Escitalopram
- Atc Codes:N06AB10
- CAS Codes:219861-08-2
- PHARMGKB ID:219861-08-2
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Adescilan, Bilodel, Cipralex, Escitil, Escitaburg, Escitagen, Escitaham, Escitalobene, Escitalodissa, Escitalofarm, Escitalopram, Escitasan, Escitatifi, Esoprex, Mozarin; Belgium: Sipralexa; Bulgaria: Cipralex, Escitalopram; Cyprus: Cipralex; Czech Republic: Cipralex, Elicea, Escirdec, Escitalopram, Escitil, Escitralix, Esoprex, Lenuxin; Denmark: Cipralex, Entact, Escitalopram, Esertia; Estonia: Anamiba, Cipralex, Ciraset, Elicea, Escitalopram, Nepanil, Starcitin ES; Finland: Cipralex; France: Seroplex; Germany: Cipralex, Escitalobene, Escitalopram; Greece: Cipralex, Entact; Hungary: Cipralex, Escitalopram, Escitil, Kapistrol, Lanocipram, Nepanil, Scippa; Ireland: Esciprex, Escitalopram, Lexapro, Scippa; Italy: Cipralex, Entact; Latvia: Cipralex, Ciraset, Elicea, Escitalopram, Nepanil, Starcitin ES; Lithuania: Cipralex, Ciraset, Escitil, Escitaham, Escitalopram, Eslorex, Kapistrol, Lanocipram, Nepanil, Starcitin ES; Malta: Cipralex; Netherlands: Cipralex, Escitalopram, Lexapro; Poland: Escitalopram, Lexapro; Portugal: Anamiba, Cipralex, Depart, Escitaham, Escitalopram, Mangolida, Tacipram, Xapesc, Zecidec, Zocital; Romania: Cipralex, Depresinal, Escitalopram, Escitasan, Escitil, Eslorex, Lenuxin; Slovakia: Cipralex, Elicea, Escitalopram, Escitil, Esoprex, Lenuxin; Slovenia: Cipralex, Ecytara, Escitaham, Escitalopram; Spain: Cipralex, Esertia; Sweden: Cipralex, Entact, Esertia, Prilect, Seroplex; UK: Cipralex.
North America
Canada: Cipralex; USA: Lexapro.
Latin America
Argentina: Aramix, Citalax, Esciterokam, EX3, Lexapro, Lextor, Meridian, Novo Humorap; Brazil: Lexapro; Mexico: Lexapro.
Drug combinations
Chemistry
Escitalopram Oxalate: C~20~H~21~FN~2~O C~2~H~2~O~4~. Mw: 414.43. (1) S-(+)-5-Isobenzofurancarbonitrile, 1-[3-(dimethylamino)propyl]-1-(4-fluorophenyl)-1,3-dihydro-, oxalate; (2) S-(+)-1-[3-(Dimethylamino)propyl]-1-(p-fluorophenyl)-5-phthalancarbonitrile oxalate. CAS-219861-08-2 (2000).
Pharmacologic Category
Antidepressants; Selective Serotonin-reuptake Inhibitors. (ATC-Code: N06AB10).
Mechanism of action
Escitalopram is the S-enantiomer of the racemic derivative citalopram, which inhibits the reuptake of serotonin with little to no effect on norepinephrine or dopamine reuptake. It has no or very low affinity for 5-HT~1-7~, α – and β-adrenergic, D~1-5~, H~1-3~, M~1-5~, and benzodiazepine receptors. Does not bind, or has low affinity for Na^+^, K^+^, Cl^-^, and Ca^2+^ ion channels.
Therapeutic use
Treatment of major depressive disorder; generalized anxiety disorders.
Pregnancy and lactiation implications
Adverse effects observed in animal studies. If treatment during pregnancy is required, tapering of therapy should be considered during the 3^rd^ trimester in order to prevent withdrawal symptoms in the infant. Potential for serious adverse effects (e.g. excessive somnolence, decreased feeding, weight loss) in nursing infants.
Unlabeled use
Treatment of mild dementia-associated agitation in nonpsychotic patients.
Contraindications
Hypersensitivity to escitalopram, citalopram, or any component of the formulation. Concomitant use or within 2 weeks of MAOIs.
Warnings and precautions
Antidepressants increase the risk of suicidal thinking and behavior in children, adolescents, and young adults (18-24 years of age) with major depressive disorder and other psychiatric disorders. Escitalopram is not FDA approved for use in children. Potentially fatal interaction (serotonin syndrome) with MAOIs or linezolid. Concurrent use of serotonin precursors (e.g. tryptophan) not recommended. Potentially life-threatening serotonin syndrome may occur. Worsening of depression and/or emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior may occur in both adult and pediatric patients with major depressive disorder or other psychiatric disorders. May unmask bipolar disorder. Escitalopram is not approved for use in treating bipolar depression. Withdrawal symptoms particularly upon abrupt discontinuance of the drug. Episodes of abnormal bleeding (e.g. upper GI bleeding) reported. SIADH secretion or hyponatremia (rarely) may occur. Activation of mania and hypomania has occurred (use with caution in history of mania). Seizures reported (initiate with caution in history of seizures). Interference with cognitive and motor performance possible. Use with caution in altered metabolism or hemodynamics. Use with caution in hepatic or renal impairment (clearance decreased and plasma concentrations increased). May cause or exacerbate sexual dysfunction. Use caution with concomitant use of NSAIDs, ASA, or other drugs that affect coagulation (risk of bleeding may be potentiated). Use caution in elderly patients (risk of hyponatremia and other adverse events may be increased). Use caution in pregnant patients (high doses of citalopram associated with teratogenicity in animals). May increase risks associated with electroconvulsive therapy. Withdrawal syndrome.