Exploring Escitalopram: Side Effects, Proper Dosage, Applications, and Additional Information.
Generic Escitalopram oral tablet, known as Lexapro in its branded form, is a prescription medication utilized for treating depression in adults and children aged 12 years and above, as well as addressing generalized anxiety disorder in adults. It falls under the selective serotonin reuptake inhibitor (SSRI) drug category.
Escitalopram Highlights
- Both a generic and brand-name version of Escitalopram can be obtained. The brand-name variant is Lexapro.
- The medication is also available as an oral solution.
- Escitalopram is employed to treat depression in adults and adolescents aged 12 years or older as well as generalized anxiety disorder in adults.
Understanding Escitalopram
As the brand-name drug Lexapro, Escitalopram oral tablet is a prescription medication. It is also available in the generic form, which often offers cost savings. However, generic versions may not be accessible in all potencies or types as the brand-name counterpart. Discuss with your healthcare professional to determine if the generic version would serve you well.
Escitalopram is additionally provided as an oral solution. This analysis primarily considers the oral tablet form of Escitalopram.
Purpose
Escitalopram is employed to manage major depressive disorder, commonly referred to as depression, in adults and adolescents aged 12 years or older. It is also used to manage generalized anxiety disorder in adults.
It's important to note that the Food and Drug Administration (FDA) has approved Lexapro, the brand-name version of this medication, to treat generalized anxiety disorder in children aged 7 years or older. However, at this juncture, escitalopram hasn't been approved for this therapy by the FDA.
Escitalopram might be utilized within combination therapies. This involves consuming the medication with other medications.
Mechanisms
This drug is granted to the class of medications known as selective serotonin reuptake inhibitors (SSRIs). SSRIs are commonly utilized to treat similar conditions. Escitalopram increases the quantity of a natural substance present in the brain called serotonin. Serotonin is responsible for preserving mental balance.
Escitalopram Side Effects
Escitalopram can induce mild or severe side effects. The accompanying list touches upon some of the notable side effects that may occur while using Escitalopram. Remember that this list does not comprise all possible side effects.
To learn further about the potential side effects of Escitalopram or to gain insights into how to manage bothersome side effects, consult with your health care provider or pharmacist.
More Common Side Effects
The more common side effects experienced by adults differ from the more common side effects observed in children.
More common side effects for adults may include:
- nausea
- drowsiness
- weakness
- dizziness
- anxiousness
- trouble sleeping
- sexual problems
- sweating
- tremors
- urinary tract infection (UTI)
- lack of appetite
- dry mouth
- constipation
- yawning
In addition to these side effects, children may experience the following more common side effects:
- increased thirst
- atypical muscle movement or agitation
- unexpected nosebleeds
- difficulty urinating
- heavy menstrual periods
- potential slowed growth rate and weight change
If these side effects are mild, they might subside within a few days or a couple of weeks. Should they be more severe or persist, talk with your healthcare provider or pharmacist.
Serious Side Effects
Contact your doctor immediately if you encounter severe side effects. Contact 911 if your symptoms feel life-threatening or if you believe you're having a medical emergency. Serious side effects and their symptoms may include:
- Severe allergic reactions. Signs can include:
- difficulty breathing
- swelling of the face, tongue, eyes, or mouth
- rash, hives, or blisters (alone or with fever or joint pain)
- Seizures or convulsions.
- Suicidal thoughts and behaviors. To learn more, see the “Escitalopram Warnings” section.
