Escitalopram (Oral)

Escitalopram, also known as the trade name Lexapro, is an antidepressant drug prescribed for treatment of generalized anxiety disorder or depression.

Overview

What is Escitalopram?

Escitalopram is available through prescription only and is typically used to treat GAD, which is known also as generalized anxiety disorder or other forms of depression. An antidepressant, Escitalopram is also sold under the trade name of Lexapro. Working to increase the serotonin levels found in the brain of patients with GAD or major depressive disorder and also referred to as MDD, Escitalopram can also be effective for weight loss and other medical conditions.

How does Escitalopram work?

Escitalopram belongs to a class of antidepressants known as SSRIs, which stands for selective serotonin reuptake inhibitors. SSRIs such as Escitalopram require several weeks to take effect by a gradual build-up of serotonin levels found in the brain. Escitalopram, as an SSRI, increases the level of serotonin not by adding more into the bloodstream but by blocking the body's reabsorption of the serotonin itself, so that a greater amount remains active in the body. This new, healthy abundance of serotonin leads to an alleviation of depression symptoms by naturally regulating the patient's mood and other health aspects.

A patient with a deficiency in serotonin levels often experiences mood disorders such as depression or anxiety. Serotonin also works to normalize daily functions such as eating, sleeping, digestion, healing and other normal bodily functions and activities. When serotonin levels are balanced, mood is regulated naturally and normally and you feel calm, happy, relaxed and more focused.

Patients who are taking Escitalopram are assessed periodically to determine the effectiveness of the drug on their depression symptoms and to make adjustments in dosage if necessary. As each patient is different, the dosage of Escitalopram varies depending on the severity of the condition and other factors.

What is GAD?

GAD or generalized anxiety disorder is a condition of anxiety that typically includes irrationally worrying about activities or events that haven't happened yet. Patients suffering from GAD are always thinking about disasters waiting to happen and are irrationally anxious about their health, death, monetary issues, friends, family, relationships or professional issues. Patients often exhibit physical symptoms as the result of their anxious behavior that include headaches, fatigue, insomnia, rashes and more. Counseling, along with medications such as Escitalopram, can greatly alleviate GAD symptoms and help patients live a normal life.

What is MDD?

MDD is an acronym for major depressive disorder and may be referred to as depression. MDD patients have low self-esteem, no interest in life or activities they may have enjoyed in the past. They have no energy and may even have physical pain that has no explanation or root cause other than the depression itself. Left untreated, MDD can affect a person's social, work, and private life as well as their general health. Again, counseling, along with medications such as Escitalopram, can greatly alleviate MDD symptoms; enabling patients to live a more normal life.

Conditions Treated

  • GAD
  • MDD
  • Major depression
  • Panic disorder
  • Agoraphobia
  • Social phobias
  • Obsessive compulsive disorder

Type Of Medicine

  • Anti-depressant

Side Effects

Because Escitalopram affects enzyme levels in the brain, it may also cause unwanted symptoms. Some of these symptoms could be the sign of an underlying medical issue requiring immediate attention. If you have any of the following symptoms while taking Escitalopram, contact your physician right away:

  • Convulsions
  • Confusion
  • Coma
  • Decrease in urine amount
  • Dizziness, weak muscles
  • Erratic, rapid heart rhythm
  • Headache
  • Pain or cramping in muscles
  • Thirst
  • Vomiting, nausea
  • Gasping for breath
  • Swollen hands, ankles or face
  • Fatigue

Other side effects are alleviated once your body has made an adjustment to treatment with Escitalopram. Your doctor's office may be able to assist you with ways of lessening these effects or eliminating them. Contact your physician if you experience the following side effects:

  • Diarrhea
  • Constipation
  • Dry mouth
  • Loss of sex drive, desire or performance ability
  • Delay in ejaculation
  • Gas and bloating, full stomach feeling
  • Heartburn
  • Erectile dysfunction
  • Insomnia
  • Fatigue or drowsiness
  • Tingling, burning, itching, numb, pins and needles, crawling feeling
  • Coughing
  • Chills
  • Loss of appetite
  • Sweating
  • Pain in joints or muscles
  • Inability to achieve orgasm
  • Shoulder or neck pain
  • Tender cheekbones or eyes
  • Nose running or sneezing with congestion
  • Shivering
  • Soreness in throat
  • Chest tightness
  • Aches in teeth or jaw
  • Difficulty breathing
  • Dreams that are vivid or strange
  • Listless, tired, fatigue or sluggish
  • Constant yawning

Some other side effects not listed here could also occur in some patients. If you have health conditions that are sudden and unusual or seem severe or prolonged after taking Escitalopram, get in touch with your healthcare provider right away.

