Escitalopram

Escitalopram is a prescription-only tablet used to treat MDD (Major Depressive Disorder) and GAD (Generalized Anxiety Disorder) in adults and adolescents. It belongs to the SSRI (Selective Serotonin Reuptake Inhibitor) class of antidepressants and works by increasing serotonin levels in the brain. Escitalopram is commonly prescribed because of its effectiveness and its once-daily dosing.

Escitalopram is FDA-approved for treating:

• Major Depressive Disorder (MDD)
• Generalized Anxiety Disorder (GAD)

Escitalopram works by helping your brain retain more of a natural chemical called serotonin. This chemical plays a major role in regulating your emotions and mood. Normally, after the brain releases serotonin, it is quickly reabsorbed. This reduces the levels available to lift your mood. Escitalopram slows down this reabsorption process, so serotonin stays in your brain longer and works more effectively. Over several weeks, this can help reduce symptoms of depression and anxiety.

• Pharmacists commonly advise patients to take Escitalopram at the same time each day to reduce side effects such as nausea or fatigue during the first few weeks.
• You may take the tablets with or without food, as you prefer.
• You can swallow the Escitalopram tablet whole with a glass of water. Don't crush or chew these tablets.
• You can choose a time of day that suits you best, morning or evening, and stick to it consistently.
• Do not stop taking Escitalopram tablets suddenly. If you do so, this may cause Escitalopram withdrawal symptoms. Always consult your doctor before making changes.
• Avoid or limit alcohol consumption, since it can increase side effects such as drowsiness or dizziness.

If you miss a dose of Escitalopram, then take this tablet as soon as you can. However, if it’s almost time for your next one, just skip the missed Escitalopram dose. After that, you can continue with your regular Escitalopram dosing schedule. Do not take a double dose of Escitalopram tablets to compensate. Missing a single dose of Escitalopram usually isn’t harmful. However, you should try to take it consistently to avoid an Escitalopram missed dose.

Taking too many Escitalopram tablets can be dangerous. This may cause Escitalopram overdosing symptoms like dizziness, nausea, rapid heartbeat, or even seizures. If you suspect an Escitalopram overdose, contact the poison control center or your healthcare provider immediately. Overdosing on Escitalopram can be serious, so it’s important to stick to the prescribed amount and never take extra doses. If symptoms are severe, call 911 or your local emergency number immediately.

When you consider the Escitalopram dose for Major Depressive Disorder and Generalized Anxiety Disorder, follow this table:

• Escitalopram may increase the risk of having suicidal thoughts and behaviors. This risk is particularly higher in teenagers, children, and young adults under 24 years of age.
• You should not take Escitalopram if you are also taking pimozide or citalopram. Combining these medications can cause dangerous heart rhythm problems.
• Escitalopram can cause serotonin syndrome if taken with other serotonergic drugs. This condition can be life-threatening.
• If you have a history of bipolar disorder, then you should use Escitalopram tablets cautiously. Escitalopram tablets may trigger manic episodes in susceptible individuals.
• People with heart disease, low potassium or magnesium levels, or those taking other QT-prolonging medications should be monitored carefully.
• People should avoid driving a vehicle or operating heavy machinery until they know how Escitalopram tablets affect them.
• Patients with liver or kidney problems should use Escitalopram with caution.
• Pregnant and breastfeeding women must consult their doctor before use.

• Store Escitalopram tablets at room temperature (20°C-25 °C or 68°F-77 °F).
• You should keep these tablets away from heat, moisture, and direct sunlight.
• Do not store the Escitalopram tablets in bathrooms or kitchens, as these areas are often humid.
• Keep the container tightly closed when not in use.
• Do not refrigerate or freeze the tablets unless instructed by a pharmacist.
• Always check the expiry date before taking the medication and discard expired tablets safely.
• Store the medicine in a secure place out of reach of children and pets.

Escitalopram has documented interactions with 717 medications, as well as 9 disease-related interactions. Among the drug interactions identified, 271 are classified as major, 395 as moderate, and 51 as minor. Some examples include:

• Major Escitalopram Interactions
  • Dronedarone
  • Bupropion
  • Ketoconazole
  • Vilazodone
  • Amiodarone
  • Granisetron
  • Methadone
  • Quizartinib
  • Sertraline
  • Paliperidone
  • Ranolazine
  • Fentanyl
  • Lisdexamfetamine
• Minor Escitalopram Interactions
  • Avacopan
  • Metoprolol
  • Clotrimazole
  • Larotrectinib
  • Goldenseal
  • Ritonavir
  • Fosaprepitant
  • Verapamil
  • Capivasertib
• Moderate Escitalopram Interactions
  • Metronidazole
  • Ibuprofen
  • Lamotrigine
  • Apixaban
  • Ramelteon
  • Ginkgo
  • Dabigatran
  • Lorazepam
  • Fenofibrate
  • Rivaroxaban
  • Cetirizine
  • Propofol
  • Acalabrutinib
• Escitalopram Disease Interactions
• Depression
• Renal dysfunction
• Hyponatremia
• Liver disease
• Mania
• Platelet function
• Seizure disorders
• SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion)
• Weight loss

If Escitalopram is unsuitable or unavailable, the following alternatives may be considered:

Other SSRIs

• Sertraline (Zoloft)
• Fluoxetine (Prozac)
• Paroxetine (Paxil)

SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)

• Duloxetine (Cymbalta)
• Venlafaxine (Effexor XR)

Atypical Antidepressants

• Bupropion (Wellbutrin XL)
• Mirtazapine (Remeron)

Tricyclic Antidepressants

• Buspirone
• Rexulti (brexpiprazole)

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