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NERVOUS SYSTEM › PSYCHOANALEPTICS › ANTIDEPRESSANTS › Selective serotonin reuptake inhibitors
escitalopram
N06AB10
Forms & Strengths
- Oral tablet: 5 mg
- Oral tablet: 10 mg
- Oral tablet: 20 mg
- Oral solution: 5 mg/5 mL
Adult Dosing
- Major Depressive Disorder: Initial 10 mg once daily; may increase to 20 mg daily after at least 1 week.
- Generalized Anxiety Disorder: Initial 10 mg once daily; may increase to 20 mg daily after at least 1 week.
- Maximum recommended dose: 20 mg once daily.
Pediatric Dosing
- Major Depressive Disorder (Adolescents 12-17 years): Initial 10 mg once daily; may increase to 20 mg daily after at least 3 weeks.
- Pediatric dosing for GAD not established.
Indications
- Major Depressive Disorder
- Generalized Anxiety Disorder
Mechanism of Action
- Selective serotonin reuptake inhibitor (SSRI)
- Potently and selectively inhibits the reuptake of serotonin at the neuronal membrane, enhancing serotonergic neurotransmission
Contraindications
- Hypersensitivity to escitalopram or citalopram
- Concurrent use of MAOIs or use within 14 days of discontinuing an MAOI
- Concurrent use of pimozide
Adverse Reactions
- Nausea, insomnia, fatigue, somnolence
- Sexual dysfunction, ejaculation disorder
- Increased sweating, dry mouth
- QT prolongation, torsades de pointes
- Serotonin syndrome, hyponatremia (SIADH)
Drug Interactions
- Monoamine Oxidase Inhibitors (MAOIs): Risk of severe, fatal serotonin syndrome
- Drugs prolonging QT interval (e.g., antipsychotics, antiarrhythmics): Increased risk of ventricular arrhythmias
- CNS active agents and serotonergic drugs (e.g., triptans, tramadol, lithium): Increased risk of serotonin syndrome
- Anticoagulants/antiplatelets: Increased risk of bleeding events due to impaired platelet aggregation
Curated Content: Needs Vetting Before Put to Clinical Use