|Information for patients
Escitalopram is used to treat depression. It belongs to a group of medicines called selective serotonin reuptake inhibitors (SSRIs). They are thought to work by their actions on brain chemicals called amines which are involved in controlling mood.
Depression is longer lasting or more severe than the “low moods” everyone has from time to
time due to the stress of everyday life. It is thought to be caused by a chemical imbalance in
parts of the brain. This imbalance affects your whole body and can cause emotional and
physical symptoms such as feeling low in spirit, loss of interest in activities, being unable to
enjoy life, poor appetite or overeating, disturbed sleep, often waking up early, loss of sex
drive, lack of energy and feeling guilty over nothing.
Escitalopram corrects this chemical imbalance and may help relieve the symptoms of depression.
Escitalopram may also be used to treat patients who may avoid and/or are fearful of social
Escitalopram may also be used to treat patients who have excessive anxiety and worry.
Escitalopram may also be used to treat irrational fears or obsessional behaviour (obsessive-
compulsive disorder). Obsessive-compulsive disorder involves having both obsessions and
compulsions. Obsessions are unwanted thoughts that occur over and over again.
Compulsions are the ongoing need to repeat certain actions as a result of these thoughts.
Your doctor, however, may prescribe it for another purpose.
Ask your doctor if you have any questions about why it has been prescribed for you.
This medicine is only available with a doctor’s prescription.
Escitalopram is not addictive.
|Before Consuming the Medicine
||Do not take Escitalopram if you are allergic to it, to any medicine containing citalopram, or
any of the ingredients listed in the contents
Symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty
breathing, swelling of the face, lips, tongue or other parts of the body, or rash, itching or hives on the skin.
Do not take it after the expiry date printed on the pack.
If you take it after the expiry date has passed, it may not work as well. The expiry date refers to the last day of the month.
Do not take it if the packaging is torn or shows signs of tampering.
|Drug Special Care
||Before you start to take it
Tell your doctor if:
1. you have allergies to any other substances such as foods, preservatives or dyes.
2. you are pregnant or intend to become pregnant.
3. you are breast-feeding or planning to breast-feed.
4. you have, or have had, the following medical conditions:
a tendency to bleed or bruise easily
bipolar disorder (manic depression)
a history of seizures or fits
restlessness and/or a need to move often.
5. you are receiving electroconvulsive therapy.
Do not give Escitalopram to a child or adolescent.
There is no experience with its use in children or adolescents under 18 years old.
Escitalopram can be given to elderly patients over 65 years of age with a reduced dose.
The effects of Escitalopram in elderly patients are similar to that in other patients.
If you have not told your doctor about any of the above, tell them before you use Escitalopram.
Things you must do
If you are about to be started on any new medicine, remind your doctor and pharmacist
that you are taking Escitalopram.
Tell any other doctors, dentists and pharmacists who treat you that you are taking this
Tell your doctor immediately if you have any suicidal thoughts or other mental or mood
changes. All mentions of suicide or violence must be taken seriously. Occasionally, the symptoms of
depression may include thoughts of suicide or self-harm. It is possible that these symptoms continue or get
worse until the full antidepressant effect of the medicine becomes apparent. This is more likely to occur if you
are a young adult, i.e. 18 to 24 years of age, and you have not used antidepressant medicines before.
If you or someone you know demonstrates any of the following warning signs of
suicide-related behaviour while taking Escitalopram, contact a health care provider
immediately, or even go to the nearest hospital for treatment:
thoughts or talk of death or suicide
thoughts or talk of self-harm or harm to others
any recent attempts of self-harm
increase in aggressive behaviour, irritability or agitation.
Do not stop taking this medicine or change the dose without consulting your doctor,
even if you experience increased anxiety at the beginning of treatment.
At the beginning of treatment, some patients may experience increased anxiety which will
disappear during continued treatment.
Tell your doctor immediately if you experience symptoms such as restlessness or
difficulty in sitting or standing still. These symptoms can occur during the first weeks of treatment.
Contact your doctor as soon as possible if you suddenly experience an episode of
mania. Some patients with bipolar disorder (manic depression) may enter into a manic phase. This is
characterised by profuse and rapidly changing ideas, exaggerated gaiety and excessive
Sometimes you may be unaware of the above-mentioned symptoms and therefore you may
find it helpful to ask a friend or relative to help you to observe the possible signs of change in
Things you must not do
Do not give the tablets to anyone else, even if they have the same condition as you.
Do not take Escitalopram to treat any other complaints unless your doctor tells you to.
Do not stop taking Escitalopram, or lower the dosage, without checking with your doctor.
Do not let yourself run out of medicine over the weekend or on holidays.
Suddenly stopping Escitalopram may cause unwanted discontinuation symptoms such as
dizziness, headache and nausea. Your doctor will tell you when and how Escitalopram should be
discontinued. Your doctor will gradually reduce the amount you are using, usually over a
period of one to two weeks, before stopping completely.
