this.
>
> > The relative side-effects of Lexapro and Celexa are as follows
> >
> >
> > Side effect..........................Lexapro..............Celexa
> >
> > Headache............................15.8%..............19.9%
> > Nausea................................15.0%..............17.2%
> > Ejaculation disorder..............9.3%(of men)...8.8%
> > Insomnia..............................9.2%................8.6%
> > Diarrhoea.............................8.0%...............10.8%
> > Somnolence.........................6.9%................4.7%
> > Mouth dry............................6.2%...............8.1%
> > Upper resp tract infection.....6.2%...............3.9%
> > Dizziness..............................6.0%...............5.6%
> > Flu-like symptoms................5.0%...............6.1%
> > Rhinitis.................................4.9%...............5.6%
> > Sinusitis................................4.3%...............5.1%
> >
> >
> > 'Overall, the type and frequency of TEAEs (treatment-emergent adverse events) reported with escitalopram and citalopram were very similar, and are in line with AEs reported for citalopram previously. For the TEAEs listed (above) there were no statistically significant differences for incidences of these events between the escitalopram and citalopram treatment groups.'
> >
> >
> > This is the official information from Lundbeck about relative side-effects. I wonder if you still stand by the comments that Lexapro has fewer side-effects than Celexa, and that Celexa causes somnolence while Lexapro does not?
> >
> >
>
Posted by Alan on November 24, 2002, at 13:44:21
In reply to Re: Side-effects - best data » dr. dave, posted by ayuda on November 24, 2002, at 12:20:36
Posted by Mr.Scott on November 24, 2002, at 14:35:27
In reply to Re: Side-effects - best data » dr. dave, posted by ayuda on November 24, 2002, at 12:20:36
I think this thread will serve as a fine place to insert my fiery rhetoric...
Some psychiatrists are stupid (even though they excel at algebra & geometry).Some pharmreps are interested only in commissions generated from scripts written for their drug. They are tenaciously persistent sociopaths disguised as helpers (yet are actually minions). They are line items in a marketing budget and human advertising vehicles sent from evil and self-serving corporate entities.
Look at all they provide with extreme caution and generality. The doctors conducting the studies are 'generally' without conscience.
You will do best to be your own doctor in many ways. How many of you are so passionate about your jobs that you would be comfortable letting people entrust their lives to you. Do you think these wise scholars are any different?
Don't let them (MD's and large corporations) make you fat, impotent, and sedated and then send you the bill. They are your employees. Make them do their job of making you feel better (numb and too full of side-effects to care doesn't count). If they can't do their jobs fire them and move on. Ultimately your destiny is in your hands. Do not relinquish it to the self-serving.
Posted by Kairos on November 24, 2002, at 14:47:18
In reply to Fiery Rhetoric, posted by Mr.Scott on November 24, 2002, at 14:35:27
"Fiery Rhetoric" OR Plain - UNVARNISHED TRUTH?
AMEN & AMEN Mr. Scott!
Thank you a million - trillion times over!
SMOOTCHES for this one!
PEOPLE - YOU ARE THE AUTHORITY!
HEAL - and don't be duped - let's DO our homeowrk and KEEP the AMA etc in LINE and honest - telling ALLL the truth - so that HEALING takes precedence and not a renewable market!
Consumer Driven Markets are Lacking ONE thing - The INFORMED "Consumer".
In Unity -
Kairos
> I think this thread will serve as a fine place to insert my fiery rhetoric...
>
>
> Some psychiatrists are stupid (even though they excel at algebra & geometry).
>
> Some pharmreps are interested only in commissions generated from scripts written for their drug. They are tenaciously persistent sociopaths disguised as helpers (yet are actually minions). They are line items in a marketing budget and human advertising vehicles sent from evil and self-serving corporate entities.
>
> Look at all they provide with extreme caution and generality. The doctors conducting the studies are 'generally' without conscience.
>
> You will do best to be your own doctor in many ways. How many of you are so passionate about your jobs that you would be comfortable letting people entrust their lives to you. Do you think these wise scholars are any different?
>
> Don't let them (MD's and large corporations) make you fat, impotent, and sedated and then send you the bill. They are your employees. Make them do their job of making you feel better (numb and too full of side-effects to care doesn't count). If they can't do their jobs fire them and move on. Ultimately your destiny is in your hands. Do not relinquish it to the self-serving.
