AboutNigel Simmons Expertise I am happy to answer general questions on medicines and hospital care. If possible, please use approved / chemical names rather than brands which are not internationally recognised.
Like all health professionals I am bound by a duty of care which prevents me giving detailed information about medication or treatment of people other than the questioner.
I will endeavour to help wherever possible or point towards more appropriate advice. If however your question crosses too far into patient confidentiality, I hope you will understand why I cannot answer your question.
Consider.. would you want me to discuss your care with a friend or relative without your knowledge?
Experience Registered as a UK pharmacist in 1982 and have worked in a number of hospital and health management posts around the UK. Formerly Chief Pharmacist for a 440 bed general hospital in Cambridgeshire.
Past/Present clients Previously Sysop on CompuServe UK Professionals forum.
Expert: Nigel Simmons Date: 3/28/2008 Subject: change of medication
Question my doctor has changed my monthly prescription of escitalopram I'm to citalopram I'm. I don't know if it is my imagination but I am starting to feel depressed and sad again. I have asked to go back on the escitalopram but he says there is no difference.The packaging seems to differ every time I pick up my prescription. I wonder where these tablets have originally come from and what rubbish am I putting into my body. I would like to come off these tablets but am afraid of the withdrawal symptoms, I have tried before. Amanda
Answer Amanda
In clinical terms there is no real difference between citalopram and eiscitalopram. The latter was introduced by the manufacturers as a means of protecting their profits as the original citalopram came to the market with a short patent life (so short period of exclusive business).
Citalopram is effectively a mix of the same drug but with "left" and "right" hand structures. In developing eiscitalopram, the makers effectively seived out one type which is less active and then sold the more active isomer as eiscitalopram.
As eiscitalopram is only the more active component, its dose is smaller than citalopram. Therefore, in switching back to citalopram the dose should be approximately doubled. If this is done, I would not expect any problems with switching. If however your doctor kept the dose the same, then you could understandably be getting a return of depressive symptoms (or deveoping signs of withdrawal).
Generic (unbranded) citalopram will be significantly cheaper than branded eiscitalopram, and this is quite probably the reason why your doctor made the change. As there will be many different manufacturers of generic citalopram, the packaging will vary.
