Healthy Skepticism Soapbox
Cipralex (escitalopram) advertisements
These are the advertisements referred to in Svensson S, Mansfield PR. Escitalopram: superior to citalopram or a chiral chimera? Psychother Psychosom. 2004 Jan-Feb;73(1):10-16.
Cipralex brochure #1, "Halverad dosering ger bättre effekt" [Half the dose is more effective]. Marketing material mailed to Swedish physicians in the northern spring of 2002.
Cipralex brochure #2, "Även för patienter med svår depression ger Cipralex bättre effekt än Cipramil" [Cipralex is more effective than Cipramil also for patients with severe depression]. Marketing material mailed to Swedish physicians in the northern spring of 2002.
Cipralex brochure #3, "Vecka efter vecka mår patienten bättre och bättre" [Week after week the patient feels better and better]. Marketing material mailed to Swedish physicians in the northern spring of 2002.
Cipralex ad, "Bilden klarnar" [The image clears]. Advertisement published in Swedish medical journals, 2003. This ad taken from "Moderna Läkare" (Journal of Swedish Association of Young Doctors), February 2003.
NB: Cipralex = escitalopram. Cipramil = citalopram.
Cipralex brochure #1
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1 Half the dose...
2 ...gives a better effect.
3 [Dosage instructions, available formulations, indications (depression, panic disorder), reference to website.]
4 Cipralex - 10 mg an effective treatment of depression
5 Symbol indicators: Placebo; Cipramil 20-40 mg od; Cipralex 10-20 mg od. * Significant difference c/f placebo, p<0.05. *** Significant difference c/f placebo, p<0.001. [Triangle] Significant difference c/f Cipramil, p<0.05.
6 X-axis: weeks. Y-axis: change in MADRS score.
7 [purple markings not in the original]
- Cipralex consists of 100% active escitalopram, to be compared with Cipramil which consists of an equal mix of S- and R-citalopram.1
- Usual dosage for depression is 10 mg od, which corresponds to 20 mg of Cipramil.1
- Cipralex gives a significantly better effect than Cipramil and placebo.1
8 Pooled data from three randomized, double-blind, placebo-controlled multicenter studies of patients with major depression (MADRS score >=22 and <40). The patients were treated with placebo, Cipramil 20-40 mg od or Cipralex 10-20 mg od for 8 weeks. Average change from baseline MADRS score, ITT-OC. Placebo n=398, Cipramil n=403, Cipralex n=520.
9 Reference: Gorman J. Efficacy comparison of escitalopram and citalopram in the treatment of major depressive disorder: Pooled analysis of placebo-controlled trials. CNS Spectrum 2002;7(1):40–44.
10 Cipralex - a step forward in the treatment of depression.
11 [purple markings not in the original]
- Cipralex is a super-selective SSRI that consists of 100% active escitalopram.1
- Cipralex 10 mg daily gives earlier symptom relief than Cipramil 20 mg. The effect can be seen as early as treatment week one.2
- Cipralex gives significantly better effect than Cipramil in the treatment of patients with severe depression.2
- Cipralex is well tolerated. The tolerance is at placebo level.3,4
- Cipralex has a minimal risk of interaction.5
- The price of Cipralex 10 mg is the same as for Cipramil 20 mg.
12
References:
1. Sánchez C. Escitalopram a super selective serotonin reuptake inhibitor.
Poster FMAD 2001.
2. Gorman J. Efficacy comparison of escitalopram and citalopram in the treatment
of major depressive disorder: Pooled analysis of placebo-controlled trials.
CNS Spectrum 2002;7(1):40-44.
3. Wade A et al. Escitalopram
10mg/day is effective and well tolerated in a placebo-controlled study in depression
in primary care. Int Clin Psychopharmacol 2002;17:95–102.
4. Burke WJ et al. Fixed-dose
trial of the singel isomer SSRI escitalopram in depressed outpatients. J Clin
Psych. 2002;63 (in press).
5. von Moltke LL et al. Escitalopram (S-Cipramil) and its metabolites in vitro:
cytochromes mediating biotransformation, inhibitory effects and its comparison
to R-citalopram. Drug Metab Disops 2001;29(8):1102-1109.
Cipralex brochure #2
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1 Also for patients with severe depression...
2 ... is Cipralex more effective than Cipramil.
3 [Dosage instructions, available formulations, indications (depression, panic disorder), reference to website.]
4 Cipralex – more effective than Cipramil in the treatment of severe depression.
5 Symbol indicators: Placebo; Cipramil 20-40 mg od; Cipralex 10-20 mg od. * Significant difference c/f placebo, p<0.05. *** Significant difference c/f placebo, p<0.001. [Triangle] Significant difference c/f Cipramil, p<0.05.
6 X-axis: weeks. Y-axis: change in MADRS score.
7
- Cipralex gives significantly better effect than Cipramil for patients with severe depression (MADRS >30 units).1
8 Pooled data from three randomized, double-blind, placebo-controlled multicenter studies of patients with severe major depression (MADRS score >30). The patients were treated with placebo, Cipramil 20-40 mg od or Cipralex 10-20 mg od for 8 weeks. Reduction in MADRS score, ITT-OC. Placebo n=398, Cipramil n=403, Cipralex n=520 (whereof approx. 40% of the patients had severe depression).
