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[daisyaday]

Hi all,

I've been taking Lexapro very successfully for about 5 years now. Due to a change in insurance companies, I'm being required to try less expensive alternatives, starting with Cytalopram (Celexa). My depression was mild to moderate when originally diagnosed and the Lexapro has been a godsend. I rarely suffer from serious or long-lasting symptoms when I'm on it.

Any thoughts as I go to the new medicine this week? I guess I'm just worried about stopping something that has worked so well. I did try something different once and my depression returned, but at a much worse level that included some very dark thoughts.

Thanks,
Daisy

[voxprincipalis]

Celexa is the same fundamental medication as Lexapro, but it's the other isomer. You shouldn't notice much of a fundamental change -- you may feel some side effects more or less strongly but I'd be surprised if you noticed a huge difference.

VP

[daisyaday]

Thank you. I'm not familiar with isomers, but I did note they are both SSRIs, so your words are encouraging.

Daisy

[greyscale]

I agree with VP that it's fundamentally the same, so it shouldn't be a bad transition. But one reason some people prefer Lexapro to Celexa is that Celexa sometimes has more side effects. Celexa is a mix of two stereoisomers of a molecule (mirror images of each other). The synthesis process makes both isomers at the same time. One is useful as an SSRI, and the other isn't. The other isomer interferes a little bit with the useful one, but it's generally assumed to be harmless. Some people think the mirror image molecule causes some of the side effects, though. Lexapro is made using a more complicated process that only results in the functional isomer. So the active ingredient is exactly the same.

Based on my friends' experience (I've only taken Celexa, not Lexapro), I wouldn't worry too much about changing but I do have one friend who found Lexapro to be much better for her. If you do have worse side effects, will your insurance approve Lexapro as an alternative?

[daisyaday]

Thank you for the information. I think I will avoid looking up the side effects so that I don't prejudice myself. Taking Celexa would certainly be a major savings. I would pay $6/month for it rather than $50 for the Lexapro.

I may be asked forced to try as many as three different alternatives to Lexapro, but yes, they would eventually approve it if nothing else works for me.

I am trying to remember that I'm fortunate to have both a job and insurance in this economy.

I should also mention that I do not have any side effects of which I am aware on the Lexapro.

[greyscale]

Best of luck! And do something fun with the money you save! I was fine on Celexa, for what it's worth.

[daisyaday]

Thanks Greyscale! I'm picking up the new Rx tonight. Maybe I'll go see Harry Potter, too!

[zuzu_]

FYI, I was "forced" to do something similar with another type of prescription drugs (PPIs), even though I know I am weird and one works A LOT better than the others. My doctor's office knows this, and they just gave me samples of my preferred PPI while I supposedly "tried" the other meds. Their idea--not mine.

[darkside]

You have every reason to be concerned. When I was forced by the Health Care Nazis to change meds a few years ago, I ended up in the hospital for a week and went through 8 months of depressive hell. Once the college admin found out I had a mental illness, they started giving me unjustified poor reviews that even mentioned my mental health status in the text, which is of course, illegal. They began making demands that I move into the district, even though I had never lived in those tiny towns in the ten years I had worked there. They even bribed my students to drop my courses in exchange for a tuition-free course of their choice the following semester so that they could cite me for poor retention and "lack of student satisfaction" in spite of very positive student evaluations.

Yes, this was all illegal. Yes, I could have sued. Do you know what happens to people who sue employers? They find themselves unable to ever get any job anywhere. Before one sues an employer, he or she must be very sure that the settlement will provide full financial support for the remainder of his or her life.

Fortunately for you, it is the insurance company and not the college itself that forcing the change. Document EVERYTHING. Most shrinks have inventories that ask questions that determine levels of depression. Get copies and fill them out DAILY. Inform your shrink, who probably hates being dictated to by insurance companies, that you are documenting and charting your illness and inform him or her that you will call and report each day you suffer symptoms. Record the calls. In other words, prepare a STRONG case if you suffer symptoms so you have grounds to sue the insurance company.

If at all possible, do not let the college know you have a mental illness. I expected that educated, intelligent people would understand bipolar disorder for what it is: a physical illness that can be controlled with medication, just as diabetes can. I was wrong. Educated does not mean enlightened and reasonable.

[daisyaday]

Darkside: Thank you for sharing your story. I'm so sorry you had to go through this.

Update: I am doing very well on the new medicine. I haven't noticed anything different. I also saw in the news yesterday that Lexapro will  have a generic alternative in March of next year. So I will have that option if my reaction to the new medicine changes. For now, I am perfectly happy.

Thank you everyone for the feedback and information!