- Serotonin syndrome. Symptoms can include:
- agitation, hallucinations, coma, or other changes in cognitive function
- coordination problems or muscle twitching (overactive reflexes)
- rapid heart rate
- high or low blood pressure
- sweating or fever
- nausea, vomiting, or diarrhea
- muscle rigidity
- Low sodium levels in your blood. Symptoms can include:
- headache
- confusion
- difficulty concentrating
- thinking or memory problems
- weakness
- unsteadiness (which may lead to falls)
- seizures
- Manic episodes. Symptoms can include:
- greatly increased energy
- severe difficulty sleeping
- racing thoughts
- reckless behavior
- bizarre behaviors
- exaggerated well-being or irritability
- excessive talking or speech that is faster than usual
Escitalopram can interact with other medications
Escitalopram can interact with multiple other medications. The effects of different drug interactions can vary. Some interactions may compromise the efficiency of a drug, while others may exacerbate the side effects.
The following list discusses medications that can interact with escitalopram. It does not include all drugs that may interact with escitalopram.
Before starting escitalopram, make sure to inform your doctor and pharmacist about all medications, supplements, and vitamins you're currently using. This information can help prevent potential drug interactions.
If you have concerns about drug interactions, consult your doctor or pharmacist.
Anticoagulants
Escitalopram might slightly impact blood clotting. Combining escitalopram with anticoagulants increases the risk of bleeding. Some examples of anticoagulants include:
- warfarin (Jantoven)
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like:
- diclofenac
- etodolac
- ibuprofen (Advil)
- indomethacin (Indocin)
- ketorolac
- meloxicam
- naproxen (Aleve)
- Medicines like apixaban (Eliquis)
- Drugs such as dabigatran (Pradaxa)
- Medications like edoxaban (Savaysa)
- Substances like rivaroxaban (Xarelto)
Migraine medications
Certain migraine medications called triptans might produce effects similar to escitalopram. Using them together could enhance side effects. Examples of migraine medications include:
- almotriptan
- eletriptan (Relpax)
- frovatriptan (Frova)
- naratriptan
- rizatriptan (Maxalt)
- sumatriptan (Imitrex)
- zolmitriptan (Zomig)
Psychotropic drugs
Certain psychotropic drugs may operate similarly to escitalopram. Using them together might increase the risk of side effects. Examples of these drugs include:
- Monoamine oxidase inhibitors (MAOIs). It's not recommended to combine escitalopram with an MAOI or within 2 weeks of stopping escitalopram unless a doctor advises it. Similarly, it's not recommended to start escitalopram if you stopped an MAOI within the previous 2 weeks unless specified by your doctor. Combining them within 2 weeks increases your risk of serotonin syndrome. Examples of these drugs include:
- isocarboxazid (Marplan)
- phenelzine (Nardil)
- tranylcypromine (Parnate)
- Medications like pimozide (an antipsychotic drug). It's not recommended to use escitalopram in conjunction with pimozide.
- Medications such as antidepressants:
- citalopram (Celexa)
- fluoxetine (Prozac)
- fluvoxamine (Luvox)
- paroxetine (Paxil)
- sertraline (Zoloft)
- Substances impacting the central nervous system:
- benzodiazepines, such as clonazepam (Klonopin)
- gabapentin (Neurontin)
- Sleeping pills, including estazolam, temazepam (Restoril), triazolam (Halcion), and zolpidem (Ambien)
Acid reducers
Taking these drugs with escitalopram might raise escitalopram levels in your body and increase the risk of side effects. One example of these drugs is cimetidine (Tagamet HB).
Diuretics
Certain diuretics can decrease sodium levels in your body. Escitalopram might also decrease sodium. Using diuretics with these drugs might increase the risk of low sodium levels. Examples of these drugs include:
- furosemide (Lasix)
- torsemide (Soaanz)
- hydrochlorothiazide
- Spironolactone (Aldactone)
Serotonergic drugs
Combining serotonergic drugs with escitalopram might increase the risk of serotonin syndrome, which can be fatal. If you're using any of these drugs, your doctor will start you on a reduced dosage of escitalopram and monitor you for signs of serotonin syndrome. Symptoms may include agitation, sweating, muscle twitches, and confusion. Serotonergic drugs include:
- selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and sertraline (Zoloft)
- serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta) and venlafaxine (Effexor XR)
- tricyclic antidepressants (TCAs), such as amitriptyline and clomipramine (Anafranil)
- opioid medications like fentanyl and tramadol (ConZip)
- the anxiolytic medication buspirone
- triptans
- lithium (Lithobid)
- amphetamines
Taking the supplements tryptophan and St. John’s wort during escitalopram treatment might also increase your risk of serotonin syndrome.