Dosage

Escitalopram should be taken exactly as your doctor has prescribed it for you. Raising or lowering the dosage or increasing or decreasing the quantity or frequency of your medication will not benefit you in any way. Your prescription should be followed as written and any questions you have should be clarified by your doctor or pharmacist before you begin your treatment regimen.

Read and understand all patient information that you receive with your prescription of Escitalopram. Any information that seems unclear should be brought to the attention of your doctor or pharmacist for clarification prior to taking your medication.

Patients who are prescribed the liquid solution form of Escitalopram are advised to shake the bottle well and measure the dosage carefully using the oral syringe, spoon or cup provided with the medication. Do not use household items to measure, as these items can vary widely.

Escitalopram's method of operation in your body to increase the levels of serotonin found in the brain takes a certain period of time to build up. This gradual build-up is assisted by a consistent dosage of the medication and can take up to one month or more to begin to show elevation of the patient's mood.

As a general rule, tablet and liquid forms of Escitalopram are prescribed to patients suffering from depression for 10 milligrams one time per day for adults and children over 12 years old. Your doctor will advise you on if you should take this drug with or without food as well as what time of day it should be taken. While the amount of Escitalopram prescribed may be adjusted, typically it will not exceed 20 milligrams per day.

Older adults and children under the age of 12 will have their dosage prescribed specifically based on several factors including symptoms and body weight. Follow all prescription instructions given to you by your doctor.

GAD sufferers will receive the same dosage amount, typically, with 10 milligrams per day taken once daily, adjusted as needed not to exceed 20 milligrams per day. Older adults and children may receive a different dosage of Escitalopram based on their specific needs.

Do not miss a dose of Escitalopram, taking care to have a consistent routine in taking this drug ensures maximum safety and effectiveness. Should you miss a dose, do not double up if it is close to your regular schedule in taking the next dose. Skip the missing dose and resume your dosage routine as soon as possible.

Interactions

Patients who have allergies to pets, foods, dyes, additives or preservatives or those who have had adverse reactions to medications in the past should alert their doctor to the possibility that they will also react negatively to Escitalopram. Disclose any other medications you may be taking to your physician before being prescribed Escitalopram and be certain to include any vitamin, holistic, herbal or over-the-counter medications you take as well.

Escitalopram may be prescribed with other medications to provide a more complete treatment for some patients depending on their symptoms. Dosage of both drugs will be taken into consideration by the prescribing physician, which is why you should always let your medical team know what you are taking.

The following medicines should not be taken with Escitalopram, so alert your physician if you are currently prescribed:

  • Amisulpride
  • Amifampridine
  • Bromopride
  • Bepridil
  • Clorgyline
  • Cisapride
  • Fluconazole
  • Dronedarone
  • Iproniazid
  • Furazolidone
  • Lazabemide
  • Isocarboxazid
  • Mesoridazine
  • Linezolid
  • Metoclopramide
  • Methylene Blue
  • Pargyline
  • Moclobemide
  • Pimozide
  • Phenelzine
  • Procarbazine
  • Piperaquine
  • Safinamide
  • Rasagiline
  • Sparfloxacin
  • Saquinavir
  • Selegiline
  • Thioridazine
  • Ziprasidone
  • Tranylcypromine
  • Terfenadine

The following medications are not typically prescribed along with Escitalopram, but use of the two may be necessary for your overall health. Let your physician know if you are taking the following drugs, in case dose adjustment needs to be made for your safety:

