Estarex

Indications

Escitalopram is used to treat depression and several anxiety conditions: generalised anxiety disorder (constant worry), panic disorder, social anxiety disorder and obsessive-compulsive disorder (OCD).

How It Works

It is an SSRI (selective serotonin reuptake inhibitor). It raises the level of serotonin, a natural brain chemical that helps control mood and anxiety. Benefit usually starts after 2 to 4 weeks, and the full effect can take longer.

Dosage and Administration

• Adults, depression and most anxiety conditions: usually 10 mg once a day. The doctor may raise it to a maximum of 20 mg a day.
• Panic disorder: usually 5 mg a day for the first week, then 10 mg a day.
• Adults over 65 and people with liver problems: usually 5 mg a day to start, maximum 10 mg a day.
• Children and teenagers: only if a specialist prescribes it.

Take once a day, morning or evening, with or without food. Treatment usually continues for at least 6 months after you feel better. Do not stop suddenly; the doctor will lower the dose slowly over 1 to 2 weeks.

Interactions

Never take it with MAO inhibitor medicines (such as Selegiline, Moclobemide or Linezolid) or with Pimozide. Taking it with other medicines that raise serotonin (such as Tramadol, Sumatriptan, Lithium, other antidepressants or St John's wort) can cause serotonin syndrome. Aspirin, NSAID painkillers (such as Ibuprofen) and Warfarin increase the risk of bleeding. Medicines that affect heart rhythm (such as some antibiotics, antipsychotics and Domperidone) need care. Omeprazole and Cimetidine can raise its level. Avoid alcohol.

Contraindications

• Allergy to escitalopram, Citalopram or any ingredient of the product.
• Taking an MAO inhibitor now or in the last 14 days, or taking Linezolid or Pimozide.
• A known heart rhythm problem called QT prolongation, or taking medicines that cause it.

Side Effects

Common: nausea, headache, sweating, tiredness or sleepiness, trouble sleeping, dizziness, dry mouth, loss of appetite and sexual problems. Many of these ease after the first few weeks.

Get urgent medical help if you have: thoughts of harming yourself or suicide (especially under age 25 and early in treatment); agitation, shaking, high fever, fast heartbeat and stiff muscles (possible serotonin syndrome); fainting or a fast or irregular heartbeat; fits; unusual bleeding or bruising; a very high mood or overactivity; or swelling of the face, lips or throat or difficulty breathing.

Pregnancy and Lactation

Use in pregnancy only if the doctor decides the benefit is greater than the risk. Use late in pregnancy can cause breathing, feeding or jitteriness problems in the newborn, so tell your doctor and midwife. It passes into breast milk; talk to the doctor before breastfeeding. If you become pregnant, do not stop the medicine on your own.

Precautions and Warnings

Tell the doctor if you have epilepsy, diabetes, liver or kidney disease, heart disease, bipolar disorder, a bleeding problem or glaucoma. Older people may develop low blood sodium (confusion, weakness, headache). It can cause drowsiness or dizziness, so do not drive until you know how it affects you. Restlessness may occur in the first weeks.

Overdose

Overdose can cause drowsiness, dizziness, shaking, agitation, vomiting, a fast or irregular heartbeat and fits. Go to the nearest hospital emergency department at once and take the medicine pack with you.

Therapeutic Class

Antidepressant, selective serotonin reuptake inhibitor (SSRI).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.