Anti depression meds

[Noi657]

Hi all... Been on citalapram for three years and am running low! Been to two hospitals and many pharmacies. Anyone know of a substitute of this drug?

Kind regards

[CharlieH]

MOVED to medicine forum

[KhunBENQ]

Where do you live? (to see a doctor)

At least it is not unknown in Thailand.

[CharlieH]

Read this for info: http://www.thaivisa.com/forum/topic/459687-advice-please-for-citalopram/

[PMNL]

Escitalopram is the closest equivalent to the citalopram, available as lexapro 10 and 20 mg, Esidep (Indian made) 10 mg. Please discuss with your dr if it is changeable.

[Stan42]

First of all: discuss any change in medication with your doctor beforehand.

My two cents: Citalopram has been overtaken by Escitalopram, which has proven to be more effective than it's predecessor while having fewer side effects. The patent expired in 2012 and there are now several brand names available. The one used in Thailand is called Lexapro. Hospitals in Bangkok are known to make profit primarily through selling medications at a higher price. However, Lexapro is a prescription only drug, which basically means they are only available through hospitals. Both the Samitivej hospital in Sukhumvit and the Manarom hospital sell Lexapro at around 300thb per pill.

If you are looking for a substitute this should be discussed with your doctor. Yes, there are cheaper medications available: A few months ago I switched from Lexapro to the slightly cheaper Zoloft, however after only 3 days I immediately slipped back into depression and have sinced switched back to Lexapro.

I have mine sent to me from my former doctor in Switzerland where 1 months supply costs around 70 swiss franc, around 30% cheaper than in Thailand. So far I have had no problems with customs and am 75% health insured.

[Noi657]

A big big thank you for your replies!

[JDGRUEN]

OP - here is a link that explains the class of drugs you have been taking. And it gives links to the drugs mentioned by others here and other drugs as well. It is a short and very informative link.

http://www.medicinenet.com/escitalopram/article.htm

Edited April 16, 2015 by JDGRUEN

[Mr Somtam]

IMO it's better to (very slowly) get off those meds altogether. I been on ADs twice and they just don't really work. They make you a dull, sleepy, emotionless, don't give a toss robot... Get some therapy and try getting off these drugs. 10% off the dose every 2 weeks is slow enough. I have done it, never felt better and I have had some rough times lately. Proud to have dealt with that ON MY OWN, not on drugs. When people talk about getting depressed again after lowering the dose it is just withdrawal, it will pass, if it's severe just stay on that dose for a longer time.

But always talk about this with your doctor/psychiatrist and family of course!!! Don't rush it.

I wish you all the best and hope some day you'll be OK and free of meds AND depression.

http://davidhealy.org/

Edited April 17, 2015 by Mr Somtam

[squatncrunch]

Hello, I was able to get a months supply of Lexapro 10 mgs from Fascino pharmacies for 1,300b. Hospitals overcharge terribly. Lexapro stopped my panic attacks from the first day. Lots of side effects getting adjusted though. When I went off I tapered slowly. It took 3 full months of various withdrawal symptoms and some were so bad I was scared at times. Heart palitations were the worst, I still get them now for no apparent reason. Best of luck to you.

[FritsSikkink]

Go see a doctor.

[rodknock]

i was on prozac(fluoxetine) for over 10 years. decided that i was going to get off of them. reduced intake over 3 months and am off of them. could not be happier.

big question, do you still have the need to keep taking anti-depressant?

[Pundi6446]

Ask if there is a generic for it, then can purchase over the counter at most Pharmacies, usually no problem, but as far as anti depressants go, there is a whole gambit of name brands, that have a generic co brand.

[cdmtdm]

very good natural alternative is Noni ....

[dblaisde]

Escitalopram is the closest equivalent to the citalopram, available as lexapro 10 and 20 mg, Esidep (Indian made) 10 mg. Please discuss with your dr if it is changeable.

Anybody know where to find "Esidep". I've looked for it at Fascino and a few other big drug stores near Siriraj and can't find it. According to MIMS it's sold in Thailand, but I'm beginning to doubt it. It would save me a lot of money vs buying Lexapro (by Ludbeck)

[malt25]

IMO it's better to (very slowly) get off those meds altogether. I been on ADs twice and they just don't really work. They make you a dull, sleepy, emotionless, don't give a toss robot... Get some therapy and try getting off these drugs. 10% off the dose every 2 weeks is slow enough. I have done it, never felt better and I have had some rough times lately. Proud to have dealt with that ON MY OWN, not on drugs. When people talk about getting depressed again after lowering the dose it is just withdrawal, it will pass, if it's severe just stay on that dose for a longer time.

