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Re: Cipramil, Paxil and PSC stages

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Hi Donna;

Cipramil is the same as Citalopram (also known as Celexa). It is in a

class of antidepressants (mood elevators) called selective serotonin

reuptake inhibitors (SSRIs). It works by increasing the amount of

serotonin in the brain. It has a number of possible side-effects

which are described at the following URL:

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a699001.html

Side effects from citalopram are common:

upset stomach

drowsiness

weakness, tiredness, or anxiety

excitement

difficulty falling asleep or staying asleep

nightmares

dry mouth

changes in appetite or weight

Paxil (paroxetine) is also an SSRI, and comes with somewhat similar

side-effects:

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a698032.html

Side effects from paroxetine are common, and include:

upset stomach

drowsiness

weakness or tiredness

excitement or anxiety

insomnia

nightmares

dry mouth

changes in appetite or weight

However, they have very different chemical structures, which can be

found at:

http://encyclopedia.thefreedictionary.com/citalopram

and

http://encyclopedia.thefreedictionary.com/paroxetine

There are 4 stages of PSC: the portal stage (1), the periportal

stage (2), the septal stage (3), and the cirrhotic stage (4):

http://www.emedicine.com/radio/topic155.htm

Stage 1: Histologic analysis in stage 1 disease identifies

degeneration of the epithelial cells lining the bile ducts associated

with inflammatory cell ductal and periportal triad infiltration and

scarring.

Stage 2: Stage 2 disease is characterized by fibrosis, paucity of

bile ductules, periportal inflammatory cell infiltration, and

piecemeal necrosis of the periportal hepatocytes.

Stage 3: In stage 3 disease, severe degenerative changes are

associated with disappearance of the bile ducts, portal-to-portal

fibrous septa, and periportal cholestasis.

Stage 4: Stage 4 depicts end-stage disease characterized by secondary

biliary cirrhosis.

Our son () was also found to be in Stage 2 by liver biopsy

analysis. It is important to note that the staging cannot tell how

slowly or quickly a patient will move from one stage to the next.

Many patients will remain essentially asymptomatic (in the early

stages 1 or 2) for many, many years. We remain hopeful that high-dose

ursodiol will delay progression in PSC.

Best regards,

Dave

(father of (19); PSC 07/03; UC 08/03)

> Hi - yep, I was dx thru LFT and don't have any outward systems,

> although my biopsy wasn't as good as I hoped. dr. says stage 2,

> unfortunately I'm not too sure what that means. As for ciprimil,

any

> side effects? I'm concerned about paxil - is it the same thing?

> I've got dr appt. in couple weeks and have a ton of questions.

> Thanks and take care - Donna

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-----Original Message-----

From:

It is important to note

that the staging cannot tell how slowly or quickly a patient will move from one

stage to the next. Many patients will remain essentially asymptomatic (in the early

stages 1 or 2) for many, many years.

I would like to add my

2 cents. People can/may remain stable

even in the later stages as evidenced by our son Ken who has been in stage 4

for the last 5 years.

Ken tried Paxil, not

only did he have many of the side effects, but he actually became even more

depressed – alarmingly so. Since that time he has been taking Celexa

with no side effects and is doing much better. I believe every one has to try the

different meds for themselves until they find the right one that works for

them. Always try using the lowest

possible dose to get the results you want. HTH

-Barb in Texas - Son Ken (30) UC 91 & PSC 99

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I've only been part of this last week, but what a great resource.

At least now I know what questions to ask.

> -----Original Message-----

> From:

> It is important to note that the staging cannot tell how slowly or

> quickly a patient will move from one stage to the next. Many

patients

> will remain essentially asymptomatic (in the early

> stages 1 or 2) for many, many years.

>

> I would like to add my 2 cents. People can/may remain stable even

in

> the later stages as evidenced by our son Ken who has been in stage

4 for

> the last 5 years.

>

> Ken tried Paxil, not only did he have many of the side effects,

but he

> actually became even more depressed - alarmingly so. Since that

time he

> has been taking Celexa with no side effects and is doing much

better. I

> believe every one has to try the different meds for themselves

until

> they find the right one that works for them. Always try using the

> lowest possible dose to get the results you want. HTH

> -Barb in Texas - Son Ken (30) UC 91 & PSC 99

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