9 Reference: Gorman J. Efficacy comparison of escitalopram and citalopram in the treatment of major depressive disorder: Pooled analysis of placebo-controlled trials. CNS Spectrum 2002;7(1):40–44.
10 Cipralex - a step forward in the treatment of depression.
11
- Cipralex is a super-selective SSRI that consists of 100% active escitalopram.1
- Cipralex 10 mg daily gives earlier symptom relief than Cipramil 20 mg. The effect can be seen as early as treatment week one.2
- Cipralex gives significantly better effect than Cipramil in the treatment of patients with severe depression.2
- Cipralex is well tolerated. The tolerance is at placebo level.3,4
- Cipralex has a minimal risk of interaction.5
- The price of Cipralex 10 mg is the same as for Cipramil 20 mg.
12
References:
1. Sánchez C. Escitalopram a super selective serotonin reuptake inhibitor.
Poster FMAD 2001.
2. Gorman J. Efficacy comparison of escitalopram and citalopram in the treatment
of major depressive disorder: Pooled analysis of placebo-controlled trials.
CNS Spectrum 2002;7(1):40-44.
3. Wade A et al. Escitalopram
10mg/day is effective and well tolerated in a placebo-controlled study in depression
in primary care. Int Clin Psychopharmacol 2002;17:95–102.
4. Burke WJ et al. Fixed-dose
trial of the singel isomer SSRI escitalopram in depressed outpatients. J Clin
Psych. 2002;63 (in press).
5. von Moltke LL et al. Escitalopram (S-Cipramil) and its metabolites in vitro:
cytochromes mediating biotransformation, inhibitory effects and its comparison
to R-citalopram. Drug Metab Disops 2001;29(8):1102-1109.
Cipralex brochure #3
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1 More about Cipralex
2 Week after week...
3 ...the patient feels better and better.
4 [Dosage instructions, available formulations, indications (depression, panic disorder), reference to website.]
5 Cipralex - more effective week after week.
6 Cipralex 10 mg gives better effect over time than Cipramil 20 mg1
7 Symbol indicators: Cipramil 20 mg od; Cipralex 10 mg od. [Triangle] Significant difference c/f Cipramil, p<0.05.
8
- 24 weeks treatment with Cipralex 10 mg od gives a better antidepressant effect than Cipramil 20 mg od (significant difference at weeks 6, 8, 16 and 24).1
9 Y-axis: change in MADRS score.
10 Data from a subanalysis of patients with moderate depression (MADRS >=22 and <30 units). From a double-blind, randomized, multinational, multicenter study among primary care patients with major depression (MADRS >=22 and <40 units). The patients got Cipralex 10 mg od (n=85) or Cipramil (n=85) for 24 weeks.
11 Reference: Data on file 99022, Lundbeck 2002.
12 Cipralex - a step forward in the treatment of depression.
13 Earlier symptom relief and better effect compared to Cipramil. Halved dose and the same price as Cipramil.
14
- Cipralex is a super-selective SSRI that consists of 100% active escitalopram.1
- Cipralex daily gives earlier symptom relief and more patients respond to treatment, compared to Cipramil.2
- Cipralex gives significantly better effect than Cipramil in the treatment of patients with severe depression.2
- The normal dosage is 10 mg once daily.
15
References:
1. Sánchez C. Escitalopram a super selective serotonin reuptake inhibitor.
Poster FMAD 2001.
2. Gorman J. Efficacy comparison of escitalopram and citalopram in the treatment
of major depressive disorder: Pooled analysis of placebo-controlled trials.
CNS Spectrum 2002;7(1):40-44.
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1 The image clears
2 Since Cipralex (escitalopram) was introduced in Sweden, new studies and supplementary data have shown, among other things, that:
3
- Serotonin levels increase more extracellularly in the cortex with Cipralex, compared to Cipramil.1
- Significantly more patients recover with Cipralex, compared to Cipramil.2
- Sustained remission is reached one week earlier with Cipralex than with Efexor Depot [Venlafaxine S/R].3
4 Indications: depression and panic disorder. Normal dosage: 10 mg Cipralex once daily. [Available formulations].
5
References:
1. Mørk A et al. Escitalopram; a comparative study of in vitro and in
vivo 5HT-uptake inhibitory acitivity. Poster CINP 2002.
2. Colonna L et al. Escitalopram is well tolerated and more efficacious than
citalopram in long-term treatment of moderately depressed patients. Poster IFMAD
2002.
3. Montgomery SA et al. Escitalopram is at least as effective as Venlafaxine
in the treatment of depression and is better tolerated. Poster ECNP 2002. (The
comparison concerns Efexor Depot [Venlafaxine S/R])
For further information, see http://www.fass.se [Swedish National Formulary]
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