Escitalopram is an antidepressant medication used to treat psychiatric disorders like anxiety and depression. Learn about its uses, dosage, drug warnings, side effects, precautions, drug interactions, and more.
Escitalopram or Escitalopram Oxalate is the generic name of the prescription medicine Lexapro. It is available in the form of oral tablets and liquid forms. It is used to treat and manage the symptoms of depression in adults, teenagers, and children above 12 years of age. It is also used in the treatment of generalized anxiety disorder (GAD) in adults.
Escitalopram can cause suicidal tendencies and thoughts when used in children (above 12 years), teenagers, and young adults (24 years of age and below) to treat psychiatric disorders. Even in the initial days of Escitalopram or while your treating physician increases or decreases its doses in the middle of treatment for improved effects, it can make you suicidal (attempt, plan, or think about killing oneself) even if you are an adult above 24 years of age.
Discuss with your doctor the benefits and potential risks of getting you or your child treated with Escitalopram.
Escitalopram is chiefly used to treat mental health disorders and belongs to the group of medications called antidepressants. Among the antidepressants, they belong to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). All SSRI antidepressants work similarly to treat depression, anxiety disorders, and other psychological conditions. Other similar SSRI antidepressants are Citalopram, Sertraline, Fluoxetine, Paroxetine, Fluvoxamine, and Vilazodone.
Escitalopram is used to treat the following mental health disorders or psychological conditions:
Major depressive disorder.
Generalized anxiety disorder.
Its off-label uses include:
Vasomotor symptoms associated with menopause.
Social anxiety disorder (SAD).
Panic disorders with or without agoraphobia.
Posttraumatic stress disorder (PTSD).
Premenstrual dysphoric disorder.
Note: The safety and efficacy of Escitalopram are not known in children below 12 years of age and are contraindicated in the pediatric population. Also, SSRIs induce suicidal tendencies and thoughts in children, adolescents, and young adults. It can also switch your depression into mania. Seek medical assistance if you experience any worsening symptoms of your or your child’s condition.
Do not abruptly stop taking medicine without your physician’s consent. It can lead to withdrawal symptoms. If you feel like quitting the drug, talk to your doctor for alternative treatment or get your dose tapered gradually.
Escitalopram is a selective serotonin reuptake inhibitor (SSRI) and is the most demanding of SSRIs. As their name suggests, they selectively inhibit serotonin’s reuptake, thereby increasing serotonin activity. The sodium-dependent serotonin transporter protein in the presynaptic neuron reuptakes serotonin from the synaptic cleft to the presynaptic neuron. Escitalopram binds to this sodium-dependent serotonin transporter protein, thereby preventing the reuptake of serotonin from the synaptic cleft, potentiating the effect of serotonin in the central nervous system. Onset Of Action: Following the oral administration, 80% of Escitalopram reaches the circulation. It is almost completely absorbed. Nearly 8% of orally administered is excreted through the urine in its unchanged form, and 10% is passed through the urine in its metabolite form. Food does not affect Escitalopram’s absorbability, and peak levels of Escitalopram reach about 5 hours after its oral intake. Habit-Forming: No habit-forming tendencies were observed in people taking Escitalopram. It does not cause addiction. Expiry Date: Do not take Escitalopram or any other medicine past its expiry date. You can find one printed on the strip, back of the pack, or in the leaflet.
To treat mental health disorders, your treating doctor will typically start with 10 mg or minimal dosage based on your symptoms. After a week, your dosage might be increased to achieve beneficial effects. You will be periodically assessed by your doctor to monitor your symptom betterment and based on which your dosages will be adjusted to maintain the lowest possible effective dose. Escitalopram is available in oral tablets of strengths 5 mg, 10 mg, 20 mg, and 1mg/mL oral solution.
Escitalopram is suggested in children above 12 years of age only in case of major depressive disorders. Caregivers or parents of such adolescents must be watchful of their activities as Escitalopram can induce suicidal thoughts.
In older adults above 60 years of age, only 10 mg per day dosage is recommended. If you have any kidney or liver diseases, your dose will be adjusted accordingly.
If you plan to switch from antidepressants of monoamine oxidase inhibitors (MAOI) to Escitalopram or other medicines of the SSRI group, at least 14 days should elapse between stopping MAOI antidepressant and starting Escitalopram.
