Brand Name: Lexapro
Generic Name: Escitalopram

Escitalopram

(es-sye-TAL-oh-pram)

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

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

BRAND NAME
Lexapro

DRUG CLASS
Antidepressant (selective serotonin reuptake inhibitor [SSRI])

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

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.

This drug is metabolized by a specific set of liver enzymes. Several other drugs interfere with these liver enzymes, and thus may increase or decrease the clearance of escitalopram from the body, potentially increasing the risk of side effects or decreasing effectiveness. When these drugs are given in combination with escitalopram, dosage adjustments may be needed. As these are too numerous to list, you should always check with your doctor or pharmacist prior to starting a new medication, herbal, or non-prescription product.

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
In 2005, the FDA announced new labeling for antidepressants regarding the need to closely monitor for worsening of depression and for the potential of increased suicidal thinking or suicidal behavior during therapy. Although this recommendation applies to all patients (adults, children, adolescents) treated with antidepressants for any indication, this is of particular importance in patients being treated for depression. Discuss the latest information regarding this safety issue with your doctor prior to initiating therapy.

Close observation may be especially important when antidepressant medications are started for the first time or when doses are changed. More information on this topic can be found at the following web site: FDA

Combination with other SSRIs, SSNRIs, tricyclic antidepressants, amphetamines, sympathomimetics, ritonavir, serotonin agonists (sumatriptan, etc.), and certain opiates carries an increased risk of serotonin syndrome. While taking this medication, check with your pharmacist or doctor before starting any new medication, herbal, or nonprescription product.