Classes
DEA Class; Rx
Common Brand Names; Lexapro
- Antidepressants, SSRIs
Description
Oral selective serotonin reuptake inhibitor (SSRI) antidepressant; an enantiomer of citalopram
Indicated in adults for major depression and generalized anxiety disorder and pediatric patients 12 and older for depression
Increased risk of suicidality during treatment initiation in pediatric and young adult patients
Indications
Indicated for acute and maintenance treatment of major depressive disorder (MDD)
Indicated for acute treatment of generalized anxiety disorder (GAD)
Contraindications
Hypersensitivity to escitalopram or citalopram
Pimozide
Adverse Effects
- Headache (24%)
- Nausea (15-18%)
- Insomnia (7-14%)
- Diarrhea (6-14%)
- Somnolence (4-13%)
- Ejaculation disorder (9-12%)
- Xerostomia (4-9%)
- Constipation (3-6%)
- Fatigue (2-8%)
- Dizziness (4-7%)
- Libido decrease (3-7%)
- Anorgasmia (2-6%)
- Indigestion (2-6%)
- Sweating increased (4-5%)
- Rhinitis (5%)
- Flu-like syndrome (5%)
- Abnormal dreaming (3%)
- Neck/shoulder pain (3%)
- Decreased appetite (3%)
- Vomiting (3%)
- Sinusitis (3%)
- Lethargy (3%)
- Impotence (3%)
- Menstrual disorder (1-2%)
- Flatulence (2%)
- Toothache (2%)
- Yawning (2%)
- Abdominal pain (2%)
- Weight gain (1%)
Warnings
Increased risk of suicidal thoughts and behaviors in adolescents and young adults; monitor all antidepressant-treated patients for any indication for clinical worsening and emergence of suicidal thoughts and behaviors, especially during initial few months of drug therapy
Conflicting evidence regarding use of SSRIs during pregnancy and increased risk of persistent pulmonary hypertension of the newborn, or PPHN (see Pregnancy)
In neonates exposed to SNRIs/SSRIs late in third trimester: risk of complications such as feeding difficulties, irritability, and respiratory problems
Activation of mania/hypomania reported in a small proportion of patients with major affective disorders treated with drugs effective in treatment of major depressive disorder; before initiating, screen for any personal or family history of bipolar disorder, mania, or hypomania
Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy
In a study in normal volunteers, escitalopram10 mg/day did not impair intellectual function or psychomotor performance; because any psychoactive drug may impair judgment, thinking, or motor skills, caution patients about operating hazardous machinery, including automobiles, until they are they know how the drug affects their cognition
SSRIs/SNRIs increase risk of abnormal bleeding owing to platelet inhibition
Pregnancy and Lactation
There are no adequate and well-controlled studies in pregnant women; therefore, use during pregnancy only if the potential benefit justifies the potential risk to the fetus
Escitalopram is excreted in human breast milk
Maximum Dosage
20 mg/day PO.
10 mg/day PO.
20 mg/day PO.
12 years: 20 mg/day PO.
6 to 11 years: Safety and efficacy have not been established; however, doses up to 20 mg/day PO have been used for anxiety and pervasive developmental disorders.
1 to 5 years: Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Escitalopram oxalate
tablet
- 5mg
- 10mg
- 20mg
oral solution
- 5mg/5mL