Things to be careful of
Avoid alcohol while you are taking this medicine. It is not advisable to drink alcohol while you are being treated for depression.
|Drug Drug Interactions
||Do not take Escitalopram at the same time as the following other medicines:
? pimozide, a medicine used to treat mental disorders
? monoamine oxidase inhibitors (MAOIs), which are also used for the treatment of depression.
Do not take Escitalopram when you are taking a MAOI or when you have been taking a MAOI
within the last 14 days. Taking Escitalopram with MAOIs may cause a serious reaction with a
sudden increase in body temperature, extremely high blood pressure and severe convulsions. Your
doctor will know when it is safe to start Escitalopram after the MAOI has been stopped.
Tell your doctor if you are taking any other medicines, including any that you buy
without a prescription from your pharmacy, supermarket or health food shop.
Some medicines and Escitalopram may interfere with each other. These include:
? bupropion, a medicine helping to treat nicotine dependence
? medicines used to treat reflux and ulcers, such as cimetidine, omeprazole, esomeprazole
? and lansoprazole
? medicines known to prolong bleeding, e.g. aspirin or other non-steroidal anti-inflammatory
? drugs (NSAIDs)
? ticlopidine and warfarin, medicines used to prevent blood clots
? mefloquine, an anti-malaria medicine
? sumatriptan, used to treat migraines
? tramadol, used to relieve pain
? medicines affecting the chemicals in the brain
? some heart medications, e.g. flecainide, propafenone, metoprolol
? tryptophan, an amino-acid
? lithium, used to treat mood swings and some types of depression
? antipsychotics, a class of medicines used to treat certain mental and emotional conditions, e.g. risperidone, thioridazine and haloperidol
? tricyclic antidepressants, e.g. imipramine, desipramine
? St John''s Wort (Hypericum perforatum), a herbal remedy
? any other medicines for depression, anxiety, obsessive-compulsive disorder or pre- menstrual dysphoric
These medicines may be affected by Escitalopram, or may affect how well it works. You may need
to use different amounts of your medicines, or take different medicines. Your doctor will
Your doctor or pharmacist has more information on medicines to be careful with or avoid
while taking Escitalopram.
|Drug Pregnancy Interaction
||Do not take Escitalopram if you are pregnant unless you and your doctor have discussed the
risks and benefits involved. If you take this medicine during the last three months of your
pregnancy, the general condition of your newborn baby might be affected.
Make sure your doctor and/or midwife know you are on Escitalopram. When taken during
pregnancy, particularly in the last 3 months of pregnancy, medicines like Escitalopram may increase the risk of a serious condition in babies, called persistent pulmonary hypertension of the newborn (PPHN), making the baby breathe faster and appear bluish. These symptoms usually begin during the first 24 hours after the baby is born. If this happens to your baby you should contact your doctor and/or midwife immediately.
If used during pregnancy Escitalopram should never be stopped abruptly.
Ask your doctor or pharmacist for advice before taking any medicine.
|Drug Breast feeding Interaction
||Do not take Escitalopram if you are breast-feeding unless you and your doctor have discussed
the risks and benefits involved. It is not recommended that you breast-feed while taking
Escitalopram as it is excreted in breast milk.
|Drug Machinery Interaction
||Be careful driving or operating machinery until you know how Escitalopram affects you.
It may cause nausea, fatigue and dizziness in some people, especially early in the treatment.
If you have any of these symptoms, do not drive, operate machinery, or do anything else that
could be dangerous.
|Drug More Information
|How to take the Medicine
||Your doctor will decide what dose you will receive.
Follow the instructions they give you.
If you take the wrong dose, Escitalopram may not work as well and your condition may not
The standard dose for this medicine is 10 mg per day. This may be increased by your doctor to 20 mg per day.
The recommended maximum dose in elderly patients is 10 mg per day.
It is recommended that patients with liver disease receive an initial dose of 5 mg daily for the first two weeks. Your doctor may increase the dose to 10 mg daily.
Your doctor may have prescribed a different dose.
Ask your doctor or pharmacist if you are unsure of the correct dose for you.
They will tell you exactly how much to take.
||How to take it
To remove tablet: - It is not recommended that you push the tablet through both layers of paper and foil. Peeling back the top layer of paper first, (as shown by an arrow on the corner of the blister), will expose the foil which when broken, will allow you to release the tablet from the blister bubble.
Swallow the tablets whole with a full glass of water.
Do not chew them.
When to take it
Take Escitalopram as a single dose either in the morning or in the evening.
Take Escitalopram with or without food.
How long to take it
Continue to take Escitalopram even if it takes some time before you feel any improvement in your condition. As with other medicines for the treatment of these conditions it may take a few weeks before
you feel any improvement. Individuals will vary greatly in their response to Escitalopram. Your doctor will
check your progress at regular intervals. The duration of treatment may vary for each individual, but is usually
at least 6 months. In some cases the doctor may decide that longer treatment is necessary.
