ESCITALOPRAM

Indications & Dose:

 Depressive illness

Generalised anxiety disorder

Obsessive-compulsive disorder

•   BY MOUTH

Adult: 10 mg once daily; increased if necessary up to 20 mg daily

Elderly: Initially 5 mg once daily; maximum 10 mg per day

Panic disorder

•  BY MOUTH

Adult: Initially 5 mg once daily for 7 days, then increased to 10 mg daily; maximum 20 mg per day

Elderly: Initially 2.5 mg once daily; maximum 10 mg per day

Social anxiety disorder

• BY MOUTH

Adult: Initially 10 mg once daily for 2–4 weeks, dose to be adjusted after 2-4 weeks of treatment; usual dose 5–20 mg daily

Children: Under 18 years not recommended Panic Disorder:  Initially 5mg once daily increased 10mg daily after 7 days; max; 20mg daily.

Elderly; Lower maintainance dose may be sufficient Children & Adolescent :Under 18 years not recommended 

Contraindications:

Concurrent use of MAOIs or use within 2 wk of discontinuation of MAOIs.

Side Effects:

Cautions:

Precautions:

Interaction:

Drugs

Buspirone: Increased risk of serotonin syndrome

Cimetidine: Increased levels of desmethylcitalopram via inhibition of CYP2D6 by cimetidine

Imipramine: Increased bioBrands Available with Cost and half-life of desipramine (the major metabolite of imipramine) via inhibition of CYP2D6 by citalopram

MAOIs, dexfenf luramine, sibutramine: increased risk of sertonin syndrome

Metoprolol: May increase levels of metoprolol, but no clinically signficant changes in blood pressure or heart rate have been observed

Naratriptan, rizatriptan, sumatriptan, zolmatriptan 4: Increased risk of weakness, hyperreflexia, and incoordination 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Migraine, parethesia, somnolence, impaired concentration, fatigue, drowsiness, sleep disturbance, confusion, restlessness, amnesia, apathy, suicidal attempt, seizures

CV: Hypotension, postural hypotension, palpitations

EENT: Visual changes

GI: Nausea, vomiting, xerostomia, taste perversion, constipation, dyspepsia; anorexia, increased appetite, flatulence

GU: Polyuria, dysuria, amenorrhea, abnormal ejaculation (>5%)

MS: Myalgia

RESP: Cough

SKIN: Increased sweating, rash 

Patient And Carer Advice: