Products
Escitalopram is commercially available as film-coated tablets, drops, and meltable tablets (Cipralex, generic). It has been approved in many countries since 2001.
Structure and properties
Escitalopram (C20H21FN2O, Mr = 324.4 g/mol) is the active -enantiomer of citalopram. It is present in drugs as escitalopram oxalate, a fine, white to slightly yellowish powder that is sparingly soluble in water. Escitalopram is a bicyclic phthalane derivative.
Effects
Escitalopram (ATC N06AB10) has antidepressant properties. The effects are due to inhibition of reuptake of the neurotransmitter serotonin into presynaptic nerve terminals. They are usually delayed in onset within two to four weeks. Escitalopram has a half-life of approximately 30 hours.
Indications
- Depression
- Social phobia
- Anxiety disorders
- Panic disorders
- Obsessive-compulsive disorders
Dosage
According to the professional information. The drug is usually administered once daily and independently of meals. Discontinuation should be gradual.
Contraindications
- Hypersensitivity
- Patients with prolongation of the QT interval
Escitalopram should not be administered with MAO inhibitors, pimozide, and drugs that prolong the QT interval. For complete precautions, see the drug label.
Interactions
Escitalopram has a high interaction potential. It is metabolized primarily by CYP2C19 as well as CYP3A4 and CYP2D6. It is an inhibitor of CYP2D6 and CYP2C19.
Adverse effects
The most common possible adverse effects include nausea, anxiety, restlessness, abnormal dreams, libido reduction, impotence, ejaculatory disturbances, muscle and joint pain, digestive disturbances, fatigue, fever, sleep disturbances, dizziness, paresthesia, tremor, sinusitis, yawning, sweating, and decreased or increased appetite. Escitalopram may prolong the QT interval.
