Escitalopram

GENERIC NAME: escitalopram

DRUG CLASS AND MECHANISM
Escitalopram is an oral drug that is used for treating depression and generalized anxiety disorder. Chemically, escitalopram is similar to citalopram (Celexa). Both are in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also includes fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). SSRIs work by affecting neurotransmitters in the brain, the chemical messengers that nerves use to communicate with one another. Neurotransmitters are made and released by nerves and then travel to other nearby nerves where they attach to receptors on the nerves. Some neurotransmitters that are released do not bind to receptors and are taken up by the nerves that produced them. This is referred to as "reuptake." Many experts believe that an imbalance of neurotransmitters is the cause of depression. Escitalopram prevents the reuptake of one neurotransmitter, serotonin, by nerves, an action which results in more serotonin in the brain to attach to receptors. The FDA approved escitalopram in August 2002.

PRESCRIPTION: Yes

GENERIC AVAILABLE: No

PREPARATIONS: Tablets: 5, 10, and 20 mg. Solution: 1 mg/ml

PRESCRIBED FOR
Escitalopram is approved for the treatment of depression and generalized anxiety disorder. Drugs in the SSRI class also have been studied in persons with obsessive compulsive disorders and panic disorders, but escitalopram is not approved for this purpose.

DOSING
The usual starting dose of escitalopram is 10 mg once daily in the morning or evening. The dose may be increased to 20 mg once daily after 1 week. Benefit may not be seen until treatment has been given for up to 4 weeks. A daily dose of 20 mg may not be anymore effective than 10 mg daily for treatment of depression. Escitalopram can be taken with or without food.

DRUG INTERACTIONS
All SSRIs, including escitalopram, should not be combined with drugs in the monoamine oxidase (MAO) inhibitor class of antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl) and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, high fevers, tremor or muscle rigidity, and increased activity. At least 14 days should elapse after discontinuing escitalopram before starting an MAO inhibitor. Conversely, at least 14 days should elapse after discontinuing an MAO inhibitor before starting escitalopram.

Tryptophan can cause headaches, nausea, sweating, and dizziness when taken with any SSRI.

Use of selective serotonin inhibitors may increase the risk of gastrointestinal bleeding in patients taking aspirin, nonsteroidal antiinflammatory drugs, and other drugs that cause bleeding.

USES
Escitalopram is a selective serotonin reuptake inhibitor (SSRI) used to treat depression and generalized anxiety disorder (GAD). It works by helping to restore the balance of certain natural chemicals in the brain (neurotransmitters).

HOW TO USE
Take this medication by mouth usually once daily with or without food; or as directed by your doctor. You should take your dosage at the same time each day, either in the morning or in the evening. The dosage is based on your medical condition and response to therapy. It is important to continue taking this medication as prescribed even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased. It may take up to several weeks before the full benefit of this drug takes effect.

SIDE EFFECTS
Nausea, diarrhea, constipation, loss of appetite, stomach pain, dizziness, drowsiness, trouble sleeping, fatigue, increased sweating, or dry mouth may occur. If any of these effects persist or worsen, notify your doctor promptly. Tell your doctor immediately if any of these serious side effects occur: changes in sexual ability/interest, unusual or severe mental/mood changes. Tell your doctor immediately if any of these unlikely but serious side effects occur: black stools, "coffee ground" vomit, easy bruising/bleeding. Males - If you experience a painful and prolonged erection, stop using this drug and seek immediate medical attention. An allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS
Tell your doctor your medical history, especially of: liver problems, kidney problems, seizures, heart problems, other mental/mood disorders (e.g., bipolar disorder), thyroid problems, mineral (electrolyte) problems (e.g., hyponatremia, SIADH), any allergies. This drug may make you dizzy or drowsy; use caution engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages. Though uncommon, depression can lead to thoughts or attempts of suicide. Tell your doctor immediately if you have any suicidal thoughts, worsening depression, or any other mental/mood changes (including new or worsening anxiety, agitation, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, rapid speech). Keep all medical appointments so your healthcare professional can monitor your progress closely and adjust/change your medication if needed. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. If this medication is used during the last 3 months of pregnancy, infrequently your newborn may develop symptoms including feeding or breathing difficulties, seizures, muscle stiffness, jitteriness, or constant crying. However, do not stop taking this medication unless your doctor directs you to do so. Report any such symptoms to your doctor promptly. This drug passes into breast milk. Because of the potential risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

OVERDOSE
If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: irregular heartbeat, fainting, severe dizziness or lightheadedness, seizures.

MISSED DOSE
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE
Store at room temperature (77 degrees F or 25 degrees C) away from light and moisture. Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Do not store in the bathroom.

Note : This product information is intended only for residents of the India. Taj Pharmaceuticals Limited, medicines help to treat and prevent a range of conditions—from the most common to the most challenging—for people around the world.