  • Abciximab
  • Acemetacin
  • Aceclofenac
  • Alfuzosin
  • Acenocoumarol
  • Amiodarone
  • Almotriptan
  • Amoxapine
  • Amitriptyline
  • Anagrelide
  • Amtolmetin Guacil
  • Anisindione
  • Ancrod
  • Apixaban
  • Antithrombin III Human
  • Ardeparin
  • Apomorphine
  • Arsenic Trioxide
  • Aripiprazole
  • Aspirin
  • Asenapine
  • Atazanavir
  • Astemizole
  • Bedaquiline
  • Azithromycin
  • Bivalirudin
  • Bemiparin
  • Bufexamac
  • Bromfenac
  • Bupropion
  • Buprenorphine
  • Cangrelor
  • Buserelin
  • Certoparin
  • Celecoxib
  • Chlorpromazine
  • Chloroquine
  • Cilostazol
  • Choline Salicylate
  • Citalopram
  • Ciprofloxacin
  • Clomipramine
  • Clarithromycin
  • Clopidogrel
  • Clonixin
  • Crizotinib
  • Clozapine
  • Dabrafenib
  • Cyclobenzaprine
  • Danaparoid
  • Dalteparin
  • Defibrotide
  • Dasatinib
  • Delamanid
  • Degarelix
  • Desipramine
  • Dermatan Sulfate
  • Deslorelin
  • Desirudin
  • Dexibuprofen
  • Desvenlafaxine
  • Dextromethorphan
  • Dexketoprofen
  • Dicumarol
  • Diclofenac
  • Dipyridamole
  • Diflunisal
  • Disopyramide
  • Dipyrone
  • Dolasetron
  • Dofetilide
  • Donepezil
  • Domperidone
  • Droperidol
  • Doxepin
  • Duloxetine
  • Droxicam
  • Edoxaban
  • Ebastine
  • Eletriptan
  • Efavirenz
  • Epoprostenol
  • Enoxaparin
  • Eribulin
  • Eptifibatide
  • Eslicarbazepine Acetate
  • Erythromycin
  • Etodolac
  • Esomeprazole
  • Etoricoxib
  • Etofenamate
  • Felbamate
  • Famotidine
  • Fenoprofen
  • Felbinac
  • Fepradinol
  • Fentanyl
  • Fingolimod
  • Feprazone
  • Floctafenine
  • Flecainide
  • Fluoxetine
  • Flufenamic Acid
  • Fluvoxamine
  • Flurbiprofen
  • Formoterol
  • Fondaparinux
  • Fosphenytoin
  • Foscarnet
  • Galantamine
  • Frovatriptan
  • Gemifloxacin
  • Gatifloxacin
  • Goserelin
  • Gonadorelin
  • Halofantrine
  • Granisetron
  • Heparin
  • Haloperidol
  • Hydroquinidine
  • Histrelin
  • Hydroxytryptophan
  • Hydroxychloroquine
  • Ibuprofen
  • Hydroxyzine
  • Ibutilide
  • Ibuprofen Lysine
  • Iloprost
  • Iloperidone
  • Indomethacin
  • Imipramine
  • Itraconazole
  • Iobenguane I 123
  • Ketoprofen
  • Ivabradine
  • Lapatinib
  • Ketorolac
  • Levofloxacin
  • Leuprolide
  • Lorcaserin
  • Levomilnacipran
  • Loxoprofen
  • Lornoxicam
  • Lumiracoxib
  • Lumefantrine
  • Mefenamic Acid
  • Meclofenamate
  • Meloxicam
  • Mefloquine
  • Methadone
  • Meperidine
  • Miconazole
  • Metronidazole
  • Milnacipran
  • Mifepristone
  • Mizolastine
  • Mirtazapine
  • Moxifloxacin
  • Morniflumate
  • Nadroparin
  • Nabumetone
  • Naproxen
  • Nafarelin
  • Nepafenac
  • Naratriptan
  • Nilotinib
  • Niflumic Acid
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Octreotide
  • Norfloxacin
  • Olanzapine
  • Ofloxacin
  • Ondansetron
  • Omeprazole
  • Oxycodone
  • Oxaprozin
  • Paliperidone
  • Oxyphenbutazone
  • Panobinostat
  • Palonosetron
  • Parnaparin
  • Parecoxib
  • Pasireotide
  • Paroxetine
  • Pentamidine
  • Pazopanib
  • Perflutren Lipid Microsphere
  • Pentosan Polysulfate Sodium
  • Phenindione
  • Perphenazine
  • Phenylbutazone
  • Phenprocoumon
  • Pimavanserin
  • Piketoprofen
  • Pitolisant
  • Piroxicam
  • Prasugrel
  • Pranoprofen
  • Procainamide
  • Probucol
  • Proglumetacin
  • Prochlorperazine
  • Propafenone
  • Promethazine
  • Propyphenazone
  • Propionic Acid
  • Protriptyline
  • Proquazone
  • Quinidine
  • Quetiapine
  • Ranolazine
  • Quinine
  • Rilpivirine
  • Reviparin
  • Ritonavir
  • Risperidone
  • Rofecoxib
  • Rizatriptan
  • Salsalate
  • Rivaroxaban
  • Salicylic Acid
  • Sertraline
  • Sodium Phosphate, Dibasic
  • Sevoflurane
  • Sertindole
  • Sodium Phosphate
  • Selexipag
  • Sibutramine
  • Sodium Salicylate
  • Sodium Phosphate, Monobasic
  • Sorafenib
  • Solifenacin
  • St John's Wort
  • Sotalol
  • Sulindac
  • Sulfinpyrazone
  • Sumatriptan
  • Sulpiride
  • Tacrolimus
  • Sunitinib
  • Tapentadol
  • Tamoxifen
  • Telavancin
  • Telaprevir
  • Tenoxicam
  • Telithromycin
  • Tiaprofenic Acid
  • Tetrabenazine
  • Ticlopidine
  • Ticagrelor
  • Tirofiban
  • Tinzaparin
  • Tolfenamic Acid
  • Tizanidine
  • Tolterodine
  • Tolmetin
  • Tramadol
  • Toremifene
  • Treprostinil
  • Trazodone
  • Triptorelin
  • Trimipramine
  • Valdecoxib
  • Tryptophan
  • Vardenafil
  • Vandetanib
  • Venlafaxine
  • Vemurafenib
  • Vilazodone
  • Vilanterol
  • Vorapaxar
  • Vinflunine
  • Vorinostat
  • Voriconazole
  • Warfarin
  • Vortioxetine
  • Zuclopenthixol
  • Zolmitriptan

