# Switching from escitalopram to citalopram



## *katie* (Nov 9, 2004)

Howdy Maz  ...me again  

All had been great this end...taking 20mg escitalopram which after the first 3 weeks of awful side effects has since turned out to be the help to make everything fab and "normal" again.  

Went to collect repeat prescription today and have been dismayed to find escitalopram is currently not being manufactured in this dose any more, and there are problems getting it in any dose currently in my area.  Was advised to ring round all pharmacies in the town to see if they had any left, but no joy.

Spoke to a locum gp who looked up my history and was hugely apologetic for the situation, and then for his lack of knowledge on such medication.  He eventually decided to get me to switch from 20mg escitalopram to 20mg citalopram from tonight.

When I first started on escitalopram my gp discussed these two medications and we debated whether I'd be best on this dose of escitalopram, or a higher doseage of citalopram.

So I'm quite surprised that the GP I spoke to today kept the dose the same.  Does that sound right?  I appreciate you're not a gp   but thought you may have some knowledge of how these meds work.

Also..the gp today did say the meds are very very similiar, but he couldn't say for sure that I wouldn't react badly again to this change.  I could barely function for 3 weeks when I first started taking these, so just wondered if it's a wise move for me to think about some "plan B's" (childcare arrangements, home-working) to see me through if this is likely to happen again?  Or was I just unlucky with the side effects before?

Cheers hun...big   to you and L.  

Love Katie xx


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## mazv (Jul 31, 2006)

Hi Hun 

Sorry not to get back to you earlier but sun has been shining up here all day  so spent all day in the garden   Hope all good with you adn the twins, way to go Harry with the walking he's doing so well 

There is a supply problem with escitalopram at the minute   but it appears to be sporadic across the country and only in certain areas depending on who your wholesaler is! Just read a letter about it in our professional journal this morning (the manufacturerers declined to comment on the complaint   ). Anyway sorry this isn't helping you......

The two drugs are almost identical; escitalopram is the S isomer of the parent chemical and citalopram is a racemic mix with both S & R isomers. Or to put it another way (without the chemistry   ) citalopram is a mixture of right and left hands (identical compounds but a mirror image of each other) and escitalopram is right hands only. They have very very similar side effect profiles and mechanism of action and although it's impossible to say for sure I wouldn't expect you to have the same reaction if you switch over. You should be fine just to switch straight over too instead of crossing over doses the way you normally do with other antidepressants.

Agree with the original GP though that the dose is not the same and if you switch from escitalopram then you should go onto a higher dose of citalopram. I would have expected you to go onto 40mg citalopram (generally speaking dose is double that of escitalopram). I'd call them on Monday to try and speak to your GP and confirm what dose you should be taking.

Glad to hear that you've been feeling back to 'normal' Do keep checking with local pharmacy if escitalopram comes back into stock
. I'm back at work on Tuesday so will ask our procurement team what the stock situation in UK is and get back to you with what I find out.

Enjoy rest of weekend 

Maz x


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## *katie* (Nov 9, 2004)

Hi Maz,

Glad to hear you and L enjoyed the one day of summer!  

Thanks so much for your reply...interesting to hear about the escitalopram situation, will certainly keep checking with our local chemist to see if/when it becomes available again.

Thanks for the info on the dosage too.  Yes that had been my understanding from the conversation with my gp, that 20mg esc'c-pram = 40mg c-pram, and not wanting to risk things starting to slide will contact her when she's in surgery on Wed.

Thanks so much....you're an absolute star....as always.  

Big        to you and gorgeous L. xx


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## mazv (Jul 31, 2006)

Hi Katie,

Hope you managed to get something sorted   Just to let you know that escitlopram is still available in UK but can only be ordered direct from manufacturer (Lundbeck) and is subject to a quota restriction when ordering. Might be worth speaking to local pharmacy directly to see if they can phone manufacturer and sort something out for you. The bigger pharmacy chains are more likely to have accounts direct with manufacturers to buy direct; avoiding wholesale supply compaines. Lundbeck are currently not supplying stock to the wholesalers.

Hope this helps

Best wishes
Maz x


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## *katie* (Nov 9, 2004)

Thanks so much Maz!  

Spoke to GP this morning who's upped my citalopram to 40mg for now, we've a telephone appt next week and then I have an appointment to see her the following week and at that point will make a "plan".

Will have a chat to our local pharmacy and discuss this with them and see if they can help (they're a chain so may be able to do something), and will see how things go.

Thanks again hun...as always you're amazing   xx


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