mild depression treatment

[somuchmore2]

OK

I thinking I need to do something about this on-going rut. HCV for 36+ years, first knew it 1997, treated twice, had a bleed, waiting for transplant or a better treatment solution. Acholol free since 199t, but the stresses of life just keep me awake and on edge most of the time. I do it all however more and more it just seems like a job and everything is just another  task.

Enough of that my question is what are pro/con's on antidrepressent drugs.

Is Citalopram which is sooo much less cost than Lexapro just as good for us HCV patients?

Liver is stage 4...but functional.

What are other choices to feel better and sleep better?

[somuchmore2]

Understood.

Thank you,

[Marcia2202]

I just wanted to stress again that the generic name for Lexapro is not Citalopram

The generic name for Lexpro is Escitalopram

Citalopram is the generic name for Celexa

Two different drugs, but closely related

[somuchmore2]

Very helpful and thank you.  I've contacted my TP center they're OK with me taking either of these so confirms your understanding.

The price at WalMart for Citalopram is only $4 so guess I'll try it first.

Again thanks,

[eureka254]

I don't believe there's any significant difference between the two; when it was prescribed to my husband, the nurse did say some insurances would give better prices on the generic, but either one was ok for him to take.  (Our particular insurance didn't have a price difference, so the pharmacy filled it as Lexapro.)

My husband had been on Lexapro about 3 months when he was started into the transplant evaluation process, and him being on an AD didn't appear to have any impact on the TP evaluation.  I don't know if the fact that he's also on inf/riba treatment makes a difference, but when he put Lexapro on his medication list, no one blinked an eye.  I do know some TP centers have their own idiosyncracies and guidelines, but Lexapro didn't seem to be of issue with my husband's TP center.  Hope that helps. ~eureka

[somuchmore2]

Thanks.

I'm seeing several people take Lexapro rather than the generic Citapram which I still do not understand. Is it really better for you husband?

The other bigger question I have is how are drugs treatment for depression and/or general anxiety disorder view be transplant teams. Not certain if my loss of feelings areo bad I would want to complicate any transplant discussions.

Do you reckon anyone here has a view about transplant and these SRRI drugs?

[Marcia2202]

Lexapro is Escitalopram and
Celexa is Citalopram.

I was put on Citalopram while on treatment. According to studies I've read, it is supposed to be the most suitable for clinical depression while on treatment.

I don't know about off treatment.

Here is a link for the comparison of the two:

http://www.ncbi.nlm.nih.gov/pubmed/15160261

Escitalopram versus citalopram: the surprising role of the R-enantiomer.
Sánchez C, Bøgesø KP, Ebert B, Reines EH, Braestrup C.

Research and Development, H. Lundbeck A/S, Ottiliavej 9, 2500 Valby Copenhagen, Denmark. ***@****
RATIONALE: Citalopram is a racemate consisting of a 1:1 mixture of the R(-)- and S(+)-enantiomers. Non-clinical studies show that the serotonin reuptake inhibitory activity of citalopram is attributable to the S-enantiomer, escitalopram. A series of recent non-clinical and clinical studies comparing escitalopram and citalopram to placebo found that equivalent doses of these two drugs, i.e. containing the same amount of the S-enantiomer, showed better effect for escitalopram. These results suggested that the R-citalopram in citalopram inhibits the effect of the S-enantiomer. OBJECTIVE: To review the pharmacological and non-clinical literature that describes the inhibition of escitalopram by R-citalopram, as well as the implications of this inhibition for the clinical efficacy of escitalopram compared to citalopram. METHODS: The information in this review was gathered from published articles and abstracts. RESULTS: In appropriate neurochemical, functional, and behavioural non-clinical experiments, escitalopram shows greater efficacy and faster onset of action than comparable doses of citalopram. The lower efficacy of citalopram in these studies is apparently due to the inhibition of the effect of the S-enantiomer by the R-enantiomer, possibly via an allosteric interaction with the serotonin transporter. Data from randomised clinical trials consistently show better efficacy with escitalopram than with citalopram, including higher rates of response and remission, and faster time to symptom relief. CONCLUSION: The R-enantiomer present in citalopram counteracts the activity of the S-enantiomer, thereby providing a possible basis for the pharmacological and clinical differences observed between citalopram and escitalopram.

[eureka254]

My understanding is that Citapram is simply the generic form of Lexapro.  My husband has cirrhosis and he was given the green light to take either (currently on Lexapro).  It's made him feel better, though it's hard to say whether or not it's made him sleep better.
Hope that helps.