Excita

Escitalopram

Major depressive disorder, panic disorder w/ or w/o agoraphobia, social anxiety disorder (social phobia), generalized anxiety disorder, obsessive-compulsive disorder.

Major depressive disorder Adult 10 mg once daily for at least 6 mth. Max: 20 mg daily after a min of 1 wk. Adolescent 12-17 yr 10 mg once daily. Max: 20 mg after a min of 3 wk. Panic disorder w/ or w/o agoraphobia Initially 5 mg for the 1st wk before increasing to 10 mg daily. Max: 20 mg daily. Social anxiety disorder 10 mg once daily. May subsequently decrease dose to 5 mg or increase to a max of 20 mg daily. Generalised anxiety disorder & obsessive-compulsive disorder Initially 10 mg once daily, may be increased to 20 mg daily. Elderly >65 yr Initially 5 mg once daily, may be increased to 10 mg daily. Mild to moderate hepatic impairment & poor metabolisers of CYP2C19 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 use w/ non-selective irreversible MAOIs, reversible MAO-A inhibitors (eg, moclobemide), reversible non-selective MAOIs (eg, linezolid); pimozide; drugs known to prolong QT interval.

Increased anxiety symptoms at the beginning of treatment in patients w/ panic disorders. Discontinue if seizures develop for the 1st time or if there is an increase in seizure frequency. Avoid in patients w/ unstable epilepsy; closely monitor those w/ controlled epilepsy. History of mania/hypomania; discontinue if patient enters a manic phase. May alter glycemic control in diabetic patients. Careful monitoring in patients w/ history of suicide-related events, or those exhibiting a significant degree of suicidal ideation prior to commencement of treatment. Akathisia/psychomotor restlessness. Hyponatremia. Concurrent administration w/ electroconvulsive therapy. Discontinue immediately if serotonin syndrome occurs. CHD. Dose-dependent prolongation of QT interval. Consider an ECG review in patients w/ stable cardiac disease before starting treatment. W/draw treatment & perform ECG if signs of cardiac arrhythmia occur during treatment. Pregnancy. Not recommended during lactation.

Nausea. Decreased/increased appetite, wt increased, anxiety, restlessness, abnormal dreams, libido decreased, anorgasmia, insomnia, somnolence, dizziness, paraesthesia, tremor, sinusitis, yawning, diarrhea, constipation, vomiting, dry mouth, sweating increased, arthralgia, myalgia, ejaculation disorder, impotence, fatigue & pyrexia.

May lead to enhancement of serotonergic effects w/ serotonergic drugs (eg, tramadol, sumatriptan & other triptans). Drugs capable of lowering seizure threshold eg, antidepressants (tricyclics, SSRIs), neuroleptics (phenothiazines, thioxanthenes & butyrophenones), mefloquine, bupropion & tramadol. Enhanced effects w/ lithium or tryptophan. Increased incidence of adverse reactions w/ herbal remedies containing St. John's wort. Increased plasma conc w/ CYP2C19 inhibitors (eg, omeprazole, esomeprazole, fluvoxamine, lansoprazole, ticlopidine) or cimetidine. Drugs mainly metabolised by CYP2D6 & have narrow therapeutic index eg, flecainide, propafenone & metoprolol or some CNS acting medicinal products eg, antidepressants (desipramine, clomipramine & nortryptyline or anti-psychotics like risperidone, thioridazine & haloperidol). Oral anticoagulants & drugs known to affect platelet function eg, atypical antipsychotics, phenothiazines, TCAs, ASA & NSAIDs, ticlopidine, dipyridamole & patients w/ known bleeding tendencies; other centrally acting drugs; alcohol (not advisable).

Antidepressants

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

Rx