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escitalopram

Pronunciation

Generic Name: escitalopram (EE sye TAL o pram)
Brand Name: Lexapro

What is escitalopram?

Escitalopram is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Escitalopram affects chemicals in the brain that may be unbalanced in people with depression or anxiety.

Escitalopram is used to treat anxiety in adults. Escitalopram is also used to treat major depressive disorder in adults and adolescents who are at least 12 years old.

Escitalopram may also be used for purposes not listed in this medication guide.

What is the most important information I should know about escitalopram?

You should not use this medicine you also take pimozide (Orap) or citalopram (Celexa).

Do not use escitalopram within 14 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Do not give this medicine to anyone under 12 years.

What should I discuss with my healthcare provider before taking escitalopram?

You should not use this medicine if you are allergic to escitalopram or citalopram (Celexa), or if:

  • you also take pimozide or citalopram.

Do not use escitalopram within 14 days before or 14 days after you have used an MAO inhibitor. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Some medicines can interact with escitalopram and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

To make sure escitalopram is safe for you, tell your doctor if you have ever had:

  • liver or kidney disease;

  • seizures;

  • low levels of sodium in your blood;

  • heart disease, high blood pressure;

  • a stroke;

  • a bleeding or blood clotting disorder;

  • bipolar disorder (manic depression); or

  • drug addiction or suicidal thoughts.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant while taking escitalopram. Do not start or stop taking this medicine during pregnancy without your doctor's advice.

Escitalopram can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Escitalopram should not be given to a child younger than 12 years old.

How should I take escitalopram?

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

You may take escitalopram with or without food. Try to take the medicine at the same time each day.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using escitalopram suddenly, or you could have unpleasant withdrawal symptoms. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking escitalopram?

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with escitalopram may cause you to bruise or bleed easily.

Drinking alcohol with this medicine can cause side effects.

Escitalopram may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Escitalopram side effects

Get emergency medical help if you have signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;

  • racing thoughts, unusual risk-taking behavior, feelings of extreme happiness or sadness;

  • low levels of sodium in the body--headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady; or

  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects may include:

  • dizziness, drowsiness, weakness;

  • sweating, feeling shaky or anxious;

  • sleep problems (insomnia);

  • dry mouth, loss of appetite;

  • nausea, constipation;

  • yawning;

  • weight changes; or

  • decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Escitalopram dosing information

Usual Adult Dose for Generalized Anxiety Disorder:

Initial dose: 10 mg orally once a day; increase if necessary after at least 1 week of treatment to 20 mg once a day
Maintenance dose: 10 to 20 mg orally once a day
Maximum dose: 20 mg orally once a day

Comment: Treatment should be periodically reassessed to determine the need for ongoing treatment; efficacy beyond 8 weeks has not been systematically studied.

Use: Acute treatment of generalized anxiety disorder

Usual Adult Dose for Depression:

Initial dose: 10 mg orally once a day; increase if necessary after at least 1 week of treatment to 20 mg once a day
Maintenance dose: 10 to 20 mg orally once a day
Maximum dose: 20 mg orally once a day

Comments:
-Acute episodes may require several months or longer of sustained pharmacological therapy beyond response to the acute episode.
-Patients should be periodically reassessed to determine the need for maintenance treatment.

Use: Acute and maintenance treatment of major depressive disorder

Usual Geriatric Dose for Depression:

Recommended dose: 10 mg orally once a day

Use: Acute and maintenance treatment of major depressive disorder

Usual Pediatric Dose for Depression:

12 years and older:
-Initial dose: 10 mg orally once a day; increase if necessary after at least 3 weeks of treatment to 20 mg once a day
-Maintenance dose: 10 to 20 mg orally once a day
-Maximum dose: 20 mg orally once a day

Comments:
-Acute episodes may require several months or longer of sustained pharmacological therapy beyond response to the acute episode.
-Patients should be periodically reassessed to determine the need for maintenance treatment.

Use: Acute and maintenance treatment of major depressive disorder

What other drugs will affect escitalopram?

Taking escitalopram with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, narcotic medication, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with escitalopram, especially:

  • any other antidepressant;

  • medicine to treat anxiety, mood disorders, or mental illness;

  • lithium, St. John's wort, tramadol, or tryptophan (sometimes called L-tryptophan);

  • a blood thinner--warfarin, Coumadin, Jantoven;

  • migraine headache medication--sumatriptan, rizatriptan, and others;

  • narcotic pain medication--fentanyl or tramadol; or

  • stimulants or ADHD medication--Adderall, Concerta, Ritalin, and others;

This list is not complete. Other drugs may interact with escitalopram, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

See also: Side effects (in more detail)

Where can I get more information?

  • Your pharmacist can provide more information about escitalopram.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 16.01.

Date modified: September 05, 2017
Last reviewed: July 19, 2017

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