Generic Name: Escitalopram

Trade Name: Cipralex (Canadian), Lexapro

Classification:
Pharmacotheraputic: serotonin reuptake inhibitor
Clinical: antidepressant
Pharmacokinetics (Mechanisms of Action):
ACTION:
o Blocks uptake of neurotransmitter serotonin at neuronal
presynaptic membranes, increasing its availability at postsynaptic receptor sites
o Therapeutic Effect: antidepressant effect
PHARMACOKINETICS:
o Well absorbed after PO administration. Protein binding:
56%. Primarily excreted in feces, with a lesser amount
eliminated in urine.
o Half-life: 35 hrs.
Indications/Uses:
Treatment of major depressive disorder exhibited as persistent,
prominent dysphoria (occurring nearly every day for at least 2
wks) manifested by 4 of 8 symptoms: appetite change, sleep
pattern change, increased fatigue, impaired concentration,
feelings of guilt or worthlessness, loss of interest in usual
activities, psychomotor agitation or retardation, suicidal
tendencies
Treatment of generalized anxiety disorder (GAD)
OFF LABEL:
o Social anxiety disorders in children and adolescents,
developmental disorders (including autism)
o Treatment of mild dementia-associated agitation in non
psychotic patient
Side Effects:
Frequent (21%-11%): Nausea, dry mouth, drowsiness, insomnia,
diaphoresis
Occasional (8%-4%): Tremor, diarrhoea, abnormal ejaculation,
dyspepsia, fatigue, anxiety, vomiting, anorexia
Rare (3%-2%): Sinusitis, sexual dysfunction, menstrual disorder,
abdominal pain, agitation, decreased libido

ADVERSE/TOXIC REACTIONS: Overdose manifested as dizziness,

drowsiness, tachycardia, confusion, seizures

Precautions/Contraindications:
Contraindications: Use within 14 days od MAOIs
Cautions: Hepatic/renal impairment, history of seizures,
concurrent use of CNS depressants, patients at high risk of
suicide, concomitant aspirin, NSAIDs, warfarin (may potentiate
bleeding risk).

BLACK BOX ALERT: increased risk of suicidal ideation and

behaviour in children, adolescents, young adults 18-24 yrs with
major depressive disorder, other psychiatric disorders

Dosage and routes of administration

Non-crushable drug!

Nursing implications:
Antidote