But always talk about this with your doctor/psychiatrist and family of course!!! Don't rush it.

I wish you all the best and hope some day you'll be OK and free of meds AND depression.

http://davidhealy.org/

"I been on ADs twice and they just don't really work. They make you a dull, sleepy, emotionless, don't give a toss robot..." UTTER RUBBISH !!!

There's many causes people are prescribed medication. Your condition is probably an isolated case that didn't require medication.

In instances as this, one shouldn't generalize. YOU didn't need meds, good for you. I would have been pushing up daisies years ago if not for prescribed meds. I was weaned off the meds on 2 occasions only to fall back into the black hole. I have a medical condition, not a physiological condition.

I'm bright, happy with my life, never feel drowsy & full of emotion.

Maybe try researching a bit about different causes of depression before you don your stethoscope & offer advice on serious medical issues.

One point in your post I do agree with.... IMO.

[Mr Somtam]

IMO it's better to (very slowly) get off those meds altogether. I been on ADs twice and they just don't really work. They make you a dull, sleepy, emotionless, don't give a toss robot... Get some therapy and try getting off these drugs. 10% off the dose every 2 weeks is slow enough. I have done it, never felt better and I have had some rough times lately. Proud to have dealt with that ON MY OWN, not on drugs. When people talk about getting depressed again after lowering the dose it is just withdrawal, it will pass, if it's severe just stay on that dose for a longer time.

But always talk about this with your doctor/psychiatrist and family of course!!! Don't rush it.

I wish you all the best and hope some day you'll be OK and free of meds AND depression.

http://davidhealy.org/

"I been on ADs twice and they just don't really work. They make you a dull, sleepy, emotionless, don't give a toss robot..." UTTER RUBBISH !!!

There's many causes people are prescribed medication. Your condition is probably an isolated case that didn't require medication.

In instances as this, one shouldn't generalize. YOU didn't need meds, good for you. I would have been pushing up daisies years ago if not for prescribed meds. I was weaned off the meds on 2 occasions only to fall back into the black hole. I have a medical condition, not a physiological condition.

I'm bright, happy with my life, never feel drowsy & full of emotion.

Maybe try researching a bit about different causes of depression before you don your stethoscope & offer advice on serious medical issues.

One point in your post I do agree with.... IMO.

My advice was to TRY with help from a doctor... Read...

[Lumbini]

Based on the first ever large study that compared mindfulness-based cognitive therapy (MBCT) with maintenance antidepressant medication for reducing the risk of relapse in depression, researchers have concluded that MBCT could be a viable alternative to antidepressants. The research is published in The Lancet.

Through the study, researchers intended to establish whether MBCT is superior to maintenance antidepressant treatment in terms of preventing relapse of depression. The researchers couldn’t arrive at a conclusion that could establish MBCT’s superiority over medication, but the results, combined with those of previous trials, suggest that MCBT may offer similar protection against depressive relapse or recurrence for people who have experienced multiple episodes of depression, with no significant difference in cost.

“Depression is a recurrent disorder. Without ongoing treatment, as many as four out of five people with depression relapse at some point,” explains Willem Kuyken, lead author and Professor of Clinical Psychology at the University of Oxford in the UK.

Study co-author Professor Richard Byng, from the Plymouth University Peninsula Schools of Medicine and Dentistry, UK said that maintenance antidepressant medication is the key treatment for preventing relapse and reducing the likelihood of relapse or recurrence by up to two-thirds when taken correctly; however, there are quite a few people who are unable to continue medication for various reasons and there are those who voluntarily do not wish to remain on medication for indefinite periods, or cannot tolerate its side effects.

This is where MBCT comes to aid. MBCT was developed to help people who have experienced repeated bouts of depression by teaching them the skills to recognise and to respond constructively to the thoughts and feelings associated with relapse, thereby preventing a downward spiral into depression.

In this trial, which was conducted from the University of Exeter, UK, 424 adults with recurrent major depression and taking maintenance antidepressant medication were recruited from 95 primary care general practices across the South West of England. Participants were randomly assigned to come off their antidepressant medication slowly and receive MBCT (212 participants) or to stay on their medication (212 participants).

