Escitalopram is an isomer of ciltalopram Mechanism of Action Potentiates serotonergic activity In the central nervous system v. selective inhibition 01 CNS neuronal reuptake of serotonin (5-HT) minimal effects on norepinephrine and dopamine neuronal reuptake or very low affinity for (a and b- adrenergic. dopamine, histamia, or muscarinic receptors escitalopram Is at least 100 fold more potent than the R-enantiomer
Indication and Uses
Depression, generalised anxiety disorder, anxiety panic disorder
Concurrrent use of MAOls or use within 2 weeks of discontinuation of MAOls.
Dose Adults Tablets:
Depressive illness: 10, once daily, dependent on individual patient response increased if necessary, to max 20mg daily. Elderly Initially half of the adult dose, lower maintenance dose may be sufficient.
Children Under 18 years not recommended Panic Disorder: Initially 5mg once daily increased 10mg daily after 7 days max 20mg daily. Elderly Lower maintenance dose may be sufficient Children and Adolescent Under 18 years not recommended
Side Effects / Adverse Reactions CNS:
Migraine, paraesthesia, sommolence, impaired concentration, fatigue, drowsiness, sleep disturbance, confusion, restlessness, amnesia, apathy, suicidal attempt, seizures CV: Hypotension, postural hypotension, palpitations ENT: Visual changes GI: Nausea vomiting, xerostomia, taste perversion, constipation, dyspepsia, anorexia, increased appetite, flatulence GU: Polyuria, dysuria, amenorrhea, abnormal ejaculation (5%) MS: Myalgia R ESP: Cough Skin: Increased sweating, rash