Post by jasmineo on Mar 5, 2015 22:27:20 GMT
Is the medication a SSRI or SNRI antidepressant?
Escitalopram is a selective serotonin reuptake inhibitor (SSRI) that is used to treat major depression, generalised anxiety disorder, social phobia and obsessive-compulsive disorder. SSRIs work by blocking the reuptake of serotonin in the pre-synaptic gap thereby making more available to amplify the ability for messages to be sent between the nerve cells. Circuits in the brain that are thought to run on serotonin messaging are known to influence mood but the exact way that they improve depression is unknown.
Common brand names
- Esipram
- Lexapro
- Esitalo
- Cilopram-S
- Escicor
-Lexham
Normal dose range
The normal dose range is 10-20mg per day. It is recommended to start at 10mg and increase if needed after 2-4 weeks to a maximum of 20mg once daily. Maintenance doses >10mg are not usually necessary. This applies to all indications.
Common side effects
Common side effects (>1%) include;
- Nausea
- Diarrhoea
- Agitation
- Insomnia
- Drowsiness
- Tremor
- Weight gain or loss
- Sexual dysfunction
- Anxiety
- Headache
- Dry mouth
Contraindications
If the patient has an allergy to Escitalopram or Citalopram.
Risk factors for the prolonged QT interval – Escitalopram may prolong the QT interval increase the risk of arrhythmia
Elderly – increased half life when compared with younger people; it is recommended not to increase the dose above 10mg daily.
Bipolar disorder – all antidepressants may provoke a manic episode when used in people with bipolar disorder.
Hepatic impairment – consider decreasing the dose
Special monitoring/nursing care requirements
- Increased suicidal thoughts and actions can occur soon after starting anti-depressants, especially in young people. Monitor patients frequently and carefully early in treatment
- Monitor the patient for serotonin toxicity and serotonin syndrome
- This drug should not be used with the following medications due to very serious interactions occurring: pimozide, drugs for weight control (e.g., dexfenfluramine, fenfluramine, phentermine, sibutramine), MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, phenelzine, procarbazine, selegiline, tranylcypromine).
- When stopping SSRI treatment taper over several weeks to avoid withdrawal
- Sexual dysfunction is a common side effect that can lead to non-compliance
- If non-compliant explore the reasons with patients
Education requirements for patients/families/carers
- Do not stop taking this medication suddenly unless you have been advised by your doctor
- Tell all doctors, dentists and pharmacists that you are taking the medication, as there can be significant interactions with other medications
- Do not use non-prescription or herbal products without discussing these with your doctor or pharmacist
- Do not drive or operate machinery until you know how the medication affects you
Tell your doctor immediately if any of these rare but very serious side effects occur: unusual or severe mental/mood changes (including rare thoughts of suicide), easy bruising/bleeding, black stools, vomit that looks like coffee grounds, fast/irregular heartbeat, fainting, seizures, changes in the amount of urine.
- If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
- Using Escitalopram together with alcohol can increase nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment.
Escitalopram is a selective serotonin reuptake inhibitor (SSRI) that is used to treat major depression, generalised anxiety disorder, social phobia and obsessive-compulsive disorder. SSRIs work by blocking the reuptake of serotonin in the pre-synaptic gap thereby making more available to amplify the ability for messages to be sent between the nerve cells. Circuits in the brain that are thought to run on serotonin messaging are known to influence mood but the exact way that they improve depression is unknown.
Common brand names
- Esipram
- Lexapro
- Esitalo
- Cilopram-S
- Escicor
-Lexham
Normal dose range
The normal dose range is 10-20mg per day. It is recommended to start at 10mg and increase if needed after 2-4 weeks to a maximum of 20mg once daily. Maintenance doses >10mg are not usually necessary. This applies to all indications.
Common side effects
Common side effects (>1%) include;
- Nausea
- Diarrhoea
- Agitation
- Insomnia
- Drowsiness
- Tremor
- Weight gain or loss
- Sexual dysfunction
- Anxiety
- Headache
- Dry mouth
Contraindications
If the patient has an allergy to Escitalopram or Citalopram.
Risk factors for the prolonged QT interval – Escitalopram may prolong the QT interval increase the risk of arrhythmia
Elderly – increased half life when compared with younger people; it is recommended not to increase the dose above 10mg daily.
Bipolar disorder – all antidepressants may provoke a manic episode when used in people with bipolar disorder.
Hepatic impairment – consider decreasing the dose
Special monitoring/nursing care requirements
- Increased suicidal thoughts and actions can occur soon after starting anti-depressants, especially in young people. Monitor patients frequently and carefully early in treatment
- Monitor the patient for serotonin toxicity and serotonin syndrome
- This drug should not be used with the following medications due to very serious interactions occurring: pimozide, drugs for weight control (e.g., dexfenfluramine, fenfluramine, phentermine, sibutramine), MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, phenelzine, procarbazine, selegiline, tranylcypromine).
- When stopping SSRI treatment taper over several weeks to avoid withdrawal
- Sexual dysfunction is a common side effect that can lead to non-compliance
- If non-compliant explore the reasons with patients
Education requirements for patients/families/carers
- Do not stop taking this medication suddenly unless you have been advised by your doctor
- Tell all doctors, dentists and pharmacists that you are taking the medication, as there can be significant interactions with other medications
- Do not use non-prescription or herbal products without discussing these with your doctor or pharmacist
- Do not drive or operate machinery until you know how the medication affects you
Tell your doctor immediately if any of these rare but very serious side effects occur: unusual or severe mental/mood changes (including rare thoughts of suicide), easy bruising/bleeding, black stools, vomit that looks like coffee grounds, fast/irregular heartbeat, fainting, seizures, changes in the amount of urine.
- If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
- Using Escitalopram together with alcohol can increase nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment.