International Nonproprietary Name

Escitalopram

Clinical-Pharmacological Group

Central Nervous System → Antidepressants → Selective Serotonin Reuptake Inhibitors (SSRIs)

Composition and Dosage Forms

• 1 tablet – Escitalopram 5 mg

• 1 tablet – Escitalopram 10 mg

• 1 tablet – Escitalopram 20 mg

Clinical-Pharmacological Group

Antidepressant, SSRI

Indications

Used for the treatment of:

• Major depressive disorder

• Panic disorder with or without agoraphobia

• Social anxiety disorder

Dosage Regimen

Tablets

The medication is taken once daily and may be taken at any time of day, with or without food. Safety of doses above 20 mg per day has not been established.

Major Depressive Disorder:

• Typical starting dose: 10 mg once daily

• Daily dose may be increased to 20 mg depending on individual patient needs and severity of depression

• Antidepressant effects usually appear within 2–4 weeks

• For relapse prevention, treatment should continue for 6 months or longer

Panic Disorder (with or without agoraphobia):

• Initial dose: 5 mg daily for the first week

• Typically increased to 10 mg daily

• Later, the daily dose may be increased up to 20 mg based on individual patient needs

• Maximum effect is usually achieved within 3 months; treatment may continue for several months

Social Anxiety Disorder (Social Phobia):

• Typical starting dose: 10 mg daily

• Symptom improvement usually occurs within 2–4 weeks

• Dose may be adjusted to 5 mg or up to the maximum recommended dose of 20 mg depending on patient needs

• Treatment response should be evaluated after 12 weeks

• For relapse prevention, treatment should continue for 6 months or longer

• Only prescribed if the disorder significantly affects professional and social functioning

• Should be used as part of a comprehensive therapeutic strategy, not as a standalone cognitive-behavioral therapy

Generalized Anxiety Disorder:

• Typical starting dose: 10 mg daily

• Dose may be increased up to 20 mg depending on individual patient needs

• Chronic condition; long-term treatment recommended for relapse prevention

Elderly Patients (>65 years):

• Start with half of the recommended dose

• Maintenance therapy should use the lowest maximum dose

Children and Adolescents (<18 years):

• Use is not recommended; safety and efficacy are unknown

Renal Impairment:

• No dose adjustment needed for mild to moderate renal impairment

• No information available for severe renal impairment (creatinine clearance <30 mL/min)

Hepatic Impairment:

• Initial dose of 5 mg for the first 2 weeks

• Daily dose may then be increased to 10 mg based on patient needs

Patients with CYP2C19 Poor Metabolism:

• Initial dose of 5 mg for the first 2 weeks

• Daily dose may then be increased to 10 mg based on patient needs