Lexapro

Escitalopram

Major depressive episodes; panic disorder w/ or w/o agoraphobia; social & generalised anxiety disorder; obsessive-compulsive disorder.

Major depressive episodes, social & generalised anxiety disorder, obsessive-compulsive disorder 10 mg or 10 drops once daily. May be increased to a max of 20 mg or 20 drops daily. Panic disorder w/ or w/o agoraphobia Initially 5 mg or 5 drops on 1st wk, may be increased dose to 10 mg or 10 drops, then further increased up to max of 20 mg or 20 drops daily. Elderly >65 yr Initially ½ the usual recommended dose, consider lower max dose. Reduced hepatic function, poor CYP2C19 metabolisers Initially 5 mg or 5 drops daily for the 1st 2 wk, may be increased to 10 mg or 10 drops daily.

May be taken with or without food: Oral Drops: May be mixed w/ water, orange or apple juice.

Hypersensitivity. Concomitant treatment w/ non-selective, irreversible MAOIs; pimozide.

Discontinue use if patient develops seizure for the 1st time; w/ previous diagnosis of epilepsy; serotonin syndrome occurs. Monitor for any clinical worsening, suicidal behaviour or thoughts & unusual changes in behaviour. Patient w/ panic disorder; unstable epilepsy; controlled epilepsy; diabetes; cirrhosis; known bleeding tendencies; angle-closure glaucoma or history of glaucoma. History of mania/hypomania; suicide-related events or exhibiting significant degree of suicidal ideation prior to treatment. Akathisia; hyponatraemia. Gradually reduce dose over a period of at least 1-2 wk. Concomitant use w/ oral anticoagulants; atypical antipsychotics, phenothiazines, most TCAs, ASA, NSAIDs, ticlopidine, dipyridamole; triptans eg, sumatriptan; opioids eg, tramadol; tryptophan; St. John's wort (Hypericum perforatum). Concurrent use of electroconvulsive therapy. Not recommended w/ monoamine oxidase-A inhibitors. May affect ability to drive & use machines. Mild or moderate renal impairment; severely reduced renal function (CrCl <30 mL/min). Increased risk of postpartum haemorrhage following SSRI/SNRI exposure w/in the mth prior to birth. Not to be used during pregnancy. Not recommended during lactation. Not to be used in childn & adolescents <18 yr.

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

Non-selective, irreversible MAOIs. Increased AUC, C_max & QTc interval w/ pimozide. Risk of serotonin syndrome w/ reversible, selective MAO-A inhibitor eg, moclobemide, irreversible MAO-B inhibitor eg, selegiline, opioids eg, tramadol, triptans eg, sumatriptan. Medicinal products lowering seizure threshold eg, antidepressants (tricyclics, SSRIs), neuroleptics (phenothiazines, thioxanthenes, butyrophenones), mefloquine, bupropion & tramadol. Enhanced effects w/ lithium or tryptophan. Increased incidence of AR w/ St. John's wort (Hypericum perforatum). Altered anticoagulant effects w/ oral anticoagulants. Increased bleeding tendencies w/ NSAIDs. Combination w/ alcohol. Increased plasma conc w/ omeprazole & cimetidine; CYP2C19 inhibitors eg, fluoxetine, fluvoxamine, lansoprazole, ticlopidine. Medicinal products metabolised by CYP2D6 enzyme w/ narrow therapeutic index eg, flecainide, propafenone & metoprolol; CNS-acting medicinal products eg, desipramine, clomipramine & nortriptyline; risperidone, thioridazine & haloperidol; CYP2C19 metabolised drugs. Increased plasma levels of desipramine or metoprolol.

Antidepressants

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

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