SSRI (Selective Serotonin Reuptake Inhibitor)
Highly selective serotonin reuptake inhibitor (SERT), enhancing serotonergic neurotransmission.
Major depressive disorder (MDD), generalized anxiety disorder (GAD)
Binge eating disorder, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), panic disorder, social anxiety disorder (SoAD), premenstrual dysphoric disorder (PMDD), vasomotor symptoms, fibromyalgia, post-stroke depression (PSD), depression in Parkinson’s disease (PD), depression in dementia
Oral tablets (5 mg, 10 mg, 20 mg)
5–10 mg p.o. daily, titrating as clinically indicated
10–20 mg/day
Half-life ~27–32 hours; metabolized primarily by CYP3A4 and CYP2C19; steady state in ~1 week
Headache, nausea, insomnia, fatigue, dry mouth, somnolence, sexual dysfunction
QTc prolongation (especially at higher doses or with other QT-prolonging agents), serotonin syndrome, hyponatremia
Monitor ECG if combined with other QT-prolonging agents or in patients with cardiac risk factors; monitor for serotonin syndrome and suicidality
Increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults with MDD and other psychiatric disorders
Escitalopram may reduce neuropsychiatric symptoms in post-stroke depression and vascular cognitive impairment. It is preferred in patients with seizure disorders due to fewer CYP450 interactions compared to other SSRIs. Use cautiously in hepatic impairment or patients with electrolyte abnormalities. QTc prolongation risk increases with higher doses or concomitant use of other QT-prolonging medications.