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Updated 07 April 2014

Escitalopram

Escitalopram is an antidepressant prescribed for the treatment of depression and associated anxiety/panic disorders.

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Escitalopram is the active ingredient of Cipralex.

General information

Escitalopram is an antidepressant prescribed for the treatment of depression and associated anxiety/panic disorders. It is of particular use in patients with ongoing feelings of sadness, despair, worthlessness, hopelessness, fatigue, pessimism and difficulty dealing with normal daily life.

Escitalopram, and products related to it, is as effective as other, older groups of antidepressants with the advantage of less side effects and drug interaction. It also does not lead to the same extend of weight gain that is seen when these older types of antidepressants ate used.

It may take several weeks for the full benefit of Escitalopram to be achieved. During this period it is important to continue taking this medication.

How does Escitalopram work?

Escitalopram is a selective serotonin re-uptake inhibitor (SSRI), meaning that it increases the levels of the neurotransmitter serotonin in the brain. Increased levels of serotonin are associated with an improvement in emotion, mood and mental state.

Fast facts

Drug schedule: Schedule 5

Available as: Tablets

What does it do? Escitalopram has an antidepressant action

Overdose risk: Medium

Dependence risk: Low

Available as a generic? No

Available on prescription only? Yes

User information

Onset of effect: Full benefit should be seen within two to four weeks.

Stopping this medicine: Escitalopram should not be stopped abruptly – sudden discontinuation may cause symptoms to recur. The dosage of escitalopram should be gradually reduced according to the advice of your doctor.

Prolonged use: Risks are few if the medication is used as recommended. Escitalopram is generally only used for 6-12 months at a time.

Special precautions

Alert your doctor before using this drug if:

  • you have liver or kidney disease,
  • you have epilepsy,
  • you have bipolar disorder,
  • you have a heart condition, or
  • You are taking or have taken other medication in the last 14 days.

Pregnancy: Avoid. It is unknown how this medication may affect your baby. Consult your doctor before using this drug, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: Safety and efficacy of this medication has not been established for children under the age of 18.

Elderly: Caution is advised in the elderly as adverse effects may be more likely. A reduced dose is advised.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how it affects you.

Alcohol: Avoid concomitant use of alcohol.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Sexual dysfunction

x

x

Dry mouth

x

x

Nausea/vomiting

x

x

Diarrhoea/ constipation

x

x

Anxiety

x

x

Headache

x

x

Dizziness/ drowsiness

x

x

Skin rash

x

x

Fever

x

x

Chest pain/ irregular heartbeat

x

x

Interactions

Drug interactions

Beta blockers

Increased chance of beta blocker toxicity

Verapamil, nifedipine

Increased side effects of vasodilators

Potential sedative substances e.g. alcohol, antihistamines, benzodiazepines

Enhanced affect on central nervous system

Oral medication for diabetes

Blood sugar may drop soon after taking SSRI

Lithium

Potential risk of lithium toxicity

Monoamine oxidase inhibitor

High blood pressure, convulsion. Allow five weeks between drugs

Metoclopramide

Unusual movement disorders

Moclobemide

Increased risk of serotonin toxicity

Buspirone, clomipramine, other SSRIs, pethidine, tricyclic antidepressants

Increased risk of serotonin toxicity

Warfarin

Potential warfarin toxicity

Terfenadine

Potential terfenadine toxicity

Disease interactions

Consult your doctor before using this drug if you have liver or kidney disease, epilepsy, bipolar disorder, or if you have a heart condition.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention. Symptoms may include dizziness, sweating and a rapid heartbeat.

Recommended dosage

Adults: 10-20mg once daily

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
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