Lexapro

Escitalopram

Major depressive episodes; panic disorder w/ or w/o agoraphobia; social anxiety disorder (social phobia); generalised anxiety disorder; obsessive-compulsive disorder (OCD).

Major depressive episodes 10 mg once daily, may be increased to max 20 mg daily. Panic disorder w/ or w/o agoraphobia Initially 5 mg for the 1st wk before increasing to 10 mg daily. May be further increased to max 20 mg daily. Social anxiety disorder 10 mg once daily. Dose may be decreased to 5 mg or increased to max 20 mg daily. Generalised anxiety disorder Initially 10 mg once daily, may be increased to max 20 mg daily. OCD Initially 10 mg once daily, may be increased to max 20 mg daily. Elderly >65 yr Initially 5 mg once daily, may be increased to 10 mg daily. Patient w/ mild or moderate hepatic impairment; poor CYP2C19 metabolisers Initially 5 mg daily for the 1st 2 wk, may be increased to 10 mg daily.

May be taken with or without food.

Hypersensitivity. Patients w/ known QT interval prolongation or congenital long QT syndrome. Concomitant treatment w/ non-selective, irreversible MAOIs; pimozide. Should not be used during pregnancy unless clearly needed & after careful consideration of the risk/benefit ratio. Breast-feeding is not recommended.

Depression is associated w/ an increased risk of suicidal thoughts, self-harm & suicide. It is a general clinical experience that the risk of suicide may increase in the early stages of recovery. Close supervision of patients & in particular those at high risk should accompany drug therapy especially in early treatment & following dose changes. Patients (& caregivers) should be alerted about the need to monitor for any clinical worsening, suicidal behaviour or thoughts & unusual changes in behaviour & to seek medical advice immediately if these symptoms present. SSRIs should be avoided in patients w/ unstable epilepsy, & patients w/ controlled epilepsy should be closely monitored. SSRIs should be used w/ caution in patients w/ a history of mania/hypomania. SSRIs/SNRIs may increase the risk of postpartum haemorrhage. SSRIs should be discontinued in any patient entering a manic phase. SSRIs including escitalopram may have an effect on pupil size resulting in mydriasis. This mydriatic effect has the potential to narrow the eye angle resulting in increased IOP & angle-closure glaucoma, especially in patients pre-disposed. Treatment w/ SSRIs may alter glycaemic control. Insulin &/or oral hypoglycaemic dosage may need to be adjusted. The use of SSRIs/SNRIs has been associated w/ the development of akathisia. Hyponatraemia has been reported rarely w/ the use of SSRIs. There have been reports of long-lasting sexual dysfunction where the symptoms have continued despite discontinuation of SSRIs/SNRIs. There have been reports of cutaneous bleeding abnormalities. Escitalopram has been found to cause a dose-dependent prolongation of the QT interval. Discontinue gradually over a period of at least 1-2 wk to reduce the possibility of discontinuation symptoms. Should not be used in childn & adolescents <18 yr.

Nausea. Decreased/increased appetite, increased wt; anxiety, restlessness, abnormal dreams, decreased libido (female & male), anorgasmia (female); insomnia, somnolence, dizziness, paraesthesia, tremor; sinusitis, yawning; diarrhoea, constipation, vomiting, dry mouth; increased sweating; arthralgia, myalgia; ejaculation disorder or impotence in male; fatigue, pyrexia.

Caution is advised when taken in combination w/ MAOIs or medicinal products known to prolong the QT interval, serotonergic medicinal products, products lowering the seizure threshold, lithium, tryptophan, St. John's Wort, oral anticoagulants or antiplatelet agents (NSAIDs), & products predominantly metabolised by the enzymes CYP2C19, CYP3A4 & CYP2D6.

Antidepressants

N06AB10 - escitalopram ; Belongs to the class of selective serotonin reuptake inhibitors. Used in the management of depression.

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