Escitalopram


Description

Escitalopram, the S-enantiomer of citalopram, belongs to a class of antidepressant agents known as selective serotonin-reuptake inhibitors (SSRIs). Despite distinct structural differences between compounds in this class, SSRIs possess similar...

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Pharmacology

Indication

Labeled indications include major depressive disorder (MDD) and generalized anxiety disorder (GAD).... Read more

Pharmacodynamic

Escitalopram is one of a class of antidepressants known as selective serotonin reuptake inhibitors (... Read more

Mechanismofaction

The antidepressant, antiobsessive-compulsive, and antibulimic actions of escitalopram are presumed t... Read more

Absorption

The absolute bioavailability of citalopram is about 80% relative to an intravenous dose.

Proteinbinding

~56%

Volumeofdistribution

12 L/kg

Clearance

oral cl=600 mL/min [Following oral administrations]

Halflife

27-32 hours

Routeofelimination

Following oral administrations of escitalopram, the fraction of drug recovered in the urine as escit... Read more

Toxicity

Signs of overdose include convulsions, coma, dizziness, hypotension, insomnia, nausea, vomiting, sin... Read more


Adverse Effects

Effect Regions Age Groups Incidences Evidence Type
Headache US
  • Kind: experimental
    • Percent: 24%
  • Kind: placebo
    • Percent: 17%
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 18%
  • Kind: placebo
    • Percent: 8%
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 15%
  • Kind: placebo
    • Percent: 7%
  • Clinical Trial
    Ejaculation disorder US
  • Kind: experimental
    • Percent: 14%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Somnolence US
  • Kind: experimental
    • Percent: 13%
  • Kind: placebo
    • Percent: 7%
  • Clinical Trial
    Insomnia US
  • Kind: experimental
    • Percent: 12%
  • Kind: placebo
    • Percent: 6%
  • Clinical Trial
    Ejaculation disorder US
  • Kind: experimental
    • Percent: 9%
  • Kind: placebo
    • Percent: <1%
  • Clinical Trial
    Dry Mouth US
  • Kind: experimental
    • Percent: 9%
  • Kind: placebo
    • Percent: 5%
  • Clinical Trial
    Insomnia US
  • Kind: experimental
    • Percent: 9%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 5%
  • Clinical Trial
    Fatigue US
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 6%
  • Clinical Trial
    Libido decreased US
  • Kind: experimental
    • Percent: 7%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Dry Mouth US
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: 5%
  • Clinical Trial
    Anorgasmia US
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: <1%
  • Clinical Trial
    Somnolence US
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Influenza-like symptoms US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Dizziness US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Sweating increased US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Influenza-like symptoms US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Constipation US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Fatigue US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Rhinitis US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Sweating increased US
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Indigestion US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Constipation US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Shoulder Pain US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Dreaming Abnormal US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Appetite decreased US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Lethargy US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Neck Pain US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Vomiting US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Indigestion US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Impotence US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: <1%
  • Clinical Trial
    Sinusitis US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Libido decreased US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Appetite decreased US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Abdominal Pain US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Yawning US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Menstrual disorder US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Toothache US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Flatulence US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Abdominal Pain US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Paresthesia US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Anorgasmia US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: <1%
  • Clinical Trial
    Sinus Congestion US
    Clinical Trial
    Nasal Congestion US
    Clinical Trial
    Coughing US
    Clinical Trial
    Bronchitis US
    Clinical Trial
    Tinnitus US
    Clinical Trial

    Contraindications

    • Route:
      • Oral
    • Regions: US
    • With Categories:
        • Name: Monoamine Oxidase Inhibitors
        • Drugbank Id: DBCAT001004
        • Mesh Id: D008996
    • Regions: US
    • With Drugs Coadmin:
        • Name: Pimozide
        • Drugbank Id: DB01100

    Food Interactions

    • Take without regard to meals.

    Interactions

    Type in a drug name to check for interaction with Escitalopram

    The serum concentration of (R)-warfarin can be increased when it is combined with Escitalopram.
    The serum concentration of (S)-Warfarin can be increased when it is combined with Escitalopram.
    The therapeutic efficacy of Escitalopram can be decreased when used in combination with 1,10-Phenanthroline.
    The risk or severity of hypoglycemia can be increased when Escitalopram is combined with 2,4-thiazolidinedione.
    The risk or severity of serotonin syndrome can be increased when Escitalopram is combined with 2,5-Dimethoxy-4-ethylamphetamine.
    The risk or severity of adverse effects can be increased when 2,5-Dimethoxy-4-ethylthioamphetamine is combined with Escitalopram.
    The therapeutic efficacy of 3,5-diiodothyropropionic acid can be decreased when used in combination with Escitalopram.
    The therapeutic efficacy of 3,5-Diiodotyrosine can be decreased when used in combination with Escitalopram.
    The risk or severity of adverse effects can be increased when Escitalopram is combined with 4-Bromo-2,5-dimethoxyamphetamine.
    The risk or severity of adverse effects can be increased when 4-Bromo-2,5-dimethoxyphenethylamine is combined with Escitalopram.
    The metabolism of 4-hydroxycoumarin can be decreased when combined with Escitalopram.
    The risk or severity of adverse effects can be increased when Escitalopram is combined with 4-Methoxyamphetamine.
    The metabolism of 5-androstenedione can be decreased when combined with Escitalopram.
    The risk or severity of adverse effects can be increased when 5-methoxy-N,N-dimethyltryptamine is combined with Escitalopram.
    The metabolism of Escitalopram can be decreased when combined with 6-Deoxyerythronolide B.
    The metabolism of 6-O-benzylguanine can be decreased when combined with Escitalopram.
    The metabolism of Escitalopram can be decreased when combined with 7-ethyl-10-hydroxycamptothecin.
    The risk or severity of adverse effects can be increased when Escitalopram is combined with 7-Nitroindazole.
    7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline may increase the serotonergic activities of Escitalopram.
    The metabolism of 9-aminocamptothecin can be decreased when combined with Escitalopram.

    References

    • 1 . Moore N, Verdoux H, Fantino B: Prospective, multicentre, randomized, double-blind study of the efficacy of escitalopram versus citalopram in outpatient treatment of major depressive disorder. Int Clin Psychopharmacol. 2005 May;20(3):131-7. [PubMed: 15812262]
    • 2 . Boulenger JP, Huusom AK, Florea I, Baekdal T, Sarchiapone M: A comparative study of the efficacy of long-term treatment with escitalopram and paroxetine in severely depressed patients. Curr Med Res Opin. 2006 Jul;22(7):1331-41. [PubMed: 16834832]
    • 3 . Bielski RJ, Ventura D, Chang CC: A double-blind comparison of escitalopram and venlafaxine extended release in the treatment of major depressive disorder. J Clin Psychiatry. 2004 Sep;65(9):1190-6. [PubMed: 15367045]
    • 4 . Nierenberg AA, Greist JH, Mallinckrodt CH, Prakash A, Sambunaris A, Tollefson GD, Wohlreich MM: Duloxetine versus escitalopram and placebo in the treatment of patients with major depressive disorder: onset of antidepressant action, a non-inferiority study. Curr Med Res Opin. 2007 Feb;23(2):401-16. [PubMed: 17288694]
    • 5 . Chen F, Larsen MB, Sanchez C, Wiborg O: The S-enantiomer of R,S-citalopram, increases inhibitor binding to the human serotonin transporter by an allosteric mechanism. Comparison with other serotonin transporter inhibitors. Eur Neuropsychopharmacol. 2005 Mar;15(2):193-8. [PubMed: 15695064]

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