Escitalopram can be taken with or without food in the morning or evening as advised by your doctor. It is usually prescribed in a once-daily dosage only. Take it at the same time every day. Do not take it in larger or smaller quantities than prescribed. Continue taking Escitalopram even if you feel better. Do not abruptly stop taking it as it might cause withdrawal symptoms like irritability, sweating, confusion, headache, mood changes, agitation, tiredness, sleeping difficulties, etc.
If you forgot to take a dose of Escitalopram, take it as soon as you remember. If it is almost the time for the next dose, skip the missed dose and continue with the consecutive dose. Do not double up your next dose to compensate for the missed one.
Allergy - If you are allergic or hypersensitive to Escitalopram or Citalopram, do not take it.
Monoamine Oxidase Inhibitors (MAOIs) and Pimozide - Concomitant use in people taking MAOIs or Pimozide is contraindicated. If there is a need for a drug switch between MAOIs and Escitalopram (SSRIs), there should be a gap of at least 14 days between the last dose of MAOI and the first dose of SSRI and vice versa.
Suicidal Intentions - Suicidal intentions and ideations tend to occur during the initial months of treatment initiation or with dosage modifications (increase or decrease). Hence, close monitoring of the person taking antidepressants is necessary.
Drug Discontinuation - Escitalopram should not be abruptly stopped. Stopping so can lead to withdrawal symptoms. If you feel like your symptoms are worsening and feel like stopping them, consult your doctor. Your dosage will be tapered, and gradually you can stop it with your doctor’s consent.
Pregnancy - There are no adequate studies on the effects of Escitalopram in the growing fetus. Hence, if you are pregnant, you can only take Escitalopram if the potential benefits and risks are assessed.
Breastfeeding - Escitalopram is excreted in breast milk. Hence if you are a nursing mother, Escitalopram will be prescribed only if you clearly need it. Either you will have to discontinue breastfeeding temporarily, or your kid should be closely monitored for any adverse effects.
Kidney and Liver Impairment - Inform your doctor if you have any kidney or liver impairment. Your dosage will be adjusted. Use with caution.
Pediatric Use - Escitalopram is contraindicated in children below 12 years of age, and for teenagers of 12 to 18 years, Escitalopram is only used to treat major depressive disorders.
Seizures - If you have seizures, inform them in advance. Escitalopram should be used in caution in people with seizures. It can induce seizures in susceptible individuals.
Bleeding - Escitaloprams can increase the risk of bleeding events like gastric bleeding, ecchymoses, epistaxis, hematomas, and serious bleeding conditions. Hence, concomitant use of Escitalopram with nonsteroidal anti-inflammatory drugs (NSAIDs) or anticoagulants, or if you have any bleeding disorder, stay cautious with Escitalopram usage.
Angle-Closure Glaucoma - If you have a history of glaucoma or have narrow angles without a patent iridectomy, Escitalopram can trigger glaucoma.
Serotonin Syndrome - Taking Escitalopram with serotonergic drugs like Tramadol, Lithium, Buspirone, Serotonin and norepinephrine reuptake inhibitors (SNRIs), MAOIs, Opioids, Cocaine, Ginseng, St.John’s Wort, etc., can raise the serotonin levels. Such extreme levels cause adverse health effects like agitation, nausea, headache, restlessness, vomiting, diarrhea, rapid heart rate, sweating, confusion, etc. If untreated it can lead to seizures, troubled breathing, coma, and eventually death.
The common side effects of Escitalopram include,
Loss of appetite.
Minor and common side effects subside with time or with drug discontinuation and do not cause any major health concerns.
Some of the serious side effects of Escitalopram include,
Altered moods (overexcitation).
Loss of coordination.
Decreased urine output.
If you experience any of the above side effects or other adverse reaction not listed above and does not go away on its own, immediately call your doctor to seek medical assistance.
Like with most drugs, Escitalopram also interacts with certain medications and disease conditions to create undesirable effects. However, this differs with people. The common interactions of Escitalopram are,
Monoamine oxidase inhibitors.
Consuming alcohol along with Escitalopram increases the risk of its pronounced side effects like drowsiness and is not recommended.
Depression - Symptoms of depression can worsen at any time. Close monitoring is required.
Heart problems (myocardial infarction and unstable heart disease).
Never share Escitalopram or any medicine with anyone whose conditions appear similar to you. Avoid self-medication and do not start or stop taking any drug without a doctor’s consent. For more queries on mental health problems and drugs, connect to iCliniq.com.
Last reviewed at:
21 Oct 2021 - 7 min read
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