DESCRIPTION
This drug inhibits serotonin reuptake by neurons, promoting increases in levels of serotonin, an important neurotransmitter in mood disorders.

ORIGINAL USES (ON-LABEL)
Depression, generalized anxiety disorder.

NEWLY DISCOVERED USES (OFF-LABEL)
Premenstrual dysphoric disorder (PMDD).

POTENTIAL SIDE EFFECTS
Somnolence, insomnia, nausea, dry mouth, sweating, anxiety, anorexia, agitation, yawning, rash, itching, sexual dysfunction, diarrhea, stomach upset, vomiting, abdominal pain, tremor, weight gain, joint aches, muscle aches, cough, rhinitis, sinusitis, low sodium levels.

CAUTIONS
  • Do not use concurrently with MAO inhibitors or within two weeks of discontinuing MAO-I.
  • Inform your doctor if you have a history of mania or seizures, or if you have kidney dysfunction.
  • Use caution if you are a high-risk suicide attempt patient during initiation of therapy.
  • Has potential to impair cognitive/motor performance; you should use caution operating hazardous machinery.
  • Elderly patients with liver impairment should receive lower dosages.
  • Use with caution in kidney insufficiency.
DRUG INTERACTIONS
MAO inhibitors or drugs with MAO inhibition (linezolid), amphetamines, buspirone, meperidine, nefazodone, serotonin agonists (sumatriptan), sibutramine, other SSRIs, sympathomimetics, ritonavir, tramadol, venlafaxine, loop diuretics, warfarin, aminoglutethimide, carbamazepine, phenytoin and rifampin, cyproheptadine.

FOOD INTERACTIONS
Alcohol.

HERBAL INTERACTIONS
Valerian, St. John’s wort, SAMe, gotu kola, kava kava.

PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category C. Excreted in breast milk. Do not use while breast-feeding.

SPECIAL INFORMATION
  • Therapeutic effect may take 1-4 week.
  • Report immediately signs of urinary retention.

    • A study published in Journal of Clinical Psychiatry compared the efficacy and tolerability of escitalopram for premenstrual dysphoric disorder (PMDD) at symptom onset or given throughout the luteal phase (after ovulation). Twenty-seven women with PMDD were given Lexapro for three consecutive menstrual cycles. Premenstrual symptoms significantly improved; the luteal (after ovulation) phase group had 57% decrease and the symptom-onset group a 51% decrease. Clinical improvement was reported by 11 of 13 women in the luteal phase group and nine of 14 women in the symptom-onset group. Lexapro was well tolerated, its adverse side effects mild and transient, with only two patients discontinuing due to side effects. PMDD improved significantly with either luteal phase or symptom-onset dosing of escitalopram. Women with more severe PMDD may respond better to luteal phase dosing than symptom-onset dosing.

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    What is Lexapro?
    Escitalopram is a selective serotonin-reuptake inhibitor (SSRI) that is typically prescribed as an antidepressant.
    BRAND NAME
    Lexapro

    GENERIC NAME
    Escitalopram

    CHEMICAL CLASS
    Bicyclic phthalane derivative

    THERAPEUTIC CLASS
    Antidepressant, selective serotonin reuptake inhibitor (SSRI)
    AVAIL FORMS
    Tablets — Oral 10 mg, 20 mg, 40 mg.
    DOSAGE
    Adult and Child >16 yr
    Depression: 10 mg qd; no dosage reduction needed for mild to moderate renal or hepatic dysfunction (minimal added benefit from increasing dose more than 10 mg)

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