Medicine details

ImageAcipam-5
NameAcipam-5
DosageTablet
Generic NameEscitalopram
Classes Central Nervous System Agent
Psychotherapeutic Agent
Serotonin Reuptake Inhibitor (SRI)
Diseases Anxiety
Mental Disorder
CompanyIbn Sina Pharmaceutical Ind. Ltd.

Drug Package Details

Strength5 mg
Storage Condition
Origin CountryBangladesh
Commercial Pack50
Price per pack250.00
Cost per pack220.00
Package unit10 tabs strip
Price per unit5.00
Cost per unit4.40
Discount0
Coupon
Remarks

Escitalopram

Escitalopram is a selective serotonin reuptake inhibitor that is used orally (SSRI). Escitalopram's antidepressant mechanism is thought to be linked to potentiation of serotonergic activity in the central nervous system (CNS) as a result of its suppression of serotonin neuronal reuptake (5-HT). Citalopram is an SSRI that has little effects on norepinephrine (NE) and dopamine (DA) neuronal reuptake.

Escitalopram is indicated in the following conditions-

  • Depression (Major depressive disorder)
  • Anxiety

Major depressive disorder

Initial treatment

  • Adolescents: Escitalopram is taken once daily at a dose of 10 mg. Escitalopram's effectiveness was established in a flexible-dose experiment (10 to 20 mg/day). If the dose is increased to 20 mg, it must be done after at least three weeks.
  • Adults: Escitalopram is taken once daily at a dose of 10 mg. A fixed-dose trial of Escitalopram found that both 10 mg and 20 mg of Escitalopram were beneficial, but that 20 mg provided a higher benefit than 10 mg. If the dose is increased to 20 mg, it should take at least one week to take effect.

Maintenance Treatment

Beyond the acute period, it is generally acknowledged that acute episodes of major depressive illness require several months or longer of persistent pharmaceutical therapy. The efficacy of maintaining Escitalopram 10 or 20 mg/day in people with major depressive disorder who responded while using Escitalopram during an 8-week acute therapy phase was proven in a systematic evaluation. However, a physician who chooses to use Escitalopram for a longer period of time should frequently re-evaluate the drug's long-term effectiveness for the individual patient. Patients should be reviewed on a regular basis to determine whether they require maintenance treatment.  

Anxiety

Initial Treatment

  • Adults: The recommended starting dose of Escitalopram is 10 mg once daily. If the dose is increased to 20 mg, this should occur after a minimum of one week.
  • Maintenance Treatment: Generalized anxiety disorder is recognized as a chronic condition. The efficacy of Escitalopram in the treatment of anxiety beyond 8 weeks has not been systematically studied. The physician who elects to use Escitalopram for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient. 

Special Populations

10 mg/day is the recommended dose for most elderly patients and patients with hepatic impairment. No dosage adjustment is necessary for patients with mild or moderate renal impairment. Escitalopram should be used with caution in patients with severe renal impairment. 

The following side effects were reported with the drug-

  • Anorexia
  • Weight gain
  • Low libido
  • Anxiety
  • Headache
  • Insomnia
  • Somnolence
  • Dizziness
  • Constipation
  • Clinical Worsening/Suicide Risk: Monitor for clinical worsening, suicidality and unusual change in behavior, especially, during the initial few months of therapy or at times of dose changes 
  • Serotonin Syndrome: Serotonin syndrome has been reported with SSRIs and SNRIs, including Escitalopram, both when taken alone, but especially when co-administered with other serotonergic agents (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John’s Wort). If such symptoms occur, discontinue Escitalopram and initiate supportive treatment. If concomitant use of Escitalopram with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases
  • Discontinuation of Treatment with Escitalopram: A gradual reduction in dose rather than abrupt cessation is recommended whenever possible 
  • Seizures: Prescribe with care in patients with a history of seizure 
  • Activation of Mania/Hypomania: Use cautiously in patients with a history of mania
  • Hyponatremia: Can occur in association with SIADH
  • Abnormal Bleeding: Use caution in concomitant use with NSAIDs, aspirin, warfarin or other drugs that affect coagulation
  • Interference with Cognitive and Motor Performance: Use caution when operating machinery
  • Angle Closure Glaucoma: Angle closure glaucoma has occurred in patients with untreated anatomically narrow angles treated with antidepressants.
  • Use in Patients with Concomitant Illness: Use caution in patients with diseases or conditions that produce altered metabolism or hemodynamic responses.

Contraindication

  • Contraindicated in patients hypersensitive to any component of the medication.
  • Co-administration with Monoamine oxidase inhibitors is contraindicated, such as-
  • Concomitant use in patients taking pimozide is contraindicated.

Contraindicated in patients with serotonin syndrome.