Escitalopram is sold under the brand name "Lexapro".
Escitalopram was the last of the SSRIs licensed for use in the US. But in a sense it was not, because it is really just half of citalopram (complex molecules, like our hands, have mirror images, called enantiomers). Escitalopram is just one of the enantiomers of citalopram, and thus not truly a new drug to the market) It is FDA approved for Major Depression and GAD. It is the only SSRI that is not available in a generic formulation.
Escitalopram, like its cousins, fluoxetine (Prozac), citalopram (Celexa), sertraline (Zoloft), paroxetine (Paxil) and fluvoxamine (Luvox), reversibly blocks the recycling of serotonin from outside the nerve to inside the nerve. This increase in serotonin in the gap between nerves in the central nervous system (the synapse) leads to alterations in serotonin function that have been associated with improvements in depression and anxiety. Each of these serotonin reuptake inhibitors (SSRIs for short) has its own personality, if you will. Escitalopram is not activating like fluoxetine and generally does not cause patients to feel lethargic and “numb” like paroxetine and fluoxetine. It's a “middle of the road” kind of SSRI.
Escitalopram is processed for elimination from the body (“metabolized”) in the liver to an inactive compound that is in turn eliminated by the kidneys. The half life of escitalopram is about one day and consequently if stopped abruptly (not recommended) it is out of the body in about 5 days.
Escitalopram in combination with a monoamine oxidase inhibitor can cause serotonin syndrome that in turn can be fatal.
Possible adverse effects can include sexual dysfunction, nausea, insomnia, agitation, diarrhea, difficulty thinking and others. Sometimes, in common with other SSRIs, it may leave a person feeling a bit numb emotionally rather than really well and “perky”.
Escitalopram has no effects on liver enzyme symptoms and consequently does not significantly affect the elimination of other medications.
Escitalopram carries a warning from the FDA, along with the other SSRIs, against neonatal pulmonary hypertension in neonates exposed to escitalopram in the final trimester of pregnancy.
All antidepressants have a warning from the FDA against new onset suicidal “thoughts and behaviors”. There is no evidence children taking antidepressants are suiciding; quite otherwise, there is very good evidence that children treated for depression suicide less often than children who are depressed who are not treated with antidepressants.
It you miss a dose of escitalopram do not add the missed dose to your next dose. As with all medications, take the escitalopram regularly as prescribed.