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Financial assistance and insurance: If you're in need of financial aid for escitalopram or assistance in comprehending your insurance coverage, help is at hand.
Consider exploring websites that offer cost resources and information. You might find help from organizations such as Medication Aid Resource and Low-Cost Meds.
For tips to reduce prescription costs, check out this article on saving money on medications.
Escitalopram precautions
Escitalopram oral tablet comes with a variety of warnings.
Federal Drug Administration alert: Suicide risk
This medication carries a serious notice. The Food and Drug Administration (FDA) provides this warning to alert doctors and patients about the potential dangers of the drug's effects.
Suicide risk alert: Escitalopram, like many antidepressants, may increase the chance of suicidal thoughts and behaviors when used for treatments related to depression or other mental health disorders. This risk is higher among children, adolescents, and young adults, especially within the initial few months of treatment or when a doctor adjusts the dose. Be vigilant about any unusual changes in your mood, behavior, thoughts, or feelings if you're taking escitalopram.
Serotonin syndrome
A severe condition named serotonin syndrome may occur when taking this medication. It appears when the levels of a natural brain chemical called serotonin are dangerously high. It's most likely to occur if you take this medication in combination with other drugs that elevate your serotonin levels. (For instance, see "Serotonin-influencing drugs" in the "Escitalopram may interact with other medications" section.)
Symptoms of this syndrome include:
- agitation
- irritability
- confusion
- hallucinations
- muscle rigidity
- tremors
- seizures
Seek emergency medical help instantly if you experience any symptoms.
Stopping the medication abruptly
Suddenly ceasing the use of this medication could result in withdrawal symptoms. Withdrawal symptoms are common when a body becomes reliant on a drug and needs it to function normally. (With dependence, the body adjusts to a drug and requires it to maintain normal function.)
Withdrawal symptoms include:
- irritability
- agitation
- anxiety
- mood swings (high or low)
- restlessness
- altered sleep patterns
- headaches
- sweating
- nausea
- dizziness
- electric shock-like sensations
- shaking
- confusion
Do not discontinue escitalopram without consulting your doctor first. Your doctor will gradually decrease your dose to prevent these side effects.
Bleeding risk
Using escitalopram may increase your risk of bleeding if you also take aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin (Jantoven), or other blood thinners. Inform your doctor if you notice any bleeding or unusual bruising.
Allergic reactions
Escitalopram can trigger an extreme allergic reaction. Symptoms can include:
- difficulty breathing
- swelling of the face, tongue, eyes, or mouth
- rash, hives, or blisters (alone or with fever or joint pain)
If you experience an allergic reaction, contact your doctor immediately. You can also contact America's Poison Control Centers at 800-222-1222 or use its online resource. However, if your symptoms are severe, contact 911 or go to the nearest emergency room.
Do not use this medication again if you've ever had an allergic reaction to it. Repeating use could be fatal (cause death).
Alcohol interaction
Consuming alcohol while on escitalopram can increase your risk of drowsiness or dizziness. If you drink alcohol, talk to your doctor about the safest amount, if any, to consume with escitalopram.
Warning for individuals with specific health conditions
For those who have a history of suicidal thoughts or behavior: Escitalopram may heighten the chance of suicidal thoughts and behaviors. This risk is higher among children, adolescents, and young adults. Disclose your history to your doctor.
For those with glaucoma: This medication may cause pupil dilation (widening), which could potentially initiate a glaucoma attack. Share your glaucoma history with your doctor before taking this medication.
