Escitalopram

How to Use

To decrease the risk of side effects, you may need to start with the lowest recommended dosage, then gradually increase your dose under doctor’s supervision. Do not take more than the prescribed dosage of this medication, it will not cause your condition to improve faster, but could lead to negative side effects.

To enjoy the maximum benefits of Escitalopram, make sure you take this medication regularly and at approximately the same time every day.

Do not stop taking Escitalopram suddenly or without consulting a doctor. If you stop taking this medication suddenly, you may suffer from withdrawal symptoms.

Overdose

Missed Dose

Notes

Storage

Important Note

Precautions

• Any allergies
• Personal or family history of psychiatric disorders (e.g. bipolar/manic-depressive disorder)
• Personal or family history of suicide attempts
• Bleeding problems
• Liver or kidney diseases
• Seizures
• Stomach bleeding (e.g. ulcers)
• Dehydration
• Low sodium levels (hyponatremia)

If you currently suffer or ever have suffered from any of the above conditions, you may not be able to take Escitalopram or you may need a dosage adjustment.

Escitalopram may cause dizziness or drowsiness. It is therefore advised not to drive or operate heavy machinery while taking this medication, at least until you are sure you can perform these activities safely.

The elderly could have a heightened sensitivity to some of the side effects of this medication, such as a decreased level of salt in the blood. The risk is even greater if these patients are also taking diuretics or water pills.

Escitalopram is classified is Pregnancy Category C by the FDA, which means it could potentially harm an unborn baby. Discuss all relevant risks and benefits with your doctor if you are currently pregnant or planning to become pregnant in the near future. Make sure you always involve your doctor first before you stop taking this medication. Depression is a serious condition and you should therefore not stop taking this medication suddenly.

Some babies born to mothers who have been using Escitalopram during the last 3 months of pregnancy, develop withdrawal symptoms after birth. These may include:

• Difficulties feeding or breathing
• Seizures
• Muscle stiffness
• Constant crying

Escitalopram passes into breast milk but it is not clear yet if this could harm an unborn baby. Discuss all relevant risks and benefits with your doctor if you are currently breastfeeding.

Drug Interactions

• MAO inhibitors (e.g. isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine – during treatment and for 2 weeks before and after)
• Pimozide
• Medicines that can cause bleeding or bruising (e.g. antiplatelet medication such as clopidogrel, NSAIDs such as ibuprofen, blood thinners such as warfarin)
• Antihistamines (e.g. cetirizine, diphenhydramine)
• Medication for sleep or anxiety (e.g. alprazolam, diazepam, zolpidem)
• Muscle relaxants
• Narcotic pain relievers (e.g. codeine)
• Any medication containing ingredients that could cause bleeding or drowsiness
• Dextromethorphan
• Lithium
• St. John's wort
• Sibutramine
• Street drugs such as MDMA (ecstasy)
• Tramadol
• Tryptophan
• Certain antidepressants including SSRIs (e.g. fluoxetine, paroxetine) and SNRIs (e.g. duloxetine, venlafaxine)
• Triptans used to treat migraine headaches (e.g. eletriptan, sumatriptan)

This is only a partial list and other medications may negatively interact with Escitalopram. Inform your doctor of all other prescription and non-prescription medication you are currently using, including vitamins, minerals, herbal pills, dietary supplements and medicines prescribed by other doctors. Do not start or stop using any medication without consulting your doctor first.

The following common side effects of Escitalopram may occur:

• Nausea
• Dry mouth
• Trouble sleeping
• Constipation
• Tiredness
• Drowsiness
• Dizziness
• Increased sweating

The above side effects are usually mild and should only last temporarily. Contact your doctor as soon as possible if any of these side effects persist or worsen.

Inform your doctor straightaway if you suffer any of these unlikely but serious side effects:

• Unusual or severe mental or mood changes (e.g. confusion, difficulty concentrating, nervousness, unusual high energy or excitement, rare thoughts of suicide)
• Decreased interest in sex
• Changes in sexual ability

Also tell your doctor immediately if you experience any of these rare but serious side effects:

• Easy bruising or bleeding
• Muscle weakness or cramps
• Changes in the amount of urine

Seek urgent medical attention if you have any of the following rare but very serious side effects:

• Bloody, black or tarry stools
• Fainting
• Vomit that looks like coffee grounds
• Seizures

In rare cases, Escitalopram may cause a severe condition called serotonin syndrome. You are more likely to develop this condition is you take this medication in conjunction with any of the medications mentioned in the ‘Drug Interactions’ section. Seek urgent medical attention if you notice any of the following symptoms:

• Hallucinations
• Unusual restlessness
• Loss of coordination
• Fast heartbeat
• Severe dizziness
• Unexplained fever
• Severe nausea, vomiting or diarrhea
• Twitching muscles

Rarely, this medication could cause a painful or prolonged erection (which lasts more than 4 hours). If this happens, stop taking the medication immediately and seek emergency medical attention to prevent long-term damage.

In rare cases, you may develop a severe allergic reaction to Escitalopram. Seek urgent medical attention if you have any of the following symptoms:

• Rash
• Itching or swelling (especially of the face, tongue or throat)
• Severe dizziness
• Trouble breathing

A small number of people under the age of 25 who take Escitalopram, may experience unusual side effects, including:

• Worsening depression
• Other mental or mood changes
• Suicidal thoughts or attempts

To avoid these side effects from occurring, make sure you discuss all relevant risks and benefits with your doctor before you start taking this medication.

People of all ages taking this medication should notify their doctor immediately if they experience any of the following symptoms, especially when you start taking the medication or after a dosage change:

• Worsening of the depression or other psychiatric condition
• Unusual behavior changes (e.g. possible suicidal thoughts or attempts)
• Other mental or mood changes (e.g. new or worsening anxiety, panic attacks, trouble sleeping, irritability, hostile or angry feelings, impulsive actions, severe restlessness, very rapid speech)

This is only a partial list and other negative side effects may occur. Inform your doctor straightaway if you experience any side effects other than the ones mentioned here, especially if they are bothersome.