AboutDr Alan Galbraith Expertise I can answer most questions on drugs, both medical and "recreational". Answers can be given in either technical or layperson terminology. My main areas of interest are psychiatric, gastrointestinal and cardiovascular drugs.
Experience I have been a university lecturer/head of department for almost thirty years, but am now retired. My research interests were alcohol, smoking and cardiovascular disease.
Organizations Institute of Biology, London.
Publications Author of "Fundamentals of Pharmacology" 5th Edition published in November 2007 by Pearson Education, Australia.
Question Thank you for that great information.
I often wonder if some Dr's and Pharmacist don't know
the answers or if they are too busy to bother and simply say the same type of things to everyone so they go away. :-/
This made me think of another question and I hope you don't find it rude of me to ask..
Last year a Dr prescribed Vistaril to me for anxiety attacks,
The Rx he wrote said Vistaril/Hydroxyzine, after he knew I am deathly allergic to all antihistamines. (I always have to make it clear and double check before I leave any office)
The name alone sounded suspicious to me so I asked if it had an antihistamine in it.
The Dr told me "yes it did" but "Its a different kind of antihistamine"
"Don't worry".
I decided to trust him and I took one. (Stupid mistake on my part)
I got tired and fell asleep.. figured it would do that much, but I woke up
in the middle of the night right in the midst of some psychotic episode & panic attack and on top of that I couldn't breath .. couldn't even feel water running on my hands..
I was a mess and had to go to the ER gasping for air.
What do you think about the "Its a different kind" statement I was given?
Is there really a different kind of antihistamine in there or did I just have some sort of side effect over-load in general?
It's very interesting to learn about these medications and I thank you very much (again) for your time.
(You just might be leading me into a carrer path for medicine after all this lol)
~Dawn
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Followup To
Question -
Hi..
I was on 20 mg of Celexa for 2 weeks, then the Dr changed me to 10 mg Lexapro, The Lexapro gave me a skin rash of red dry patches so I asked to change back.. The Dr said not to bother b/c they are the same medication only made by different companies... well I went someplace else and went back on 20 mg Celexa and was fine again.
when I asked at the Pharmacy, the man told me, they are the same medication but the patent ran out on Celexa so another company started making Lexapro
with a different filler in it.
Just what is the story between these 2 meds?
Can you tell me if there is a difference between Celexa and Lexapro?
and if the difference is just a filler .. what the heck is it so I can avoid getting more itchy red spots in the future.
Thanks so much for your time.
~Dawn
Answer -
Dear Dawn
An excellent and important question (in my opinion). Lexapro is escitalopram and Celexa is citalopram and as you see from these generic names they are similar but not the same. The easiest way too differentiate between them both and the way I tell students is to think of citalopram being the same as a box of both right and left hand gloves. You can easily sort them out into their correct category but try to describe the difference between the left handed ones and the right handed one in words. Not an easy task. Escitalopram is the right-handed glove but citalopram is both the left and right-handed one. The body can tell the difference and it is said by some that the escitalopram is better than the citalopram but many hotly dispute this. They cannot be considered to be the same; this is wrong never mind about the excipients (fillers).
The same manufacturer makes them both (Lundbeck) and I am giving you the manufacturers short list of adverse effects and you can see even they are not identical.
Both can cause an allergic rash but this is not common and it seems you will be more allergic to the escitalopram than the citalopram. I really think your pharmacist and prescriber should be more knowledgeable about these drugs as both gave you wrong information. My advice would be to go back to the Celexa and inform your prescriber of your knew knowledge which is better than theirs'.
Regards
Dr Alan Galbraith
Answer Dear Dawn
It was a rather sweeping statement to say that hydroxyzine is a different type of antihistamine. There are different groups of antihistamines the sedating and non-sedating and the H1 and H2 antagonists. Both the sedating and non-sedating are H1 antagonists in that they act mainly on the tissues to slow down the immune response which is related to allergies. The sedating types also cross into the brain causing the sedation. The non-sedating do not enter the brain and thus are non-sedating eg Claratyne (loratidine). Hydroxyzine is strongly sedating. The H2 antagonists act mainly on the stomach and stop acid being produced and are thus used in the treatment of ulcers eg Zantac (ranitidine)and are useless in allergies.
All antihistamines are different chemicals but have one thing in common in that they stop histamine from producing its effects in various parts of the body. As they are all different there effects vary somewhat but are generally very similar in their action. Hydroxyzine is one of the most strongly sedating ones but in some people it can have the opposite effect and cause insomnia. Your doctor was technically correct in saying that hydroxyzine is a different kind of antihistamine but so is every one of them. Morphine is a narcotic analgesic, pethidine (meperidine) is a narcotic analgesic but they are not the same therefore it saying that it is different type of analgesic is correct as they are different drugs (chemicals).They are all distinct entities but a statement such as this can be very misleading to the general public as it makes one think they are very different from the others. In my opinion such statements are wrong because of what may be perceived by the patient. In pharmacology all drugs are grouped according to there action on the body but they are all different otherwise we would not need so many, (we do have too many!!).
I hope that this makes some sense to you and does not confuse you further. I do not know your level of understanding pharmacology and have tried to simplify it as much as possible while still retaining scientific accuracy.