Posted by Squiggles on November 24, 2002, at 15:07:08
In reply to Fiery Rhetoric, posted by Mr.Scott on November 24, 2002, at 14:35:27
If only it were so easy: the reason
why psychiatrists may not be able to
put you right again, is not because they
are necessarily any more stupid than
a brain surgeon. The reason (imho) is
complex:- the drugs are often new, poorly tested,
unpredictable, only seen on rats for a few
months;- the push to sell the drugs may be so urgent
that there has not been enough time to see
how this drug fares in the long run;- the psychiatrist does not know you as
intimately as your spouse or brother e.g.,
they do not know your idiosyncrancies -- what
is normal or not normal for your character- the diagnosis itself is at best a good guess,
as we do not have blood tests for mental illness
or anything quite so concrete, except in some
cases;- and matching the drug with the symptom is
like matching two colours to get the exact
hue of torquoise or majenta;So, "firing" your psychiatrist because he or she
does not fix your state, does not guarantee you
that the next shrink you employ will be of a
superiour calibre.Squiggles
Posted by dr. dave on November 24, 2002, at 15:46:01
In reply to Re: Side-effects - best data » dr. dave, posted by ayuda on November 24, 2002, at 12:20:36
The plain truth is that there are NO SIDE-EFFECTS that any scientific study has shown to be significantly less on Lexapro than Celexa. The scary thing is that while this is absolutely clear cut, and the research is available publicly, people are still being led to believe Lexapro has an advantage on this.
While it cannot be proved that you will definitely get the same disconnected feeling on Lexapro, it seems overwhelmingly likely. There is abundant evidence that the side-effect profiles are essentially identical (see below). So, do you judge for yourself on the basis of the evidence, or do you just go with what you're being told even though it makes no sense? It's up to you. You have the power (as does everyone else reading this) to refuse to accept being told what to believe and to find out the facts for yourself.
=======================================================================
> The worst side effect I had from Celexa, and the number one reason I had to go off of it, was a feeling of what I called "disconnection." That is, I felt like I wasn't part of the experiences I was going through. It's kind of hard to explain, but it isn't one of those things that is usually listed from any study, because you can't measure it physically. I just felt like I wasn't there, that my "self" had left me. If anyone has ever seen Jerry Seinfeld's stand-up routine about being in a NYC taxi-cab -- or if you've ever been in a NYC taxi-cab -- it's a similar thing: you know you are there, and (intellectually) that you are part of the experience, but emotionally or psychically you are just watching.
>
> So my point is this: my doctor (a psychiatrist) is under the impression that Lexapro has NONE of the side effects that Celexa has. From Dr. Dave's post, I can see that that is not true, and in some cases (such as insomnia) it has a higher instance of adverse effects. When I told my doctor last week that several people on this site have been experiencing insomnia, she said that that has not been her experience. I don't know who else she has on this medication, or how comfortable they are with telling her about their s/e's, but I think that she is buying into the idea that this medication has NO s/e's, and will be unwilling to listen to my complaints about it. Especially if I start to experience that disconnection again.
>
> Does anyone have any experience with the side effect I am talking about, or something similar? What are the chances that it is something that I will also find in Lexapro? I know that that is an unfair question, but I am also not all that knowledgeable about what s/e's the scientists think are not a part of Lexapro that are present in using Celexa -- I have read the website for the medications, etc., and still don't have a clue. I am a PhD student and my mom's a nurse -- if I can't figure out what these things are saying, I can't imagine what anyone who is less familiar with this kind of information will get out of it.
>
>
> > Dear Pharmrep,
> >
> > Good to see you back! The idea that Lexapro has fewer side-effects than Celexa seems to be floating around again. I presented the most recent and accurate data on this a while back and invited your comments. I may have missed them so forgive me if I am needlessly repeating myself, but it would be good to be clear about your views on this.
