Escitalopram should not be started until 2 weeks after stopping MAOIs

MAOIs should not be started until atleast 1 week after stopping Escitalopram

Concurrent use of escitalopram and moclobemide may increase risk of CNS toxicity

Risk of CNStoxicity is increased by sumatipram

Escitalopram may enhance the sedative effects of alcohol

Major depressive disorders

Selective serotonin reuptake inhibitors include-

Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Citalopram, Escitalopram

Refer- Fluoxetine

Nausa, diarrhea, increase sweating, insomnia, impotence and ejaculation disorder, fatigue, and somnolence

Concomitant use in patients taking Monoamine Oxidase Inhibitors (MAOIs)

Hyperesensitivity to escitalopram or citalopram

History of mania,history of seizure disorders

Use with caution during works requiring mental alertness eg, operating hazardous machinery, including automobiles

Severe renal impairment, hepatic impairment

Special Precautions:

 

Selective serotonin reuptake inhibitors includ- Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Citalopram, Escitalopram

Refer- Fluoxetine

Use with caution during works requiring mental alertness eg, operating hazardous machinery, including automobiles

Pharmacology:

       The mechanism of antidepressant action of escitalopram is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT) It has minimum effects on nonepinephrine and dopamine neuronal reuptake. Escitalopram is 100-fold more potent than the R-enantiomer with respect to inhibition of 5-HT reuptake and inhibition of neuronal firing rate.

Pharmacokinetics:

          Escitalopram displays high bioavailability(80%) after oral,administration. Absorption of escitalopram is not affected with food. Peak plasma concentrations are observed 5 +/- 1.5 hours after a single oral dose (20mg tablet) Approximately 56% of escitalopram is protein bound. Escitalopram is metabolised by hepaticCYP isozymes to S-desmethyl-citalopram (S-DCT) and S-di-demethylcitalopram (S-DDCT) . Escitalopram is at least 7 times more potent than S-DCT and S-SSCT, respy, in the inhibition of serotonin reuptake. The oral clearance of escitalopram is 600ml/min. Seven percent of administered drug is excreted through urine. About 8% of it is excreted as it is and 10% as S-demethlcitalopram (S-DCT)

Absotption o fescitalopram not affected by food