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Escitalopram used for depression and anxiety is an SSRI antidepressant often prescribed for major depressive disorder and generalized anxiety disorder. It is the active ingredient in products marketed in some places as Lexapro, and clinicians may use it for other anxiety-related diagnoses based on clinical assessment. For follow up and real time monitoring recommendations see Live monitoring and Safety.

Essential facts in a quick view:

  • The core active ingredient is escitalopram
  • Typical uses: depression, generalized anxiety disorder
  • Common strengths available in Australia: 5 mg, 10 mg, 20 mg

Before you start up

Before beginning escitalopram, provide your doctor and pharmacist with a full list of medicines, supplements and your medical history. Several conditions and situations influence whether escitalopram is appropriate:

  • Seizure disorder history
  • Liver disease or reduced kidney function
  • Known heart rhythm problems or other cardiac disease
  • Personal or family history of bipolar disorder or manic episodes
  • The chronic condition called diabetes or issues controlling blood glucose
  • Allergies to escitalopram, citalopram or tablet ingredients
  • Previous or current suicidal thoughts or self-harm
  • Recent or concurrent electroconvulsive therapy
  • Pregnancy, planning to become pregnant or to breastfeed

If you are unsure about a specific medicine or conditiona review Interaction and Risk Alerts and ask your prescriber or pharmacist for tailored advice.

What is the right way to take escitalopram?

Follow the dosing times as instructed by your prescriber. Below are practical tips to support safe and effective use.

  • Swallow the tablets whole and wash them down with water. It can be taken with or without food; take with a meal if it causes nausea.
  • Try to take the medicine at the same time each day to maintain steady blood levels.
  • Do not increase the dose or take extra tablets unless advised by a clinician. If you need to stop treatment, discuss a gradual taper with your prescriber to avoid discontinuation symptoms.
  • Some people notice early changes in sleep, appetite or anxiety within 1 to 2 weeks, but full benefit often takes several weeks.
  • Prescribing for children and adolescents should be done by or in consultation with a specialist.
  • In emergencies such as overdosed on medication call Triple Zero (000), attend the nearest emergency department or ring the Poisons Information Centre on 13 11 26.

For instructions on forgot to take my doses read Dose skipped Instructions.

If you skip your dose

If you forget to take a scheduled dose, take it as soon as you remember unless the next dose is due soon. If it is nearly time for your next dose, skip the missed tablet and continue your normal schedule. Never double up doses to make up for a dose was omitted.

Drug a mutual exchange of ideas alerts and cautions

Escitalopram oral medication can interact with numerous medicines, supplements and herbal products. Some combinations may cause serious harm, including serotonin syndrome or dangerous changes in heart rhythm. Avoid using escitalopram with:

  • Monoamine oxidase inhibitors (MAOIs) such as phenelzine, tranylcypromine or selegiline
  • Citalopram, an SSRI antidepressant or other close chemical relatives at the same time
  • Pimozide, a dopamine receptor antagonist or certain antipsychotics like thioridazine
  • Certain older appetite suppressants and some withdrawn agents
  • St Johns wort oil due to additive serotonin effects

Medicines that may need dose changes or extra keeping track of metrics include:

  • Triptans used for migraine (for example sumatriptan)
  • Linezolid, an antibiotic and other agents with MAOI activity
  • NSAIDs and aspirin, which can increase bleeding risk
  • Among anticoagulants, warfarin is a common option.
  • Drugs that affect liver enzymes, for example carbamazepine or ketoconazole
  • Certain antitubercular and antiretroviral drugs
  • Amphetamine-type stimulants and tryptophan supplements
  • Other antidepressants, anxiolytics or antipsychotics

This is a partial list. Keep an updated list of everything you take and discuss the study maps how the act of engaging with otherss evolve over time. with your clinician or pharmacist.