> >
> > > The relative side-effects of Lexapro and Celexa are as follows
> > >
> > >
> > > Side effect..........................Lexapro..............Celexa
> > >
> > > Headache............................15.8%..............19.9%
> > > Nausea................................15.0%..............17.2%
> > > Ejaculation disorder..............9.3%(of men)...8.8%
> > > Insomnia..............................9.2%................8.6%
> > > Diarrhoea.............................8.0%...............10.8%
> > > Somnolence.........................6.9%................4.7%
> > > Mouth dry............................6.2%...............8.1%
> > > Upper resp tract infection.....6.2%...............3.9%
> > > Dizziness..............................6.0%...............5.6%
> > > Flu-like symptoms................5.0%...............6.1%
> > > Rhinitis.................................4.9%...............5.6%
> > > Sinusitis................................4.3%...............5.1%
> > >
> > >
> > > 'Overall, the type and frequency of TEAEs (treatment-emergent adverse events) reported with escitalopram and citalopram were very similar, and are in line with AEs reported for citalopram previously. For the TEAEs listed (above) there were no statistically significant differences for incidences of these events between the escitalopram and citalopram treatment groups.'
> > >
> > >
> > > This is the official information from Lundbeck about relative side-effects. I wonder if you still stand by the comments that Lexapro has fewer side-effects than Celexa, and that Celexa causes somnolence while Lexapro does not?
> > >
> > >
> >
>
>
Posted by Geezer on November 24, 2002, at 15:47:34
In reply to Fiery Rhetoric, posted by Mr.Scott on November 24, 2002, at 14:35:27
WOW!! What an important and honest message. "You will do best to be your own doctor in many ways..." - how true that is. In fact, the patient would be well ahead of the game to rely on the anecdotal information found on this board as opposed to trying to reason it out with your average "in the dark psychiatrist". Once the patient comes to the realization that there is not one empirical medical test (PET and SPEC scans prove nothing and have no diagnostic value) in psychiatry, sooooo...everything from the DX forward is guess work and a "roll of the dice".
The drug companies are simply making a product as close to what they already have as possible. Big inovations risk too much legal exposure and the "powers that be in Washington" wouldn't approve the drug anyhow. Looking for altruism in the public or private sector is a waste of time - INCENTIVE is what is needed.
The most important point here is to "take controll of your own care", in psychiatry, no one else will.
Posted by Squiggles on November 24, 2002, at 15:56:02
In reply to Re: Fiery Rhetoric » Mr.Scott, posted by Geezer on November 24, 2002, at 15:47:34
I think that this is a very presumptuous
attitude, and maybe dangerous too. Why
should i know more than a doctor who has
studied this stuff for 20 years? And has
seen so many examples of patients.If there is doubt, and doctors are not
always right - they make mistakes - you might
do best to get a doctor who cooperates with
your knowledge found on the net regarding
your case, as mine did.I think playing your guessing game can land
you in really hot water, unless you are a
Scientologist or a Shaaman or something like
that, who has access to spiritual strength.
Squiggles
Posted by JLM on November 24, 2002, at 16:02:31
In reply to Re: Side-effects - best data » dr. dave, posted by ayuda on November 24, 2002, at 12:20:36
Dear Sir,
I believe what you are describing is termed 'depersonalization'. I had the same thing happen when I took Prozac. Like you say its somewhat hard to describe. For me it was like watching a movie of my day to day life, rather than participating in it myself, if that makes sense.
I'd get another doc personally. The idea that there is ANY drug out there that has 0 SE's is just plain nut.
On a side note, I predict that Pharmrep will never address the issue of SE frequency, at least not in our lifetimes ;)
Posted by ayuda on November 24, 2002, at 16:08:17
In reply to Re: Side-effects - best data - get a new doctor... (nm), posted by Alan on November 24, 2002, at 13:44:21
Unfortunately, not that easy. I am graudate student, living on a 12K/year stipend, in Miami, not a cheap city. I use the university's health services because I only have a $5 copay -- I would have to pay out-of-pocket for a shrink otherwise. And even though my mental health is important, and worth the money, so is electricity and having a working telephone. And trust me, I am that financially strapped that one visit with another doctor would be the difference between lights and no lights. So I have to work with who I have access to.
Posted by Mr.Scott on November 24, 2002, at 16:10:37
In reply to Re: Fiery Rhetoric » Geezer, posted by Squiggles on November 24, 2002, at 15:56:02
Studied what for twenty years...how to exploit sick people? Is that why the best treatment and the only one that anyone seems to be excited about hass usually just been approved by the FDA!
In the last 20 years almost everything has been completely turned on it's head almost twice anyways. How many people have suffered at the hands of ineptitude or the fad of the times?
My advice is that you better know what you have and what might benefit you before you walk into a shrinks office. Otherwise you're liable to spend a great deal of time and money getting nothing but added misery and weiight at your own expense.
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