Escitalopram

Pronunciation

Generic Name: escitalopram (ES-sye-TAL-oh-pram)
Brand Name: Lexapro

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using escitalopram outweigh the risks.

Families and caregivers must closely watch patients who take escitalopram. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.

Escitalopram is not approved for use in all children. If escitalopram is prescribed for your child, talk with the doctor to be sure that escitalopram is right for your child.


Escitalopram is used for:

Treating depression or generalized anxiety disorder. It may also be used for other conditions as determined by your doctor.

Escitalopram is a selective serotonin reuptake inhibitor (SSRI). It works by restoring the balance of serotonin, a natural substance in the brain, which helps to improve certain mood problems.

Do NOT use escitalopram if:

  • you are allergic to any ingredient in escitalopram or to citalopram
  • you have a certain type of irregular heartbeat (long QT syndrome) or uncorrected low blood potassium or magnesium levels
  • you are taking or have taken linezolid or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine, selegiline) within the last 14 days
  • you are taking pimozide

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Top 9 Symptoms Of Depression To Watch For

Before using escitalopram:

Some medical conditions may interact with escitalopram. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
  • if you have a history of seizures, liver problems, kidney problems, heart problems (eg, heart failure, slow or irregular heartbeat), high blood pressure, stroke, bleeding problems, stomach or bowel bleeding, increased eye pressure or glaucoma, or metabolism problems
  • if you have a condition or take medicine that may increase your risk of low potassium or magnesium levels. Check with your doctor if you are not sure if any of your conditions or medicines may increase this risk
  • if you are dehydrated, have low blood volume or low blood sodium levels, or drink alcohol
  • if you will be having electroconvulsive therapy (ECT)
  • if you take any medicine that may increase the risk of a certain type of irregular heartbeat (prolonged QT interval). Check with your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of this type of irregular heartbeat
  • if you are taking a medicine that contains methylene blue

Some MEDICINES MAY INTERACT with escitalopram. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Buspirone, fenfluramine derivatives (eg, dexfenfluramine), fentanyl, linezolid , lithium, MAOIs (eg, phenelzine, selegiline), meperidine, metoclopramide, nefazodone, serotonin 5-HT1 receptor agonists (eg, sumatriptan), sibutramine, SNRIs (eg, duloxetine, venlafaxine), other SSRIs (eg, fluoxetine, paroxetine), St. John's wort, trazodone, or tryptophan because severe side effects, such as a reaction that may include agitation, blood pressure changes, coma, confusion, delirium, fever, irritability, mental changes, and rigid muscles, may occur
  • Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased
  • Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased
  • Tramadol because the risk of seizures may be increased
  • Arsenic, cimetidine, halofantrine, nilotinib, omeprazole, phenothiazines (eg, chlorpromazine, thioridazine), pimozide, or vandetanib because the risk of irregular heartbeat may be increased
  • Carbamazepine or cyproheptadine because they may decrease escitalopram's effectiveness
  • Aripiprazole, beta-blockers (eg, propranolol), clozapine, risperidone, or tricyclic antidepressants (eg, amitriptyline) because the risk of their side effects may be increased by escitalopram

This may not be a complete list of all interactions that may occur. Ask your health care provider if escitalopram may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use escitalopram:

Use escitalopram as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Escitalopram comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get escitalopram refilled.
  • Take escitalopram by mouth with or without food.
  • Taking escitalopram at the same time each day will help you remember to take it.
  • Continue to take escitalopram even if you feel well. Do not miss any doses.
  • Do not suddenly stop taking escitalopram without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start escitalopram and whenever a change in dose is made.
  • If you miss a dose of escitalopram, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use escitalopram.

Important safety information:

  • Escitalopram may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use escitalopram with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol while you are using escitalopram.
  • Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using escitalopram; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • One to 4 weeks may pass before your symptoms improve. Do NOT take more than the recommended dose, change your dose, or use escitalopram for longer than prescribed without checking with your doctor.
  • Children, teenagers, and young adults who take escitalopram may be at increased risk for suicidal thoughts or actions. Watch all patients who take escitalopram closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
  • Escitalopram and a medicine called citalopram have the same active ingredient. Do not take escitalopram if you are also taking citalopram.
  • If your doctor tells you to stop taking escitalopram, you will need to wait for several weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone). Ask your doctor when you should start to take your new medicines after you have stopped taking escitalopram.
  • Escitalopram may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.
  • Serotonin syndrome is a possibly fatal syndrome that can be caused by escitalopram. Your risk may be greater if you take escitalopram with certain other medicines (eg, "triptans," MAOIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
  • Certain antidepressants, including escitalopram, may increase the risk of bleeding. Sometimes, bleeding can be life-threatening. Discuss any questions or concerns with your doctor.
  • Some people may be at risk for eye problems from escitalopram. Your doctor may want you to have an eye exam to see if you are at risk for these eye problems. Call your doctor right away if you have eye pain, vision changes, or swelling or redness in or around the eye.
  • Use escitalopram with caution in the ELDERLY; they may be more sensitive to its effects, especially low blood sodium levels.
  • Caution is advised when using escitalopram in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.
  • Escitalopram should be used with extreme caution in CHILDREN younger than 12 years old; safety and effectiveness in these children have not been confirmed.
  • Escitalopram may cause weight changes. CHILDREN and teenagers may need regular weight and growth checks while they take escitalopram.
  • PREGNANCY and BREAST-FEEDING: Escitalopram may cause harm to the fetus if it is used during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using escitalopram while you are pregnant. Escitalopram is found in breast milk. Do not breast-feed while taking escitalopram.

Possible side effects of escitalopram:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; dry mouth; headache; increased sweating; light-headedness when you stand or sit up; loss of appetite; nausea; stomach upset; tiredness; trouble sleeping.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; black or bloody stools; chest pain; confusion; decreased concentration; decreased coordination; decreased sexual desire or ability; fainting; fast, slow, or irregular heartbeat; hallucinations; memory loss; menstrual period changes; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent or severe ringing in the ears;persistent, painful erection; red, swollen, blistered, or peeling skin; seizures; severe dizziness; severe or persistent anxiety or trouble sleeping; severe or persistent headache; shortness of breath; stomach pain; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual or severe mental or mood changes; unusual weakness; worsening of depression.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of escitalopram:

Store escitalopram at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep escitalopram out of the reach of children and away from pets.

General information:

  • If you have any questions about escitalopram, please talk with your doctor, pharmacist, or other health care provider.
  • Escitalopram is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take escitalopram or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about escitalopram. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to escitalopram. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using escitalopram.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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