Cipramil - What sort of person does that make me?

Question

Hi, my GP has just prescribed me cipramil. How does this drug compare to other anti-d's? What are the reasons for choosing this drug over another? Is this usually prescribed to people with mild depression or high-level depression? There are so many drugs out there and I'm curious to know how doctors know which one to prescribe.

Answer 1

Hi, I'm sorry to hear you are feeling out of sorts at the moment, but it's good that you are talking to your GP about this and that you have decided to give these tablets a go.

Cipramil is a generic form of the drug citalopram, and it is a class of anit-depressant called an SSRI (selective-serotonin reuptake inhibitor).  Simply put, the workings of the brain are rather a mystery and no one will profess to knowing how anti-depressants work exactly, but likewise no-one knows precisely how paracetamol works on a headache either.  

If memory serves me well, the first generation of SSRIs was prozac (fluoxetine hydrochloride), and since then newer drugs have been made that are also SSRIs but 'cleaner' acting.  The older drugs affected numerous targets in the brain, not just the serotonin uptake channels - so the new generations of drugs were much more direct acting, and only seem to interfere with serotonin uptake.  I hope this makes sense.  Basically, if prozac was a Ford, then cipramil is a Porsche.

You level of depression is really only for you and your doctor to assess, but cipramil is often prescribed for people who suffer with various forms of anxiety, and is effective against what is known as 'free-floating anxiety' - this is being anxious with no real attributable cause. It can also help people with body dysmorphic disorder (in which the sufferer has a rather distorted and negative self image).  

Depression is something that is difficult to assign as being 'mild' or 'high-level'.  Indeed, experimental psychology, years ago now (probably the 70s) provided evidence that depression is a state that results from anxiety (and mild can become high-level), so this would explain the success which anti-anxiety (anxiolytic) drugs like cipramil has had as anti-depressants.  

It is however, a carefully monitored game of trial and improvement when a dr and patient try to find the best drug.  Generally, something like cipramil will be prescribed, and it will need a few weeks to kick in, but often times patients report results much sooner.  There are side effects with these drugs, but everyone responds differently and some people have more trouble than others, and in general the side effects aren't going to be too bothersome by any means. This is especially the case with the newer generation of SSRIs (eg. cipramil).

I know this is a ramble, but what I want to say is that these tablets have proven to be very effective for many kinds of depression, and it's not really possible to make inferences about your depression level, or indeed your GP's opinion of your depression level from the tablet type. Perhaps you are worried they are too strong, or on the other hand, you might think he has 'fobbed you off' with mild tablets, but this is not the case. He's prescribed what could be considered the 'drug of choice' for many patients.  Of course, the dose is a factor, but most people will be started at the lowest dose, and gradually increased if need be.

I hope this helps, and that the tablets help too.

Best Wishes