Escitalopram is used to treat depression.
This medicine may also be used to treat other mood-related disorders such as general feeling of anxiousness, social anxiety disorder (fear of social situations), panic disorder (with or without a fear of places and situations that might cause a feeling of being trapped, helpless, or embarrassed), and obsessive compulsive disorder or OCD (a disorder characterised by uncontrollable urge to do repetitive and ritualised behaviours).
Take Escitalopram exactly as directed by your doctor or according to the instruction on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
This medicine is available as a tablet, orodispersible tablet, or oral solution.
If you are taking the orodispersible tablet, follow these steps:
- Remove it from the foil only just before you take it. Do not leave the orodispersible tablet exposed to air. Do not push the orodispersible tablet through the foil as it is fragile and easily broken.
- Remove the orodispersible tablet with dry hands by peeling the backing off the foil and tipping the tablet onto your dry hands.
- Place the orodispersible tablet directly on your tongue as soon as it is taken out of the foil. The orodispersible tablet will immediately start to melt on the tongue. It can then be swallowed with or without water.
Do not cut, break, or crush the orodispersible tablet.
If you are taking the oral solution, shake the bottle well before you take the medicine to ensure that the liquid is evenly mixed. Follow the instructions on the label or your doctor's advice when measuring your dose. If provided, use the measuring cup or spoon to measure your dose.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type of your condition and response to the medication.
Do not stop taking Escitalopram suddenly as it may worsen your condition. Your doctor will gradually reduce the dose before stopping it completely. Follow your doctor's instructions carefully.
Escitalopram must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have a heart rhythm disorder as Escitalopram may not be suitable for you.
Do not take this medicine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Do not take Escitalopram with medicines for mood disorders, irregular heartbeat, cold or allergy, malaria (a disease that is transmitted to people through the bite of an infected mosquito), methaemoglobinaemia (a blood disorder in which too little oxygen is delivered to the cells), or antibiotics. Please see the section "Can I take this with other medicines?" below for more information.
Inform your doctor if you have the following conditions:
- epilepsy (fits or seizures) or history of seizure disorder
- bipolar disorder (a mental condition that causes extreme mood changes) or history of mania (feeling highly excited, being over-active and easily irritated or distracted)
- having thoughts of self-harm
- bleeding tendency
- heart disease or problem e.g. slow heartbeat, recent heart attack
- changes in the levels of electrolytes in the blood e.g. low levels of potassium or magnesium
- current or history of glaucoma (increased pressure in the eye)
- diabetes
- liver disease
- severe kidney disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Escitalopram to a child or the elderly. Children and elderly people may be more sensitive to the side effects.
Notify your doctor if you are scheduled for or have recently undergone electroshock therapy (also known as electroconvulsive therapy or ECT).
Medicines for depression such as Escitalopram may increase the risk of suicidal thoughts and behaviour. As depression and some psychiatric disorders are themselves associated with an increased risk of suicide, it is important for you or your family members to monitor your condition, especially at the start of treatment and if your dosage is still being adjusted. If you experience new or sudden changes in mood, behaviour, thoughts or feelings, or a worsening of your depression with suicidal thoughts or attempts, harm to self or harm to others, contact your doctor immediately.
Some genetic traits can affect this medicine's efficacy or can enhance its side effects. Individuals who are ultrarapid metabolisers of CYP2C19 may respond poorer to Escitalopram, while those who are poor or intermediate metabolisers of CYP2C19 may have an increased risk of experiencing the side effects of this medicine. Although not routinely done, your doctor may advise you to undergo genetic testing to check if this medicine is best suited for you. If you know you have this gene type, inform your doctor.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Screening for personal or family history of mania or bipolar disorder must be done before treatment to know if this medicine is suited for you to take.
- Routine tests (e.g. liver and kidney functions, electrolyte levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring of signs and symptoms of serotonin syndrome (drug reaction that results from excessive serotonin levels in the body) may also be needed.
What lifestyle changes should I make to cope with depression?
Regular exercise and eating a healthy diet will help increase energy and hormones in the body such as serotonin, endorphins and other feel-good chemicals that minimise mood swings. Get enough sleep, as lack of sleep may cause irritability, moodiness, sadness, and tiredness.
Escitalopram may cause drowsiness or affect your ability to make decisions, think clearly, or react quickly. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: headache, dizziness, nausea, diarrhoea, vomiting, constipation, dry mouth, tiredness, fever, increased sweating, joint or muscle pain, lack of or increased appetite, weight gain, numbness or tingling sensation in the hands and feet, difficulty sleeping, yawning, and clogged nose.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs and symptoms of serotonin syndrome e.g. agitation, confusion, hallucinations (seeing, hearing or feeling things that are not existent), fever, fast heartbeat, excessive sweating, muscle stiffness or spasms
- unusual bleeding or bruising or bleeding that takes a long time to stop
- having thoughts of self-harm or worsening anxiety (being more anxious)
- fast or irregular heartbeat, fainting
- fits or seizures
- changes in sex drive
- trouble focusing, memory problems, weakness, change in balance
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Escitalopram if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine, or tranylcypromine in the last 14 days.
Do not take Escitalopram with the following medicines:
- medicines for mood disorders e.g. pimozide, haloperidol, chlorpromazine
- medicines for irregular heartbeat e.g. quinidine, amiodarone
- certain antibiotics e.g. linezolid, sparfloxacin, moxifloxacin
- certain medicines for cold or allergy e.g. astemizole, mizolastine
- halofantrine (medicine to treat malaria)
- intravenous methylthioninium chloride [also known as methylene blue] (medicine used to treat methaemoglobinaemia)
Inform your doctor and pharmacist if you are taking any of these medicines:
- blood-thinning medicines e.g. aspirin, warfarin, ticlopidine, dipyridamole
- NSAIDs (medicines for pain and inflammation) e.g. ibuprofen, diclofenac
- strong painkillers e.g. tramadol, fentanyl
- other medicines for mood disorders e.g. lithium
- other medicines for depression e.g. fluvoxamine, bupropion, desipramine
- medicines for migraine e.g. sumatriptan
- medicines that reduce stomach acid production e.g. omeprazole, cimetidine
- buspirone (medicine for anxiety)
- mefloquine (medicine to treat malaria)
- fluconazole (medicine to treat fungal infection)
- metoprolol (medicine for high blood pressure)
- St. John's wort (herbal medicine)
This list does not include all medicines that may interact with Escitalopram.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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