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Escitalopram is prescribed for major depression, a persistently low mood that interferes with daily functioning. To be considered major, depression must occur nearly every day for at least two weeks, and must include at least five of the following symptoms: low mood, loss of interest in usual activities, significant change in weight or appetite, change in sleep patterns, agitation or lethargy, fatigue, feelings of guilt or worthlessness, slowed thinking or lack of concentration, and thoughts of suicide.

Escitalopram is also prescribed for generalized anxiety disorder, a condition marked by excessive worry and anxiety that is hard to control and interferes with daily life. To be diagnosed with this disorder, your symptoms must have lasted at least 6 months and you must have at least three of the following: restlessness, fatigue, poor concentration, irritability, muscle tension, and sleep disturbances.

Escitalopram works by boosting levels of serotonin, one of the chief chemical messengers in the brain. The drug is a close chemical cousin of the antidepressant medication Celexa. Other antidepressants that work by raising serotonin levels include Paxil, Prozac, and Zoloft.

Brand name: Lexapro

Generic name: Escitalopram

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Most important fact about Escitalopram

Do not take Escitalopram for 2 weeks before or after taking any drug classified as an MAO inhibitor. Drugs in this category include the antidepressants Marplan, Nardil, and Parnate. Combining these drugs with Escitalopram can cause serious and even fatal reactions marked by such symptoms as fever, rigidity, twitching, and agitation leading to delirium and coma.

How should you take Escitalopram ?

Take Escitalopram exactly as prescribed, even after you begin to feel better. Although improvement usually begins within 1 to 4 weeks, treatment typically continues for several months. Escitalopram is available in tablet and liquid forms and can be taken with or without food.

If you miss a dose of Escitalopram

Take the forgotten dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular schedule. Do not take two doses at once.

Storage instructions for Escitalopram

Store at room temperature.

What side effects may occur when taking Escitalopram ?

Side effects of Escitalopram cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe to continue using Escitalopram.

More common side effects of Escitalopram may include:

Constipation, decreased appetite, decreased sex drive, diarrhea, dizziness, dry mouth, ejaculation disorder, fatigue, flu-like symptoms, headache, impotence, indigestion, insomnia, nausea, runny nose, sinusitis, sleepiness, sweating

Why should Escitalopram not be prescribed ?

You'll be unable to use Escitalopram if it causes an allergic reaction, or if you've ever had an allergic reaction to the related drug Celexa. Remember, too, that you must never take Escitalopram while taking an MAO inhibitor such as Marplan, Nardil, or Parnate.

Special warnings about Escitalopram

In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Escitalopram or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Escitalopram has not been studied in children or adolescents and is not approved for treating anyone less than 18 years old.

Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with Escitalopram and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly, especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.

Escitalopram makes some people sleepy. Until you know how the drug affects you, use caution when driving a car or operating other hazardous machinery.

In rare cases, Escitalopram can trigger mania (unreasonably high spirits and excess energy). If you've ever had this problem, be sure to let the doctor know.

Also make sure that the doctor knows if you have liver problems or severe kidney disease. Your dosage may need adjustment.

Convulsions have been reported during Escitalopram treatment. If you have a history of seizures, use this drug with caution.

Serotonin-boosting antidepressants could potentially cause stomach bleeding, especially in older people or those taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), and ketoprofen (Orudis KT). Consult your doctor before combining Escitalopram with NSAIDs or blood-thinning medications.

You should never stop taking Escitalopram without consulting your doctor. An abrupt decrease in dose could cause withdrawal symptoms such as mood problems, lethargy, insomnia, and tingling sensations.

Possible food and drug interactions when taking Escitalopram

Do not use Escitalopram if you are taking the related drug Celexa. Be sure to avoid MAO inhibitors when taking Escitalopram. Although Escitalopram does not interact with alcohol, the manufacturer recommends avoiding alcoholic beverages.

If Escitalopram is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Escitalopram with the following:

Aspirin
Carbamazepine (Tegretol)
Cimetidine (Tagamet)
Desipramine (Norpramin)
Drugs that act on the brain, including antidepressants, painkillers, sedatives, and tranquilizers
Ketoconazole (Nizoral)
Linezolid (Zyvox)
Lithium (Eskalith)
Metoprolol (Lopressor)
Narcotic painkillers
Nonsteroidal anti-inflammatory drugs such as Advil and Motrin
Sumatriptan (Imitrex)
Warfarin (Coumadin)

Special information on Escitalopram if you are pregnant or breastfeeding

There have been reports of newborns developing serious complications after exposure to Escitalopram late in the last 3 months of pregnancy. If you are pregnant or plan to become pregnant, inform your doctor immediately. Escitalopram should be taken during pregnancy only if its benefits outweigh the potential risks.

Escitalopram appears in breast milk and can affect a nursing infant. If you decide to breastfeed, Escitalopram is not recommended.

Recommended dosages for Escitalopram

ADULTS

The recommended dose of Escitalopram tablets or oral solution is 10 milligrams once a day. If necessary, the doctor may increase the dose to 20 milligrams after a minimum of 1 week, but the higher dose is not recommended for most older adults and people with liver problems.

Overdosage with Escitalopram

A massive overdose of Escitalopram can be fatal. If you suspect an overdose of Escitalopram, seek emergency treatment immediately.

Typical symptoms of Escitalopram overdose include:

Dizziness, sweating, nausea, vomiting, tremors, drowsiness, rapid heartbeat, seizures
In rare cases, an overdose of Escitalopram may also cause memory loss, confusion, coma, breathing problems, muscle wasting, irregular heartbeat, and a bluish tinge to the skin.

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