Escitalopram Sandoz

Escitalopram

Major depressive episodes, panic disorder w/ or w/o agoraphobia, social anxiety disorder (social phobia). Generalized anxiety disorder (GAD) & obsessive-compulsive disorder.

Major depressive episodes 10 mg once daily. Max: 20 mg once daily, after at least a wk. After symptoms resolve, treatment for at least 6 mth is required. 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, obsessive-compulsive disorder & GAD 10 mg once daily. Max: 20 mg once daily. Elderly >65 yr Initially 5 mg once daily, may be increased to 10 mg once daily. Patients w/ mild or 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. Concomitant use w/ non-selective, irreversible MAOIs; reversible MAOIs eg, moclobemide or reversible non-selective MAOIs linezolid; drugs known to prolong QT interval. Patients w/ known QT-interval prolongation or congenital long QT syndrome.

Paradoxical anxiety. Discontinue if seizure occurs. Increased risk of suicide-related events. Avoid use in patients w/ unstable epilepsy. Closely monitor patients w/ controlled epilepsy. History of mania/hypomania. May alter glycaemic control. Development of akathisia or psychomotor restlessness. Patients at risk of hyponatraemia, eg, elderly & patients w/ cirrhosis; w/ known bleeding tendencies; CHD, QT interval prolongation, significant bradycardial; recent acute MI or uncompensated heart failure; angle-closure glaucoma or history of glaucoma; electroconvulsive therapy (ECT). Concomitant use w/ oral anticoagulants, drugs known to affect platelet function. Gradually taper drug when discontinuing treatment over a period of several wk or mth. Correct electrolyte disturbances eg, hypokalaemia & hypomagnesemia prior to treatment. Consider an ECG review in patients w/ stable cardiac disease. W/draw treatment if signs of cardiac arrhythmia occurs during treatment & perform ECG. May impair the ability to drive or use machinery. Pregnancy & lactation. Childn & adolescents <18 yr.

Headache; 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, impotence (male); fatigue, pyrexia.

Concomitant use w/ irreversible non-selective MAOIs & reversible, selective MAO-A inhibitor eg, moclobemide are contraindicated; reversible, non-selective MAOI eg, linezolid; irreversible, selective MAO-B inhibitor eg, selegiline; drugs that prolong QT interval eg, Class IA & III antiarrhythmics, antipsychotics (eg, phenothiazines, pimozide, haloperidol), TCAs, certain antimicrobials (eg, sparfloxacin, moxifloxacin, erythromycin IV, pentamidine, anti-malarials), certain antihistamines (eg, astemizole, mizolastine). Serotonin syndrome w/ serotonergic drugs eg, tramadol, sumatriptan & other triptans. Seizure threshold may be lowered w/ antidepressants, neuroleptics, mefloquine, bupropion & tramadol. May have enhanced effects w/ lithium & tryptophan. Increased adverse reactions w/ herbal remedies containing St. John's wort (Hypericum perforatum). May alter anti-coagulant effects of oral anticoagulants. Alcohol. Increased risk of malignant arrhythmias w/ hypokalaemia/hypomagnesaemia-inducing drugs. Moderate increased plasma conc w/ omeprazole & cimetidine. Drugs w/ narrow therapeutic index eg, flecainide, propafenone & metoprolol (when used in cardiac failure); antidepressants eg, desipramine, clomipramine or nortriptyline, antipsychotics eg, risperidone, thioridazine & haloperidol. May cause weak inhibition of drugs metabolised by CYP2C19.

Antidepressants

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

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