Escitalopram
From Wikipedia, the free encyclopedia
| Image:Escitalopram-skeletal.png | |
| Image:S-(+)-citalopram-3D-sticks.png | |
| Escitalopram
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| Systematic (IUPAC) name | |
| S-(+)-1-[3-(dimethylamino)propyl]- 1-(p-fluorophenyl)- 5-phthalancarbonitrileoxalate | |
| Identifiers | |
| CAS number | 128196-01-0 |
| ATC code | N06AB10 |
| PubChem | 146570 |
| DrugBank | APRD00683 |
| Chemical data | |
| Formula | C20H21N2FO |
| Mol. weight | 324.392 g/mol (414.40 as oxalate) |
| Pharmacokinetic data | |
| Bioavailability | 80% |
| Protein binding | ~56% |
| Metabolism | Liver, specifically the enzymes CYP3A4 and CYP2C19 |
| Half life | 27-32 hours |
| Excretion | ? |
| Therapeutic considerations | |
| Pregnancy cat. |
C |
| Legal status |
℞ Prescription only |
| Routes | Oral |
Escitalopram (Cipralex®) is a medication developed by the Danish pharmaceutical company Lundbeck, that acts as a selective serotonin reuptake inhibitor (SSRI). It is typically used as an antidepressant to treat depression associated with mood disorders, although it also may be used in the treatment of body dysmorphic disorder and anxiety, including OCD. In the United States, the drug is marketed under the name Lexapro® by Forest Laboratories, Inc.
The recommended dosage of Lexapro is 10-20 mg a day. Exceptions include the elderly, who should only take up to 10 mg a day, and pregnant women in their third trimester should not use Lexapro at all (Forest Laboratories, [1]). As both General Anxiety Disorder (GAD) and Depression are both considered chronic conditions, treatment is recommended for several months. However, the efficacy of Lexapro over long periods of time has not been studied, therefore consistent reevaluation of the treatment is recommended for longer periods of treatment (Forest Laboratories, [2]).
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[edit] Side effects
Citalopram and other SSRIs have been shown to cause sexual side effects in most patients, both males and females<ref>Clayton A, Keller A, McGarvey EL. Burden of phase-specific sexual dysfunction with SSRIs. J Affect Disord 2006;91:27-32. PMID 16430968.</ref>. Although usually reversible, these sexual side effects can sometimes last for months, years or possibly indefinitely even after the drug has been completely withdrawn. This disorder is known as Post SSRI Sexual Dysfunction. Also causes weight gain.
[edit] Discontinuation symptoms
Discontinuation from antidepressants, especially abruptly, has been known to cause certain withdrawal symptoms. One possible discontinuation symptom from Escitalopram is a type of spontaneous nerve pulse known as paresthesia or "electric shock sensations", described by some patients as a feeling of small electric shocks, which may be accompanied by dizziness. These pulses may be short in duration, only milliseconds long, may affect any region of the body, and recur up to several times a minute, throughout all waking hours. They can be increased by physical activity, but are not solely linked to muscular activity. Other discontinuation symptoms include extreme sensitivity to loud sounds and bright lights, chills, hot flushes, cold sweats, reddening of the face, abdominal pain, weight gain and extreme mental fatigue. Also possible is severe irritability and sadness/depression like symptoms.<ref>Lexapro -- Warnings. RxList (12/08/2004). Retrieved on 2006-10-22.</ref>
One study, using a specific assesment scale, such as DESS, suggests that in the case of escitalopram the incidence rate of discontinuation symptoms are mild and comparable to that of placebo, citing it as "very well tolerated".<ref>Wade A, Michael Lemming O, Bang Hedegaard K (2002). "Escitalopram 10 mg/day is effective and well tolerated in a placebo-controlled study in depression in primary care.". Int Clin Psychopharmacol 17 (3): 95-102. PMID 11981349.</ref>
[edit] Footnotes
<references/>
[edit] External links
- Lexapro (Forest Laboratories) Official Lexapro Homepage
- Cipralex (Lundbeck) Official Cipralex Homepage
- Pharmacological information Lexapro
- Lexapro Feedback Depression Blog
- Link page to external chemical sources.
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