Continue taking your medicine for as long as your doctor tells you, even if you begin to feel better. The underlying illness may persist for a long time and if you stop your treatment too soon, your symptoms may return.
|Excess Drug Consumption
||Immediately telephone your doctor, or the Poisons Information Centre or go to Accident and Emergency at your nearest hospital, if you think you or anyone else may have taken too much Escitalopram. Do this even if there are no signs of discomfort or poisoning.
You may need urgent medical attention.Symptoms of an overdose may include dizziness, low blood pressure,
nausea (feeling sick), vomiting, agitation, tremor (shaking) and rarely convulsions and coma.
|Forgot Drug Consumption
||If you miss a dose and remember in less than 12 hours, take it straight away, and then go back to taking it as you would normally. Otherwise, if it is almost time for your next dose, skip the dose you missed and take the next dose when you are meant to. Do not take a double dose to make up for the dose you have missed.
If you are not sure what to do, ask your doctor or pharmacist. If you have trouble remembering when to take your medicine, ask your pharmacist for
|Stop Drug Consumption
||Do not stop taking this medicine suddenly.
If Escitalopram is stopped suddenly you may experience mild, but usually temporary, symptoms such as dizziness, pins and needles, electric shock sensations, sleep disturbances (vivid dreams, inability to sleep), feeling anxious or agitated, headaches, feeling sick (nausea), vomiting, sweating, tremor (shaking), feeling confused, feeling emotional or irritable, diarrhoea, visual disturbances, or fast or irregular heart beats.
When you have completed your course of treatment, the dose of Escitalopram is gradually reduced over a couple of weeks rather than stopped abruptly.
Your doctor will tell you how to reduce the dosage so that you do not get these unwanted effects.
|Possible Side Effects
||All medicines may have some unwanted side effects. Sometimes they are serious, but most
of the time they are not. Your doctor has weighed the risks of using this medicine against the
benefits he/she expects it will have for you.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are
It helps most people with depression, social anxiety disorder (social phobia), generalised
anxiety disorder and obsessive-compulsive disorder, but it may have unwanted side effects in
a few people.
The side effects of Escitalopram are, in general, mild and disappear after a short period of time.
Tell your doctor if you notice anything else that is making you feel unwell.
Other side effects not listed above may occur in some people.
Do not be alarmed by this list of possible side effects.
You may not experience any of them.
|Common Drug Side Effects
||Tell your doctor if you notice any of the following and they worry you:
? decreased appetite or loss of appetite
? dry mouth
? nausea (feeling sick)
? fatigue, sleepiness or drowsiness, yawning
? increased sweating
? sexual disturbances (decreased sexual drive; problems with ejaculation or erection; women may experience difficulties achieving orgasm).
|Rare Drug Side Effects
||Tell your doctor as soon as possible if you notice any of the following:
? agitation, confusion, panic attacks, anxiety, restlessness
? dizziness when you stand up due to low blood pressure
? low sodium levels in the blood (the symptoms are feeling sick and unwell with weak muscles or feeling confused)
? abnormal liver function tests (increased amounts of liver enzymes in the blood)
? difficulties urinating
? unusual secretion of breast milk
? increased tendency to develop bruises
? rash, itching, patches of circumscribed swellings.
These may be serious side effects of Escitalopram. You may need urgent medical attention.
|Very Rare Drug Side Effects
||Tell your doctor immediately, or go to Accident and Emergency at your nearest hospital, if you notice any of the following:
? serious allergic reaction
? (symptoms of an allergic reaction may include swelling of the face, lips, mouth or throat
? which may cause difficulty in swallowing or breathing, or hives)
? high fever, agitation, confusion, trembling and abrupt contractions of muscles
? (these symptoms may be signs of a rare condition called serotonin syndrome)*
? mania*, hallucinations
? seizures, tremors, movement disorders (involuntary movements of the muscles)*.
These are very serious side effects. You may need urgent medical attention or hospitalisation.
*The side effects marked with an asterisk (*) are a number of rare side effects that are known to occur with medicines that work in a similar way to Escitalopram.
|Drug Side Effects Symptoms
|How to Store the Medicine
|How to Store the Medicine
Keep Escitalopram tablets in the blister pack until it is time to take them.
If you take the tablets out of the box or the blister pack they may not keep well.
Keep Escitalopram tablets in a cool dry place where the temperature stays below 30°C.
Keep Escitalopram oral solution in a cool dry place where the temperature stays below 25°C.
Discard Escitalopram oral solution 3 months after first opening.
Do not store it or any other medicine in the bathroom, near a sink, or on a window-sill.
Do not leave it in the car.
Heat and damp can destroy some medicines.
Keep it where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
If your doctor tells you to stop taking Escitalopram, or the medicine has passed its expiry date, ask your pharmacist what to do with any that is left over.
Return any unused medicine to your pharmacist.