escitalopram, Lexapro (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
PREGNANCY: The safety of escitalopram during pregnancy and breastfeeding has not been established. Therefore, escitalopram should not be used during pregnancy unless, in the opinion of the physician, the expected benefits to a patient outweigh unknown hazards to the fetus.
NURSING MOTHERS: Escitalopram is excreted in human milk. Escitalopram should not be given to nursing mothers unless, in the opinion of the physician, the expected benefits to the patient outweigh the possible hazards to the child.
SIDE EFFECTS: The most common side effects associated with escitalopram are agitation or restlessness, blurred vision, diarrhea, difficulty sleeping, drowsiness, dry mouth, fever, frequent urination, headache, indigestion, nausea, increased or decreased appetite, increased sweating, sexual difficulties (decreased sexual ability or desire, ejaculatory delay), taste alterations, tremor (shaking), and weight changes. Although changes in sexual desire, sexual performance, and sexual satisfaction often occur as a result of depression itself, they also may be a consequence of the drugs used to treat depression. In particular, about one in 11 men given escitalopram report difficulties ejaculating.
Some patients experience withdrawal reactions upon stopping SSRI therapy. Symptoms may include dizziness, tingling, tiredness, vivid dreams, irritability, or poor mood. In order to avoid these symptoms, the dose of SSRI can be slowly reduced instead of abruptly stopped.
Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of escitalopram or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults beyond 24 years of age. There was a reduction in risk of suicidality with antidepressants compared with placebo in adults 65 years of age and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients who are started on therapy with antidepressants should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.
Reference: FDA Prescribing Information
Last Editorial Review: 5/31/2013
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