Escitalopram, which is sold under the brand names of Lexapro®, Cipralex®, Seroplex®, Lexamil® and Lexam®, is member of the selective serotonin reuptake inhibiting class of drugs. This class of drugs includes popular psychiatric medications like Prozac® and Paxil®, which in 2008 began falling out of as treatments for depression but gained in popularity for the management of anxiety and obsessive compulsive disorder. The dosage recommendations for escitalopram are relatively similar for patients of different ages and weights, although caution should be exercised when administering the medication to elderly patients or those with lowered levels of kidney or liver function.
Although escitalopram has occasionally and controversially been used to treat depression in pediatric patients, as of 2011 the United States Food and Drug Administration has expressly not approved the medication for use in this population. Adults being treated for major depressive disorder should initially receive an oral escitalopram dose of 10 mg once per day. Higher doses have not been shown to be more effective in the treatment of depression. While intended for use in acute depressive episodes, the medication may sometimes be used for longer periods as to maintain positive clinical outcomes in patients who respond well to the drug.
Patients suffering from generalized anxiety disorder may also benefit from treatment with this medication. The same initial escitalopram dose used for depression may be used. If after a period of two to four weeks control of the condition is not achieved, the escitalopram dose may be increased to 20 mg per day. While considered to be an effective treatment for chronic anxiety, as of 2011 no longitudinal studies have been conducted that conclude escitalopram is effective beyond the initial eight week treatment period. If using this medication to treat generalized anxiety disorder, the patient should be evaluated again every three months to determine if it is continuing to be effective.
When discontinuing use of the medication, the daily escitalopram dose should be gradually reduced over a period of weeks. Patients over the age of 65 suffering from reduced liver or severely reduced kidney function should be given a daily escitalopram that dose not exceed 10 mg per day. Other risks of escitalopram include the possibility for a fatal hypertensive crisis when taken within 14 days of the cessation of antidepressant therapy with a monoamine oxidase inhibiting drug.
With similar pharmacological properties, clinical applications, and spectrum of side effects, escitalopram has followed roughly the same trajectory as Prozac® and Paxil®. The most common side effects of escitalopram are insomnia, pupillary constriction, anhedonia, dry mouth, drowsiness, sweating, dizziness, constipation, indigestion, fatigue, decreased sex drive, delayed ejaculation, genital anesthesia, and inability to achieve orgasm. While most side effects subside shortly after the use of the medication is discontinued, the sexual side effects of the drug may persist for months or years after use.
