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escitalopram (Lexapro)

S-enantiomer of citalopram. Generic available 2012 [3] Indications: - see citalopram - less effective than estrogen for relief of hot flashes & other menopausal symptoms [2] - may diminish Abeta42 in CSF of normal adults (10 mg QD) [8] * on list of drugs to avoid for treatment of depression [7] - risk of QT prolongation cited Dosage: - 10-20 mg PO QD (no benefit in higher doses) - optimal dosage for major depression is 16.7 mg QD [5] * maximum dose in elderly 20 mg QD [6] Adverse effects: - see citalopram - QT prolongation [4]

Interactions

drug interactions drug adverse effects (more general classes)

Related

cytochrome P450 2C19 (cytochrome P450 2C17, cytochrome P450 11A, mephenytoin 4-hydroxylase, cytochrome P450 254C, CYP2C19) cytochrome P450 3A4 (cytochrome P450 C3, nifedipine oxidase, P450-PCN1, NF-25, CYP3A4)

General

citalopram (Celexa, nitalapram)

Properties

SIZE: MW = 405.4 G/M MISC-INFO: elimination route LIVER protein-binding 80% 1/2life 35 HOURS

Database Correlations

PUBCHEM correlations

References

  1. Prescriber's Letter 9(9):53 2002
  2. Freeman EW et al Efficacy of Escitalopram for Hot Flashes in Healthy Menopausal Women: A Randomized Controlled Trial JAMA. 2011;305(3):267-274 PMID: 21245182 http://jama.ama-assn.org/content/305/3/267.short
  3. FDA NEWS RELEASE: March 14, 2012 FDA approves first generic Lexapro to treat depression and anxiety disorder http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm296006.htm
  4. Castro VM et al QT interval and antidepressant use: a cross sectional study of electronic health records. BMJ 2013;346:f288 PMID: 23360890 http://www.bmj.com/content/346/bmj.f288
  5. Jakubovski E et al. Systematic review and meta-analysis: Dose-response relationship of selective serotonin reuptake inhibitors in major depressive disorder. Am J Psychiatry 2015 Nov 10; PMID: 26552940 http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2015.15030331
  6. Wetherell JL, Petkus AJ, White KS, et al. Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults. Am J Psychiatry. 2013 Jul 1;170(7):782-789 PMID: 23680817
  7. Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/
  8. Sheline YI, Snider BJ, Beer JC et al Effect of escitalopram dose and treatment duration on CSF Abeta levels in healthy older adults. A controlled clinical trial. Neurology. Sept 10, 2020 PMID: 32913021 https://n.neurology.org/content/early/2020/09/10/WNL.0000000000010725