Generic Name: escitalopram (Oral route)
Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults with major depressive disorder (MDD) and other psychiatric disorders in short-term studies. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Not approved for use in pediatric patients .
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antidepressant
Pharmacologic Class: Serotonin Reuptake Inhibitor
Uses For Lexapro
Escitalopram is used to treat mental depression and generalized anxiety disorder (GAD).
Escitalopram belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). These medicines are thought to work by increasing the activity of the chemical serotonin in the brain.
This medicine is available only with your doctor's prescription.
Before Using Lexapro
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of escitalopram in children and teenagers with depression 12 years of age and older. However, safety and efficacy have not been established in children less than 12 years of age.
Appropriate studies have not been performed on the relationship of age to the effects of escitalopram in children with generalized anxiety disorder. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of escitalopram in the elderly. However, elderly patients are more likely to have age-related liver problems, which may require an adjustment in the dose for patients receiving escitalopram.
|All Trimesters||C||Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.|
Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Methylene Blue
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Antithrombin III Human
- Dermatan Sulfate
- Flufenamic Acid
- Magnesium Salicylate
- Mefenamic Acid
- Niflumic Acid
- Pentosan Polysulfate Sodium
- Salicylic Acid
- St John's Wort
- Tiaprofenic Acid
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Bipolar disorder (mental disease with cycles of elation and depression), history of or
- Bleeding problems or
- Hyponatremia (low sodium in the blood) or
- Seizures, history of—May make these conditions worse.
- Diseases affecting metabolism or diseases involving blood circulation—Caution should be used in patients with these medical problems.
- Drug abuse, history of—Potential for increased dependence on medicine.
- Heart disease (unstable) or
- Myocardial infarction (heart attack), recent history of—The effects of escitalopram in patients with these conditions are not known.
- Kidney disease, severe or
- Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
- Mania or hypomania, history of—Use of escitalopram may activate these conditions.
Proper Use of Lexapro
Take this medicine only as directed by your doctor to help your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.
This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
Escitalopram may be taken with or without food on a full or empty stomach. If your doctor tells you to take it at a specific time, follow your doctor's instructions.
If you are using the oral liquid form of escitalopram, shake the bottle well before measuring each dose. Use a marked measuring spoon, oral syringe, or medicine cup to measure each dose.
You may have to take escitalopram for 1 to 4 weeks before you begin to feel better.
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (oral solution and tablets):
- For depression:
- Adults, teenagers, and children 12 years of age and above—At first, 10 milligrams (mg) once a day, taken either in the morning or evening. Your doctor may increase your dose gradually if needed. However, the dose usually is not more than 20 mg a day.
- Older adults and patients with liver problems—Usually 10 mg once a day, taken either in the morning or evening.
- Children below 12 years of age—Use and dose must be determined by your doctor.
- For anxiety:
- Adults—At first, 10 milligrams (mg) once a day, taken either in the morning or evening. Your doctor may increase your dose gradually if needed. However, the dose usually is not more than 20 mg a day.
- Older adults and patients with liver problems—Usually 10 mg once a day, taken either in the morning or evening.
- Children—Use and dose must be determined by your doctor.
- For depression:
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions While Using Lexapro
It is very important that your doctor check you or your child's progress at regular visits to allow for changes in your dose and to help reduce any side effects.
Do not take escitalopram with or within 14 days of taking a drug with monoamine oxidase (MAO) inhibitor activity (e.g., isocarboxazid [Marplan®], phenelzine [Nardil®], procarbazine [Matulane®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]). Do not take an MAO inhibitor within 14 days of taking escitalopram. If you do, you may develop extremely high blood pressure or convulsions (seizures). Do not take escitalopram with pimozide (Orap®).
Make sure your doctor knows about all the other medicines you are using. Escitalopram may cause serious conditions such as serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reactions when taken with certain medicines. Do not use escitalopram with linezolid (Zyvox®), lithium, tryptophan, St. John's Wort, or some pain or migraine medicines (e.g., tramadol [Ultram®], sumatriptan [Imitrex®], zolmitriptan [Zomig®], or rizatriptan [Maxalt®]).
Escitalopram may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your doctor or your child's doctor right away.
Do not suddenly stop taking this medication without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. This is to decrease the chance of having symptoms such as increased anxiety; burning or tingling feelings; confusion; dizziness; headache; irritability; nausea; nervousness; trouble with sleeping; or unusual tiredness or weakness.
This medicine may cause some people to become drowsy, to have trouble with thinking, or to have problems with movement. Make sure you know how you react to escitalopram before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated.
Avoid drinking alcoholic beverages while you are taking escitalopram.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Lexapro Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:Rare
- decreased urine output
- fast or irregular heartbeat
- increased thirst
- muscle pain or cramps
- nausea or vomiting
- shortness of breath
- swelling of the face, ankles, or hands
- unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- decreased interest in sexual intercourse
- dry mouth
- ejaculation delay
- gas in the stomach
- inability to have or keep an erection
- increased sweating
- loss in sexual ability desire, drive, or performance
- sleepiness or unusual drowsiness
- stomach pain
- trouble with sleeping
- unable to sleep
- decreased appetite
- general feeling of discomfort or illness
- joint pain
- loss of appetite
- muscle aches and pains
- not able to have an orgasm
- pain or tenderness around the eyes and cheekbones
- runny nose
- sore throat
- stuffy nose
- tightness of the chest or wheezing
- trouble with breathing
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Lexapro side effects (in more detail)
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