Escitalopram

What is escitalopram?

Escitalopram is used to treat depression in adults and children and teenagers 12 years of age or older. Escitalopram is also used to treat generalized anxiety disorder (GAD; excessive worry and tension that disrupts daily life and lasts for 6 months or longer) in adults, teenagers, and children 7 years of age and older. Escitalopram is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.

How should this medicine be used?

Escitalopram comes as a tablet and a solution (liquid) to take by mouth. It is usually taken once a day with or without food. To help you remember to take escitalopram, take it at around the same time every day, in the morning or in the evening. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take escitalopram exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of escitalopram and increase your dose after 1 week in adults and after 2 or 3 weeks in teenagers and children 7 years of age and older.

It may take 1 to 4 weeks or longer before you feel the full benefit of escitalopram. Continue to take escitalopram even if you feel well. Do not stop taking escitalopram without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking escitalopram, you may experience withdrawal symptoms such as mood changes, irritability, agitation, nausea, dizziness, burning, numbness, or tingling in the hands or feet, anxiety, confusion, headache, sweating, shaking, frenzied or abnormally excited mood, tiredness, and difficulty falling asleep or staying asleep. Tell your doctor if you experience any of these symptoms while you are decreasing your dose of escitalopram or soon after you stop taking escitalopram.

What special precautions should I follow?

Before taking escitalopram,

• tell your doctor or pharmacist if you are allergic to escitalopram, citalopram (Celexa), any other medications, or any of the ingredients in the tablets or solution. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
• tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past two weeks: a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Emsam, Zelapar), and tranylcypromine (Parnate).
• you should know that escitalopram is very similar to another SSRI, citalopram (Celexa). You should not take these two medications together.
• Some medications should not be taken with escitalopram. Other medications may cause dosing changes or extra monitoring when taken with escitalopram. Make sure you have discussed any medications you are currently taking or plan to take before starting escitalopram with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking escitalopram, please get the advice of your doctor or pharmacist.
• The following nonprescription or herbal products may interact with escitalopram: aspirin, ibuprofen (Advil, Motrin IB), naproxen (Aleve), St. John's wort, or tryptophan. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking escitalopram. Do not start any of these medications while taking escitalopram without discussing with your healthcare provider.
• tell your doctor if you have a low level of sodium in your blood, if you drink or have ever drunk large amounts of alcohol, or use or have ever used street drugs or have ever overused prescription medications. Also tell your doctor if you have recently had a heart attack and if you have or have ever had bleeding problems; seizures; glaucoma (a condition in which increased pressure in the eye can lead to gradual loss of vision); or liver, kidney, or heart disease.
• tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breast-feeding. If you become pregnant while taking escitalopram, call your doctor. Escitalopram may cause problems in newborns following delivery if it is taken during the last months of pregnancy.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking escitalopram.
• you should know that escitalopram may make you drowsy and may affect your judgment, thinking, and movements. Do not drive a car or operate machinery until you know how this medication affects you.
• remember that alcohol can add to the drowsiness caused by this medication.
• you should know that escitalopram may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.

What side effects can this medication cause?

Escitalopram may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• diarrhea
• constipation
• sexual problems in males; decreased sex drive, inability to get or keep an erection, or delayed or absent ejaculation
• sexual problems in females; decreased sex drive, or delayed orgasm or unable to have an orgasm
• drowsiness
• yawning
• shaking
• difficulty falling asleep or staying asleep
• increased sweating
• dizziness
• heartburn
• stomach pain
• excessive tiredness
• dry mouth
• decreased appetite
• weight loss
• flu-like symptoms
• runny nose
• sneezing

Some side effects can be serious. If you experience either of the following symptoms or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections, call your doctor immediately:

• unusual excitement
• seeing things or hearing voices that do not exist (hallucinating)
• rash
• hives or blisters
• itching
• fever
• joint pain
• difficulty breathing or swallowing
• swelling of the face, throat, tongue, lips, or eyes
• fever, sweating, confusion, fast or irregular heartbeat, severe muscle stiffness or twitching, agitation, hallucinations, loss of coordination, nausea, vomiting, or diarrhea
• abnormal bleeding or bruising
• nose bleeding
• headache
• unsteadiness
• problems with thinking, concentration, or memory
• seizures
• difficult or painful urination

Escitalopram may decrease appetite and cause weight loss and height in children. Your child's doctor will watch his or her growth carefully. Talk to your child's doctor if you have concerns about your child's growth or weight while he or she is taking this medication. Talk to your child's doctor about the risks of giving escitalopram to your child.

Escitalopram may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• dizziness
• nausea
• vomiting
• drowsiness
• fast or pounding heartbeat
• seizures
• coma (loss of consciousness for a period of time)

🔗 Reference: https://medlineplus.gov/druginfo/meds/a603005.html