For those with bipolar disorder: Inform your doctor if you have a history of bipolar disorder. If you have a history of this condition, taking this medication alone may trigger a mixed or manic episode.
For those with seizure disorders: Escitalopram may cause seizures. If you have ever had a seizure, report this to your doctor before taking this medication. Your risk of having more seizures might increase while taking this medication.
For those with heart problems: Taking this medication may lead to a prolonged QT interval. This refers to an issue with your heart rhythm that might cause your heartbeat to be irregular. Your risk of QT interval prolongation is greater if you have heart disease. Talk to your doctor before taking this medication.
Studies in pregnant animals prescribed this drug have shown negative impacts on the fetus. Due to limited human trials, it's uncertain how this drug may affect unborn babies.
This medication should only be used if the possible advantages outweigh the potential risks.
For nursing mothers: Escitalopram may seep into breast milk and potentially cause side effects in the nursing infant. Discuss this with your physician. You might need to wean your infant or cease medication consumption.
For older adults: Elderly individuals (ages 65 and above) are at a higher risk of less sodium levels. Since this drug can reduce sodium levels, elderly individuals are likely to experience an even greater risk of low sodium levels.
For children: Children using medications like escitalopram may experience weight loss and decreased appetite.
Contact your physician
Contact your doctor if your emotional state suddenly shifts. Call your doctor immediately or 911 in an emergency if you exhibit any of the following symptoms, especially if they're new, worsening, or distressing:
- suicidal thoughts or behaviors
- engaging in harmful impulses
- behaving aggressively or violently
- new or worsening depression
- new or worsening anxiety or panic attacks
- feeling agitated, restless, angry, or irritable
- trouble sleeping
- an increase in activity or talking more than usual
How to use escitalopram
The prescribed escitalopram dosage will depend on various factors, such as:
- the condition being treated
- your age
- the form of the medication
- your overall health
Generally, your doctor will initiate you on a small dosage and gradually adjust it to reach the optimal dosage for you. They will ultimately prescribe the minimum dosage to achieve the desired effect.
The following information discusses generally recommended dosages, but listen to your doctor's specific instructions:
Forms and strengths
Brand: Lexapro
- Form: oral tablet
- Strengths: 5 milligrams (mg), 10 mg, 20 mg
- Form: oral solution (not currently available)
- Strength: 5 mg/5 milliliters (mL)
Generic: escitalopram
- Form: oral tablet
- Strengths: 5 mg, 10 mg, 20 mg
- Form: oral solution
- Strengths: 5 mg/5 mL
This article primarily focuses on the escitalopram oral tablet, but the recommended dosages listed below also pertain to the escitalopram oral solution.
Dosage for major depressive disorder
Adult dosage (ages 18 to 64 years)
The standard dosage ranges from 10 mg to 20 mg once daily.
Child dosage (ages 12 to 17 years)
The usual dosage ranges from 10 mg to 20 mg once daily.
Child dosage (ages 0 to 11 years)
The efficacy and safety of this drug have not been established in children younger than 12 years.
Older adult dosage (ages 65 years and above)
- If you are elderly, your liver may not function as well as it used to. This can lead to drugs remaining in your system for a longer period, increasing the risk of side effects.
- Your doctor may initiate you on a lower dose or prescribe a different medication schedule to prevent drug levels from accumulating too much in your body.
- The suggested dosage is 10 mg once daily.
Special considerations
Liver problems: In the event of liver problems, the recommended dosage is 10 mg once daily.
Dosage for generalized anxiety disorder
Adult dosage (ages 18 to 64 years)
The recommended dosage ranges from 10 mg to 20 mg once daily.
Child dosage (ages 0 to 17 years)
Lexapro, the brand-name version of escitalopram, has gained FDA approval to treat generalized anxiety disorder in children aged 7 years and above. However, escitalopram itself has not been officially approved for this use. Furthermore, its safety and effectiveness in children younger than 7 years have not been confirmed.
