Description

Simple

A medication used to treat depression and anxiety.

Clinical

A selective serotonin re-uptake inhibitor used in the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and other select psychiatric disorders such as obsessive-compulsive disorder (OCD).

Overview

Escitalopram is a selective serotonin re-uptake inhibitor (SSRI) and the S-enantiomer of racemic [citalopram].[11] It is used to restore serotonergic function in the treatment of depression and anxiety.[18,19,20] Escitalopram is approximately 150 times more potent than citalopram’s R-enantiomer and is responsible for the vast majority of citalopram’s clinical activity, with some evidence suggesting that the R-enantiomer of racemic citalopram actively dampens the activity of escitalopram rather than existing simply as an inactive enantiomer.[6,Read more

Pharmacology

Indication

Escitalopram is indicated for both acute and maintenance treatment of major depressive disorder (MDD) and for the acute treatment of generalized anxiety disorder (GAD).[18] It... Read more

Pharmacodynamic

Escitalopram belongs to a class of medications called selective serotonin re-uptake inhibitors (SSRIs). These agents cause an increase in serotonin levels in neuronal synapses by preventing the re-uptake of serotonin (5-HT) into the presynaptic terminals of serotonergic neurons.[ Read more

Mechanism of action

Escitalopram, like other selective serotonin re-uptake inhibitors, enhances serotonergic activity by binding to the orthosteric (i.e. primary) binding site on the serotonin transporter (SERT), the same site to which endogenous 5-HT binds, and thus prevents the re-uptake of serotonin into the presyna... Read more

Absorption

Absorption of escitalopram following oral administration is expected to be almost complete, with an estimated absolute bioavailability of approximately 80%. Tmax occurs after about 4-5 hours.[ Read more

Protein binding

Escitalopram exhibits relatively low protein binding at approximately 55-56%.[18,19 Read more

Volume of distribution

Escitalopram appears to distribute extensively into tissues, with an apparent volume of distribution of approximately 12-26 L/kg.[18, Read more

Clearance

The oral plasma clearance of escitalopram is 600 mL/min, of which approximately 7% is due to renal clearance.[18, Read more

Half life

The elimination half-life of escitalopram is 27-32 hours, though this is increased by approximately 50% in the elderly and doubled in patients with reduced hepatic function.[ Read more

Route of elimination

After oral administration of escitalopram, approximately 8% of the total dose is eliminated in the urine as unchanged escitalopram and 10% is eliminated in the urine as S-desmethylcitalopram.[ Read more

Toxicity

Symptoms of overdose may include CNS effects (dizziness, convulsions, coma, somnolence), gastrointestinal distress (nausea, vomiting), and/or cardiac abnormalities (hypotension, tachycardia, ECG changes).[ Read more

Adverse Effects

Effect Regions Age Groups Incidences Evidence Type
Headache US
  • Kind: experimental
    • Percent: 24
  • Kind: placebo
    • Percent: 17
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 18
  • Kind: placebo
    • Percent: 8
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 15
  • Kind: placebo
    • Percent: 7
  • Clinical Trial
    Ejaculation disorder US
  • Kind: experimental
    • Percent: 14
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Somnolence US
  • Kind: experimental
    • Percent: 13
  • Kind: placebo
    • Percent: 7
  • Clinical Trial
    Insomnia US
  • Kind: experimental
    • Percent: 12
  • Kind: placebo
    • Percent: 6
  • Clinical Trial
    Dry Mouth US
  • Kind: experimental
    • Percent: 9
  • Kind: placebo
    • Percent: 5
  • Clinical Trial
    Ejaculation disorder US
  • Kind: experimental
    • Percent: 9
  • Kind: placebo
    • Percent: <1
  • Clinical Trial
    Insomnia US
  • Kind: experimental
    • Percent: 9
  • Kind: placebo
    • Percent: 4
  • Clinical Trial
    Fatigue US
  • Kind: experimental
    • Percent: 8
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 8
  • Kind: placebo
    • Percent: 6
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 8
  • Kind: placebo
    • Percent: 5
  • Clinical Trial
    Libido decreased US
  • Kind: experimental
    • Percent: 7
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Anorgasmia US
  • Kind: experimental
    • Percent: 6
  • Kind: placebo
    • Percent: <1
  • Clinical Trial
    Somnolence US
  • Kind: experimental
    • Percent: 6
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Dry Mouth US
  • Kind: experimental
    • Percent: 6
  • Kind: placebo
    • Percent: 5
  • Clinical Trial
    Influenza-like symptoms US
  • Kind: experimental
    • Percent: 5
  • Kind: placebo
    • Percent: 4
  • Clinical Trial
    Constipation US
  • Kind: experimental
    • Percent: 5
  • Kind: placebo
    • Percent: 4
  • Clinical Trial
    Rhinitis US
  • Kind: experimental
    • Percent: 5
  • Kind: placebo
    • Percent: 4
  • Clinical Trial
    Fatigue US
  • Kind: experimental
    • Percent: 5
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Influenza-like symptoms US
  • Kind: experimental
    • Percent: 5
  • Kind: placebo
    • Percent: 4
  • Clinical Trial
    Dizziness US
  • Kind: experimental
    • Percent: 5
  • Kind: placebo
    • Percent: 3
  • Clinical Trial
    Sweating increased US
  • Kind: experimental
    • Percent: 5
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Sweating increased US
  • Kind: experimental
    • Percent: 4
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Shoulder Pain US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Lethargy US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Appetite decreased US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Dreaming Abnormal US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Neck Pain US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Vomiting US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Indigestion US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Impotence US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: <1
  • Clinical Trial
    Sinusitis US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Libido decreased US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Appetite decreased US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Constipation US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Indigestion US
  • Kind: experimental
    • Percent: 3
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Menstrual disorder US
  • Kind: experimental
    • Percent: 2
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Yawning US
  • Kind: experimental
    • Percent: 2
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Toothache US
  • Kind: experimental
    • Percent: 2
  • Kind: placebo
    • Percent: 0
  • Clinical Trial
    Flatulence US
  • Kind: experimental
    • Percent: 2
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Abdominal Pain US
  • Kind: experimental
    • Percent: 2
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Paresthesia US
  • Kind: experimental
    • Percent: 2
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Anorgasmia US
  • Kind: experimental
    • Percent: 2
  • Kind: placebo
    • Percent: <1
  • Clinical Trial
    Abdominal Pain US
  • Kind: experimental
    • Percent: 2
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Dry Eyes US
    Literature
    Flushing US
    Post Marketing
    Photosensitivity reaction US
    Post Marketing
    Grand mal Seizures US
    Post Marketing
    Leukopenia US
    Post Marketing

    Contraindications

    • Route:
      • Oral
    • Regions: Canada
    • Patient Conditions:
        • Name: Congenital long QT syndrome
        • Drugbank Id: DBCOND0107917
    • Route:
      • Oral
    • Regions: Canada
    • Patient Conditions:
        • Name: QT Interval Prolongation
        • Drugbank Id: DBCOND0058707
    • Route:
      • Oral
    • Hypersensitivity:
      • true
    • Regions: US
    • Route:
      • Oral
    • Regions: US
    • With Drugs Coadmin:
        • Name: Pimozide
        • Drugbank Id: DB01100
    • Route:
      • Oral
    • Time Period: Do not use within 14 days of each other
    • Regions: US
    • With Categories Coadmin:
        • Name: Monoamine Oxidase Inhibitors
        • Drugbank Id: DBCAT001004
        • Mesh Id: D008996

    Food Interactions

    Take with or without food. The absorption is unaffected by food.