Safety and also the act of monitoring systems assessments

Your prescriber will usually arrange follow up to assess effectiveness and assess the quality for incidental outcomes. Typical keeping track of metrics focuses on:

  • Mood and behavior changes: watch for worsening depression, new self-harm thoughts, increased agitation or impulsive behavior, especially after starting or changing dose
  • Physical effects: drowsiness, dizziness or low blood pressure; avoid driving or heavy machinery until you know how you respond
  • Bleeding signs: unusual bruising or bleeding, particularly if combined with NSAIDs or blood thinners
  • Withdrawal symptoms if treatment is stopped abruptly; a gradual taper is usually recommended
  • A drink containing ethanol use: alcohol can increase sedation and impair alertness; avoid or limit alcohol while taking escitalopram

If you notice worrying symptoms contact your GP, mental health service or call healthdirect on 1800 022 222 for advice.

Possible untoward effects

Some adverse reactions require urgent medical attention. Seek immediate help if you experience any of these:

  • Allergic reaction: rash, hives, swelling of the face, lips or tongue
  • New or worsening psychosis, hallucinations or severe agitation
  • Epilepsy-related seizures
  • Fainting, severe dizziness or frequent falls
  • Marked mood changes or emergence of suicidal thoughts
  • Unexpected bleeding or easy bruising

More common and usually less severe effects to mention to your clinician if persistent include:

  • Nausea or mild stomach discomfort
  • Headache flare
  • My eyesight is blurred
  • Appetites and weight changes
  • Profuse sweating
  • Altered sexual desire or performance

If you are uncertain about a symptom, speak with your prescriber or local pharmacist. For emergencies call Triple Zero (000) or Poisons Information Centre on 13 11 26. Look at the dosing guideline section of the package insert. How to Take It Safely and Effectively.

Storage management and disposal strategy

  • Keep medicines out of reach of kids and animals.
  • Store at normal room temperature, typically 15 to 30 C (59 to 86 F).
  • Do not use medicines past the printed expiry date. Take unused or expired medicines back to a pharmacy for safe disposal.

Medicines that are comparable and another way forward choices

If escitalopram is not suitable or not effective, your prescriber may recommend other options, including different drug classes or non-drug therapies:

  • Additional agents in the SSRI category are sertraline, fluoxetine, paroxetine, fluvoxamine, and citalopram.
  • Items in the SNRI category include venlafaxine, desvenlafaxine, and duloxetine.
  • Other antidepressants: mirtazapine, bupropion (note PBS listing differences), agomelatine, vortioxetine
  • Psychological therapies: cognitive behavioral therapy, interpersonal therapy and other evidence-based psychotherapies, which may be used alone or combined with medication

Generic medicines are generally cheaper than brand-name formulations. Survey the comparison of prices data Prices shown in AUD in Australia.

Prices around Australia in AUD - rough guide

The antidepressant escitalopram is commonly listed on the Pharmaceutical Benefits Scheme (PBS). Out-of-pocket costs vary with PBS eligibility, concession status and whether you choose a brand or generic product.

  • Generic escitalopram, 28 or 30 tablets of 10 mg or 20 mg: private prices often fall between AUD 12 and AUD 45. On the PBS general patient co-payment is typically around AUD 30 to AUD 33 per script; concession card holders usually pay about AUD 7 to AUD 8. Verify current PBS figures for exact prices.
  • Brand name Lexapro: private monthly costs can be higher, roughly AUD 25 to AUD 60 depending on strength and pharmacy; a brand premium may apply.
  • Lower strengths such as 5 mg can have a higher unit cost; check with your pharmacy.

Example private price band ranges for other antidepressants (approximate and subject to change):

  • Sertraline therapy regimens (generic): about AUD 10 to AUD 40
  • Fluoxetine (generic): about AUD 8 to AUD 35
  • Duloxetine usage (SNRI): about AUD 25 to AUD 80

PBS co-payments, safety net thresholds and brand premiums are updated periodically. Consider telehealth or e-prescription services to speak with a prescriber and compare prices across multiple pharmacy centers.

Additional aspects about Lexapro