Escitalopram: therapeutic uses and side effects

Selective serotonin reuptake inhibitors are the antidepressant drugs most used. In this article we will describe Therapeutic Uses and Side Effects of Escitalopram, a very popular SSRI that is especially effective in treating depression and various anxiety disorders because of its precise pharmacological activity.

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What is escitalopram?

Escitalopram is an antidepressant drug in the class of selective serotonin reuptake inhibitors (SSRIs). Other widely used drugs in this group are sertraline, paroxetine, fluoxetine, fluvoxamine and citalopram, a very similar antecedent to escitalopram.

This psychotropic drug was created between 1997 and 2001 by the pharmaceutical companies H. Lundbeck A / S and Forest Laboratories, which had previous experience in the production of citalopram. It is currently one of the most widely used SSRIs.

It is marketed under different names in many countries around the world. Some of the best known are

Cipralex, Lexapro, Esertia, Meridian, Ipran and Heipram; a large number of brands include the term "Escitalopram" in the product name.

Unlike other SSRIs, escitalopram exerts its effect highly selectively on serotonin receptors; this means that its interaction with receptors for other neurotransmitters is low. For this reason, some authors attribute it to be more effective than other SSRIs in the treatment of severe depression.

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Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are the most commonly prescribed group of antidepressants. Its effectiveness in treating symptoms of depression and anxiety It is attributed to its agonism of different monoamines (a very relevant type of neurotransmitter): serotonin, norepinephrine and dopamine.

The mechanism of action of SSRIs is not exactly known, although its effects are known to be associated with blocking serotonin reuptake, as the name suggests. These drugs increase the availability of serotonin in the synaptic space by limiting its reabsorption by postsynaptic receptors.

Medications in this class are used primarily to treat symptoms of depression, although many of them have also been shown to be effective in the management of anxiety disorders, such as generalized anxiety disorder or obsessive compulsive. Fluoxetine is also prescribed in some cases of bulimia nervosa.

What is it for?

Like other SSRIs, escitalopram has been shown to be effective in treating multiple symptoms related to anxiety and depression, although not all countries have approved their use for them disorders.

Let's see what they are the most common therapeutic uses of escitalopram.

1. Major depressive disorder

Various scientific investigations have demonstrated the efficacy of escitalopram in the treatment of major depressive disorder. Some of the additional uses of this drug are associated with disorders biologically related to depression, particularly generalized anxiety disorder, obsessive-compulsive disorder, and bulimia nervosa.

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2. Generalized anxiety disorder

The therapeutic effects of escitalopram in cases of generalized anxiety disorder they are meaningful and fast; Clear improvements in the condition of the majority of patients are detected approximately two months after starting treatment.

3. Panic disorder

Panic disorder is characterized by onset of panic attacks, during which symptoms such as tachycardia, breathing difficulties and fear of dying appear. May or may not be accompanied by agoraphobia.

4. Social phobia

In social phobia appear anxiety and avoidance symptoms associated with social interaction. In addition to antidepressants, anxiolytics, particularly beta-blockers and benzodiazepines, are sometimes prescribed.

5. Obsessive-compulsive disorder

Escitalopram and some other SSRIs are also frequently used to treat obsessive-compulsive disorder or OCD, which is diagnoses when obsessive anxiety-provoking thoughts and behavioral rituals are present that aim to reduce the discomfort.

Escitalopram side effects

The most common side effects of taking escitalopram are headache, nausea, diarrhea, and insomnia. Others less common include the appearance of anxiety, dizziness, fatigue, drowsiness, sweating, dry mouth, constipation, burning and stomach gas.

It is also relatively common for sexual dysfunctions as a consequence of treatments with escitalopram and other SSRIs, especially decreased desire, genital anesthesia, arousal disorders, delayed ejaculation and anorgasmia.

Among the serious adverse reactions that may occur with taking escitalopram, although they are uncommon, the following stand out: seizures, breathing difficulties, heart rhythm disturbances and swelling of the face, hands and ankles.

Precautions and contraindications

Special caution should be exercised when prescribing escitalopram if the person has heart, respiratory, liver, or kidney disorders relevant, as well as if you have suffered manic episodes or epileptic seizures.

Hostile behaviors and suicide attempts associated with escitalopram appear in children and adolescents with a higher frequency than has been detected in adults; however, in older people it is also possible that these reactions occur, which are usually detectable by monitoring the effects of treatment during the first weeks.

Since there is a certain risk of drug tolerance and dependence, abrupt discontinuation of drug use can lead to serotonin syndrome characteristic of SSRIs. In this case, the most common symptoms are the appearance of depressive reactions, irritability, feelings of dizziness and akathisia.

Its potential for negative interaction with other substances is low compared to that of other SSRIs, particularly paroxetine. Taking escitalopram and antidepressants from the class of monoamine oxidase inhibitors (MAOIs) should be avoided due to the increased risk of developing the serotonin syndrome.

Bibliographic references:

• General Council of Official Associations of Pharmacists. (2009). Mood disorders: depression and anxiety. Strategic plan for the development of pharmaceutical care. '09 [Internet].
• Morán I, Baldirà J, Morocco L, Nogué S. (2011). Clinical toxicology. Madrid: Legal Dissemination and Current Topics S.A.
• Spanish Agency for Medicines and Health Products. Use of antidepressant medications in Spain during the period (2015). 2000-2013. Drug utilization report [Internet] 2015 [Access: August 2, 2018] Available at: http://www.aemps.gob.es/medicamentosUsoHumano/observatorio/docs/antidepresivos2000-2013.pdf