brr

[lilamp]

winter blindsided us all of a sudden like. the butter i leave out on the counter for spreadable softness is hard. :( i have three blankets on my bed.

bz halloween party was lots of fun for the most part, then i spent a while stuck in a painful place inside my head, then finally (in conversation with colin) i found enough peace to sleep, which helped quite a bit. still, there's a lot roiling about inside of me, thoughts and emotions that are difficult to deal with, that i sometimes wish desperately i could cut out of me or run away from, but that i know can only be satisfied by building my own inner strength. it's lonely and isolated inside my head, and nobody else can get in there to keep me company... i let down my walls rarely, but too much perhaps, leaving a gaping hole that i don't yet know how to fill on my own. i get easily frustrated, but i know that it's a long process, and i'm optimistic that i'll get there someday. yar.

lexapro is not on the drug list for my insurance. grumble. pharmacy will call and see if my doctor's office can get it approved.

time for sleep.

Comments

[spider88.livejournal.com]

I'm pretty sure that the biggest difference between Lexapro and Celexa is marketing. Celexa is likely to be on your insurances formulary. 'Course, I'm just now reading your journal, and you might have a good reason for Lexapro over Celexa.

[valdelane.livejournal.com]

Celexa was a mixed-enantiomer formulation. Once they figured out that only the S-enantiomer was doing any good (the R accounting for most of the adverse effects), they released the S-e as Lexapro.
--more-- (http://www.lexapro.com/mediacenter/background/isomer_science.asp)

[spider88.livejournal.com]

Nearly all pharmaceuticals - heck nearly anything at all - contain mixed-enantiomers, with one the enantiomers active, and the other half usually inert.

They are marketing this as a whole new drug, when it's really their processing methods that are new, not the substance.

I'm skeptical that the Rs were responsible for the adverse effects, since most side-effects of SSRIs are due to the rise in serotonin itself. Which, by the way, heavily implies that it's not lowered serotonin that causes depression, but less sensitive specific serotonin receptors. Then the other serotonin receptors get harder hit, and you get lowered sex-drive, GI trouble, and such. Celexa's big claim to fame was that it hit only specific receptors, and consequently had a much lower side-effect profile that other SSRIs.

In fact the web page you include doesn't say that the R enantiomer of Celexa was causing trouble. It just says "In some cases, one enantiomer of a drug molecule may have a therapeutic effect while the other enantiomer may have no useful effect or an undesirable one." Some cases... a drug...may.. or...

Here's a factiod - there are eight chiral centers in cocaine. If just of them were oriented the opposite direction, it wouldn't make you high. Funny, I think that's the only thing I remember from 2nd semester OChem. :)

[lilamp]

i don't think they're marketing lexapro as a "whole new drug," although i haven't seen much of the marketing so i dunno. everything i read just said that it was derived from celexa, requires a lower dosage, and therefore had less incidence of side effects. *shrug*

[spider88.livejournal.com]

i don't think they're marketing lexapro as a "whole new drug,"

Sure they are. What's the point of giving it a new name and getting a new patent? That was the whole reason for doing so. New patent, more money.

requires a lower dosage, and therefore had less incidence of side effects. *shrug*

It requires a lower dose because half the filler has been removed. It's like drinking 8oz of juice in 8oz of water, or just drinking the 8oz of juice. Same amount of juice, sugar, calories - same effect on the body. That's not going to give you less side-effects.

I just thought I'd bring it up since your insurance doesn't cover Lexapro. They are likely to cover Celexa.

[lilamp]

> It requires a lower dose because half the filler has been removed.

heh, good point.

as far it being a new drug, i mean, yes they just took out the bit of celexa that was important, but it does have a different makeup. juice and water is not the same thing as just juice, especially if the water has lots of minerals in it, say... i just didn't see that they were really trying to say "hey this is an all new thing!" they're pretty clear on it just being taken from celexa.

anyway, if my insurance doesn't want to approve lexapro, i'm sure my doctor will say to go with celexa instead.

[lilamp]

ok actually celexa isn't covered either. insurance company wants me to go with prozac unless it is "proven ineffective" in which case they might cover the lexapro. hm.

[valdelane.livejournal.com]

GaaaHHH. I hate hate hate that insurance companies get to say which treatments are appropriate. It should be entirely in the discretion of the dr.

[lilamp]

yah, it is the sucky suck. i don't really want to go on prozac... i talked to my doctor and she did not seem optimistic about getting the insurance company to authorize anything not on their list unless i'd tried pretty much everything that was, but i will talk to her again about my concerns and see what happens. blah. i have some prozac in the medicine cabinet now at any rate, heh.

[valdelane.livejournal.com]

Well, at least you have something with which to do a, say 1 month, check if you have a serotonin depletion issue. That will be valuable data. Whether or not prozac turns out to be the right one for you in the longer term is a different matter, obviously.

[lilamp]

now that there is a very good point. if the prozac ssri action doesn't do it for me, side-effects aside, then certainly the others wouldn't either, so at least i will know!