Common Tradenames (See Complete Tradename Listing)
Lexapro
Class
Antidepressant
Serotonin Reuptake Inhibitor
Dosage, Adult (usual)
Depression: initial, 10 mg/day ORALLY as a single dose in the morning or evening
Depression: maintenance, 10-20 mg/day ORALLY
Generalized anxiety disorder: initial, 10 mg/day ORALLY as a single dose in the morning or evening
Generalized anxiety disorder: maintenance, 10-20 mg/day ORALLY
Mixed anxiety and depressive disorder: initial, 10 mg/day ORALLY as a single dose in the morning or evening
Mixed anxiety and depressive disorder: maintenance, 10-20 mg/day ORALLY
Dosage, Pediatric, (usual)
safety and effectiveness in children have not been established
Dose Adjustments:
geriatric: 10 mg/day ORALLY
liver disease: 10 mg/day ORALLY
Administration
may take without regard to meals
at least 14 days should elapse between discontinuation of escitalopram and initiation of treatment with MAO inhibitors or the discontinuation of a MAO inhibitor and the initiation of treatment withescitalopram
if increasing the dose to 20 mg, do so only after a minimum of 1 week at the 10 mg dose
acute episodes of major depressive disorder require several months or longer of sustained therapy beyond response to the acute episode
Monitoring
periodic monitoring of heart rate, blood pressure, hepatic function tests, and complete blood counts is advised during prolonged therapy
monitor patients receiving antidepressants for worsening of depression or suicidality, or unusual changes in behavior, especially at the initiation of therapy or when the dose increases or decreases
How Supplied
Oral Solution: 5 MG/5 ML
Oral Tablet: 5 MG, 10 MG, 20 MG
Indications
FDA labeled indications
Depression
Generalized anxiety disorder
Non-FDA labeled indications
Mixed anxiety and depressive disorder
Contraindications
MAO inhibitors 14 days before or after escitalopram use
Hypersensitivity to escitalopram or citalopram products
Precautions
Suicidal ideation and behavior or worsening depression; increased risk, particularly in children and adolescents, during the first few months of therapy
Bipolar disorder; the possibility that a major depressive episode may be the initial presentation of bipolar disorder should be ruled out prior to initiating antidepressant therapy
Abnormal bleeding (concurrent use of NSAIDs or aspirin may potentiate risk of upper GI bleeding)
Concurrent use of linezolid
Discontinuation of treatment (withdrawal symptoms have been reported; gradual reduction of dose is recommended)
Diseases or conditions that produce altered metabolism or hemodynamic responses
Hepatic function impairment
History of mania
History of myocardial infarction or unstable heart disease
History of seizure disorder
Hyponatremia
Interference with cognitive and motor performance
Severe renal impairment
Adverse Effects
COMMON
Dermatologic: Excessive sweating
Gastrointestinal: Diarrhea, Nausea
Psychiatric: Sleep disorder, Somnolence or insomnia
Reproductive: Disorder of ejaculation, Impotence
Other: Fatigue
SERIOUS
Psychiatric: Depression, worsening (rare), Suicidal thoughts (rare), Suicide (rare)
Drug Interactions
Cimetidine (moderate, probable)
Clorgyline (contraindicated, theoretical)
Desipramine (moderate, probable)
Eletriptan (moderate, probable)
Frovatriptan (moderate, probable)
Furazolidone (contraindicated, theoretical)
Ginkgo (moderate, probable)
Isocarboxazid (contraindicated, theoretical)
Ketoconazole (moderate, probable)
Lazabemide (contraindicated, theoretical)
Linezolid (major, theoretical)
Lithium (moderate, established)
Metoprolol (moderate, probable)
Moclobemide (contraindicated, theoretical)
Naratriptan (moderate, probable)
Phenelzine (contraindicated, theoretical)
Rizatriptan (moderate, probable)
Selegiline (contraindicated, theoretical)
Sibutramine (major, probable)
St John's Wort (major, probable)
Sumatriptan (moderate, probable)
Tramadol (major, theoretical)
Tranylcypromine (contraindicated, theoretical)
Zolmitriptan (moderate, probable)
Notes
20 mg/day doses have not demonstrated greater efficacy than 10 mg/day doses
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