An antidepressant of the selective serotonin reuptake inhibitor (SSRI) class.
It increases intrasynaptic levels of the neurotransmitter serotonin by blocking the reuptake of the neurotransmitter into the presynaptic neuron.
Escitalopram is mainly used to treat major depressive disorder or generalized anxiety disorder.
It is taken by mouth.
Trade name Lexapro.
Pregnancy category US: C (Risk not ruled out).
Routes of administration-oral.
Selective serotonin reuptake inhibitor.
Bioavailability 80%.
Protein binding about 56%.
Metabolism via liver, specifically the enzymes CYP3A4 and CYP2C19?
Elimination half-life 27–32 hours.
Common side effects include trouble sleeping, nausea, sexual problems, and feeling tired.
Side effects may include suicide in people under the age of 25.
It is the (S)-stereoisomer of the earlier medication citalopram, hence the name escitalopram.
Approved for the treatment of major depressive disorder in adolescents and adults, and generalized anxiety disorder in adults.
Escitalopram is modestly superior to citalopram in efficacy and tolerability, but other studies conclude that all second-generation antidepressants are equally effective, although they may differ in onset and side effects.
A 2018, a systematic review and network meta-analysis showed escitalopram to be one of the most effective antidepressant medications.
Escitalopram appears to be effective in treating general anxiety disorder, with relapse rate of 20%, less than placebo of 50%.
Escitalopram, as well as other SSRIs, are effective in reducing the symptoms of premenstrual syndrome.
SSRIs are not useful for preventing tension headaches or migraines.
Affects sexual functions causing side effects such as decreased libido, delayed ejaculation, and anorgasmia.
There is a statistically insignificant 1.5 to 2.4-fold increase of suicidality among the adults treated with escitalopram for psychiatric indications.
It is not associated with weight gain.
Associated with dose-dependent QT interval prolongationand should not be used in those with congenital long QT syndrome or known pre-existing QT interval prolongation, or in combination with other medicines that prolong the QT interval.
Abrupt discontinuation may cause withdrawal symptoms such as electric shock sensations, known as brain shivers, dizziness, acute depressions and irritability, as well as heightened senses of akathisia.
Some experience persistent sexual side effects after they stop taking SSRIs: post-SSRI sexual dysfunction.
Common symptoms of post-SSRI sexual dysfunction include: genital anesthesia, erectile dysfunction, anhedonia, decreased libido, premature ejaculation, vaginal lubrication issues, and nipple insensitivity in women.
There may be an association of SSRI use during pregnancy with heart problems in the baby, and such dr]
Overdoses usually cause relatively minor untoward effects, such as agitation and tachycardia, but dyskinesia, hypertonia, and clonus may occur.
It seems to be less dangerous than citalopram in overdose and comparable to other SSRIs.
Of the SSRIs on the market, it has the highest selectivity for the serotonin transporter (SERT) compared to the norepinephrine transporter (NET), making the side-effect profile relatively mild in comparison to less-selective SSRIs.
It is a substrate of P-glycoprotein and hence P-glycoprotein inhibitors such as verapamil and quinidine may improve its blood brain barrier penetrability.
Inhibits CYP2D6 and hence may increase plasma levels of a number of CYP2D6 substrates such as aripiprazole, risperidone, tramadol, and codeine.
Should be taken with caution when using Saint John’s wort, and dextromethorphan as serotonin syndrome, liver damage, and other negative side effects have been reported.
Exposure to escitalopram is increased, by about 50%, when it is taken with omeprazole.
It can prolong the QT interval and hence it is not recommended in patients that are concurrently on other medications that also have the ability to prolong the QT interval: include antiarrhythmics, antipsychotics, tricyclic antidepressants, some antihistamines and some antiretrovirals.
Should not be given concurrently with MAOIs or other serotonergic medications.
Lexapro is available as 5-, 10-, or 20-milligram (mg) coated tablets.
It also comes in liquid form.
Generally, the effective dose of Lexapro ranges from 10 to 20 mg daily.
For depression and generalized anxiety disorder, most people start by taking 10 mg a day.
An increase in the the dose to 20 mg after at least one week can proceed.
People usually take Lexapro once a day, either in the morning or at night, with or without food.
It may take four weeks or more before experiencing the full benefits.