Escitalopram in Pakistan is marketed by various companies. More than 100 different brands are available including the research brand Cipralex. Escitalopram in Pakistan is commonly indicated for the treatment of the following conditions:

·         acute Generalized Anxiety Disorder

·         acute and maintenance therapy in patients with Unipolar Major Depressive Disorder.

It may also be used in the treatment of the following disorders:

o    Binge eating disorder

o    Bulimia nervosa

o    Obsessive-compulsive disorder

o    Body dysmorphic disorder

o    Panic disorder

o    Posttraumatic stress disorder

o    Premature ejaculation

o    Premenstrual dysphoric disorder

o    Vasomotor symptoms associated with menopause

How to administer escitalopram?

It may be taken with or without meals after breakfast or in the evening. [select-faq faq_id='7597']

What are the common side effects of escitalopram?

Common side effects of escitalopram include Headache, insomnia, drowsiness, nausea, diarrhea, and sexual/ ejaculatory dysfunction. [select-faq faq_id='7598']

It should not be advised to the following group of patients:

1. Patients allergic to escitalopram
2. Patients using an MAOI.
3. Patients receiving linezolid, methylene blue or Pimozide
4. Patients known to have a prolonged QT interval or congenital Long QT syndrome.

Other important precautions one should take include:

1. Escitalopram may be associated with suicidal tendencies.
2. It has been associated with bleeding diathesis.
3. It impairs higher mental functions.
4. Like other SSRIs, it has also been associated with an increased risk of QT interval prolongation.
5. Symptoms of narrow-angle glaucoma may worsen as it causes pupillary dilation.
6. It may cause an increased risk of bone fractures.
7. Serotonin syndrome is a life-threatening side effect of its use manifested by hyperthermia, altered mental status, and rigidity.
8. It may cause sexual dysfunction and decrease libido.
9. It should not be given to patients with bipolar depression.
10. It should be gradually tapered off as it may result in worsening of the symptoms. This is called discontinuation syndrome.

Is escitalopram safe during pregnancy and breastfeeding?

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• Escitalopram crosses over the placenta, and is distributed in amniotic fluid.
• However, there are contradicting results for the teratogenic effects.

These effects are not teratogenic:

• Cyanosis
• Apnea
• Seizures
• Neonatal Respiratory distress
• Hypoglycemia and feeding difficulties
• Hypotonia or hypertonia
• Persistent crying, irritability and jitteriness
• Tremors
• Discontinuation syndrome
• The newborn may have persistent pulmonary hypertension

Breastfeeding:

Breast milk contains Escitalopram. The child should be closely monitored for changes in sleep patterns or behavior. It is preferable that the patient be switched to an SSRI during breastfeeding. Pregnant women who are taking escitalopram during pregnancy can still take the medication.