Certain unwanted effects could occur if you are taking any of the following medications while being treated with Escitalopram. It is best to let your physician advise you on the best course of action if you are currently taking:

  • Lamotrigine
  • Cimetidine
  • Hydrocodone
  • Ginkgo
  • Lithium
  • Boceprevir

In addition to adverse drug interactions, Escitalopram may also have an effect on medical conditions unrelated to the depressive disorders. For this reason, it is wise to report your full medical history to your physician prior to beginning a course of treatment with Escitalopram. Specifically, if you have the following conditions, make sure your doctor is aware of them:

  • Bleeding
  • Hyponatrema (low blood sodium)
  • Galucoma
  • Bipolar disorder
  • Mania
  • Seizures
  • Kidney or liver disease

Some of these conditions may be worsened with treatment of Escitalopram and others may cause unwanted health effects. For your own safety, disclose your health history to your physician.

Warnings

No adequate data exists to prove effectiveness or insure safety of the use of Escitalopram in children who are younger than 12 years of age. Teenagers with depression who are prescribed Escitalopram will typically be required to have regular appointments with their physician to monitor their weight and growth rate. With regard to pediatric patients who exhibit symptoms of GAD, there is no information that this drug is safe or effective in this age group.

Geriatric patients can typically be safely treated with Escitalopram, however they should be tested for low blood sodium, a condition known as hyponatremia, prior to treatment, as this condition would require cautious use of this medication.

No studies have been performed with regard to fetal risk on patients who are pregnant or who may become pregnant while being treated with Escitalopram. If you are pregnant, make sure that your physician is aware of your condition so that use of this medication can be discussed with regard to the safety of your unborn child.

