Although coadministration of escitalopram doubled blood levels of metoprolol in one single-dose study, no clinically significant effects on blood pressure or heart rate were observed.
Citalopram also has a relatively low potential for drug-drug interactions via other mechanisms, such as interference with protein binding or renal elimination.
No adjustment of starting dose is required for special patient populations including elderly patients or those with renal or hepatic impairment. Escitalopram is available in 5-mg tablets and mg or mg scored tablets. Sustained improvement in symptoms of depression was first seen at 1—2 weeks, and continuing improvement was noted during long-term studies.
The low propensity of escitalopram for CYP-mediated drug-drug interactions is a potential advantage for the average adult patient, who will most likely take more than one medication in the course of long-term therapy. It also is an advantage for the elderly, who tend to take more than one medication on a regular basis, as well as for those with chronic medical illnesses, which often require extensive polypharmacy.
In conclusion, the data presented here support the use of escitalopram as a first-line antidepressant. Recent patterns of medication use in the ambulatory adult population of the United States. American Psychiatric Press; Escitalopram is a medicine that may be used for the treatment of major depressive disorder depression and generalized anxiety disorder anxiety.
How does it work? The exact way escitalopram works for the treatment of depression or anxiety is not known but is thought to be related an increase in serotonin, a chemical transmitter, in nerve synapses the spaces between nerves in the brain. Serotonin is involved in the regulation of mood, appetite, and sleep. What symptoms of depression does escitalopram treat?
In people with depression, treatment with escitalopram aims to: Reduce feelings of sadness Improve the ability to initiate and perform everyday activities Improve concentration Restore the experience of enjoying pleasurable activities and the ability to react with the appropriate emotion Reduce pessimistic or suicidal thoughts Improve your quality of life What symptoms of anxiety does escitalopram treat? In people with anxiety or a related mood disorder, treatment with escitalopram aims to: Alleviate worries or fearful anticipation Decrease inner tension and help with insomnia Improve concentration and memory Reduce the physical symptoms associated with anxiety such as nausea, trembling, a pounding heartbeat, hot and cold flushes, sweating, or tingling sensations Improve your quality of life How long does escitalopram take to start working?
Although small changes in the symptoms of depression or anxiety may be noticed within a week, it may take from 4 to 6 weeks after reaching your target dose for significant improvements to be seen. Friends, family members, or your partner may notice changes that you are not even aware of. It may be useful to keep a diary of your symptoms to monitor your progress. Escitalopram may not be suitable for some people and should not be given to children aged less than twelve with depression, or less than 18 years with anxiety.
An allergy to escitalopram or citalopram Taken a monoamine oxidase inhibitor MAOI within the past two weeks. A MAOI is a specific type of antidepressant such as phenelzine , rasagiline , and selegiline Or if you are taking pimozide a medicine used to reduce the number of tics in people with Tourette Disorder Tell your doctor if you or anyone in your family has experienced any of the following, because these conditions may increase the likelihood that you may suffer certain side effects from escitalopram: A seizure or epilepsy Attempted suicide or spoke about suicidal thoughts Narrow-angle glaucoma glaucoma is an eye condition Symptoms of depression , bipolar disorder , psychosis , or any other mental illness A recent history of myocardial infarction or unstable heart disease, liver disease, kidney disease, or a medical condition that alters your metabolism or affects blood or fluid balance levels.
Dosage How Should I take Escitalopram? Escitalopram may be taken with or without food. Take once a day in the morning or evening. Escitalopram takes at least a week in adults to reach steady blood levels after a dosage increase. Treatment is usually required for several months or longer; however, your doctor should re-evaluate the need for treatment every now and then Depression in Adolescents Initial dose: After a minimum of three weeks, the dosage may be increased to 20mg if necessary.
If treatment is to be changed from citalopram to an MAOI or vice-versa, there should be a 14 day period without either drug before the alternative drug is started.
Tryptophan , a common dietary supplement, can cause headaches , nausea, sweating, and dizziness when taken with any SSRI. Linezolid and intravenous methylene blue are also MAO inhibitors and should not be combined with citalopram.
Use of an SSRI with aspirin , nonsteroidal anti-inflammatory drugs or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding. Lexapro All SSRIs, including Lexapro, should not be combined with drugs in the monoamine oxidase MAO inhibitor class of antidepressants such as isocarboxazid Marplan , phenelzine Nardil , tranylcypromine Parnate , selegiline Eldepryl and procarbazine Matulane or other drugs that inhibit monoamine oxidase such as linezolid Zyvox and intravenous methylene blue.
Such combinations may lead to confusion, high blood pressure , high fevers, tremor or muscle rigidity, and increased activity. At least 14 days should elapse after discontinuing Lexapro before starting an MAO inhibitor.
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