Indications

Escitalopram oxalate is indicated for the treatment of major depressive episodes.

• Treatment of panic disorder with or without amnesia.
• Treatment of social anxiety disorder (social phobia).
• Treatment of generalized anxiety disorder.
• Treatment of obsessive-compulsive disorders.

Pharmacology

Escitalopram is an oral selective serotonin reuptake inhibitor (SSRI). Escitalopram is the pure enantiomer of the racemic bicyclic phthalate derivative, citalopram. Escitalopram is at least 100 times more potent than Renantiomer in inhibiting 5HT reuptake. Escitalopram has little or no affinity for serotonergic or other receptors, including alpha and beta-adrenergic receptors for dopamine, histamine, muscarinic, and benzodiazepines.

Dosage & Administration

The safety of daily doses above 20 mg has not been demonstrated. Escitalopram Oxalate is administered as a single daily dose and may be taken with or without food.

Major depressive episodes: Usual dosage is 10 mg once daily. Depending on individual patient response, the dose may be increased to a maximum of 20 mg daily. Usually, 2-4 weeks are necessary to obtain an antidepressant response. After the symptoms resolve, treatment for at least 6 months is required for consolidation of the response.

Panic disorder with or without agoraphobia: An initial dose of 5 mg is recommended for the first week before increasing the dose to 10 mg daily. The dose may be further increased, up to a maximum of 20 mg daily, dependent on individual patient response. Maximum effectiveness is reached after about 3 months. The treatment lasts several months.

Social anxiety disorder: Usual dosage is 10 mg once daily. Usually, 2-4 weeks are necessary to obtain symptom relief. The dose may subsequently, depending on individual patient response, be decreased to 5 mg or increased to a maximum of 20 mg daily. Social anxiety disorder is a disease with a chronic course, and treatment for 12 weeks is recommended to consolidate response. Long-term treatment of responders has been studied for 6 months and can be considered on an individual basis to prevent relapse; treatment benefits should be re-evaluated at regular intervals. Social anxiety disorder is a well-defined diagnostic terminology of a specific disorder, which should not be confounded with excessive shyness. Pharmacotherapy is only indicated if the disorder interferes significantly with professional and social activities. The place of this treatment compared to cognitive behavioral therapy has not been assessed. Pharmacotherapy is part of an overall therapeutic strategy.

Generalized anxiety disorder: Initial dosage is 10 mg once daily. Depending on the individual patient response, the dose may be increased to a maximum of 20 mg daily. Long-term treatment of responders has been studied for at least 6 months in patients receiving 20 mg/day. Treatment benefits and dose should be re-evaluated at regular intervals.

Obsessive-Compulsive Disorder: Initial dosage is 10 mg once daily. Depending on the individual patient response, the dose may be increased to a maximum of 20 mg daily. As OCD is a chronic disease, patients should be treated for a sufficient period to ensure that they are symptom-free. Treatment benefits and dose should be re-evaluated at regular intervals.

Escitalopram should generally be administered once daily, morning or evening with or without food.

Interactions

As an SSRI or related antidepressant, it should not be used within 2 weeks after stopping MAOI. On the contrary, MAOI should not do this. Start at least 1 week after stopping SSRI or related antidepressants (paroxetine and sertraline for 2 weeks, fluoxetine for at least 5 weeks).

Contraindications

Patients who are known to be allergic to escitalopram or citalopram or to any inactive ingredients in pharmaceuticals should not use escitalopram. Patients taking monoamine oxidase/pimozide are prohibited from using escitalopram at the same time.

Side Effects

SSRIs are less sedating and have fewer antitoxic and cardiotoxic effects than tricyclic antidepressants. Side effects of SSRIs include gastrointestinal effects (dose-related and quite common including nausea, vomiting, dyspepsia, abdominal pain, diarrhea, and constipation), anorexia with weight loss (increased appetite and weight gain also reported), and hypersensitivity reactions including rash, urticaria, angioedema, anaphylaxis, arthralgia, myalgia, and photosensitivity; Other side effects include dry mouth, nervousness, anxiety, headache, insomnia, tremors, dizziness, weakness, hallucinations, drowsiness, convulsions, galactorrhea, sexual dysfunction, urinary retention, sweating, mania or mania, dyskinesia and dyskinesia, disorders visuals.

Pregnancy

When treating pregnant women with Escitalopram in the third trimester, doctors should carefully weigh the potential risks and benefits of treatment. It is excreted in breast milk. The decision to continue or discontinue breastfeeding or treatment with Escitalopram should take into account the risk of exposure to citalopram for the infant and the benefit of treatment with Escitalopram for the mother.

Precautions

SSRIs should be used with caution in patients with epilepsy (avoid use when there is poor control, discontinue use if seizures occur), synchronized electroconvulsive therapy (fluoxetine reports prolonged seizures), history of mania, heart disease, diabetes, angle glaucoma closed, simultaneous. The use of medications increases the risk of bleeding, a history of bleeding disorders (especially gastrointestinal bleeding), and liver and kidney damage.

Therapeutic Class

SSRIs & related anti-depressant drugs

Storage Conditions

Store below 30°C temperature and protect from light & moisture. Keep the medicine out of the reach of children.

Generic

Pharmaceutical Name

Popular Pharmaceuticals Ltd