The antidepressant action of escitalopram is presumably linked to the potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibitory effect on the reuptake of 5-HT from the synaptic cleft. Escitalopram is the S-enantiomer of the racemate citalopram and is the enantiomer to which the therapeutic activity is attributed.
Indications:-
Depressive illness, Generalized anxiety disorder, Obsessive-compulsive disorder, Social anxiety disorder.
Side Effect:-
Most common side effects are- decreased appetite, decreased libido, insomnia, somnolence, dizziness, sinusitis, nausea, diarrhoea, constipation, sweating increased, ejaculation disorder, impotence, fatigue, pyrexia.
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Precaution:-
dysphoric mood, irritability, agitation, anxiety, confusion, sensory disturbances, insomnia, dizziness.
Contraindications:-
Escitalopram should not be used if- *The patient enters a manic phase *Hypersensitive to escitalopram and any excipients of the product *The patient is taking monoamine oxidase inhibitor (MAOI), reversible MAOI (RIMA) and moclobemide.
Use in Pregnancy & Lactation:-
Escitalopram has had limited use in pregnancy without a reported increase in birth defects. Neonates should be observed if maternal use of Escitalopram continues into the later stages of pregnancy, particularly in the third trimester.
Drug Interaction:-
CNS drugs – caution should be used when escitalopram is taken in combination with other centrally acting drugs.
MAO Inhibitors – There have been reports of serious, sometimes fatal reactions when escitalopram is taken in combination with MAO inhibitors.
Overdose:-
Tremor, somnolence, unconsciousness, seizures, tachycardia, changes in the ECG, respiratory depression etc.