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Escitalopram

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Escitalopram
Clinical data
Pregnancy
category
  • C
Routes of
administration
Oral
ATC code
Legal status
Legal status
  • US: WARNING[1]
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability80%
Protein binding~56%
MetabolismLiver, specifically the enzymes CYP3A4 and CYP2C19
Elimination half-life27-32 hours
Identifiers
  • S-(+)-1-[3-(dimethylamino)propyl]-
    1-(p-fluorophenyl)-
    5-phthalancarbonitrileoxalate
CAS Number
PubChem CID
DrugBank
CompTox Dashboard (EPA)
ECHA InfoCard100.244.188 Edit this at Wikidata
Chemical and physical data
FormulaC20H21FN2O
Molar mass324.392 g/mol
(414.40 as oxalate) g·mol−1

Escitalopram (Cipralex®) is a medication developed by the Danish pharmaceutical company Lundbeck, that acts as a selective serotonin reuptake inhibitor (SSRI). It is typically used as an antidepressant to treat depression associated with mood disorders, although it also may be used in the treatment of body dysmorphic disorder and anxiety, including OCD. In the United States, the drug is marketed under the name Lexapro® by Forest Laboratories, Inc.

The recommended dosage of Lexapro is 10-20 mg a day. Exceptions include the elderly, who should only take up to 10 mg a day, and pregnant women in their third trimester should not use Lexapro at all (Forest Laboratories, [1]). As both General Anxiety Disorder (GAD) and Depression are both considered chronic conditions, treatment is recommended for several months. However, the efficacy of Lexapro over long periods of time has not been studied, therefore consistent reevaluation of the treatment is recommended for longer periods of treatment (Forest Laboratories, [2]).

Discontinuation symptoms

Discontinuation from antidepressants, especially abruptly, has been known to cause certain withdrawal symptoms. One possible discontinuation symptom from Escitalopram is a type of spontaneous nerve pulse known as paresthesia or "electric shock sensations", described by some patients as a feeling of small electric shocks, which may be accompanied by dizziness. These pulses may be short in duration, only milliseconds long, may affect any region of the body, and recur up to several times a minute, throughout all waking hours. They can be increased by physical activity, but are not solely linked to muscular activity. Other discontinuation symptoms include extreme sensitivity to loud sounds and bright lights, chills, hot flushes, cold sweats, reddening of the face, abdominal pain, weight gain and extreme mental fatigue. Also possible is severe irritability and sadness/depression like symptoms.[2]

One study, using a specific assesment scale, such as DESS, suggests that in the case of escitalopram the incidence rate of discontinuation symptoms are mild and comparable to that of placebo, citing it as "very well tolerated".[3]


Footnotes

  1. ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 Oct 2023.
  2. ^ "Lexapro -- Warnings". RxList. 12/08/2004. Retrieved 2006-10-22. {{cite web}}: Check date values in: |date= (help)
  3. ^ Wade A, Michael Lemming O, Bang Hedegaard K (2002). "Escitalopram 10 mg/day is effective and well tolerated in a placebo-controlled study in depression in primary care". Int Clin Psychopharmacol. 17 (3): 95–102. PMID 11981349.{{cite journal}}: CS1 maint: multiple names: authors list (link)

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