Breastfeeding women studied for use of Escitalopram have been shown to pass on this medication in breast milk, which can be harmful to infants. Use of this drug in breastfeeding women is not advised, so if you are breastfeeding, you may be required to stop during treatment with this medication.

Do not stop taking this medication, as this could cause symptoms of withdrawal that can be harmful to your overall health. Gradually stopping Escitalopram dosage, supervised by your physician, is required for discontinuation of this drug. If you experience symptoms of withdrawal such as being dizzy or irritable, being tired or having strange dreams, report these to your medical doctor right away.

Patients who have epilepsy should stop taking Escitalopram if they experience an increase in seizures while taking this medication.

Escitalopram may adversely affect sugar levels in the blood, so patients who are diabetic should monitor their insulin and adjust accordingly.

Some patients taking anti-depressant medications such as Escitalopram have experienced an increase in suicidal thoughts. If you are in your teen years or if you are an adult who has previously thought of suicide, contact your health care provider or get emergency medical care right away if these thoughts increase while being treated with this medication.

Patients who must use a MAO inhibitor should not use Escitalopram within 14 days of last using these drugs. If you are being treated for atypical depression or Parkinson's disease with these drugs, caution your health care provider prior to being treated with Escitalopram.

A rare condition known as serotonin syndrome may happen in some patients. Report the following symptoms to your health care provider immediately if you experience them:

  • Hallucinations
  • Fever
  • Agitation
  • Sweating
  • Rapid heart rhythm
  • Stiff or twitching muscles
  • Loss of coordination
  • Diarrhea
  • Vomiting
  • Nausea

Storage

Properly storing Escitalopram, according to manufacturer's instructions, is required to maintain the integrity of the drug, ensuring safety and effectiveness for the patient. Store your dosage of Escitalopram in the original packaging at room temperature, out of sight and reach of children and pets. Protect your medication from exposure to heath and light sources and never allow it to freeze. Expired Escitalopram or any doses that you will not be taking should be disposed of according to safety guidelines provided by your doctor or pharmacist.

Summary

Escitalopram, sold under many trade names world-wide such as Lexapro and Cipralex, is an SSRI antidepressant drug prescribed in tablet or liquid solution form. Escitalopram is effective in the treatment of major depressive disorder as well as generalized anxiety disorder, both commonly referred to as depression, MDD or GAD. Patients are typically prescribed 10 milligrams taken once daily, adjusted depending on their personal response to the drug. No more than 20 milligrams per day should be taken by any patient.

As an SSRI class drug, Escitalopram works by increasing serotonin levels found in the brain by stopping the reuptake of these neurotransmitters. Over time, this works to increase serotonin, a substance that affects the patient's mood and their ability to function normally through life. Patients with imbalanced serotonin levels can experience debilitating symptoms and be unable to work, go to school, or have relationships with friends or family. This leads to greater depressed moods and sometimes even suicidal thoughts. Treatment with Escitalopram along with counseling and regular monitoring by their physician can help patients lead a more normal life.

Side effects from taking Escitalopram include headaches, nausea, sexual disorders including ejaculation delays, drowsiness and insomnia. These symptoms are typically relieved over time as the patient becomes tolerant to the drug. Though allergy symptoms may happen when some patients take Escitalopram, it is urged that patients who have a tendency for allergies report this to their physicians for their own safety.

Escitalopram interacts with several prescription as well as non-prescription drugs and vitamins. For this reason, it is important to report any and all medications being taken to the medical team to insure safety and effectiveness of treatment. Medical conditions such as bleeding disorders, kidney or liver diseases as well as other mental disorders such as bipolar conditions should be reported to your doctor prior to taking this medication.

Patients are urged to follow their prescription information exactly and to direct any questions to their doctor or pharmacist if they are unclear on the amount or frequency of their dosage. Skipping missed doses is favored over double dosing to catch up, but following a routine in order to prevent missed doses is advised. Do not stop taking this drug unless under doctor's supervision, as sudden stoppage could cause withdrawal symptoms.

Store this drug at room temperature, protecting it from heat, moisture and light as well as preventing it from freezing. Keep out of reach of children and pets for their safety and only dispose of this medication by following the guidelines provided to you with the patient information leaflet.