Cipramil? Cipralex? which one?

For all those (I know you are one Scott) who have tried Cipramil, can you tell me which one you used and how did it affect you.

I have a friend who has this MAV and has done really well over the last two years with Cipralex. They asked her to try a generic one (I have just emailed her to ask her which one this was) and she was dizzier and nauseous. They put her back on the above and she was fine again.

I was given Citalopram last time and had instant migraine which lasted until I stopped the tablets.

For those of you on these pills, can you say the name of the one you are on and if someone had bad side effects, which one you were on. Because of the success my friend and others have had with this, I think it may be worth another go, but I would like to know I am trying the correct one.

Thanks

Christine

Hi Christine,
I know Scott will respond, but he was on the name brand in AU. I tried the generic here in Las Vegas, and I got more dizzy/anxious…Scott told me the same thing happened to him …I guess name brand vs. generic really can make a difference.
I have had some break though dizziness and more anxiety for some unknown reason…I’ve had a pretty good run on Cymbalta, but I either need to take it up, or add something to the mix.
Good luck to you!!
Kelley

Hey Christine,

When citalopram (the non-trade name) is manufactured it produces what is called a “racemic” mixture of molecules. The two citalopram molecules that result are called steroeisomers. The best way to illustrate this is to think of your hands as stereoisomers. They are mirror images of each other when placed palm-to-palm. The same thing happens when they make citalopram. One citalopram molecule is called the S enantiomer (version) and the other is the R enantiomer.

When citalopram is packaged in its racemic state, that is, both S and R versions of the molecule, it is called Cipramil or Celexa. The dose of one full pill is 20 mg.

It turns out that only one of the enantiomers is active and the other one – the R version – does nothing. It may increase side effects but I’m not sure. They have now been able to isolate only the active molecule, or the S enantiomer, which is called escitalopram. The shelf name for this one is either Lexapro or Cipralex. Not surprisingly because the extra molecule has been removed, Lexapro is stronger at the same dose as Cipramil and so the full pill is 10 mg. Apparently, the activity of Lexapro is 4X higher then Cipramil and so it may be possible to get the same effect on 5 mg of Lex as you would on 20 mg of Cip.

I was able to take Cipramil without any increased anxiety, however, I was dizzier on it at first for about 2-3 weeks and then it was a MAV killer. Unfortunately, it also caused me increased neck pain and migraine headaches, not to mention weight gain and a libido hit at 15 mg. I tried Lexapro twice thinking a cleaner version would be better but I could never get past the startup. It caused massive anxiety unlike Cipramil. Strange. Right now I’m on very lowdose Paxil and wanting to try Prothiaden again.

Scott 8)

Thanks Kelley, Scott,

Not sure about the Cipralex being any better for me either. I tried Cipramil years ago and had the same instant migraine for days as I had with it recently.

I think the prothiaden would be a good bet Scott, out of over 20 preventatives I have tried, it was one of the handful I could tolerate years ago although I did have a bit of trouble with it more recently, but didnt give it a fair go this time.

I got up to about 150 mg on it and it knocked out the heads. I remember feeling tired on it and a bit depressed but that could have been because we were trying to adopt from abroad at the time. In the end, it stopped working. Definitely another one I was thinking of trying again though.

Christine

Christine – maybe you and I share a similar migraine physiology. We both seem to get a lot of the same aches and pains from this which seems like fibro or ME and we both get headaches from Cipramil. I think you’re the only other person I’ve come across who has that reaction too. It’s a bummer because it did work for me in killing the visual vertigo and all of the other vestibular crap. Slept well on it too as long as I had a dose in the morning and not before bed. But the damned pain was too much to handle.

S

Scott,

We do seem to get the same reactions to the same drugs.

I should have some news on the ME scene soon. I will let you know.

Christine

Just had an answer back from my friend regarding which one caused her problems and which one makes her feel good.

She had been on Cipralex for ages, feeling good and they swapped her to Citalopram, she felt really bad on it, she has been swapped back to Cipralex and it took 4 weeks and she is back to hardly any dizziness, even the muscle pains and fatigue are a lot better on it.

Looking at your post Scott, bit confused here, are you saying that Cipralex is Citalopram? I want to try and get this clear in my mind as I was given Citalopram and had instant migraine but my friend is so good on Cipralex I am wondering whether to go and ask for this, or will I be making a fool of myself as its exactly the same thing :oops:

Christine

Hi Christine,

Yes, the active molecule in both drugs is identical; the only difference is the citalopram has the non-functional “R” enantiomer in it. In other words think of this analogy: A citalopram pill contains millions of copies of both your right and left hand in the mixture on a microscopic level. But only your left hand has the antidepressant properties you want. When they manufacture escitalopram (Cipralex) they remove the non-functional right hand (both molecules are mirror images jsut like your hands) and just leave the left hand in the mix.

