Escitalopram

Antidepressant · SSRIs

Indications

Depression, panic disorder with or without agoraphobia.

Dosage

Adults: Depression: Usually 10 mg once daily, increasing if necessary to max 20 mg once daily. Continue treatment for minimum 6 mth. Panic disorder: Initially 5 mg once daily for 1st wk then 10 mg once daily; max 20 mg once daily. Elderly: Reduce initial and max dose. 10 mg once daily. Children: Not recommended.

Adverse Effects

Nausea, sweating, somnolence, dizziness, insomnia, GI upset, reduced appetite, sexual dysfunction, fatigue, pyrexia, sinusitis, yawning, nausea, headache, wt gain, dry mouth, sexual dysfunction, anxiety, agitation, abnormal dreams, paraesthesia, tremor, arthralgia, myalgia.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Serotonin syndrome. Unstable epilepsy. Within 2 weeks of stopping MAOIs or 1 day of stopping moclobemide. Precautions: Hepatic or severe renal impairment, diabetes, cardiac disease, stable epilepsy, psychosis, ECT, mania, risk of bleeding, narrow-angle glaucoma, or history of glaucoma. Monitor for suicidal ideation. Risk factors for QT prolongation or torsade de pointes. Advise patients to report cardiovascular symptoms. Dose increases may be detrimental in patients who develop akathisia. Poor CYP2C19 metabolisers. Elderly. Withdraw gradually.

Interactions

MAOIs, lithium, tryptophan, pimozide, other neuroleptics, St. John's Wort, other SSRls, SNRIs, 5HT1 agonists, triptans, other serotonergic drugs, linezolid, drugs that prolong QT interval, tramadol, anticoagulants, NSAIDs and other drugs affecting platelet function. CYP2D6 substrates (e.g., metoprolol), CYP2C19 inhibitors (e.g., PPIs), cimetidine, drugs that reduce seizure threshold. Drugs that induce hypokalaemia, hyponatraemia or hypomagnesaemia. Alcohol.

Advice to Patient

Take with or without meals. Do not stop taking medication abruptly, gradually lower the dose and then stop. Contact prescriber if there is severe headache, nightmares, lack of sleep, irritability, confusion, impaired concentration, abdominal disturbances, change in vision, ringing in ears, unusual cough, chest pain, palpitations, menstrual cramps, muscle pain, cramps or tremor. Do not take other stimulants, caffeine and alcohol. On start of therapy or change of dosage, patient should be watched carefully for suicidal tendency by caregiver or family.

Pharmacokinetics

Onset of action: Depression: The onset of action is 1-4 weeks; however, individual response varies greatly and full response may not be seen until 8-12 weeks after initiation of treatment. Metabolism: Hepatic. Bioavailability: 80%; tablets and oral solution are bioequivalent. Half-life elimination: Mean: Adolescents: 19 hours. Adults: Approx. 27 to 32 hours (increased approx. 50% in the elderly and doubled in patients with hepatic impairment). Time to peak: Escitalopram: Adolescents: 2.9 hours; Adults: Approx. 5 hours. Excretion: Urine (8% as unchanged drug; S-DCT 10%).

Brands with this active ingredient

• A-Calm
• Ablixa
• Albopram
• Anidep
• Ansidap
• Anzmet
• Arestalo
• Atcopram
• Attention
• Avepram
• Belexa
• Blexa
• Cheer Up
• Cipralex
• Cironex

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.