Escitalopram

💊 What is Escitalopram used for?

• •Major depressive disorder (MDD) in adults and in people 12 years of age and older
• •Generalized anxiety disorder (GAD) in adults

How it works

The label describes escitalopram as a selective serotonin reuptake inhibitor (SSRI). The label excerpt does not explain its effects in more detail.

How it is usually taken

• •The label says escitalopram is taken by mouth once a day, in the morning or evening, with or without food. Follow the instructions from your prescriber or pharmacist about how to take it.

Comes as

• •5 mg tablets (film-coated, round)
• •10 mg tablets (film-coated, round, scored)
• •20 mg tablets (film-coated, round, scored)

⚠️ Escitalopram side effects

🛑 Who should not take Escitalopram, and who should be careful

The label says not to take it if

• 🚨You are taking a monoamine oxidase inhibitor (MAOI), or you stopped one within the last 14 days. This includes the antibiotic linezolid and intravenous methylene blue. Do not start an MAOI for at least 14 days after stopping escitalopram.
• 🚨You are taking the antipsychotic medicine pimozide.
• 🚨You are allergic to escitalopram, citalopram, or any of the ingredients in escitalopram tablets.

Tell your doctor before taking it if

• •Tell your provider about all medical conditions, including seizures or convulsions, bipolar disorder, mania, or hypomania (including family history), low blood sodium, bleeding problems, glaucoma, and heart, liver, or kidney problems.
• •Tell your provider if you are pregnant, may become pregnant, or are breastfeeding.
• •Tell your provider about all medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.
• •Your provider should screen for a personal or family history of bipolar disorder before starting this medicine.
• •The label warns of caution with a history of seizures and with operating machinery, because escitalopram can affect thinking and movement skills.

🔀 Escitalopram with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •MAOIs: taking them with escitalopram increases the risk of serotonin syndrome, and escitalopram is not to be used with them.
• •Pimozide: this combination is not allowed.
• •Other serotonin-affecting drugs, including other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids (such as tramadol, fentanyl, meperidine, and methadone), lithium, buspirone, amphetamines, tryptophan, and St. John's Wort: these can increase the risk of serotonin syndrome.
• •Sumatriptan: the label mentions reports of weakness, overactive reflexes, and poor coordination when an SSRI was used with sumatriptan.
• •Blood-thinning or pain medicines such as aspirin, NSAIDs, other antiplatelet drugs, and warfarin: these may increase the risk of bleeding. Warfarin users need careful monitoring of INR.
• •Diuretics (water pills): the label lists these as medicines to tell your provider about.
• •Concurrent use with SSRIs, SNRIs, or tryptophan is not recommended, according to the label.

Alcohol and food

The label says escitalopram can be taken with or without food. The label excerpt does not give information about alcohol use.

🤰 Escitalopram in pregnancy and breastfeeding

Pregnancy

The label says escitalopram may harm an unborn baby. Use during the third trimester may cause withdrawal symptoms or breathing, temperature control, feeding, or other problems in the baby after birth. The label also mentions an increased risk of postpartum bleeding with SSRI use near delivery and a risk of a lung condition in newborns (persistent pulmonary hypertension of the newborn). The label says there is a pregnancy registry, the National Pregnancy Registry for Antidepressants at 1-844-405-6185. Tell your provider right away if you become pregnant or think you may be pregnant.

Breastfeeding

The label says escitalopram passes into breast milk and may harm the baby. Talk with your provider about the best way to feed the baby. If you breastfeed, call your provider if the baby becomes sleepy or fussy, or is not feeding or gaining weight well.

🗓️ Storage, missed doses and taking too much

Storage

The label does not say.

If a dose is missed

The label does not say.

If too much is taken

The label lists these effects reported with overdose: seizures (which may be delayed), altered mental status including coma, heart rhythm and electrical changes (which may be delayed), high blood pressure (less often low blood pressure), and serotonin syndrome. The label recommends prolonged heart monitoring after overdose. It also says activated charcoal may be considered if given early. Seek emergency medical help right away if an overdose is suspected.

🗒️ Questions to ask about Escitalopram

• Is escitalopram right for my condition, and how long will I need to take it?
• What warning signs of worsening mood or suicidal thoughts should I watch for, and who should I call?
• Are any of my current medicines, supplements, or herbs (such as St. John's Wort) a concern with escitalopram?
• Should I be screened for bipolar disorder before starting?
• What should I do if I think I may be pregnant or I am breastfeeding?
• How should I stop taking escitalopram, and will my dose need to be reduced gradually?
• What should I do if I have bleeding, unusual sweating, or sexual side effects?

❓ Escitalopram: frequently asked questions