So, it’s probably that even though the non-functional R version of the citalopram molecule does nothing for migraine or depression, it might still be causing a nasty side effect – headache. It therefore makes more sense to use Cipralex instead of Cipramil. The problem I had with Cipralex (also Lexapro) was that it was so much stronger in this purer verison that I found it near impossible to start up on. It put a rocket up my butt every time whereas this effect did not occur on Cipramil.

This non-headache effect your friend mentions certainly makes me wonder if I should have had another go and stuck it out. Cipramil gave me rotten headaches and pain.

Hope the above is clear.

Scott 8)

thanks Scott - i am still hoping to get to try Celebrex (that’s the citalopram i guess) i hope it doesn’t have too many side effects. i’m hoping it’ll help with anxiety.

so many drugs it’s amazing.

thanks for the info

chris

Chris, I think Celebrex is an anti-inflammatory, not the same thing.

Thanks for clearing this up Scott. So it appears that the Cipralex is a cleaner version of citolapram, its got the active ingredient needed without the extra stuff thats not needed that might well be causing side effects. After all the preventatives I have tried, it is now a case I think of going back to the handful that I was able to tolerate to some degree and maybe take a low dose of two, something they have never done with me in the past. Might just have to try it myself. Seems Luke is doing OK on Cipramil and Sandomigran for instance.

Christine

Yeah, Celebrex is used for arthritis and inflammation – different deal Chris although they do sound similar.

You’ve got it sorted Christine … Lex is a cleaner version.

I’m thinking about trying 8 mg of Prothiaden tonight. :shock:

Duh! Brain fog i guess or brain something!

Celebrex - no idea why i wrote that. I think this being sick is really getting to me. i’m so messed up right now.

I’m gonna try one or the other i hope. Celexa seems like fewer side effects after reading patient’s storiees on Druglib.com

interesting site.

one or the other in super low dosages maybe i can start with

Good luck on the Pro tonight Scott - let us know how that goes.

Never heard of that before

chris

Hey Chris,

I was thinking about your fear of taking meds this morning and wondered if you could explain what the fear is if you’re up for it? If you can try to put your fear into words and actually face what it is, you may find that it’s really nothing like your mind is making it out to be. Think about what it is exactly. Is it that you think you’ll lose control or that it will make you feel more ill? Remember, you can always start on small amounts and work your way up slowly. If it’s really all too hard on a particular med and you’re sure you can’t keep at it, then you can just move on. If you’re a migraineur, you may have to face the fact that you’ll have to trial a number of meds until you hit the nail on the head. Of course you may be great on the first thing you try too.

If you think about it, you’re already in the trenches with this dizzy junk and you’ve already shown that you are very capable of dealing with some of the worst symptoms anyone would ever want to have to cope with, yet you are although it’s a misery – and you’re working too!

Best … Scott :slight_smile:

Thanks for asking Scott - yes i’ll explain it to you. I’ve always been ultra sensitive to any meds. Always take baby dosages of almost everything. Hate side effects if they are worse than the illness. I can’t even take cold medicines. I take very little allergy meds too. Yeah it would be great if they can start me off on like 5 mg of celexa or 10 no more. Cymbalta starts with 20s and i don’t have those - was given samples of 30s - no way am i ready for anything of the sort.

The other fear is that i will be stuck on them forever cuz of the withdrawl stuff i read about - yeah i know i should quit reading so much but that also tells me good things about celexa and stuff. I printed out the success stories from the board today and plan on reading those at home. Those give me hope.

I’m willing to try something soon. I am hoping to talk to one of my doctors soon about all of this. I think the neuro is just intimidating. I have a dr that is super nice and knows how drug sensitive i am.

I’m also very allergic to everything. I am allergic to almost every antibiotic out there so i have a fear of being allergic to meds.

I am actually probably going to talk to a therapist next week for the first time - i think that might help with some of my driving anxiety and stuff. I was reading where a guy had horrible anxiety from driving - didnt talk about dizziness but had anxiety attacks and after a short amount of time on celexa or lexapro he got over it so that gives me hope.

i’ve managed to make it through a whole day - actually past a whole day right now at work so i’m happy today nice to be around people. started off shaking like crazy with anxiety after being so sick at work the other day. I did it though. Just waiting for ride. Can’t wait to drive myself in again!!!

Scott - thanks and thank all of you on here!

chris