Typical dosage of Lexapro for generalized anxiety disorder is ranked from 10 mg to 20 mg once daily.
Older adult dosage (ages 65 years and above)
- If you are elderly, your liver may not function as well as it used to. This can lead to drugs remaining in your system for a longer period, increasing the risk of side effects.
- Your doctor may initiate you on a lower dose or prescribe a different medication schedule to prevent drug levels from accumulating too much in your body.
- The suggested dosage is 10 mg once daily.
Special considerations
Liver problems: In the event of liver problems, the recommended dosage is 10 mg once daily.
If you cease using the medication abruptly or never use it: Abruptly discontinuing escitalopram might lead to withdrawal symptoms. Avoid halting escitalopram usage without first consulting your physician. If you need to stop using the medication, your doctor will gradually lower the dosage to lessen withdrawal symptoms.
If you forget or overlook doses or utilize the medication as directed: The medication may not function optimally, or it might stop functioning altogether. For this drug to be effective, a certain amount must always be present in your system.
If you take an excessive amount: You might have dangerous levels of the drug in your body. Symptoms of an escitalopram overdose can include:
- dizziness
- unusual blood pressure levels (high or low)
- sleep difficulties
- nausea or vomiting
- rapid heartbeat
- seizures
- coma
If you suspect an overdose, contact your doctor immediately. Alternatively, you may contact America's Poison Centers at 800-222-1222 or utilize its online tool. However, if your symptoms are severe, contact 911 or go to the nearest emergency room.
What to do if you miss a dose: Take the missed dose as soon as you remember. However, if you remember just a few hours before your next scheduled dose, take only one dose. Never attempt to compensate by taking two doses at once. This could result in serious side effects.
Determining if the medication is effective: You should observe an improvement in your condition. However, you may not notice any changes in your condition for the first few weeks. Escitalopram may take up to 2 months to function effectively.
Considerations for using escitalopram
Bear in mind these considerations if your doctor prescribes escitalopram oral tablets for you.
General
- You can take this drug with or without food. Consuming it with food might help alleviate stomach discomfort.
- You can divide or crush the 10-mg and 20-mg tablets. However, you cannot divide or crush the 5-mg tablets.
Storage
- Store escitalopram at room temperature between 59°F and 86°F (15°C and 30°C). Keep it away from high temperatures.
- Avoid storing this medication in damp or humid areas, such as bathrooms.
Refills
Your prescription for this medication is refillable. You should not require a new prescription to refill it. Your doctor will write the number of authorized refills on your prescription.
Travel
Traveling with your medication:
- Always carry your medication with you. During flights, do not put it in a checked bag. Keep it in your carry-on bag.
- Airport X-ray machines will not harm your medication.
- You may be required to show airport staff your medication's pharmacy label. Always carry the original prescription-labeled box with you.
- Do not store this medication in your car's glove compartment or leave it in the car. Be sure to avoid doing this during extreme hot or cold weather.
Clinical monitoring
Your doctor will monitor your emotional state. Your doctor will watch for sudden changes in mood, behavior, thoughts, or feelings. If your child is taking escitalopram, in addition to such changes, their doctor will also monitor them for changes in height and weight.
Are there any alternatives?
Other medications are available to treat your condition. Some may be a better fit for you than others. Discuss other drug options with your doctor that may work for you.
Disclaimer: Medical News Today has made every effort to ensure all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for a healthcare professional's knowledge and expertise. Always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Sentence 1: Treatment-seekers with depression or generalized anxiety disorder, especially adults and children aged 12 years and above, can consider using Escitalopram, which is also known as Lexapro, to manage their symptoms as it falls under the selective serotonin reuptake inhibitor (SSRI) drug category.
Sentence 2: Some individuals, such as those with a history of suicidal thoughts or behavior, should exercise caution when using Escitalopram, as it may increase the risk of suicidal thoughts and behaviors, particularly among children, adolescents, and young adults.
