Escitalopram

Sounds like 'ES-sigh-talo-pram'

Key points about escitalopram

  • Escitalopram is used to treat a number of mental health conditions including depression and anxiety.
  • We don't know for certain, but researchers think that SSRIs work by increasing the activity of serotonin which is thought to improve mood, emotion and sleep.
  • Find out how to take it safely and possible side effects.
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Escitalopram is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI)Escitalopram is used to treat a number of mental health conditions including depression, anxiety (social anxiety and generalised anxiety) and obsessive compulsive disorder. We don't know for certain, but researchers think that SSRIs work by increasing the activity of serotonin which is thought to improve mood, emotion and sleep. Read more about SSRIs.

If you need help or want to talk to somebody about your mental health, you can get support from any of the following:

  • Free call or text 1737 any time for support from a trained counsellor
  • Lifeline 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP)
  • Suicide Crisis Helpline 0508 828 865 (0508 TAUTOKO)
  • Healthline 0800 611 116
  • Samaritans 0800 726 666.

In New Zealand escitalopram is available as tablets (10 mg, 20 mg).

  • The usual dose of escitalopram is 10 mg once a day.
  • Depending on your response, your doctor may increase your dose to 20 mg once a day.
  • Always take your escitalopram exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much escitalopram to take, how often to take it and any special instructions. 

  • Take escitalopram once a day. Take your dose at the same time each day, either in the morning OR in the evening. You can take escitalopram with or without food but if you think it is upsetting your stomach, try taking it with food. Take your dose with a glass of water.
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take it at the right time. Don't take double the dose.
  • Keep taking escitalopram every day. It may take 4 to 6 weeks before you notice the full benefits of escitalopram and you should start to feel better after 1 to 2 weeks. Some people notice side effects in the first few weeks before they start to feel better. Escitalopram is often needed for at least a few months. Your doctor will discuss with you how long to take it for; this depends on what you are taking it for, and how well it is working.
  • If you think escitalopram is not working for you. Do not stop taking it suddenly; talk to your doctor or nurse before stopping. It is usually best to stop taking escitalopram very slowly to avoid side effects.

Here are some things to know when you're taking escitalopram. Other things may be important as well, so ask your healthcare provider what you should know about.

  • Limit alcohol intake as alcohol can increase your chance of side effects such as drowsiness and reduced concentration.
  • Avoid driving and doing other tasks where you need to be alert until you know how this medicine affects you.
  • Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
  • Escitalopram can interact with some other medicines (including anticoagulants and anti-inflammatories such as ibuprofen), herbal supplements (such as St John's Wort), and recreational drugs, so check with your doctor or pharmacist before starting escitalopram and before starting any new products.
  • If you have diabetes, you may need to check your blood glucose more often because escitalopram can affect the levels of glucose in your blood.

Like all medicines, escitalopram can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine. 

Side effects What should I do?
  • Nausea (feeling sick)
  • Vomiting (being sick)
  • Headache
  • Dry mouth
  • Increased sweating
  • Diarrhoea (runny poos)
  • This is quite common when you first start escitalopram.
  • If you have nausea, try taking your dose with food.
    Tell your doctor if they bother you.
  • Difficulty falling asleep
  • This is quite common. Try taking your dose in the morning.
  • Feeling sleepy, drowsy, dizzy or tired
  • Difficulty concentrating
  • These are quite common. 
  • Try taking your dose in the evening.
  • Be careful when driving or using tools until you know how this medicine affects you.
  • Avoid drinking alcohol. Read more about how alcohol affects medicines.
  • Feeling less or more hungry than usual
  • Changes in weight (increase or decrease)
  • Tell your doctor if they cause you problems.
  • Loss of sex drive or libido
  • Changes in periods (menstruation)
  • Signs of low sodium such as dizziness, confusion, agitation, cramps, unsteadiness, feeling faint or tired.
  • This is most common in older people, women, people who are also taking diuretics (water tablets) or omeprazole and people with low body weight.
  • Let your doctor know if you get these symptoms.
  • Suicidal feelings or behaviour such as agitation, aggression, self-harm, worsening of low mood.
  • These are rare but serious side effects.
  • They are most likely to happen during the start of treatment or when doses are changed.
  • Contact your doctor immediately
  • For urgent help contact Healthline 0800 611 116 or Lifeline 0800 543 354 (available 24/7).
  • Signs of serotonin syndrome such as feeling agitated and restless, heavy sweating, shivering, fast heart rate or irregular heartbeat, headache, diarrhoea and rigid or twitching muscles.
  • These are rare but serious side effects
  • You are at increased risk of serotonin syndrome if you just started taking the SSRI or increased the dose or started other medicines that can cause serotonin syndrome
  • Tell your doctor immediately or ring Healthline 0800 611 116.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.(external link)

The following links provide more information on escitalopram:

Escitalopram Patient Information(external link) (te reo Māori(external link)) NZ Formulary, NZ
Escitalopram (Apotex)(external link) Medsafe Consumer Information Sheet, NZ

References

  1. Escitalopram(external link) NZ Formulary, NZ, 2022
  2. Escitalopram (Ethics)(external link) Medsafe Product Information, 2021, NZ
  3. Selective serotonin re-uptake inhibitors(external link) NZ Formulary, NZ, 2022

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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