Indication and Side Effects of Escitalopram 5/10/20mg

Escitalopram is antidepressant that belongs to Selective Serotonin Release Inhibitors (SSRIs), which are being used to treat anxiety, depression, social anxiety disorder, headache, depressive illness, and panic disorders.

Indications

For the treatment of major depressive episodes

For the treatment of the panic disorder

For the treatment of social anxiety disorders such as social phobia

For the treatment of generalized anxiety disorder

For the treatment of migraine headache

Prevention of depression relapse

Social anxiety disorders

Dosage and administration

Dosage

Normal Dose: 10mg/day

Maximum Dose: 20mg/day

Elderly patients (65 years and above):  5mg/day

Reduced Hepatic/Renal Function: 5mg/day

Treatment of major depressive episodes

The usual dosage for major depressive disorder is 10mg once daily. The dose may be increased to 20mg daily depends on the condition and severity. The treatment duration is usually 2-4 weeks while for consolidation of the response the treatment can be extended to 6 months.

Treatment of panic disorder with or without agoraphobia

For panic disorder, the recommended dosage is 5mg once daily. The dose can be increased to 10mg-20mg depends on the individual patient’s response. You may find maximum effectiveness in 3-6 months.

Treatment of social anxiety disorders such as social phobia

The recommended dose for social anxiety disorder is 10mg once daily. If the desired therapy is not be covered within 1 week, the dose can be increased to 20mg. 3 months of treatment is also recommended for social anxiety disorder.

Treatment of generalized anxiety disorder

For general anxiety disorder, the recommended dose is 10mg once daily. If you want to achieve consolidate response, you need to treat your patient for about 3-6 months. For elder patients, the recommended dose is 5mg once daily and can be increased to 10mg in severe conditions.

It is not recommended for children below 18 years.

Why Use Escitalopram?

Depression is a serious concern; don’t take it easy.

FDA approved drug for major depressive disorders and generalized anxiety disorders

Maintains the mental balance by increasing the serotonin level in the brain

Escitalopram 10mg daily is more effective than Paroxetine and Placebo for generalized anxiety disorder

Safe in patients with medical conditions like cardiovascular disorders and diabetes

Side Effects of Escitalopram

Escitalopram is usually well-tolerated, the undesirable events that can occur include insomnia, nausea, changes in sexual functions, sweating, fatigue, somnolence, drowsiness, and headache.

Physical and Psychological Dependence

Physicians should carefully evaluate Escitalopram patients for history of drug abuse and follow such patients closely e.g development of tolerance, incrementations of dose, drug-seeking behavior.

Contraindications

Hypersensitivity to escitalopram or to any of the excipients. Concomitant treatment with non-selective, irreversible monoamine oxidase inhibitors (MAO-inhibitors).

Seizures

If it starts to develop seizures in any patient, just discontinue Escitalopram. Secondly, SSRIs should be discontinued if there is an increase in seizures frequency. Do not give Escitalopram to patients with unstable epilepsy.

Diabetes

SSRIs should be cautious in patients with an SSRI that may alter glycaemic control. In such cases, insulin and oral hypoglycaemic dosage may need to be adjusted.

Mania

SSRIs should be discontinued in any patient entering a manic phase.

Suicide

The possibility of suicide attempts is inherent in depression and may persist until significant improvement occurs.

Pregnancy and Lactation

In reproductive toxicity studies performed in rats with Escitalopram embryo-fetotoxic effects were observed but no increased incidence of malformations.  There is limited clinical data available about Escitalopram regarding exposure in pregnancy.

It is expected that Escitalopram will be excreted into human milk and breastfeeding is not recommended during the treatment.