Participants in the MBCT group attended eight 2 ¼ hour group sessions and were given daily home practice. After the group they had the option of attending 4 follow up sessions over a 12 month period. The MBCT course consists of guided mindfulness practices, group discussion and other cognitive behavioural exercises. Those in the maintenance antidepressant group continued their medication for two years.

All trial participants were assessed at regular intervals over 2 years for a major depressive episode using a psychiatric diagnostic interview tool–the Structured Clinical Interview for DSM-IV.

Over 2 years, relapse rates in both groups were similar (44% in the MBCT group vs 47% in the maintenance antidepressant medication group). Although five adverse events were reported, including two deaths, across both groups, they were not judged to be attributable to the interventions or the trial.

According to study co-author Professor Sarah Byford, from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, UK, “As a group intervention, mindfulness-based cognitive therapy was relatively low cost compared to therapies provided on an individual basis and, in terms of the cost of all health and social care services used by participants during the study, we found no significant difference between the two treatments.”

According to Professor Kuyken, “Whilst this study doesn’t show that mindfulness-based cognitive therapy works any better than maintenance antidepressant medication in reducing the rate of relapse in depression, we believe these results suggest a new choice for the millions of people with recurrent depression on repeat prescriptions.”

Study participant Mr Nigel Reed from Sidmouth, Devon, UK, comments that, “Mindfulness gives me a set of skills which I use to keep well in the long term. Rather than relying on the continuing use of antidepressants mindfulness puts me in charge, allowing me to take control of my own future, to spot when I am at risk and to make the changes I need to stay well.”

Writing in a linked Comment, Professor Roger Mulder from the University of Otago in New Zealand says, “Because it is a group treatment that reduces costs and the number of trained staff needed, it might be feasible to offer [mindfulness-based cognitive therapy] as a choice to patients in general practice…We therefore have a promising new treatment that is reasonably cost effective and applicable to the large group of patients with recurrent depression.”

http://www.techienews.co.uk/9728689/mindfulness-based-therapy-pegged-as-a-viable-alternative-to-antidepressants/

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[Kalbo]

First of all: discuss any change in medication with your doctor beforehand.

My two cents: Citalopram has been overtaken by Escitalopram, which has proven to be more effective than it's predecessor while having fewer side effects. The patent expired in 2012 and there are now several brand names available. The one used in Thailand is called Lexapro. Hospitals in Bangkok are known to make profit primarily through selling medications at a higher price. However, Lexapro is a prescription only drug, which basically means they are only available through hospitals. Both the Samitivej hospital in Sukhumvit and the Manarom hospital sell Lexapro at around 300thb per pill.

If you are looking for a substitute this should be discussed with your doctor. Yes, there are cheaper medications available: A few months ago I switched from Lexapro to the slightly cheaper Zoloft, however after only 3 days I immediately slipped back into depression and have sinced switched back to Lexapro.

I have mine sent to me from my former doctor in Switzerland where 1 months supply costs around 70 swiss franc, around 30% cheaper than in Thailand. So far I have had no problems with customs and am 75% health insured.

Lexapro is available from the large pharmacy in Soi 77, just down the road from the Big C in On Nut, for about B1,200 - B1,300 per box of 28 10mg tablets.

[cheeryble]

Hello, I was able to get a months supply of Lexapro 10 mgs from Fascino pharmacies for 1,300b. Hospitals overcharge terribly. Lexapro stopped my panic attacks from the first day. Lots of side effects getting adjusted though. When I went off I tapered slowly. It took 3 full months of various withdrawal symptoms and some were so bad I was scared at times. Heart palitations were the worst, I still get them now for no apparent reason. Best of luck to you.

Very interesting Squatncruch

I have been bouncing in and out of the black hole for quite some months, been murder, but been trying to adjust my thinking like self CBT, and avoiding meds as

1. Most people without a lifelong condition seem to come out of it den if they might have a reoccurrence sometime.

2. I don't want two problems (like you gotta stop sometime.....haven't you?) instead of one.

However i am way on the anxiety side of the scale and have had agoraphobia for decades and it has occurred to me that hey it may be well worth some potential downside from taking something like Lexapro for the ability to get on a plane again and live a more normal life.

ps I personally wouldn't worry much about physical symptoms like palpitations.....been having them for decades.

Edited April 26, 2015 by cheeryble

[dblaisde]

Esidep (cheaper Lexapro) isn't widely available in Thailand. I had to contact the distributor to get some. The price is 23 baht a tab vs about 40 baht a tab for Lexapro from pharmacies like Fascino.